Nutritional Therapy and Lifestyle Changes for Obstructive Sleep Apnoea

Obstructive sleep apnoea involves repeated interruptions in breathing during sleep due to narrowing or collapse of the upper airway. It can be detrimental to health by increasing the risk of chronic conditions.

Fortunately, nutritional therapy and lifestyle measures can influence airway stability and sleep quality. This is because, during sleep, there are underlying influences related to body composition, inflammatory activity together with muscle function.

Nutritional therapy for sleep apnoea

Sleep apnoea is strongly linked to cardiovascular, metabolic, and neurological conditions, primarily caused by oxygen drops and fragmented sleep.

Key associated conditions include high blood pressure (hypertension), Type 2 diabetes, heart disease (including heart failure and atrial fibrillation), stroke, obesity, and depression (13).

Weight reduction and airway pressure (1)

Dietary intervention is often directed towards weight reduction, given the established association between excess body mass and airway obstruction. Plus, tissue accumulation around the neck and upper airway increases pressure on surrounding structures, which can restrict airflow during sleep. Furthermore, a reduction in body weight has been linked with measurable improvements in breathing patterns.

Dietary patterns and inflammatory regulation (1,2)

Food intake contributes to inflammatory processes while also shaping metabolic function. A Mediterranean dietary pattern, based on vegetables, fruits, whole grains, olive oil and oily fish, supports metabolic regulation and contributes to inflammatory control.

A higher intake of plant-based foods has also been associated with a lower likelihood of obstructive sleep apnoea. Diets rich in fibre and phytonutrients may assist with weight regulation and support respiratory function.

In addition, (refined) carbohydrate intake is sometimes adjusted to support the lowering of inflammatory signalling while also affecting neuromuscular control of the airway in a way that could help improve the sleep apnoea condition.

Physical activity and respiratory function (3,4)

Regular physical activity supports weight regulation while contributing to respiratory efficiency. Improvements in oxygen levels and symptom patterns have been observed with consistent aerobic exercise, even in the absence of significant weight change.

Micronutrients and nutritional status (5,6,7,8,9)

Micronutrient status remains a relevant consideration, this includes vitamin D and dietary antioxidants.

Lower vitamin D levels are frequently observed in those with more severe sleep apnoea, and it’s thought that correction via supplementation may support the condition.

Antioxidants such as vitamins C and E are involved in managing oxidative stress linked to intermittent reductions in oxygen levels during sleep. Furthermore, magnesium is sometimes thought of as a helpful adjunct due to its role in muscle relaxation alongside its influence on sleep quality.

Alcohol and airway stability (9)

Alcohol influences muscle tone within the upper airway. Reduced tone increases the likelihood of airway narrowing during sleep, particularly when consumed in the evening.

In one study, removal of alcohol for a single night was associated with a reduction in the apnoea-hypopnoea index from 22.1 to 7.5, indicating a change from moderate to mild severity of the condition.

Smoking and airway inflammation (10)

Smoking contributes to local inflammation alongside fluid retention within airway tissues, and these changes can reduce airway diameter and increase resistance to airflow. Therefore smokers with sleep apnoea are recommended to stop smoking.

Other lifestyle factors related to sleep apnoea

Sleep position (11)

Body position during sleep influences how gravity acts on airway structures. When lying on the back, soft tissues may be positioned in a way that promotes obstruction. Therefore, side sleeping has been associated with improved airway patency in some individuals.

Orofacial muscle support (12)

Exercises involving the muscles of the mouth and tongue are used to support airway structure. Improved muscle tone in this region may reduce the likelihood of airway collapse during sleep.

Main Takeaways

It is important to remember that weight reduction, quality of the diet, physical activity, micronutrient status and avoidance of alcohol and smoking all influence airway function connected to sleep apnoea. In addition, sleep position and orofacial exercises may further support breathing this condition during sleep.