Avatar_dr_m
Steven Y Park, MD  
Male, 46
New York, NY

Specialties: Sleep-breathing disorders

Interests: Running, Baking, origami
Private Practice
212-315-9058
New York, NY
All Journal Entries Journals

The Biggest Throat Problem for Sleep Apnea Sufferers

Dec 15, 2010 - 2 comments
Tags:

chronic cough

,

GERD

,

hoarseness

,

LPRD

,

lump

,

mucous

,

OSA

,

post-nasal drip

,

relfux

,

Sleep Apnea

,

throat pain

,

Pleurisy



If you wake up every morning needing to hack up lots of thick mucous, or have throat pain, hoarseness, or a chronic cough, you’re not alone. You may think it’s the beginning of a cold, but a cold doesn’t continue for weeks to months without progressing into the full-blown viral symptoms.
Instead, these symptoms are the beginnings of the most common throat problem sleep apnea sufferers face. And as I explain below, without understanding why this occurs, it can be one of the hardest problems to treat.
Beware of the “Vacuum Effect”
People with obstructive sleep apnea are more prone to breathing problems at night due to partial or total collapse of one or more areas of the entire upper airway, from the nose to the tongue. It’s usually worse when on your back, since the tongue can fall back more in this position. During deep sleep, your muscles naturally relax and you’ll be more susceptible to breathing stoppages.
Pressure sensors placed inside sleep apnea patients reveal that every time an apnea occurs, a tremendous vacuum effect is created inside the chest and throat, which literally suctions up your normal stomach juices into your esophagus and throat. This can happen occasionally, even for normal people, but if you happen to have a late meal or a snack just before bedtime, there will be even more stomach juices lingering in your stomach to come up into the throat. If you happened to drink a nightcap, the situation is even worse since alcohol is a strong muscle relaxant.
What comes up into your throat is not only acid, but also bile, digestive enzymes, and even bacteria. Washings of lung, sinus and ear contents have shown H. pylori, a common stomach bacteria, and pepsin, a major stomach digestive enzyme. So what comes up can cause severe irritation in your throat, provoking the mucous secreting glands of your throat to try to dilute these substances.
Although people generally attribute throat mucous to post-nasal drip, in most cases there’s nothing dripping down the back of the throat. It’s actually coming from your stomach. However, in some cases, since your stomach juices can reach your nose, it can cause nasal congestion and inflammation, which can aggravate tongue and soft palate collapse by creating a vacuum effect downstream. Ultimately, it’s a vicious cycle.
Chronic acid and other irritating substances lingering in your throat can have other detrimental effects. One recent study showed that chronic acid exposure can numb or deaden the protective chemoreceptors in your throat. These are sensors that detect any acid in the throat to prevent aspiration of your stomach contents into your lungs. If these chemoreceptors sense any acid in your throat, a feedback signal is sent to the brain, causing you to wake up so that you can swallow. This is what’s called a reflux arousal.
Treating Reflux For Good
So besides not eating late and avoiding alcohol close to bedtime, what else can you do?
I’m assuming that many of you that are reading this article are already being treated for obstructive sleep apnea, via either CPAP, oral appliances, or even with surgery. The problem is that no matter which option you choose, there will always be some degree of reflux. Taking acid reflux medications can help sometimes, but for the most part, these reflux medications don’t really do anything for reflux. All they do is to lower the acid content content before it comes up into your throat.
Other options include stimulating your stomach via natural remedies or prescription medications to empty your stomach much faster. One fascinating study showed that using a combination of pseudoephedrine (Sudafed) and a pro-motility agent (domperidone) eliminated snoring in most people. Unfortunately, we don’t have the equivalent of domperidone here in the US. Other similar medications are available, but have more serious side effects.
This is why eating early at least 3-4 hours of bedtime is so important whether or not you have obstructive sleep apnea. The same also applies to alcohol. If your nose is stuffy, talk with your doctor to find a way to breathe better through your nose. Make sure you’re sleeping in your preferred or optimal sleep position. Lastly, work with your sleep physician to fully optimize your sleep apnea treatment, no matter which option you choose.


Steven Y. Park, M.D., Author of the book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. Endorsed by New York Times best-selling authors Christiane Northrup, M.D., Dean Ornish, M.D., Mark Liponis, M.D., and Mary Shomon,  For a free e-book on How to Un-Stuff Your Stuffy Nose, click here: http://doctorstevenpark.com/unstuff-your-stuffy-nose.

Comments
Post a Comment
874521_tn?1375890587
by opus88, Jan 10, 2011
dr Park in one of your posts you made the comment that sleep apnea can also be the cause(?) of Alzheimers would you please give me more information on that please...

http://www.medhelp.org/posts/Alzheimers-Disease/Neurologic-Complications-of-Sleep-Apnea/show/1387992

Avatar_f_tn
by Amaqwati, Sep 08, 2011
Am in South Africa Whenever therz a slight drop in temperature i get a mucus build up,at night i often have to wake up to clear nose of big dried up chunks of mucus,which once i've done that start going down my throat,then about 30 min i have to clear that.in the morning when i brush teeth i also have to clear mucus which i can definately feel drippin frm nose to throat causing which sort of want to induce vomiting,i havent tried much except for a nasal spray.After drinking it is worse and i get a sort of feelin that my brain is swollen and the sensation that the mucus is draining frm there.sometimes its bloody especialy after drink or heavy mariujana smokin,plz help,i cant even sleep over peoples pads for the embarasment and its been 10yrs nw

Post a Comment