Experts can come from a variety of sources. This post is mainly written by a patient of mine who became an expert out of necessity, not settling for the mediocre options available to her. She did the work. She figured it out. And I’ve learned a lot from her in the process.

Obstructive sleep apnea (OSA) is incredibly common. I’ve heard for years that perhaps 90% of those with this condition are undiagnosed. Much of the conventional wisdom on sleep apnea is likely incorrect. We think of a thick-necked, obese middle-aged man as the classic person with OSA. There are risk factors and treatment options that are not acknowledged by medical experts.

My Airway Journey, by Brenda F.

Like most things, I blamed it on stress and menopause. Turns out, I wasn’t entirely wrong. I was exhausted, overweight, and foggy. I hadn’t gotten a good night’s sleep in what felt like an eternity. A few years earlier, when my husband told me I was snoring, I didn’t believe him. A teeth grinder, yes. I had been grinding my teeth my entire life. But snoring…there was just no way. It wasn’t until he brought home a ziplock bag full of earplugs that I thought maybe, in fact, I was.

I made an appointment with my dentist, who also specializes in airway issues. She told me that as women age and go through menopause, our oral muscles and upper airway can atrophy much like the muscles in the rest of our body. This can lead to loose tissue in the soft palate and an un-toned tongue, which can cause snoring or, worse, obstructive sleep apnea. She ordered a home sleep study for me. When the results came back, I was flabbergasted. Severe OSA (obstructive sleep apnea). My Apnea-Hypopnea Index (AHI score—the number of times your breathing stops per hour) clocked in at 31 times per hour. The longest stretch of time not breathing…55 seconds! My blood oxygen level was dangerously low at 88%. The solution, or the only one presented to me, was a CPAP machine. I immediately asked the sleep technician if there was any way to reverse this diagnosis holistically. She suggested a 10- to 15-pound weight loss and oral myofunctional therapy. And so my journey began.

I started walking five to six days a week, aiming for a minimum of 30 minutes per day. If I could only squeeze in 15 to 20 minutes, that’s what I did. I cut way back on inflammatory foods: sugar, dairy, and gluten. I got back on track, avoiding as many foods containing seed oils as possible. I completed three rounds of the Prolon Fasting Mimicking Diet to support weight loss and inflammation reduction, and I began working virtually with an airway coach. I consulted with my primary care physician, and we discussed utilizing a CPAP machine to help me get “over the hump,” so to speak. The thought process was that if I could sleep better in the interim, it would hopefully help me regain some of my energy until I lost some weight and strengthened my tongue and airway muscles. The CPAP arrived. I set it up and cried. I felt defeated, embarrassed and broken. It was hard to get used to, and even harder to sleep with that tube/machine attached to my nose. I just couldn’t accept that I would be tied to that machine for the rest of my life. I persevered in the moment, and at my dentist’s recommendation, I made an appointment with an ENT.

My airway coach provided me with several tongue toning exercises to be performed twice a day, with the goal of keeping my tongue suctioned to the roof of my mouth both during the day and at night while sleeping. She also introduced me to Buteyko breathing, which would help me slow down my breathing during the day, ultimately leading to slower breathing at night. These two things alone were monumental in my journey. But it took a little more digging to really get to the root. It turns out I have a severely deviated septum, and what I learned is that grinding your teeth is often a sign of your body struggling to breathe while you sleep. I had been struggling to breathe while sleeping for my entire life! The extra weight, menopause, and atrophied airway muscles had tipped the scale. Instead of rushing into surgery to fix the deviation, my ENT suggested we repeat the sleep study to see if I had made any progress naturally with all of the work I had been doing.

I continued walking, started working on my lymphatic system more regularly to drain fluid from my sinuses, and began eating more foods rich in collagen precursors to help strengthen my upper airway. I foam rolled my back every night before bed to help break up fascial adhesions, allowing me to breathe better while I slept. I raised the head of our bed 4 inches and added nightly nasal rinses for the same reason. I made sure to perform a “tongue check” multiple times a day to confirm my tongue was in its proper resting posture, suctioned to the roof of my mouth, unless I was talking or eating. I used the REMplenish myo-nozzle on my water bottle daily and started using a nasal dilator to ensure optimal airflow through my nose while I slept.

Six months later, having stopped using the CPAP, I repeated the at-home sleep study. I was down 13 pounds and knew my tongue had grown significantly stronger. Daily Buteyko breathing also successfully helped me slow my breathing way down. The results were astonishing. My AHI score decreased from 31 to 7 episodes per hour, and my blood oxygen saturation increased from 88% to 94%! No CPAP, oral appliance, or surgery needed. My ENT was blown away. My airway coach, beyond proud. And my PCP, well…he asked me to write this article.

I surrounded myself with professionals who listened, believed in me, and guided me, and I put in the work. I now recognize that this is a major lifestyle change—one that requires ongoing effort to maintain—and I’m okay with that. I know I still have more work to do. In an ideal world, my AHI score would drop to 5 or less per hour. But I also know exactly what steps I need to take to get there, and I am willing to do the work because my health and sleep are well worth it.

Was it hard work? Yes. Did it take commitment, determination, and willpower? Absolutely. But what I realized through it all is that the concepts themselves were actually quite simple once I understood what needed to be done.

I was made to believe that a CPAP or oral appliance was my only option. But I am here to tell you that it’s not always true. Even with an anatomically compromised nasal passageway and upper airway, it is still possible to breathe slowly and quietly through your nose while sleeping without the aid of a device. My airway coach put it best: “Another person would have taken the fate they thought they were dealt. You decided to radically change everything so that you could get the sleep you deserve.”

Lessons From Brenda’s Journey

Brenda’s process probably seems daunting. I don’t think everyone would have to follow the complete plan, although the chances of success are likely higher. A combination of weight loss, mouth taping, and airway strengthening exercises would likely improve and cure many OSA cases.

James Nestor, author of the book Breath, has several YouTube videos on mouth taping, as well as others on myofunctional exercises for snoring/OSA. I taped my mouth for a couple of months; it was easier than expected and cured my snoring.

I’m grateful to know Brenda and thankful that she gives us a more righteous path forward.