Snore Centre eNewsletter February 2020

Sleep apnoea could be linked to the amount of fat on the tongue

When sleep apnoea patients lost weight, it was the reduction in tongue fat that lay behind the resulting improvements, researchers said. Larger and fattier tongues are more common among obese patients.

But the Pennsylvania team said other people with fatty tongues may also be at risk of the sleep disorder. The researchers now plan to work out which low-fat diets are particularly good at slimming down the tongue.

"You talk, eat and breathe with your tongue - so why is fat deposited there?" said study author Dr Richard Schwab, of Perelman School of Medicine, Philadelphia. "It's not clear why - it could be genetic or environmental - but the less fat there is, the less likely the tongue is to collapse during sleep."

Researchers at the Perelman School of Medicine, University of Pennsylvania, scanned 67 people with obstructive sleep apnoea who were obese and had lost 10% of their body weight, improving their symptoms by 30%.

By looking at the size of patients' upper airway structures, the research team was able to find out what changes had driven the improvements. The patients' weight loss also led to a reduction in the size of a jaw muscle that controls chewing and muscles on either side of the airway, which also helped.

"Now that we know tongue fat is a risk factor and that sleep apnoea improves when tongue fat is reduced, we have established a unique therapeutic target that we've never had before," said Dr Schwab.

The study is published in the American Journal of Respiratory and Critical Care Medicine.

"We know that weight loss is important as it can help to reduce upper airway narrowing," says Dr Nick Hopkinson, medical director at the British Lung Foundation.

"This research adds some information about the exact mechanisms involved, but there aren't any ways to reduce tongue fat specifically so it doesn't seem to have any immediate practical implications for people with the condition."

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Sleep position chart divides internet 

How do you sleep? That is the burning question at the centre of a big debate on social media. Whether you get a full night of snooze or find yourself restless when trying to reach the land of nod, what the internet really wants to know is how you go about it.

When jumping under the sheets, do you lie on your front or side? And are your legs completely straight or do you like to sprawl across the covers?

A picture depicting 18 different sleeping positions has gone viral after a man named Allan Bell shared it with his Twitter followers.

Alongside the image, he wrote: "I'm a No. 9, which are you? (Also if anyone says they are a 13 just what are you doing lol)."

In just three days the post has racked up 1.4k retweets and over 13,000 likes, with many debating which sleep position is "best" and which is just plain "weird."

Twitter users had a lot to say about the sleep chart, with one commenting: "Start off a 6 and progress through the rest excluding 12-13. Seriously, WTF are those two?"

Another added: "I'm close to 17, but it’s more like doing the tree in yoga. I’m beginning to think that might be a little weird."

"I rotate during the night into positions 1, 3, 4, 5, 7 & 14 rolling back and forth from one side of the bed to the other," wrote a different user.

And while there was essentially no particular overall majority, sleep experts have previously shared which sleep positions are best.

Neil Stanley, author of How To Sleep Well, revealed the most common way to sleep is in the foetal position, on the side with the knees tucked. However, the "ideal position" is sleeping on your back as it can reduce pressure on the muscles and joints - as long as you don't have sleep apnoea or snoring problems.

Sleep counsellor Sammy Margo agreed with this, adding: "Try not to sleep on your front, it’s the worst position for deep rest. If you sleep on your side, put a pillow between your legs, as this aligns your hips so you’re less likely to be disturbed by back pain. I encourage patients to learn to sleep on their back, with a pillow under the knees. There’s less strain on your body, you don’t crease and age your skin and your night creams absorb and work better."

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Study investigates whether marijuana can help you sleep

Medical marijuana may not provide long-term relief of sleep issues in people battling chronic pain, a new study finds, mainly because users may develop a tolerance to the drug.

The finding is important "considering the ageing of the population, the relatively high prevalence of sleep problems in this population, along with the increasing use of medicinal cannabis," said an Israeli team led by Sharon Sznitman, from the School of Public Health at the University of Haifa.

According to the study authors, chronic pain affects between 19% to 37% of adults in the developed world, many who have sleep problems. Some are turning to medical marijuana for help getting good shut-eye. But how well does it work?

To find out, Sznitman's group assessed sleep and pain in 128 patients who'd had chronic pain for at least a year. All were over age 50 and about half (66) said they used medical marijuana to help manage their sleep problems.

The type of sleep issues varied: About one in four patients said they always woke up early and weren't able to get back to sleep; one in five said they always had difficulty falling asleep, and 27% said they woke up during the night.

Of the patients who used marijuana, average duration of use was four years, using an average of 31 grams of the drug per month. Most (69%) said they smoked marijuana, and about one in five used either cannabis oil or vapour.

The study found that pot users were less likely to wake during the night, but there were no differences between users and nonusers in the time it took them get to sleep or in the frequency of early awakening. And there seemed to be a downside: The researchers found that more frequent marijuana use was associated with greater difficulty in falling asleep, plus more frequent awakenings during the night.

"This may signal the development of tolerance," Sznitman's team wrote. But the study couldn't prove cause-and-effect, so other factors might be at play. For example, the authors said that more frequent pot use might simply be an indicator that these people were in more pain or might be depressed/anxious. That might explain these participants' higher propensity for sleep problems.

One US sleep medicine expert said that for some patients with chronic pain, medical marijuana can offer "some hope".

The new study is far from conclusive as to the drug's benefits or risks, said Dr Margarita Oks, attending physician in pulmonary, critical care and sleep medicine at Lenox Hill Hospital in New York City.

Both studies were published in the journal BMJ Supportive & Palliative Care.

BBC Stories: Are you holding your breath in your sleep?