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Holding Breath Whilst Awake?
Just been asked by a Twitter follower who has sleep apnea if it's normal to sometimes hold our breath whilst awake. I do this sometimes and have queried it before with my GP who told me I'm more 'expert' than he is on these matters LOL, so in other words he didn't know. My theory is that it could be a habit we've picked up due to it happening so often in our sleep.
Does anyone else notice this?
Views: 4360
Replies to This Discussion
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Permalink Reply by David E. Lawler DDS D.ABDSM on
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It is very common for those with sleep-related breathing disorders to have some awareness of shallow breathing, holding the breath, or "forgetting to breathe" during the daytime.
The tongue, which is the villain in sleep-related breathing disorders, can also have a negative impact during breathing during the daytime. This is not known by most in the medical community and is a very difficult concept to convey. I have done my best to make this clear on my website
To give a specific example of a patient with sleep apnea who presents with many of common symptoms including an awareness of not breathing in enough air, go to the following video of her consultation:
This same patient is seen in this video at the beginning of an appointment where she will soon be fitted with a removable Oral Systemic Balance orthotic which alters her tongue posture in the mouth. In this very short video she talks about the symptoms that she is feeling on this particular day.
This video demonstrates the almost immediate effect that a modification of the tongue position has on the symptoms that she has previously discussed.
To be as succinct as I can:
- Her tongue posture in her mouth contributed to BOTH her sleep apnea and a swallow impairment.
- Swallowing occurs several thousand times a day. Every swallow is an opportunity to get something down the airway.
- The nervous system protects the airway with a vengeance.
- While keeping the airway free of food, water or saliva, the price paid was chronic head and neck pain as the muscles in the head and neck instinctively compensated, as directed by the nervous system, to assist the impaired swallow process.
With the tongue in a more appropriate position swallowing was made easier, the protective mechanism relaxed, pain was relieved, and the ease of breathing was increased.
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Permalink Reply by MZH on
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I just glanced through the material on your link and all I can say is WOW! I can't wait to go through all the videos and material you've got on your blog. I always felt my tongue was a problem. I just found a sleep dentist to see on Feb 2 so your info comes at the right time for me. Thnaks!
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I to have noticed this, also the late going to bed, trying to become exhausted so I go to sleep quicker. I have the same problems as everyone else, mask leaks, headaches, daytime napping, weight gain, I could go on and on, I was diagnosed 14 months ago and was happy that there was something I could do, now, still waiting to feel better, I guess the lack of support in a small Australian country town has frustrated me the most. All my knowledge and support comes from reading forums like this, so thankyou.
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Marcia, a dentist well trained in dental sleep medicine can be very helpful to you in assisting you with your breathing during sleep. However, if you relate to the symptoms specific to the patient above, such as daytime breathing issues, head and neck pain, etc. this is best addressed by someone with training in Oral Systemic Balance. To find an OSB practitioner, go here for assistance. If you live near Washington DC, this is a great website with lots of information.
Marcia Herman said:I just glanced through the material on your link and all I can say is WOW! I can't wait to go through all the videos and material you've got on your blog. I always felt my tongue was a problem. I just found a sleep dentist to see on Feb 2 so your info comes at the right time for me. Thnaks!
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David E. Lawler DDS D.ABDSM said:Marcia, a dentist well trained in dental sleep medicine can be very helpful to you in assisting you with your breathing during sleep. However, if you relate to the symptoms specific to the patient above, such as daytime breathing issues, head and neck pain, etc. this is best addressed by someone with training in Oral Systemic Balance. To find an OSB practitioner, go here for assistance. If you live near Washington DC, this is a great website with lots of information.
Marcia Herman said:I just glanced through the material on your link and all I can say is WOW! I can't wait to go through all the videos and material you've got on your blog. I always felt my tongue was a problem. I just found a sleep dentist to see on Feb 2 so your info comes at the right time for me. Thnaks!
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Marcia Herman said:
David E. Lawler DDS D.ABDSM said:Marcia, a dentist well trained in dental sleep medicine can be very helpful to you in assisting you with your breathing during sleep. However, if you relate to the symptoms specific to the patient above, such as daytime breathing issues, head and neck pain, etc. this is best addressed by someone with training in Oral Systemic Balance. To find an OSB practitioner, go here for assistance. If you live near Washington DC, this is a great website with lots of information.
Marcia Herman said:I just glanced through the material on your link and all I can say is WOW! I can't wait to go through all the videos and material you've got on your blog. I always felt my tongue was a problem. I just found a sleep dentist to see on Feb 2 so your info comes at the right time for me. Thnaks!
All right, I just sent my request for a practitioner. I think my new dentist is into the jaw angle and not the tongue, but time will tell. I have a feeling that he's a young, pro-active type who will learn about it if asked about it.
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Permalink Reply by Kristi Halsey on
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Thanks for the link, Mary! I've been looking for helpful info. on central apnea since I was diagnosed with it in November.
Mary Z said:I think sometimes when we hold our breath during the day it has more to do with intense concentration or stress. You know how when you get stressed out someone might remind you to breathe, to take slow deep breaths. When we're asleep the airway either partially or completely collapses unless we're having a clear airway event where for some reason we just don't take a breath (or a cenral).
http://www.nlm.nih.gov/medlineplus/ency/article/003997.htm here is a good overview of central apnea not associated with sleep apnea, but due to oter diseases.
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Permalink Reply by Mary Z on
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Dr. Lawler, I think it only fair to address the cost of the orthotic and reimbursement by insurance. We know the costs on most of the other treatment modalities. Could you please give us a ball park figure, or I will say what I was told and you can correct me? We have had several members use it very effectively, though it seems it is not for everybody. In other words it is not always acceptable in every patient who needs a dental device. I am not against your device. There are such practical problems such as cost, and lack of certified dentists. I don't think it's available for many of us.
David E. Lawler DDS D.ABDSM said:....
This same patient is seen in this video at the beginning of an appointment where she will soon be fitted with a removable Oral Systemic Balance orthotic which alters her tongue posture in the mouth. In this very short video she talks about the symptoms that she is feeling on this particular day.
This video demonstrates the almost immediate effect that a modification of the tongue position has on the symptoms that she has previously discussed.
To be as succinct as I can:
- Her tongue posture in her mouth contributed to BOTH her sleep apnea and a swallow impairment.
- Swallowing occurs several thousand times a day. Every swallow is an opportunity to get something down the airway.
- The nervous system protects the airway with a vengeance.
- While keeping the airway free of food, water or saliva, the price paid was chronic head and neck pain as the muscles in the head and neck instinctively compensated, as directed by the nervous system, to assist the impaired swallow process.
With the tongue in a more appropriate position swallowing was made easier, the protective mechanism relaxed, pain was relieved, and the ease of breathing was increased.
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Mary, some of the issues that you raise are what have kept me from posting on this site for quite some time. However, when I got an email asking about "holding your breath" I really did not feel it appropriate to at least answer WHY this phenomenon occurs. And if you can't at least suggest a solution, there is little point in much discussion as to the "why".
To my knowledge, there are no Oral Systemic Balance practitioners outside of the United States and there are very few in the US with current certification. This can be extremely frustrating for those without potential help nearby. This is a relatively new concept in upper airway management, and like any new concept, it takes awhile for it to become understood and accepted, particularly with no clinical trials to verify efficacy. However, I and other OSB practitioners have accumulated a vast amount of anecdotal data with well document video recordings of patients experiencing the effect of swallow management with OSB orthotics. This can be with a single, lower orthotic as shown in the patient above, sometimes a lower and sometimes a special orthotic that moves the mandible forward (similar but also very different from traditional dental sleep appliances). The video documented results of this kind of treatment leaves those with tradition medical backgrounds scratching their heads in wonder.
Because some patients are best served with different combinations of orthotics and because there are different fees based on cost of living in various areas of the country, discussing fees in this forum is not appropriate. I am not trying to be evasive, but pragmatic. I can say without hesitation that this type of care is not inexpensive because of the significant amount of time invested in adjusting the orthotics to optimum function. For those curious about cost, I would recommend that they first get clear if their symptoms match those symptoms that are commonly addressed with information gathered in various websites like mine. If they feel that the treatment is a match, then see if someone is available to perform that treatment. Once that process is complete, any OSB practitioner would be candid about potential cost prior to scheduling an appointment.
Regarding insurance, and I can say this regarding my personal experience in our office, we have had little trouble getting significant medical insurance reimbursement for patients with a diagnosis of OSA.
In answering the question, "does it work for everybody?" I can say that we are trying to enhance human anatomy and make the swallowing process more efficient with a piece of plastic. Certain patients present more challenges than others. With that said, I have never seen a more predictable way of addressing the constellation of symptoms that OSB treats.
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Mary, some of the issues that you raise are what have kept me from posting on this site for I have heard that in general the cost of your therapy is $35,000. I also think it worthwhile to mention the dearth of practitioners in the US. I appreciate what you are trying to achieve with your therapy, and I respect you. However this mode of therapy is out of the reach of most of us. I realize it will take investigation into the purposes of your device in treating our particular symptoms and your post is entirely appropriate and appreciated to the subject raised. You are the only one with an explanation and who presents a solution and I do thank you for that.
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I believe holding your breath is a learned behavior that can become a bit of a bad habit. It can be fairly easily corrected simply by observing your breathing and learning to refrain from holding your breath in the presence of triggering events or thoughts. Here's a hint: when you feel startled, you naturally hold your breath as you check out your environment for tigers, wolves, hefalumps, and other dangers.
The following discussion is from a little book I am writing (The Handbook of Fearlessness, to be published on Kindle this year).
ABDOMINAL BREATHING
When you are troubled and fearful, your breathing tends to be disrupted -- you may hold your breath or you may engage in rapid, shallow breathing. Since the breath, body, and mind are closely linked, disrupted breathing increases the level of stress you are experiencing.
You can learn to employ abdominal breathing to correct this problem and help restore mental and emotional balance. Abdominal breathing (breathing from the diaphragm) causes the abdomen to move out slightly when you inhale and to move in slightly when you exhale. This breathing tends to be smooth, continuous, and rhythmical.
Yoga practitioners learn not only to breathe from the diaphragm but also to use their complete lung capacity by sitting upright, filling their lungs with air from bottom to top as they inhale, and evacuating the air from top to bottom as they exhale. They believe that habitually disrupted breathing can contribute to various illnesses and that abdominal breathing is good for one’s health.
Abdominal breathing ties in with a simple meditation exercise: focus attention on each exhalation; count each out breath from one to ten -- see how high you can count without shifting your attention; or simply repeat a meaningful word or phrase (like “relax” or “peace”) in your mind each time you breathe out.
There are at least two good reasons to practice abdominal breathing: (1) it will help you quickly recover the natural rhythm of breathing when your breathing is disrupted by an emergency startle reaction; (2) it will reduce stress in your everyday life and help keep your breath, body, and mind in balance.
In the beginning, some people who are experiencing anxiety may find it difficult to work directly on their breathing pattern. In meditation training, people who are having some difficulty in this regard are sometimes advised to take a different approach to relaxation and not try too hard to breathe in any special way. Sitting with someone experienced in abdominal breathing (such as a friend who meditates regularly) can help you get the hang of this natural way to breathe.
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Permalink Reply by ZolliStar on
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Thank you so much for posting this, Robert.
Robert Woods Mann said:I believe holding your breath is a learned behavior that can become a bit of a bad habit. It can be fairly easily corrected simply by observing your breathing and learning to refrain from holding your breath in the presence of triggering events or thoughts. Here's a hint: when you feel startled, you naturally hold your breath as you check out your environment for tigers, wolves, hefalumps, and other dangers.
The following discussion is from a little book I am writing (The Handbook of Fearlessness, to be published on Kindle this year).
ABDOMINAL BREATHING
When you are troubled and fearful, your breathing tends to be disrupted -- you may hold your breath or you may engage in rapid, shallow breathing. Since the breath, body, and mind are closely linked, disrupted breathing increases the level of stress you are experiencing.
You can learn to employ abdominal breathing to correct this problem and help restore mental and emotional balance. Abdominal breathing (breathing from the diaphragm) causes the abdomen to move out slightly when you inhale and to move in slightly when you exhale. This breathing tends to be smooth, continuous, and rhythmical.
Yoga practitioners learn not only to breathe from the diaphragm but also to use their complete lung capacity by sitting upright, filling their lungs with air from bottom to top as they inhale, and evacuating the air from top to bottom as they exhale. They believe that habitually disrupted breathing can contribute to various illnesses and that abdominal breathing is good for one’s health.
Abdominal breathing ties in with a simple meditation exercise: focus attention on each exhalation; count each out breath from one to ten -- see how high you can count without shifting your attention; or simply repeat a meaningful word or phrase (like “relax” or “peace”) in your mind each time you breathe out.
There are at least two good reasons to practice abdominal breathing: (1) it will help you quickly recover the natural rhythm of breathing when your breathing is disrupted by an emergency startle reaction; (2) it will reduce stress in your everyday life and help keep your breath, body, and mind in balance.
In the beginning, some people who are experiencing anxiety may find it difficult to work directly on their breathing pattern. In meditation training, people who are having some difficulty in this regard are sometimes advised to take a different approach to relaxation and not try too hard to breathe in any special way. Sitting with someone experienced in abdominal breathing (such as a friend who meditates regularly) can help you get the hang of this natural way to breathe.
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