Sleep apnoea is a condition in which people stop breathing in their sleep. Quite often the person with sleep apnoea is unaware of it, and it is likely that their partner or someone else in their household will advise them of the problem. Sleep apnoea is generally classified into two types: obstructive sleep apnoea (OSA) and the less common central sleep apnoea (CSA). Diagnosis is confirmed by having an overnight sleep study, referred to as a polysomnograph.
Most people are familiar with snoring and the negative effects it can have on relationships with partners and other members of the household. Snoring often leads to the onset of sleep apnoea. From the Buteyko perspective both sleep apnoea and snoring occur due to incorrect breathing, specifically overbreathing or hyperventilation. People exert most control of their breathing and breathe smaller volumes of air when upright. The closer a person becomes to the horizontal position the deeper the breathing volume becomes and the more loss of carbon dioxide (CO2) there is from the lungs. The worst way to sleep is on the back with the mouth open without the use of a pillow. This is the situation in which the breathing volume increases significantly.
People with sleep apnoea and snoring will typically display one or more of the following:
- Apnoeas of duration 10 seconds or more (they can be up to and even over 2 minutes)
- Snoring (though not always with CSA)
- Excessive movement and restlessness
- Restless legs syndrome
- Breathing through the mouth
- Dry mouth and throat during the night and in the morning
- Thirst overnight and/or on waking
- Waking unrefreshed, often feeling as tired or even more tired than when going to bed
- Daytime fatigue
- Poor daytime concentration
- Tendency to fall asleep in meetings, in front of the TV, and even in the car while driving
- Breathlessness on exercise
Normal sleep occurs in several stages. The middle and latter stages before REM (Rapid Eye Movement) sleep involve the most restful and deep sleep. When a person is over breathing, or hyperventilating, they are prevented from easily reaching these stages and remain in the light sleep stages during which they are easily disturbed. A person with sleep apnoea has the added difficulty of ‘arousal’ occurring each time an apnoea finishes with a gasping breath. This will either wake the person or take them close to waking. The fact that some people do not actually fully awaken after an apnoea explains why they often do not initially accept that they have a problem needing investigation. The observer of course knows otherwise.
The Buteyko Institute Method corrects the breathing pattern by reducing the hyperventilation, with a resulting decrease in both the duration and frequency of apnoeas, a decrease in snoring and the return to normal sleep patterns. Hyperventilation decreases the arterial and alveolar levels of carbon dioxide (CO2) to the point where the breathing reflex is depressed. This is interpreted as an apnoea or hypopnoea to an observer. A hypopnea is defined as when breathing is reduced by 50% or more. During cessation of breathing (apnoea) the CO2 slowly accumulates until it triggers the body to take the next breath. By correcting the breathing pattern the body no longer needs to suppress the breathing reflex as the CO2 level is maintained within normal limits.
When apnoeas no longer occur CPAP (Continuous Positive Air Pressure) machines are no longer required and surgery can be avoided.
BIBH Sleep Apnoea Survey
A 2010 survey of Buteyko Institute practitioners who had taught the method to over 11,000 people with sleep apnoea found that:
- Over 95 percent of clients with sleep apnoea had improved sleep.
- Approximately 80 percent of clients had been able to cease use of their CPAP machine or oral appliances.
- Symptoms such as snoring, headaches, restless legs, low concentration levels and decreased energy levels also improved in the majority of clients.
To view the survey results and the full report please see:
Birch, M. 2012. Sleep apnoea and breathing retraining. To what extent is the Buteyko Institute Method of breathing retraining effective for sleep apnoea? A survey of Buteyko Institute practitioners’ experiences with clients suffering from sleep apnoea.
Birch, M. 2012. Sleep Apnoea: a survey of breathing retraining, Australian Nursing Journal, October, 20(4):40-41.
Birch M. 2004. Clinical Update: Obstructive sleep apnoea and breathing retraining, Australian Nursing Journal, August.