Lifestyle Changes to Manage Sleep Apnea

Untreated sleep apnea can stress your heart, raise your blood pressure, and worsen your mood. You might have trouble thinking clearly because you’re not getting the deep sleep you need. And your snores or gasps for air at night may disturb loved ones.

But there are ways to breathe easier. A continuous positive airway pressure (CPAP) device is one option. But it’s not your only choice.

Christine Won, MD, specializes in sleep-related breathing disorders at Yale Medicine and says lifestyle changes can help. Some take aim at your sleep apnea. Others are geared toward better sleep in general. “This can help with the fragmented and poor-quality sleep you get with sleep apnea.”

Here’s what you need to know.

Lose Weight

Sleep apnea is more common in obese adults. That’s because extra fat tissue can block your upper airways. Your genes and natural physical traits also play a role, says Kuljeet Gill, MD, a sleep medicine specialist a Northwestern Medicine Central DuPage Hospital. But “losing weight is probably the first recommendation.”

Won agrees that weight loss can help lessen how bad symptoms are in some people. But it might not get rid of your need for the CPAP completely, she says.

Anyone of any size can get sleep apnea, even kids. That’s why Meir Kryger, MD, a sleep medicine specialist at Yale Medicine, asks adults with sleep apnea this question: “Do you have children, and do any of them snore?” Early treatment in children may ward off problems down the road, he says.

Exercise More

Your odds of sleep apnea go up if you’re not physically active. Exercise can help you shed fat around your upper airways. Even without a big drop in weight, Kryger says regular movement can raise your energy levels and improve your overall health.

Outside of weight loss, research shows physical activity can help people with sleep apnea in the following ways:

• Boost your oxygen levels
• Help you feel less sleepy
• Improve your sleep quality
• Lessen how bad your sleep apnea is

We need more research to know exactly how exercise helps with sleep apnea. But try to work in 2 days of weight training and at least 150 minutes of aerobic activity each week. Think 30 minutes a day, 5 days a week. Gill says your mood and sleep quality might get better with just 10 or 20 minutes a day.

Quit Drinking and Smoking

Alcohol use can make sleep apnea worse for a couple of reasons. “We know that it reduces the tone of the upper airway breathing muscles,” Kryger says. “But also, people who drink a lot of alcohol tend to put on weight.”

Gill says it’s best to give up booze completely. But she knows that’s not doable for everyone. If you’re going to drink, tips on how to lessen alcohol’s impact on your sleep apnea include:

• Stop drinking at least 3 to 4 hours before bed.
• Limit alcohol use to weekends.
• If you’re a heavy drinker, try to cut back to 1 or 2 a day.

If you smoke, quit. Experts aren’t exactly sure how cigarette smoking relates to sleep apnea. But studies show people who have the sleep disorder or more likely to smoke. Plus, chemicals in cigarettes can harm your health and worsen sleep quality.

Avoid Certain Medication

Gill says you’ll want to be extra careful with opioids, a type of strong painkiller. They can slow down your breathing rate and relax breathing muscles even more.

Other drugs that might affect sleep apnea include:

Ask your doctor if it’s OK to use over-the-counter sleeping pills. It’s not that OTC sleep aids make sleep apnea worse, Gill says, but “you don’t want to mask an underlying breathing problem.”

Change Your Sleep Position

You might breathe easier if you snooze on your side. “I sometimes have [older] men buy pregnancy pillows to avoid their back,” Gill says.

Take a look at your mattress choice, too. “A bed that elevates your head might also help,” Won says.

But keep in mind that a change in body position won’t fix the cause of your sleep apnea. And it might not do much if you have serious symptoms. “But it may help people who are snorers or who have a mild sleep-breathing problem,” Kryger says.

Try a Dental Device

You might hear this called oral appliance therapy. These tools pull your tongue away from your throat or bring your lower jaw up and forward, Kryger says. That keeps your throat open at night. For some people, a dental appliance can be “virtually as effective as CPAP,” he says.

You’ll need to get one made by a dentist or orthodontist who works with your sleep doctor. But dental devices can be a lot more expensive than a CPAP, and your insurance may not cover it.

Treat Nasal Congestion

A stuffy nose doesn’t cause sleep apnea. The problem starts back in your throat, behind your tongue, Kryger says. But managing your allergies — either with surgery, anti-inflammatory agents, or corticosteroids — may help if you have mild sleep apnea, he says. 

In addition to allergy treatment, Gill suggests rinsing with saline one or two times a day. You can buy over-the-counter nasal sprays or irrigation kits. Gill says whether you use a CPAP machine or not, “part of breathing better is opening the nose.”

Practice Good Sleep Habits

This won’t treat your sleep apnea. But healthy habits can make it easier to get a good night’s rest. There are lots of behavioral strategies your doctor might want you to try.

Won says exercise may help you stay alert during the day and make you tired enough to crash at night. And she says relaxation practices such as meditation might help you get to sleep easier and reach a deeper level of sleep.

Gill says a strict sleep-wake schedule is key. Here are some of her tips:

• Go to bed within 15 or 30 minutes of the same time each day.
• Keep the same sleep routine on weekdays and weekends.
• Avoid daytime naps if you can’t fall asleep easily at night.

Gill also suggests you put down electronic devices at least 2 or 3 hours before bed. Those are things like laptops, smartphones, or tablets. “Television and reading are very different,” she says.

Watch What You Eat

Experts agree that it’s best to avoid heavy meals, caffeine, and spicy foods at night. These can worsen heartburn. That’s when acid travels from your stomach up to your throat. “The reflux, or acid, can actually go high enough that it can irritate the upper breathing passage,” Kryger says. “It can make the apnea worse.”

Give Yourself Time to Sleep

A lack of shuteye can lead to weight gain. It can also raise your odds of mental health problems. “People who have untreated sleep apnea are much more likely to be depressed or have depression-like symptoms,” Kryger says. “And they’re way more likely to be very irritable.”

Carve out 7 to 9 hours for sleep. If you get a lot less than that, Kryger says some of your symptoms, such as sleepiness, may not get better even if you make other lifestyle changes or use a breathing device.

Play an Active Role in Your Care

If you do use a CPAP, make sure it works the right way. Ask your doctor how to check your machine. Kryger says your device might connect to a smartphone app that sends info straight to your doctor. They can check that data and make changes to your CPAP remotely.

“Sleep medicine is fairly up to date in terms of telemedicine,” he says. “We can do a lot in helping (people with sleep apnea) take care of themselves.”