Tuesday, December 4, 2007

The Paleo Diet As a Sleep Aid

I hadn't mentioned it before, but I have suffered from severe Obstructive Sleep Apnea (OSA) for many years (it was officially diagnosed by a sleep study done in December 2004), as well as a mild case of Restless Legs Syndrome (RLS) and occasional bouts of insomnia.

I was curious to see what effect, if any, the Paleo Diet might have on these conditions and, though my comments about it here are entirely anecdotal, I can tell you with some confidence that the Paleo Diet does play an important role in reversing, if not negating these conditions.

The RLS and the insomnia are gone. I noticed this within the first few weeks. Loren Cordain says, in The Paleo Diet, that your sleep will improve as a result of the diet and I believe he's entirely correct. This effect, plus possible repair of nerve damage that might be partially involved in my RLS, seems to have rendered it a thing of the past. As for the insomnia, I have had no trouble getting to sleep relatively quickly since about the third week of the diet.

Now, where the OSA is concerned, I didn't expect that to be affected by the diet, as the cause of it is a blockage of my airway by my soft palate and other tissues in my airway that relax when I'm asleep. However, this is not to say there hasn't still been a positive change in the amount and quality of sleep I'm getting - there has been. Nevertheless, I can still tell that I've had apneas during the night, as I still suffer some daytime drowsiness. But, the good news is that this has been reduced, at least to the point at which I'm feeling better rested, have more stamina and less drowsiness.

Even though I probably should not expect the Paleo Diet will reverse or cure my sleep apnea, a thought has occurred to me: if the soft palate, like all fleshy parts of the body, contains fat, then isn't it at least possible that the fat loss I'm experiencing as a result of the diet might also have the added effect of shrinking and tightening my soft palate? Pursuing this thought further, I did a little Googling and found the following on the Journal of Applied Physiology website:

Lateral pharyngeal fat pad pressure during breathing in anesthetized pigs

W. Christopher Winter 1, Tom Gampper 2, Spencer B. Gay 3, and Paul M. Suratt 1

Departments of 1 Internal Medicine, 2 Plastic Surgery, and 3 Radiology, University of Virginia Medical Center, Charlottesville, Virginia 22908

"It has been hypothesized that the pressure in tissues surrounding the upper airway is one of the determinants of the size and shape of the upper airway. To our knowledge, this pressure has not been measured. The purpose of this study was to test whether the pressure in a tissue lateral to the upper airway, the lateral pharyngeal fat pad pressure (Pfp), differs from atmospheric and pharyngeal pressures and whether it changes with breathing. We studied six male lightly sedated pigs by inserting a transducer tipped catheter into their fat pad space by using computerized tomographic scan guidance. We measured airflow with a pneumotachograph attached to a face mask and pharyngeal pressure with a balloon catheter. Pfp differed from atmospheric pressure, generally exceeding it, and from pharyngeal pressure. Pfp correlated positively with airflow and with pharyngeal pressure, decreasing during inspiration and increasing during expiration. Changes in Pfp with ventilation were eliminated by oropharyngeal intubation. We conclude that Pfp differs from atmospheric and pharyngeal pressures and that it changes with breathing."

So, it would seem there is something to my theory, after all. The tissues of the upper airway are the chief culprit implicated in obstructive sleep apnea. Further, this study confirms that these upper airway tissues are at least partly composed of fat. These tissues are found to put pressure on the upper airway, thus constricting it, causing momentary cessations in breathing (i.e., apneas). Now, consider that when one loses body fat, the loss of fatty tissue is universal; i.e., it occurs all over the body, as the body uses fat for fuel. This fat burning is indiscriminate; the body has no preference for fat in any one particular part of the body (hence the myth of spot reduction; i.e., the incorrect belief that sit-ups and crunches will removed abdominal fat). Thus, as fat is lost from all the body's tissues at once, it stands to reason that these pharyngeal fat pads are also losing fat - they are shrinking. If this is correct, then the tissues of the upper airway involved in obstructive sleep apnea might very well respond favorably to the fat-loss effect of the Paleo Diet. This might, at least, lead to reducing my severe case of OSA to a milder case, much as it was during the mid-nineties, when I first suspected I might have sleep apnea. This is encouraging!