Tag Archives: respiratory system

Not Everyone Breathes While they Sleep: The Dangers of Sleep Apnea

You might think that breathing in our sleep should come naturally – if breathing and sleeping are both physiologically necessary, then we must be able to do them simultaneously right? Unfortunately, almost a quarter of middle-aged American men and nearly 10% of women suffer from sleep apnea, a chronic condition characterized by repeatedly stopping breathing while sleeping. The clinical symptoms seem rather benign – snoring, sleepiness, fatigue during the day or other issues sleeping. However, by far the most dangerous aspect of this disease is that it puts patients at increased risk of high blood pressure, stroke, coronary heart disease, as well as occupational and/or automobile accidents. Over the last several decades, a variety of therapy options have been studied to treat this condition, ranging from drugs to masks to surgery.

One of the earliest documented therapy options is using protriptyline to treat obstructive sleep apnea. Protriptyline is an anti-depressant drug that was used for its ability to clear airway obstructions during sleep; however, it did not gain significant popularity due to its adverse effects including cardiac complications and limited demographics for whom it would be an appropriate treatment.

The next treatment discussed was altering sleep positions for patients suffering from sleep apnea. A seemingly simple idea, a study determined that laying on the back significantly increased the severity of sleep apnea. Interestingly, the difference in severity between back and side sleeping positions was most noticeable in healthy, non-obese patients. The authors believe that lying on the back causes tissues of the throat to obstruct the trachea and prevent smooth airflow during breathing, as shown in the image below, which would explain why obesity can exacerbate sleep apnea.

Diagram of airflow obstruction through mouth and throat
Photo by Habib M’Henni on Wikimedia Commons.

Multiple non-invasive devices were also studied, including oral appliances, sleep posture alarms, and positive airway pressure devices. Oral appliances can either protrude the lower jaw or restrain the tongue; both aim to restructure the upper airway (mouth, trachea, etc.). Sleep posture alarms were suggested to train patients to sleep on either side, rather than on their backs. Positive airway pressure devices (Bi-PAP, CPAP) are the most commonly used treatment for sleep apnea currently; they maintain a consistent air pressure flowing into the mouth to ensure the airways do not collapse during sleep.

Man sleeping while using CPAP machine
Photo by ApneaMed

The final treatment studied was nocturnal supplemental oxygen (NSO), which involves increasing the concentration of oxygen in the air inhaled while sleeping. However, a study comparing use of a CPAP with use of NSO found that CPAP treatment was far more effective at decreasing the patients’ blood pressure and still proved effective in patients already taking blood pressure medication.

Overall, the best method for treating sleep apnea is dependent on the patient and his or her underlying conditions. Changes in sleep posture could greatly enhance the sleep quality of a moderate case of sleep apnea; CPAP would be ideal for someone who can easily tolerate the mask and does not frequently move in his or her sleep. Each of these demographics makes it difficult to define one optimal solution for treating sleep apnea, but the variety of available treatment options provides hope for those patients who suffer from this chronic illness.

How to Shine at Karaoke and Master the Art of Singing

Woman singing with microphone
Photo by Josh Rocklage on Unsplash

Are you tired of going to karaoke with your friends and not being able to master those high notes like singers Whitney Houston or Mariah Carey? While this blog post cannot promise the high quality of those amazing singers, it will demonstrate how through practice you can master the art of singing. To master singing you must first understand the biology and mechanics of your singing voice, so you can learn how to manipulate both to your benefit. This can extend to vocal production and communication studies, but the focus will be singing.

Diagram of vocal system including larynx, vocal cords, trachea
From University Physics Volume 1 on Wikimedia Commons

The vocal anatomy in the human body is composed of vocal chords, the larynx or voice box, trachea, diaphragm muscle, and airflow passages. Vocal chords, commonly referred as vocal folds, are flexible and delicate tissues that can withstand high frequency vibrations. The larynx is a tube in the human neck that holds the vocal chords. The trachea is a long tube that extends from the larynx and passes air to and from the lungs, otherwise known as the windpipe. Lastly, the diaphragm is a large muscle that separates the cavity containing the heart and lungs from the abdominal cavity. These definitions will become useful when discussing the process of singing.

 

Diagram of the respiratory system including the diaphragm, lunch, and trachea
From BruceBlaus on Wikimedia Commons

The organization Learn to Play Music described the biological process involved in singing in a blogpost. As humans inhale, the diaphragms contracts, the lungs expand and draw in air. During exhalation, the diaphragm relaxes, and air exits through the lungs. As air exits the “breath” travels upward through the trachea and vocal chords which begin to vibrate. This vibration leads to the production of sound which is then augmented (made louder) by areas of mouth, throat, and behind the nose. Additionally, these spaces allow the sound by vibration to last longer and affect the tone of a person’s voice. The shape of a person’s mouth, tongue, and lip movements can change the way the sound leaves the mouth by shaping the sound produced.

Music Professor Leigh Carriage at Southern Cross University analyzed how to use biomechanics to improve singing in an article. Singing involves varying pitches, loudness, voice quality (raspy, breathy, clear sounding) which requires control and coordination of muscles. These muscles must be flexible and strong which can be formed by practicing breathing control. To master singing a person needs to control the air pressure in their lungs and use their abdominal muscles to control the air flow. The most efficient way to control this pressure is through repetition or regular singing. This practice would strengthen the vocal system and improves vocal tone and power. Additionally, further expanding the abdomen when inhaling can lead to an increased contraction of the diaphragm. This would allow for more breath support when it comes to changing tone, pitch, or holding a note.

There are many biological and mechanical aspects to singing that can be analyzed to control the singing voice. See two additional readings here and here to learn more. Overall, practicing the control of your breathing during inhalation and exhalation helps master singing. By controlling the air flow, you can improve tone, pitch, and the power behind your voice at karaoke!

 

Check out this cool video!

 

 

The Study of Snoring is Anything but Boring

Here we take a deeper look about that noise that plagues some of our family members, our roommates…or even ourselves!

Elderly man sitting in the sun, asleep with head back and mouth open.
Photo by Stephen Oliver on Unsplash

What Causes You to Snore in the First Place?

The human upper airway contains anatomical parts that are membranous, meaning they lack support from cartilage. Some parts include the tongue, the soft palate, and the tonsillar pillars. A lack of cartilaginous support enables these parts of the airway to be susceptible to vibrations.

Anatomical diagram of the human upper airway.
Modified from Huang, Quinn, Ellis, and Williams, “Biomechanics of Snoring,” from Endeavor, 1995.

During sleep the upper airway muscles relax and cause the size of the airway space to decrease, resulting in airflow limitation and turbulence.

Whenever we inhale, the turbulent flow through the relaxed airway causes those membranous structures to vibrate and produce a sound most commonly known as snoring.

A Brief Mechanical Explanation of Snoring

Examining snoring in the view of mechanical systems, respiratory noise is created by the oscillation of the upper airway with the air passing through it. This oscillation is indicative of an issue with flow instability (turbulent flow) over a flexible structure (the relaxed airway).

An experiment was created to model the movement of the soft palate during snoring, where a piece of wood was used to simulate the hard palate and a piece of leather simulated the soft palate. The leather and wood were attached to each other inside of a rigid tube that was connected to a pump (meant to model the lung inspiration).

During inspiration, the leather flap oscillated until it reached its full amplitude. Upon reaching the maximum amplitude, the leather flap hit the wall of the tube and created a noise known as palatal “flutter”. This palatal flutter is the most common method of noise production in humans: snoring.

Is Snoring Something to Be Concerned About?

Young woman waking up in the morning, appearing tired.
Photo by Kinga Cichewicz on Unsplash

Approximately 44% of men and 28% of women are habitual snorers.

Snoring can be a symptom of obstructive sleep apnea, a condition distinguished by snoring and breathing that is labored by repetitive and obstructive gasps.

The fragmented sleep resulting from sleep apnea can lead to decreased energy and poor attention and concentration. Sleep apnea can also be related to vascular issues like hypertension and its prevalence appears to increase in people over 65 years of age.

What Are Some Remedies to Snoring?

Remedies for snoring range from noninvasive devices to invasive surgical procedures.

The surgical option to remedy snoring involves removing a portion of the vibratory tissue from the back of the upper airway. For those people wanting to avoid surgery, non-invasive solutions include the use of nasal strips to lift and open the nasal passages; experimenting with sleep positions other than sleeping on the back; or using oral appliances and nasal continuous positive airway pressure (nCPAP) to prevent the tongue and soft palate from collapsing into the upper airway. Losing weight, avoiding smoking and alcohol can also help to reduce snoring.

There are also resources for snoring in kids, as well as additional home remedies and surgical information regarding snoring.

Below is a great animated video which gives an introductory explanation to snoring.