kris ulland

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Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts.

The main types of sleep apnea are:

  • Obstructive sleep apnea is the more common form that occurs when throat muscles relax. It is estimated to affect 10% to 30% of adults in the United States. Obstructive sleep apnea (OSA) occurs when the airway at the back of the throat becomes constricted or blocked during sleep, which may cause snoring  as air can’t get through normally. In response to the airway obstruction, a person usually wakes up, engages the muscles in their throat, and takes several gasps or deep breaths, often accompanied by sounds like snorting or choking.
  • Central sleep apnea occurs when your brain doesn’t send proper signals to the muscles that control breathing.  For people with CSA, a part of the brain called the brain stem fails to properly recognize carbon dioxide levels in the body during sleep. This leads to repeated episodes of breathing that is slower and shallower than it should be. As a result, there are temporary pauses in breathing. The prevalence of central sleep apnea is low compared to obstructive sleep apnea. It is estimated that less than 1% of people have CSA.
  • Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea

Although frequently associated with older adults, sleep apnea can occur in children. In young people, obstructive sleep apnea is much more common than central sleep apnea. It is estimated that 1% to 5% of children have obstructive sleep apnea.

Children with OSA may not experience excessive daytime sleepiness as seen in adults with sleep apnea. Instead, they may exhibit daytime symptoms like hyperactivity, learning difficulties, or behavior problems.

As in adults, snoring is common for children with obstructive sleep apnea. However, children may have other nighttime symptoms like sweating, bedwetting, or sleepwalking. Children with severe untreated OSA may also experience problems with their growth and development. For many children, obstructive sleep apnea is caused by enlarged tonsils and adenoids in the throat, and surgery to remove these tissues may be an option for treatment.

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:

  • Loud snoring
  • Episodes in which you stop breathing during sleep – which would be reported by another person
  • Gasping for air during sleep
  • Awaking up with a dry mouth
  • Morning headache
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Difficulty paying attention while awake
  • Irritability

When you stop breathing during an episode of OSA, your heart rate drops the longer your body is deprived of oxygen. Then, your involuntary reflexes cause you to startle awake at the end of that period of not breathing. When this occurs, your heart rate tends to accelerate quickly and your blood pressure rises.

These are changes that take place acutely when you stop breathing. However, your body starts to experience chronic effects if you experience frequent apnea. Data suggests increased risk, particularly when you stop breathing roughly 30 times or more per hour. But there is likely a risk at even lower frequency rates.

For example, your blood pressure tends to go up, your heart walls thicken due to increased workload and the structure of your heart changes. It tends to become stiffer and less flexible because there are more fibrous cells growing in between the muscle cells.

All of those things increase the risk that you can have either atrial or ventricular arrhythmias. They also tend to reduce the function of the heart so that it’s less efficient at pumping blood.

Multiple factors affect a person’s chances of developing sleep apnea, and those factors are different for OSA and CSA.

The primary risk factors for obstructive sleep apnea are related to age, sex, body weight, and certain anatomical features of the head and neck area.

  • Age: The risk of developing obstructive sleep apnea increases with age until a person is in their 60s and 70s.
  • Sex: Men or people assigned male at birth are generally more likely to have obstructive sleep apnea, especially in the earlier stages of adulthood.
  • Head and neck anatomy: Obstructive sleep apnea occurs more frequently in people who have specific anatomical features including a larger tongue and a shorter lower jaw.
  • Body weight: Multiple studies have found a correlation between a higher body mass index (BMI) and an elevated risk of developing obstructive sleep apnea.
  • Cigarette smoking: Some research has found a noticeably higher risk of obstructive sleep apnea in people who smoke cigarettes compared to people who have quit or never smoked.
  • Hormone abnormalities: Hormone conditions like an underactive thyroid or excess production of growth hormone may increase the risk of OSA by causing swelling of tissue near the airway or by contributing to a higher body mass index.
  • Sleeping position: Sleep apnea may develop or be worsened when people sleep on their back because of how that sleeping position affects the shape and positioning of the tissue around the airway.
  • Family history of sleep apnea: There are some indications that a family history of OSA can increase a person’s risk of obstructive sleep apnea, which may relate to anatomical features in the head and neck that are shared among family members.
  • Nasal congestion: Difficulty breathing through the nose has been linked with a higher likelihood of having OSA.
  • Using alcohol and some medications: Alcohol and some prescription and narcotic drugs are associated with an elevated risk of obstructive sleep apnea.
  • Certain medical conditions: People with some medical problems, including several heart and lung conditions, may have a greater tendency to develop OSA.

Central sleep apnea most often occurs as a consequence of another medical problem, such as an infection or injury affecting the brain stem, heart or kidney failure, stroke, or excess growth hormone production. Studies have identified some additional factors that are linked with a heightened risk of central sleep apnea.

  • Age: People who are over age 65 have a heightened risk.
  • Sex: Central sleep apnea is more common in men or people assigned male at birth, which may be related to levels of certain sex hormones.
  • Use of certain drugs: Chronic use of opioid drugs and some prescription medications can affect breathing and have been associated with a higher risk of CSA.
  • Being at high altitude: Spending time at high-altitude is associated with CSA because of the decreased availability of oxygen.

Positive airway pressure (PAP) therapy is a treatment offered to almost all people with obstructive sleep apnea. PAP therapy keeps the airway open with pressurized air that is pumped from a machine through a hose and a mask worn on the face. PAP therapy uses a continuous positive airway pressure (CPAP) device that sends a stream of air that is always set to the same pressure level.

Some types of mouthpieces that hold the jaw or tongue in a specific position are a treatment option for people with certain anatomical features and less severe OSA. These oral appliances often do not improve breathing as much as PAP therapy, but they can reduce snoring.

An additional component of treatment for obstructive sleep apnea involves lifestyle changes to help manage symptoms. These suggestions may include:

  • Reducing BMI by losing weight
  • Getting regular exercise, which may decrease OSA symptoms even without weight loss
  • Altering sleeping position to avoid back sleeping
  • Reducing alcohol consumption

Treatment for central sleep apnea often focuses on addressing the medical issue causing abnormal breathing. If sleep disruptions are mild, treatment for the underlying cause may be all that is required.

Chamomile

Chamomile is a flowering herb. It looks like a tiny daisy, with a yellow central disc surrounded by delicate white petals.  A member of the Asteraceae family, chamomile is closely related to echinacea, sunflowers, marigolds, and other daisy-like flowers. The name comes from the Greek word chamaimēlon, meaning “ground apple.” The flowering herb has been used as a medicinal tonic and topical remedy for thousands of years. Though its use likely predates the period, it is known to have been drunk by Ancient Egyptians. Chamomile was also used as both a beverage and incense by the Romans.

There are two main types of chamomile: Anthemis nobilis (Roman chamomile) and Matricaria chamomilla (German or wild chamomile). The Roman variety was named by a botanist in the 19th century who found it growing near the Colosseum in Rome. German chamomile tends to have a more robust, almost pungent scent, while Roman chamomile is sweeter and fruitier.

The most widespread use of chamomile is as an herbal tea. Chamomile is also used in other beverages, such as liquor infusions, a beer additive, and to make wine. It’s commonly used in Spain to flavor Manzanilla sherry and is found in Greek cuisine as well. The floral flavor can be infused into syrups and used in ice cream, other desserts, or savory dishes such as soups.

Due to its aroma and healing aspects, it is common to find chamomile in topical lotions, oils, soaps, shampoos, and cosmetics. Many of these products use chamomile essential oil, which should never be ingested or applied directly to the skin on its own. The oil may be used in aromatherapy applications, including diffusers and candles.

The chamomile plant’s flowers and buds are harvested for tea as the flowers open. It continually blooms for a few months, depending on the climate in which it’s grown. Egypt and Eastern Europe lead chamomile cultivation, though it’s grown worldwide, and German chamomile often grows wild. After harvest, the flowers are dried to prolong the shelf life. When this occurs, the white petals turn a pale yellow and may fall off the yellow head, which is its most recognizable form.

Chamomile might benefit the quality of your sleep. It contains apigenin, an antioxidant that binds to receptors in your brain that may promote sleepiness and reduce insomnia. Apigenin has also been shown to fight cancer cells, especially those of the breast, digestive tract, skin, prostate and uterus. One study of 537 people observed that those who drank chamomile tea 2-6 times per week were significantly less likely to develop thyroid cancer than those who did not drink chamomile tea.

In one study, postpartum women who drank chamomile tea for two weeks reported better sleep quality compared to a group that did not drink chamomile tea. They also had fewer symptoms of depression, which is often linked with sleeping problems.

Another study found that people who consumed 270 mg of chamomile extract twice daily for 28 days had 1/3 less time lying awake and fell asleep 15 minutes faster than those who did not consume the extract.

A few animals studies have found that chamomile extract has the potential to protect against diarrhea. This is attributed to its anti-inflammatory properties. Another study found chamomile to be helpful in preventing stomach ulcers, as it may reduce acidity in the stomach and inhibit the growth of bacteria that contribute to ulcer development.

Chamomile has been used to treat several digestive ailments, including nausea and gas.

Drinking chamomile tea may also aid in lowering blood sugar levels. Its anti-inflammatory properties may prevent damage to the cells of your pancreas, which occurs when your blood sugar levels are chronically elevated. The health of your pancreas is extremely important, as it produces insulin, the hormone responsible for removing sugar from your blood. In one study of 64 diabetic people, those who consumed chamomile tea daily with meals for eight weeks had significantly lower average blood sugar levels than those who consumed water.

Several animal studies suggest that chamomile tea may lower fasting blood sugar levels by a considerable amount, and it may also be beneficial for preventing blood sugar spikes after eating.

How to Buy

Whole, dried chamomile flowers can be purchased at natural food stores, tea shops, and online. Packages may include just a few ounces or up to a pound. Larger bulk quantities are available, though the flowers do not weigh much: One pound should fill a one-gallon jar.  Chamomile tea bags are very common and available at grocery stores.

How to Store

Fresh chamomile is dried for long-term storage. If you harvest them from your garden, spread the flowers out and place in a dry, cool spot out of the sun for up to a week. They can also be dried in a food dehydrator or oven.

Once dry, store chamomile in an airtight container out of direct sunlight and away from heat and humidity. It will retain its flavor for up to a year.

How to Cook

When using chamomile to make tea, use between 1 and 4 tablespoons of fresh or dried flowers for each cup of water. The recommended water temperature is 200 degrees Fahrenheit or near boiling. Steep the herb for 3 to 5 minutes, depending on your taste.

Vegan Chamomile & Lemon Shortbread

Aimee/ Wallflower Kitchen

20 Cookies

Ingredients

  • ¾ cup + 2 tbsp dairy-free butter
  • 1 tsp vanilla paste
  • 2 tbsp dried chamomile flowers or contents of 2 chamomile tea bags
  • Zest of 1 lemon
  • ½ cup coconut sugar
  • 2½ cups gluten-free baking flour, sifted
  • 1 tbsp corn flour

Instructions

  • Cream the vegan butter, vanilla, chamomile, lemon and sugar together. Stir in the flour and corn flour and mix into a dough. Wrap in parchment or wax paper and chill in the fridge for at least 30 minutes to firm up.
  • Meanwhile, preheat the oven to 350° F and line a baking tray with parchment paper.
  • Once the dough is chilled, roll out to approximately 1/4″ thickness and cut into shapes. Place on the baking sheet, sprinkle with a little extra sugar and bake for 12-15 minutes until golden brown at the edges, turning half way through to ensure even baking.
  • Leave to cool for at least 10 minutes before serving or decorating.

Resources

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https://www.ninds.nih.gov/health-information/disorders/sleep-apnea
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