It’s commonly thought that sleep apnea is simply a problem of obesity or structural issues that interfere with breathing. However, a commonly overlooked cause of sleep apnea in men and women is the brain. When the brain is not functioning properly, this can interfere with the body’s ability to maintain proper breathing function while asleep.
Sleep apnea and the brain in women
The brain’s influence on sleep apnea can be seen in women during perimenopause and menopause if their estrogen drops too low.
Insufficient estrogen causes the brain to fail in signaling the palate and tongue to maintain tone during sleep. The resulting lack of tone blocks the airway.
The brain-related cause of sleep apnea is different in men. In a rat study, young male rats responded to normal episodes of oxygen deprivation during sleep by automatically increasing brain activity to take deeper and more frequent breaths. However, the older male rats did not respond in the same way due, it’s theorized, to more aged brains.
Researchers observed a much different response to these normal episodes of sleep-induced oxygen deprivation in female rats. For one thing, older female rats responded much more positively to these hypoxic events than the older males.
Younger female rats had an even better response, especially during specific times in the menstrual cycle. This led scientists to believe female hormones play a role in how they respond to normal episodes of oxygen deprivation during sleep.
This theory is what leads researchers to believe estrogen deficiency contributes to sleep apnea in women during perimenopause and menopause. Estrogen influences serotonin, a brain neurotransmitter chemical that plays a role in giving the tongue and palate tone, including during sleep.
Estrogen tells the brain to breathe in women
To test the theory that the interplay between estrogen and serotonin plays a role in sleep apnea, researchers induced menopause in female rats by removing their ovaries. Sure enough, post-mortem brain biopsies showed less serotonin in the area of the brain that controls the tongue. This had made it harder for the female rats to respond to episodes of oxygen deprivation during sleep. This helps explain why sleep apnea affects more women in midlife.
Sleep apnea and the brain in men
Middle-aged men also experience higher rates of sleep apnea due to the effect of declining testosterone on the brain.
In midlife, men snore more and have more episodes where they stop breathing.
Middle-aged women, however, more commonly complain of insomnia, as well as headaches, fatigue, and irritability caused by sleep deprivation and poor sleep quality. That estrogen deficiency promotes weight gain, and restless leg syndrome only worsens the problem of sleep apnea.
Hormone status that plummets too low in midlife can be the result of chronic stress, poor diets, lack of exercise, and other standard bad habits of modern living. These are areas we can address through functional medicine.
Functional neurology and sleep apnea
Sleep apnea can also arise in relation to traumatic brain injuries, childhood brain development disorders such as autism, or other brain-related issues. In functional neurology we can identify areas of dysfunction related to sleep apnea, such as with nerves traveling from the tongue to the brain through the brainstem. Based on findings, customized rehabilitation exercises may help address problems with sleep apnea.
Functional medicine and neurology strategies can profoundly improve both brain and hormone function so you not only sleep better, but also feel and function better. Ask my office for more advice.