106: Emma Cooksey, Sleep Apnea Podcaster, Writer & Speaker: Could Exhaustion & Sleeplessness Be A Sign of Sleep Apnea?

Welcome to the Sleep is a Skill podcast. My name is Mollie McGlocklin, and I own a company that optimizes sleep through technology, accountability, and behavioral change. Each week I'll be interviewing world class experts, ranging from doctors, innovators, and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper.

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Let's jump into your dose of practical sleep training.

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Welcome to the Sleep is a Skilled podcast. Now this episode, I really hope that you refer to if you are dealing with sleep apnea or if you know someone who is dealing with sleep apnea or you are someone that suspects you have sleep apnea or you are someone that maybe never considered you have sleep apnea.

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So I guess what I'm saying is that I hope that anyone listening really, really takes note of today's episode. Why? Because we are gonna be discussing all things sleep apnea with a actual great friend of mine. She's been fantastic in this world of sleep. To really, really bring awareness to the topic of not only how to discover if you have sleep apnea, but how to navigate sleep apnea because anyone that maybe believes that they have sleep apnea or has been diagnosed with sleep AP.

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Unfortunately, sometimes that's where it ends and people just say, Ugh, well, I'm not gonna wear the mask. Or they try and they fail, and then it becomes really an untreated problem. So Emma Cooksey is all about disrupting that. So really about sharing stories of other people with sleep apnea and herself. And helping to demystify this problem and really demonstrating how transformative it can be when you get up under this issue and treat it effectively.

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So a little bit about Emma. She is a podcast host and writer. She was diagnosed with obstructive sleep apnea at the age of 30, after more than a decade of unexplained health problems. Once diagnosed, she felt alone while navigating life with sleep apnea and adjusting to C P A P therapy. In 2020, Emma began hosting a weekly podcast, sleep apnea stories by sharing her journey and encouraging others to tell their stories.

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Emma has been breaking down stereotypes of sleep apnea while also raising awareness of symptoms and treatment options as a board member of Project Sleep, a nonprofit. Emma works to raise awareness about sleep, health and sleep disorders. And one of the things that we spoke about in this episode is just how often women unfortunately are left out of this conversation and some of their signs for sleep apnea are missed.

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So we get into more around how you can be on the lookout for possible symptoms for women that might look a little different than it might look for men or some of the traditional things that we might be thinking about that would denote sleep apnea. So without further ado, let's jump into the podcast.

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So I get a lot of questions around sleep supplements, and I'm very hesitant to just throw out a whole laundry list of possibilities. One, I don't think it's the most responsible thing to do. I really do believe in testing to see what types of supplements make sense for you. And two, because I really truly believe that most of the things that you can do to improve your sleep are behavioral, psychological, environmental in nature, and often don't cost a dime.

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However, there is one supplement that I personally take every day and that I do feel quite comfortable with suggesting for most individuals to experiment with because of couple of reasons. It's high safety profile and high rates of deficiencies in our modern society. Some put the numbers as somewhere around 80% of the population being deficient in this one area, and that is magnesium.

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So magnesium has been called the calming mineral, and some report that magnesium can increase gaba, which encourages relaxation on a cellular level, which is critical for sleep. Magnesium also plays a key role in regulating our body's stress response system. Those with magnesium deficiency usually have higher anxiety and stress levels, which negatively impacts sleep As.

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Now before you go out and buy a magnesium supplement, it's important to understand that most magnesium products out there are either synthetic or they only have one to two forms of magnesium. When in reality, your body needs all seven forms of this essential sleep mineral. So that's why I recommend a product for my friends over at Bio Optimizers, they have created something called the Magnesium Breakthrough, and taking this magnesium before bed helps you relax and wake up, refresh and energize.

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Again, that's the magnesium supplement that I use every single night by going to www dot mag. M a g, so mag breakthrough.com/sleep as a skill and be sure to use the code sleep as a skill for 10% off. And welcome to the Sleep is a Skilled podcast, Emma, I am so happy to have you here. Emma is just such a wealth of, uh, information, but also personal passion on a topic that I'm clear that one of the things that I wanna make sure we do a better job of on the Sleep as a Skill podcast is really, really helping to articulate the whole world.

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That is sleep apnea, which is just Emma. You can help, you know, educate us and fill us in. But it is just another language. There is just so much there. So I'm just so grateful that you're taking the time to help one on this podcast to help us understand this more. But two, taking the time to create what you've created, which is your own podcast, the sleep apnea stories, which I've shared to so many people.

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So just thank you so much for the work you're doing and thank you for being here. Oh, thank you so much for having me. Oh, I'm so grateful. I love your podcast. So it's exciting to get to be on here. Plus we're actual in real life friends now cause you've actually met. I know. Loving it. So cool. I mean, it was so great to meet up with you at Sleep 2022 and being able to just have some good old laughs and you had, uh, your little on the go speaker, you're like an investigative reporter.

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It was like a lapel microphone, but it worked. Oh my God. It was amazing. I was like, geez, I gotta step up my game. So yeah, it's just such an honor. I'm wondering if we can kinda start at the beginning for people to really just share how did it get to be that you were, you one certainly discovered your own case of sleep apnea, but then even took the steps to then create this podcast and really make this, you know, your life's work.

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How did that all begin? Yeah, I'd love to dig into that. It's my favorite subject. Yes. So I'm originally from Scotland, just in case anyone's listening and they're kinda. Strange accent, wonder where she's from. So I grew up in Scotland and then I did four years at university studying law. And then right after that I took a year and I went traveling around the world for a year.

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And so as part of that I was living in Australia, in Sydney and I was working for a big law firm there for six months. Well, sorry dad, it was okay. But I really was thinking I'm quite tired. You know, like the days seemed quite long and it just was quite grueling work. And you know, I was there lots of hours and every morning I would just think, wow, I feel really tired, but I feel as though I just didn't even sleep.

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And so that kind of progressed and got worse and worse for six months to the point where the last month I was there, I cried in the shower every morning. Ugh. So I was. You know, waking up in this house full of backpackers and most of them were working in bars and stuff, and I would just like, you know, take my shower and just have a good cry cuz I was so tired.

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And so at that point I started to think to myself like, there's something wrong with me. Like, this isn't normal. So I didn't have a doctor there, but when I got back to Scotland, I went to the doctor and I explained all of my different symptoms. So at that point I was having really bad headaches in the morning.

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Um, I was waking up a lot at night. I felt really anxious all the time for no, you know, there's nothing going on on in my life to cause any anxiety, but I just felt terrible and I was really tired. I had daytime sleepiness every day where it was a struggle to stay awake at at my job. So the doctor said, okay, well run all the tasks.

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So did lots of blood tests. I went back and he said, essentially, there's nothing wrong with you. He was like, yeah, I know all the things you're saying, but we just didn't see anything in the blood tests, so you're probably just a bit stressed. Um, and sent me away. And so that was kind of a theme that carried on for 10 years, all through my twenties.

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Um, so I know that we'll probably talk a little bit about women and how this experience coming different for, for women than it is for men. Um, but a lot of doctors are not looking for sleep apnea in women. So I would go with all of the symptoms of sleep apnea and I would be told, maybe it's a hormonal thing.

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Maybe you're having mood swings because of your hormones. Maybe it. Depression, right? Like people who are depressed have issues with their sleep and feel tired. So I just got no answers for the whole of my twenties. So then I got pregnant when my first child. So really quickly I moved from Scotland to Florida.

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I'd met my husband and we got married in Scotland, and then we moved to Florida and I had my first child, I was pregnant. And so we can talk a bit about it, but sleep apnea gets significantly worse often with pregnancy because there's weight gain. Mm. And that can be a factor that exacerbates it. So my sleep got significantly worse while I was pregnant.

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I had my first daughter and. Which was great, you know, all went really well, but I was so exhausted. And of course everybody's exhausted with a newborn, right? But I knew that it was not just that. So I went to the doctor and I said, I know you're gonna say that I have a new baby, and that's why I'm tired, but that's not why I'm tired.

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There's something wrong with my sleep. And they looked at me and they said, I know, but you have a newborn. So that's probably what it. Well, three weeks after that doctor's appointment, I was driving back, um, from my mother-in-law's house and I was on a really big bridge with like four lanes of traffic each side.

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And I got that feeling that I know a lot of people listening will be able to relate to where I couldn't keep my eyes open. And I was looking at the truck in front of me that was quite far away thinking. Keep some distance between you and the truck. The last thing I remember was looking at the license plate and not quite being able to read it.

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And then I woke up with a star and the license plate was coming right towards me in slow motion, really big. And I had to slam on my brakes to not hit the truck. So I fell on, fell asleep. And so that day I went home and I just was determined not to take no for an answer. And I phoned that doctor back and I said, I just fell asleep at the wheel and could have died.

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I need to finds about my sleep. So that was how I got a sleep study. And with the sleep study I got the diagnosis of obstructive sleep apnea. And from there I was prescribed a C P A P machine. So then I pretty much like, just like most people had no idea what I was doing, had no support. You know, they basically give you a C P A P machine and just leave you to get on with it and it's quite a difficult therapy to get used to.

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So I went through like every mask and all the different settings and everything. And so over like months and months I managed to kind of, you know, settle down with it. And it did start helping me. I didn't feel a hundred percent, but I definitely wasn't falling asleep at the wheel anymore. So that part was really good.

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Um, then sort of jumped forward, I kind of just went about my business. I had another child, so I had, then I had Katie and Rosie, and they. Five years apart and just, it was all really busy and I wasn't really thinking too much about my sleep. And then it got to be the summer of 2020. It was that period where my kids were home cuz it was quarantine.

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And I feel like all my friends came up with a project to entertain themselves, like they were baking sourdough bread or whatever it was. And I just always thought I should start a blog. I never see any women, like in the media or out there. I don't really see a lot about sleep apnea at all. Yeah. But when I do see it, it's only older, overweight men that are featured.

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You know, it's never women. It's never moms. So I kind of thought, well, maybe I should write a blog. But then I realized what I really like doing, as you can gather, is talking to people. So that's where the idea to start the podcast came from. And I started to sleep apnea stories, really not knowing. How it would go.

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Like my goal was really to just provide a platform for people to share their stories. And I just think there's a lot of power in that because I know from so many people that have reached out to me that they never, you know, heard of somebody like them. Like whether it's like an ultrafit, you know, I interviewed an athlete, I've interviewed several athletes now, but you know, like people are like, well, I went to the doctor and they said I couldn't have sleep apnea because I don't look like someone that would have sleep apnea.

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So it's really trying to shatter those stereotypes and also feature all the different treatment options because there are so many now, but we're not hearing about them because they're available from all different, whether it's a dentist or a surgeon or a, you know, it's all different people and it's not a very joined up system.

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So just trying to help people. Mm. Amazing. Well, one, thank you so much for sharing your story and sorry that I had to get to that point. So scary that it had to reach that to actually have that sense of urgency and be heard, or at least that's what I'm hearing from your doctors and what have you. And it's incredible that you advocated for yourself because sometimes people miss this altogether and don't connect those dots.

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So that's fantastic. That's very common. Ugh. So common. And so that's one of the reasons why I'm so appreciative that you're helping to bridge this gap for people, um, to say, oh wait, that's me. I have the morning headaches. And those things see themselves in what you're sharing. So I'm wondering, maybe we could start there is like, what are some of the symptoms?

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What should we be on the lookout for, and what are some of the symptoms that people totally missed, you know, and how are they different between men and women? Great question. I love that. So the first couple of things that. Are pretty difficult to ignore or almost everybody has daytime sleepiness. Yeah. So sleep apnea is a really strange condition where you can get people, like I've interviewed people who say, I only went to the doctor because my wife said I snored and I didn't really notice any problems.

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And Right. But that's not most people. Most people, if your sleep is really disrupted by sleep apnea, you're gonna be really sleepy during the day. Yeah. So that's definitely number one. The second thing is, hopefully I can clear up some confusion about this, right. So loud snoring can definitely be a symptom of sleep apnea, but you don't have to snore to have sleep apnea.

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So there are, especially women, there are some very quiet women who pause breathing. And wake up and with a start and feel really anxious and all of the things, but they don't snore. So they think they can't have sleep apnea, but that's not true. People definitely can have sleep apnea and not snore, but that is an indicator like if somebody is snoring loudly, equally, you can be a snorer who doesn't have sleep apnea, but it just can be an indicator that there's something not right with your airway.

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Um, so those are two big things. Let's see what else? Morning headaches can be a really big indicator just because you're not getting enough oxygen to your brain. So if you have a morning headache, which goes away over time during the day, That, you know, especially if it is kind of like clues, right? So especially if you have sleepiness during the day and you're snoring and you have morning headaches, it starts to build up to be something you should talk to your doctor about, right?

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So there's those things. Some of the things that I didn't know about before I start in my podcast, and I've had a number of experts, like different doctors and sleep specialists on, so there's a few d. Sexual health things. So erectile dysfunction in men? Yep. It's not necessarily, there's not enough research to say sleep apnea definitely causes erectile dysfunction.

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That's not what the doctor that I interviewed said. But what he did say was, there are people who come to him because of sleep apnea, and when they begin treatment for sleep apnea, they will come back and say, I had erectile dysfunction. And now it's resolved itself with the effect of treatment of the sleep apnea.

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So again, there's not a research study out there that shows one directly causes the other. Yeah. But that seems to anecdotally be something that's happening. For some men, there's also reduced libido. So people who notice a decline in their libido sometimes that. Be something that happens with sleep apnea.

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Also needing to pee at night a lot. So I think sometimes people think like, oh, I'm drinking too much, or something to do with my bladder, or whatever. People who have sleep apnea often wake up to go to the bathroom a lot of times at night. So again, if you have that along with some of these other things, it would be a really good thing to talk to your doctor about.

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Let's see, what else? Oh my gosh. I feel like I talk about this all the time and then I forget one. I know. No, there's so, brain fog Yeah. Is huge. Yeah. So cognitive function during the day, if you notice that you're, you know, not able to think of words. Yeah. Or you get halfway through a sentence and you don't know, you know, like what the end of the sentence is.

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Those kind of things like any, any sort of cognitive impairment, especially if they run along with these other things, can be a sign of sleep apnea. So then I'd also say for people with bed partners, It's really good to have someone observe you sleeping. So you can usually, if you have somebody just watch you when you're sleeping, an apnea will just look like a pause where you think is the person going to breathe again?

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Yeah. So, and then oftentimes when that pause finishes, the person will go like in gas at the end of it. So any sort of gasping, um, during your sleep and even people who are not in a relationship or don't have a bad partner, there's apps now that you can use. There's snore lab, like there's a bunch though, like all the different sleep apps usually track that.

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So you can just do that and it will usually, as well as the snoring, it will tell you if there's gaps where you're, you don't seem to be breathing cuz you're not making the noise kind of thing. Mm. So good. Well, those are great ones. A hundred percent. Yeah. Did we articulate two? Cause I, I loved what you said about the fact that you got missed.

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So Yeah, the last part of your question was to do with the differences between men and women. Yeah, I know. Sorry to throw 10 questions at you. I have a tendency. No, that's okay. I just was like, I think I missed something. Yeah, no, you're perfect. Yeah. So the last part. Sleep apnea can often show up really differently between men and women, and it also just shows up differently between different people.

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Yeah. It just depends why your airway is becoming block or obstructed. So with women, so the part that I missed out there was to do with mood and mental health. Right? Yeah. So it's worth saying, most people I talk to who've been struggling with sleep apnea, like there's some sort of mental health thing going on as well, because as you know, if your sleep is really disrupted, I mean, there's so many great things that are supposed to be happening while you're asleep to your brain.

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Yes. Yeah. And if you're missing out on that, it oftentimes it's, it's a mixture of that. And also the fact that what happens during an apnea, I should've maybe started with that, right? No, no. This is amazing. So much to cover. What happens during an apnea is your airway is becoming blocked or obstructed, or it's collapsing.

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So for some reason, and there can be multiple different reasons why that happens. Your upper airway is not working correctly, so the oxygen doesn't get to your brain. So what happens is your brain panics and says, oh gosh, like we need to wake up because we're not getting enough oxygen, and sends a lot of stress hormones.

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Throughout your body to wake you up, which is good cuz then you don't die. But then you have all of this cortisol and different stress hormones going on. And that can be why people are waking up with a pounding chest or feeling just unexplained anxiety all the time because they're kind of, when they're supposed to be sleeping, they're constantly being woken up and falling asleep.

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And yeah. So that's one thing that I think a lot of women that I've talked to, um, I've done a number of different interviews on my podcast, was women who have been misdiagnosed and told that they have panic disorder or they're having panic attacks at night or anxiety. Right. So they get diagnosis, having anxiety, which anxiety can stand alone as a condition.

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Sure. But with people with sleep apnea, oftentimes it's the underlying sleep apnea. Is the cause of that. And so treating the sleep apnea can help with the anxiety, but with women, the one of the things that's really interesting in, and I've obviously lived this as a woman with sleep apnea who went undiagnosed for 10 years, but there's so many things throughout a woman's life and hormonal fluctuations, which can almost mimic sleep apnea or sleep apnea, like, you know, it seems.

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Explains sleep apnea symptoms and so especially around pregnancy and menopause. So people during pregnancy, you gain weight and that can be a factor in either developing sleep apnea for the first time or worsening sleep that you already have. So that's actually quite common, but it goes misdiagnosed and undiagnosed all the time because OB GYNs aren't really trained to look for that.

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Yeah. So they're more checking on the health of the baby and making sure, you know, they're looking at some things like blood pressure, but they're not really digging into what's happening with the mother's sleep, which I think is a huge, really needs to change because obviously like imagine a mother who is stopping breathing multiple times an hour.

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Mm. The oxygen isn't going to their brain, but it's also not getting to the baby. So we're way too early. Like they're only just starting to research this stuff. But it's certainly, I mean, just common sense like that can't be good, you know? Right. So it would be better if more women were screened for sleep apnea during pregnancy, but the other one is menopause.

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Yeah. So during menopause, so yeah, in pregnancy people are told you're tired cuz you're pregnant. Right. You know, they're essentially just kind of turned away and not tested for sleep apnea. And then in menopause what happens is so many of the symptoms, so, so women are at greater risk of sleep apnea sort of during and after menopause.

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It's partly weight gain, but there's also other elements that feed into that. And I'm not researcher, so I Yeah, sure. But certainly there's a lot of people researching like those links. Yeah. And so what happens though is, Doctors see women and they say, I'm having disrupted sleep. I'm getting up to use the bathroom a lot at night.

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I, um, am having really big mood swings and you know, like mental health issues, like all these different things and lots of doctors are saying, well that seems like it would be menopause and would be normal to go along with menopause. So it can be really difficult to tease out what's happening. But I think that if people have like daytime sleepiness consistently, even though they're sleeping for long enough at night, that's, you know, they're having a full night's sleep.

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I kind of think like the daytime sleepiness really needs to be investigat. Uh, hundred for people. Percent. Yeah. And you know, some of the things that we can see the unfortunate courses that people end up going down when they are going into their doctors, and unfortunately I think it's a systemic problem.

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Their doc in our current situation in the West, the average doctor is getting around two hours of training in sleep, period. Yes. I mean, and that's out of Harvard Medical. So good luck getting even any sort of knowledge cause they just don't know. And unfortunately we, we've got a systemic problem here that is real gap in a missing of the prioritization of this thing that we do a third of our lives.

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So what ends up happening, because they don't have the screening available for themselves to then screen you properly. So then what ends up happening is we often see then people are being put onto different medications for the mental health concerns or cardiovascular concerns or all the systemic fallouts here.

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So I really appreciate that you're helping us to get more towards what could be the root cause for so many people. So it's just, I think, I mean, that's. So true. Like, so true. But I also think that Sam Khan would have an argument with me. But so Dr. Khan is always like, well, we just need to change the whole system and train those doctors.

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Yeah. And make sure that they know more, which I totally agree with them. Yeah. But in the meantime, I think empower as many patients as you can to say, and you really do have to advocate for yourself. You do. You have to say, I have all of the symptoms for obstructive sleep apnea. Please refer me for a sleep study.

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Yeah. And one of the other problems about screening, I mean it is even getting a doctor that knows enough to even know that they need to screen you for a sleep apnea. Right? Yeah. Like good luck. Even the ones who know about sleep apnea, they're using quite often screening questions that really are more skewed towards older, overweight men.

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Yeah. So there's no doubt that there's a lot of sleep apnea in that population. Right. Which is why they do it statistically. They're like, well, if you're, you have a much bigger neck and you're an older overweight man, you're statistically more likely to have sleep apnea. Right? But the problem with that is that those are the people that they're looking for, and those of us who definitely have sleep apnea but don't fit a lot of those criteria, just don't get even on screening tests.

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You know, like even though I have sleep apnea, I still would not pass that test. Yeah, a hundred percent. Yeah. And to your point around the empowerment and taking the time to learn for all of us, I think there's a real opportunity and also this kind of sleep renaissance that's kind of happening where we're starting to see more and more companies making it easier and easier.

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There's certain companies that within 24 hours you can get a sleep test available to your home around 200 bucks or what have you. And so that's what I'm so excited for. Right. Cause it's really changing. At the moment. I'm putting together a little series for my podcast, which will come out in January, and I'm speaking to different patients who have used all sorts of telemedicine home testing for this.

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One of the things I do on my podcast is just kind of provide an opportunity for lots of grown men to cry. But I had an ex-marine who had been struggling with this stuff for so long, and he had been to the doctorate and he'd been for the sleep study. He has sleep apnea. They gave him a sleep AP machine.

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He had no support and he, he just abandoned it. Yeah. Which is what happens with so many people. So for good reason, right, because it's difficult. Yeah. And you need support. But he used a company, one of these companies where he did the telemedicine appointment and they just like, Held him by the hand through the whole process.

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And even after he got his machine, he had someone talking to him all the time about how to, you know, which mask was gonna work for him, how to improve his settings for his comfort. And after years and years of having to sleep in the other room, he got to move back into his bedroom with his wife. Mm. Oh, that's life changing sometimes it ma, it makes the people's lives is huge and I think oftentimes the current system is failing people.

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I could not, not agree more. So I'm excited for a lot of those. Like, I think that that's the way it's gonna go. I think that the better wearables get and then the better that telemedicine support gets those things together are just. Make it so much easier changing people to get diagnosed. Yes. So huge. So with that, well one, I think I highly recommend and have shared for so many people to check out your podcast because you know, it's called sleep apnea stories for a reason because you create a forum in which people can share their stories, but also share their victories.

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So if anyone is listening and saying, Ugh, well all right, fine, maybe I, I was either diagnosed with sleep apnea, but I don't quite know what to do next or had struggled with my current options that I went through and they didn't fit for me, but I need more guidance. Like you answer those things. Or if people are.

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Questioning, oh, maybe this is me. I better get tested. Then there's a whole world of steps and actions that can be taken. Yeah, I mean the, just even the oral appliance options that are available just in the hundreds and hun, I mean, just so many in alignment with C P A P and maybe both in tandem. I mean, there's so much that can be taken on.

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So I think one of the needs I think that my podcast is trying to fill is that whole, so the current system, a lot of times what happens is people will go, they'll get tested, they'll have sleep apnea, and then be prescribed a C P A P machine by a sleep specialist, and then that's kind of all they're offered, right?

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Yeah. But actually there's more of a spectrum of different treatments available, but it's just knowing where to go and which specialist to ask. So especially, so you mentioned with the oral appliances, so one of the big things about that is. Finding a specialist dentist that can fit one of those for you.

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Yeah, so that's one of the thing. I mean, I've had lots of people on the podcast talking about it, but really with that, you wanna start with the American Academy of Dental Sleep Medicine and find a provider near you who's. Done all the training in this and can really do a good job thinking that. But also, well, we haven't, this is a total tangent, but we haven't even talked about mild, moderate, and severe.

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Yes, yes, I know. That's the struggle I have in our conversation is to not take hours for you. I know I have 9 million questions I want to be able to bring to, so yes, please, if you, if you do have the time, please share that. So really quickly, the, the treatment options are gonna largely depend on how severe your sleep apnea is.

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So side note, this is kind of an odd thing about sleep apnea. So there's a thing called the apnea hypo apnea index. Yeah. And what they do is the sleep tech who scores your sleep study marks how many times you stop breathing for 10 seconds or more. And then they also look at what's called a hypopnea, where your airway narrows.

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It doesn't completely close and shut off the air, but it, it drops your oxygen. So they look at your oxygen desaturation. So since everybody listening's, probably techy, you know, probably like all that. So they look at that, they give you a score, and so the ranges are, so they reckon anything below five they consider normal.

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Even though I've talked to a lot of people who are stopping breathing four times an hour and are exhausted as you might imagine. So that's a whole nother thing. But as far as a sleep specialist is concerned, anything below five is just normal and you don't have sleep apnea. So for those people, there's another thing called upper airway resistance syndrome, where you would probably have to go to like either get the actual results of your test and go to a sleep tech who can individually tell you if you have a prayer resistance syndrome.

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So that's a whole nother show. But then if you're between five and 15, then that's called mild sleep apnea. Between 15 events and 30 events is moderat sleep apnea. Anything above 30 events an hour is considered severe. So the reason that's important is for the oral appliances you're talking about, those are FDA approved for people with mild and moderate sleep apnea.

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So if you have less than 30 events an hour doesn't work for every single person, but it it's definitely an option that, that you could try. So they tend to not recommend those as much for people with severe sleep apnea just because the data isn't as compelling. Yeah. So for other things that people can do, so people that are in the mild category, it's kind of different from moderate and severe.

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Moderate and severe. If you leave the sleep apnea untreated. They reckon your chances of long-term like stroke and harsh attack and all sorts of comorbidities goes way up. Mm-hmm. So it's really important to get some sort of effective treatment. Yeah. For mild sleep apnea, the same can't be said. So with mild sleep apnea, I think it's always a great idea to find something that'll help you to breathe better and sleep better at night.

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Right. So if I were you, I would totally try and find like an oral appliance or something that would help. But as far as like long-term health consequences, it's not quite as dire for people with mild sleep apnea. One of the things that just came on the market is the XI O s a Yes device, which you probably already talked about on your show.

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Yes. Essentially what that does is tones and strengthens your tongue, and often your tongue is involved with blocking your airway at night, and so they're still kind of in the clinical trials. They're still looking at what it does with moderate sleep apnea, but certainly it's approved for mild sleep apnea right now and snoring too.

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And so it could be, if you're in that category, that might work for you. I interviewed a couple of people that did that, and you, you actually use that device during the day and it just helps, you know, to tone and strengthen everything and improve it. So that's another option for mild sleep apnea. And so hopefully that's gonna be, it'll depend what their clinical trials say for, for moderate sleep apnea, but maybe it'll help.

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The rest of us too. I dunno. Absolutely. And then some other things are the Inspire Implant. So essentially what the Inspire Implant does is they implant it in your chest and they run a tiny wire up to your tongue. And it essentially as you breathe in, or inspire, which is why it's called that, it moves your tongue out of your airway so you can breathe.

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And so for some people, not for everybody, but if you're, you can go and see a surgeon that does that operation and they can tell you if you're a good candidate or not. But for some people, that can be a total lifesaver game changer. So that's another. So many options and yeah, there's a lot. And how about like the airway stints and vivos and all of these, you know, just goes to the Yeah.

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The bespoke element of this, how it really does depend on what each individual person is dealing with. Yeah. For, for those, some other ones, for a lot of people, so for some people they have sleep apnea because they have, maybe they had a big weight gain and there's more pressure on their airway and, and that's the main reason, right?

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Other people have something where their airway didn't really develop properly, and a lot of that is to do with. Mouth breathing as a child, oftentimes people have low and forward tongue posture, which means that their upper palate didn't expand properly and they develop as mouth breathers. They're, they're not nasal breathers, and that's really important when it comes to sleep apnea.

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So there's a couple of different removable appliance options. There's either Vivos or Homeo block those, I mean, we're still really waiting for enough data on that, right? Yeah. To kind of see exactly how many people that helps. Like I've interviewed, I've certainly interviewed one woman who's here in Florida, who that worked really well for.

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She wore these appliances for two years, and her a HHI went from severe to less than five. You know, and it solved her issue. And so usually the expansion thing is happening along with myofunctional therapy and also breathwork, particularly BCO breathing. So you're looking at changing your functional breathing patterns to nasal breathing and not mouth breathing.

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So, yeah. And so people are interested in that. You've probably talked about James Nester's book breath. Yes. But that's usually where people start, and then you go down the rabbit hole from there. Yeah. But as far as like other pallet expansion options, the reason that that helps people is expanding your pallet.

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If you imagine your, no, your roof of your mouth is the floor of your nose. So the theory goes, um, expands your nasal airway. So, so your nasal cavity gets larger because of that. So again, there's not really enough. Data that they've done to say, do this and it will definitely get rid of your sleep apnea.

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It's not like that, but depending on the individual person, it depends what you have going on. And if you find a specialist dentist who really knows about this stuff, they can kind of advise you more. The other options are, have you talked to traditionally trained dentists? They'll tell you it's not possible to use a removable appliance to expand your upper pallet because they think the P will suture, uh, fuses an adulthood.

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So a lot more sort of accepted by the dental community is doing Mar or Sarie or Ms. E. There's these different ways of, what they do is make an incision and cut your palatal suture and. Expand it using various different devices. So that's another option. And that leads into double jaw surgery. Oh, yes.

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Where some people do, and yeah. Can be really effective for some people. Yeah. In expanding their airway, meaning they don't need any sort of C P A P or oral appliance at night. So yeah, there's a lot of different options. There's a lot of different options. Okay. Well then having said all. One, I think one of the things that you're pointing to is just, this is not a one and done.

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It's not where you get diagnosed with sleep apnea, no matter, mild, moderate, severe, upper airway, airway resistance, and then you get this one thing and then you're done. For li, like you have to actually actively educate yourself and advocate for yourself if you shared so that you can be at the source of, okay, this, this worked a little, but we also need some tweaking here.

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Or, this didn't work at all. We need something totally different. You have to really be at the source of this end. Yeah. But what's on the other side of that? And I'm sure with your stories that you've shared with people and for yourself, a whole other world, that opens up of feeling rested and having some of these just fundamental shifts in the ability to feel at ease, the mental clarity, the lowering of anxiety, the mood stability, uh, cardiovascular.

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I mean, just the list is endless. I mean, honestly, for a lot of people, The ability to work. Yeah. And basic human needs maintain relationships. Yeah. And like it really is. I think that sometimes when I speak to people who, you know, have had a really bad experience and which I totally understand, like some people haven't been supported through the C P A P thing at all.

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Yeah. And they haven't been told there's any other options and they just got really fed up with it, which I understand. But I also look at the future health events that you're preventing. Like it's difficult to think long term, but I've interviewed a number of people now that have lost loved ones to untreated sleep apnea, and it is really serious.

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So I think. It's that, but it's also, like you say, the improved quality of your life is huge. Huge. Like, you know, going from falling asleep at the wheel and just not even having any energy from my kids to being able to actually, you know, function. Now I'm not a great success story cuz I don't think my journey's over yet, Molly.

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But, but a lot that makes you even better I think because, and listen up people, because that makes me even more encouraging of people to listen to your podcast because you're in the thick of it and you're helping to shepa. I do it all. Yeah. Sherpa. I feel like there's, there's nothing that I'm not trying.

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Yeah. Which we want. We don't want someone that's all perfect and now they're fine. Like, no, but I, I also, I also think it's one. Things that's really misunderstood. Yeah. By people because this changes a lot over your life. Yeah. And there's a lot you can do to really take control of your health. So like my most recent excursion has been into, so I have a lot of different allergies and so recently anti-inflammatory eating.

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Like yes. There's been a number of studies where they've talked about not just for sleep apnea, for a lot of chronic conditions about how following like an anti-inflammatory diet can really help improve how you sleep at night, but also like the quality of your life the rest of the time. Yeah. When you're awake.

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Yes. So that's one of the things I've been experimenting with and it is really astonishing the difference. I know that, you know, people are all different and it's important to have. Testing with a doctor or you know, wherever you go. But for me individually, I have the issues with gluten and with dairy.

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Yeah. And so I find it's completely different, you know, a day where, I mean, I pretty much just don't really dabble with them anymore just because my sleep is so much worse. Yep. You know, percent, there's things like this that you learn over time that can really help. And one of the other elements to all this is your nose and having a functioning nose.

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And so many people have problems with their nose, and that really feeds into problems with C P A P because you're really supposed to breathe through your nose all the time. But so many of us have, um, either what we talked about before where it didn't develop, our face didn't develop properly because of the way that we were mouth breathing and didn't have the correct tongue posture and all these factors.

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But also a lot of people have deviated septums and turbinate problems and things that are exacerbated by allergies and inflammation. So that's a big factor. So sometimes for some people, seeing an E N T helps them, right? Yeah. So I've talked to people who have been to an E N T and had tonsils removed and surgery done to their nose, and they go from having sleep apnea and struggling with C P A P to not having it anymore.

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But you know, that's not every person. So the whole thing I was just gonna say about diagnostic testing, like we have sleep studies, which shows what's happening after your airway collapses or is blocked. But the only real test we have to show what's actually happening in someone's airway at the moment is called a DICE procedure, a drug-induced sleep endoscopy.

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And those are really expensive and not available to most people. And they do them usually as part of, like if you're going in for another surgery, they might do it at the same time. And essentially that kind of shows them how your airway is collapsing. Which areas to focus on or, or whatever, like, especially if they're doing some sort of surgery to your throat.

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But for most people we don't have that. So a lot of it is a sort of trial and error. This treatment worked for me, this one didn't. And you know, it can be frustrating and a long journey, which is why you need a supportive gang. Yes, absolutely. Well, for anyone listening, make sure that you get connected to Emma's gang because she is created just so many different kind of allies in this conversation, and with project sleep and all of these different things that, you know, really helping to share that we don't have to be alone on this journey.

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Right. That they're. Many people and many companies and nonprofits and for-profit and all these different opportunities for other people to be along the journey with you. So I so appreciate that. And maybe one of the things we might be able to learn more about is by understanding how you are managing your sleep apnea right now.

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And I love how you're open about the fact that you're like, I'm still, you know, it's improved but you're still, you know, doing all these different things. So I think it will be really cool for us to see, well what are you doing? What's the latest? So we always ask people four questions and our first one is, what is your nightly sleep routine looking like right now?

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And I'm very curious to hear what the latest is. Okay. So my nightly sleep routine is, I make sure that I have nothing to do with my children's bedtimes. Great. Because they, they got older and neither 15 and 10. Yeah. And they stay up too late for me cuz I go to bed really early. Yes. So I usually. Go. I feel like I don't do all the right things because I'm probably on screens too late for you.

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All. Good. So I interviewed Olivia Ala Hmm. Yes. And she was telling me about these light bulbs that don't have like the, they only have a certain type of light. They don't have blue light or whatever. Yes. Uhhuh. So I have that in the lamp on my bedside table. So I feel like I'm crushing it with that. Yes.

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And then what else happens in my routine? I always have a warm shower or a bath. Great. And wash my face if I'm really crushing it. Yes. And then I. Get all situated with my C P A P and yes. What does that look like? Tell us everything. So what that looks like is, so cleaning ccp, P A ps is a whole thing. Oh, yes.

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Which I spend a lot of time on Instagram and on my podcast talking about. So everything's already super clean by the time I'm there. Cause I've already done that earlier in the day. And then I am essentially just make sure that my humidifier is completely full with distilled water. Good. And then I go to sleep and I think that's about my only routine.

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I don't, I would lie and say that I do yoga and stuff, but I don't. No, nope. I appreciate that. We, we wanna keep it real. Right. Okay. So I'm curious your thoughts on the mouth tape piece, any outs there? Any concerns? Okay. Cautions, anything? So here's the thing about the mice tape. If you can breathe well through your nose.

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Yeah, I think mice tape is a great idea. Yeah. If you can't breathe super well through your nose. I mean, I think honestly, with the mice taping thing, I think it's a great idea to just. Get checked if you have any concerns about it. Like most people who have no problems with their nose are just gonna shove my safe on and be like, this is great, and try it out.

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Right, right. Sure. So if you have concerns that you can't breathe properly through your nose or you can't get enough oxygen, then I would go and see either a myofunctional therapist or an E N T. Yeah. And have them look at your nose and just kind of say that you're thinking about my taping and see what they say.

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So for me, I sometimes do do my taping, but I usually use like myo tape. Yep. Which goes around your mouth. Mm-hmm. Or you can actually do the same thing with Kinesio tape. Mm-hmm. You can just like cut it and it doesn't actually go in front of your mouth. So those are ideas just because I think a lot of people using C P A P worry about.

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I mean, you'd probably have to try hard, like with some of the mouth tapes on the market to actually like breathe them in or something. Yeah. But if you're worried about any of that, there are options that don't actually go in front of your mouth. They just gently keep your mouth closed. But certainly keeping your mouth closed is really important for any c p user.

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Sure. And it's really important generally for people with snoring and sleep apnea. Yeah. Because the worst thing, you don't want to be lying flat on your back with your mouth open is just like the worst. The worst. So, and I have my video about that have like, yay three tips for start to sleep apnea. And so, and I think that they would work for anybody.

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It's really about the best position to be in so that you don't snore. And obviously that. I love that so people can check the out. So helpful. Thank you. Yeah, cuz it is layered, I think now it's, you know, become this thing that's Oh, another hack. Okay. Yeah. Throw some mouth tape on. And there are considerations that we wanna really be clear on.

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So thank you. And I think all, especially people who are doing it because they're snoring. Like I've, I've seen on social media a little bit, like there's people who are like, oh, my husband was snoring. I made him use my tape. But I'd rather that they look at like, why is he snoring? Yeah. And does he need to go and have a sleep study just to check that he doesn't have sleep apnea?

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Because Yeah, if you have sleep apnea and then you just put tape on your mouth, that is not gonna solve your sleep AP definitely not. Wouldn't that be nice? Yeah. If it did, I would've already figured that I, yeah, we would've invested in mouthy companies. So at the moment I'm not doing. My type is much, but it depends.

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Yeah. So my nose is tiny. Yeah. And I have the allergies and all the stuff. Yeah. So if I'm not eating dairy and gluten and I am doing my nasal sprays and it's not any major allergy, like seasonal allergy situation. Yeah. Then I'll sometimes my tape, and I do know it's the difference. I do think it's better, but one of the reasons.

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Not good for people to sleep with. An open mouth with C P A P is, especially if you have a nasal mask or a nasal pillows mask. Yeah, it really affects whether your treatment works because if you have your mouth open, any sleep tech will tell you that the pressure isn't going into your airway to open. You know, like it's affecting your pressure cuz the air.

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Goes in your nose, not your mic. Absolutely. Ugh. See everyone, this is why you need to check out her podcast because clearly there is so manys layers. There's so much. There's so much. Oh my gosh. It's so, it's wild. So, okay, then what may we see with your morning sleep routine? And we say your morning sleep routine on purpose, because we, um, are pointing to that how you're managing your day really does impact your results with your sleep.

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So curious if there's, I think you're gonna be really impressed with me, Molly. Okay. So here's what I now do. In the morning, I stumble out of bed. I used to make myself get up really early and yeah, get my kids ready. And now they just basically want to be left alone to get ready on their own and they don't need me.

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So now I wake up and I straight away put on my running shoes and my. Like, you know, workout clothes that I put out the night before. Oh my God. And I walk around my circle. I live on a circle. It's really suburban. Yeah. So I walk outside in the morning sunlight, which is really good for my sleep. Yes. So I usually do, so it's like 2.4 miles.

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So I do, I always do one circle. I sometimes do two. It depends. Ooh, look at you. And I look. So that's kind of my morning. And then I come back and, you know, get ready and start spreading awareness of my sleep apnea full day ahead. The fact that you do that first part is like half the battle for so many people just to start that kind of circadian process.

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I, you know, letting our bone and the other, what I love about my walk is how many things it layers, right. So we've got, we're have it stacking. Yes. So we've got the outside. We've got the social interaction with people that I go, Hey, and I chat to 'em every morning. Yeah. And which is really good for your mental health and people are not doing that.

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Chit-chatting with people on your morning walk is huge. Oh yeah. We're about to have, um, Sonia Leber murky on the podcast, which we're so excited about, who wrote the How of Happiness and big researcher on Happiness. And that's one of the things she speaks to is it's huge connections and then includes, you know, connection with the local, say hi, clerk can say hi.

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Yeah, that's it. Yeah. Yeah, definitely. So good. Thank you for that. So yeah, there's that. And then I also, so I did do myofunctional therapy for a number of months with a myofunctional therapist to help me retrain to nasal breathing and have my tongues somewhat where it's supposed to be. Yeah. Still working on it.

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Uhhuh. But, so in the morning I do some. So while while I'm on my walk, I'm making sure that I have my tongue in the correct position on the roof of my mouth. Yes. And I also do some bot potato breathing exercises. Oh, stacking it all. See, so yeah, stir the day. Right. So I think sometimes people are like wondering like, well, why would you do that during the day?

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Like, how is that helping your sleep apnea? But partly how you're breathing during the day does feed into how you breathe at night. Yes. But also just that having your tongue in the correct place and doing correct breathing improves the quality of your life. Yes. So really, really, Calms you down. Mm. And so I really don't, I've always struggled with anxiety and I noticed that that is a lot more under control.

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The more that I breathe correctly and the more I have my tongue in the correct position. I love that. And it just points to, you know, for me personally, I felt I can now say that I feel grateful for what I went through with my sleep. You know, my periods of insomnia, my rock bottoms in my life, because it's actually taught me so much about what you can bring in.

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Yes. Your own level of self-efficacy to help support your life and the workability to your life. And look at just this amazing knowledge bank that you have available to yourself and to share with others. It's just, Fantastic. Okay, so great. So you got this great morning routine and stacking and all these things are here.

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So then what might we see on your nightstand or maybe proverbial nightstand. So meaning even when you're traveling, like what's there? Yeah. I, on my bedside table, I have my c a p machine. Yeah. But I have it on like a sort of fancy looking tray. Ooh, ok. This is new. Tell me more. Someone, one of my Instagram followers sent me this, this picture of this amazing, she had like her CPA in a sort of basket Ooh.

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That ooh. Was kind of like a rustic basket with, and you couldn't see the CPA really? And, and she was just like, it looks amazing. I was like, it does look amazing. So I don't have that, but I have like a, a tray. And then I have like kind of all the stuff that goes with my C P A P right there, and, and, and then I always have books.

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I should have looked before I Oh, that's ok. Ok. Oh, actually what I'm reading right now is an advanced copy of Amy Porterfield's books to his Oh, great. Notice. Yeah, so that is literally what's on my nightstand. And I usually have like, I don't know, printed out sleep apnea research and a highlighter pen and that's kind of the main thing.

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That sounds like my nightstand. Fantastic. And the lamp with the not blue light. Yes. Fantastic. Light. Mindful, I'm just trying to like, you know, score points with you got all the points. Technology, like I have my, I don't like, like I kind of dabbled with, kind of had an Nora ring for a while. Yeah. Which I still have, but I kind of, I do it like once every few months.

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Yeah. Because if I do every night I get obsessed too much. Understood. No tech, just like my phone's plugged in the other side of the room. That's it. I think there's, I think there's something really to be said for that simplicity, minimalism, even from an E M F perspective, but then even just from a mental kind of perspective, I think that's fantastic.

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Then the last question would be, what has made the biggest change to your sleep game or maybe the biggest aha moment you've had in managing your sleep? So I would, there are so many. I know. Yeah. It's a hard one. I know. Same. There are so many. So I think the biggest one is finally, Giving myself permission to be okay for my husband to sleep in the other room.

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Oh, I love that one. That's a huge deal. And we got a dog, so we have a dog called Bear. I don't really think of myself as a dog person at all. Yeah. And I said no for the longest time. And then my kids just would look at me like so sorrowful. And finally we got this dog. So we've had Bear for about two years.

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And of course I love him. Yeah, of course. But I definitely just with dealing with C P A P and having sleep apnea, I, even though it's well treated and all that, I still get irritated if I get woken up. So I'm okay with like, I'll wake up from time to time and shift my mask or use the bathroom or something.

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But when other people wake me up, it just really aggravates me. So, to begin with, when we got the dog and my husband was, you know, sleeping next to me, the dog would come in, the dog would go out. And it was waking me up and so we kind of talked about it and my husband's fine with, you know, whatever. So yeah, he started sleeping in in the other room and with the dog, our dog is so spoiled, but that really just made me feel like the cam of nobody is interrupting me.

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Yeah, it's a little bit, I feel a little bit bad cause I hear my husband telling my kids like, don't wake your mother up. But it's so, it makes such a difference to the next day for me if I'm not interrupted by anything. So that really has been a huge. Positive for us.

I love that you say that because, um, we had, uh, Dr. Wendy Drexel on the podcast and she was speaking to her book, sharing the covers, and really trying to help people explore this topic. You know, it gets this dramatic name, a sleep, divorce, or like all the triggers that go off in our brain of like, well, this must be a problem. Oh my. But really she's pointing too that there can be so many times where that can make such a tremendous difference for people.

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And it can be a real strategy to ensure that you're both happy people getting, managing your sleep effectively. And sometimes people are different schedules or, you know, considerations or habits or whatever. And so it can just be a game changer so that you're actually available mentally, physically, emotionally, to, you know, have a great relationship.

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Yeah. And or get at the source if someone is snoring and that's keeping you awake, well let's check them for sleep apnea. Let's get, you know, treatments. So then we can, if we do choose to share the covers, great. If we choose to go in different rooms and we do share the covers at other times, I don't want people to be worried like, our marriage is great, it's just that while we're actually sleeping.

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Yes. Like well said, I don't wanna be woken up by other people, so, oh my God. I love that asterisk. I think, uh, Wendy would love that too. We do actually share the covers when we need to share the covers. Yeah. That is amazing. Well, that is, I'm so glad you pointed to that one. Cause I thought for sure you would say sleep apnea, but I think that what's so great is that you're actually pointing to that this is, there's so many layers to sleep.

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Yeah, and I think, so one thing that we, I mean, we could talk all day, and so I think that one of the things as well that needs a lot more attention is the fact that people that have sleep apnea or any other sleep disorder, they can still struggle with other things that anyone is struggling with with their sleep.

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Right? So there's so many people that have sleep apnea and have co-occurring insomnia at the same time. Absolutely. So the thing about that, like I know that you had Dr. Shelby Harris on your podcast and I had her on mine, and so on mine, we talked about how these two co-occurring things can both be treated.

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Yeah. So people don't have to struggle with, they feel like they sleep badly because they have sleep apnea. Well, Sometimes that's co-occurring insomnia, which she can also treat with C B T I or another treatment, you know, to treat them both at the same time and just get the best sleep you possibly can, so, absolutely.

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Oh, so good. Well, the last thing I wanna say for you is how can people follow you? I'm sure people listening are like, wow, okay, this woman knows her stuff. I need to be a part of what she's doing. And so how can they do that? What are the best, uh, So there's also some people listening going, oh gosh, I'm glad that my partner is not listening to this because she would make me go and get Yeah, the best way to reach me.

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So I'm on social media wise, I'm only really on Instagram. Yeah, reliably. Same. Yeah. So my Instagram handle is sleep apnea stories. And then, um, you can go to my website. I talked a little bit about, I've got a free video, about three top tips for like, you know, the best positions to sleep in for sleep apnea and that kind of thing.

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So people can go to my website, which is sleep apnea stories.com. And I also just really quickly wanted to mention, I'm on the board of directors for Project Sleep. Yes. So that's a nonprofit run by patient advocates with sleep disorders. And so we have a lot of big goals around raising awareness about sleep health, sleep equity, and sleep disorders.

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So that's also a good place to connect with this community of people with sleep disorders. So you can find project sleep on any social media. Project sleep, and then their website is project sleep.com. So Good. Oh, well thank you so much for the work that you're doing for the difference you're making. Um, thank you for the work you are doing.

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Aw, well I so appreciate that. It's so wonderful to be connected with you, like you said, to the fact that we got to meet in real life and just I know, and I know more and more to come and I'm just so excited to continue to follow you. And I really, again, I, I can't underscore how much I appreciate your honesty and vulnerability and sharing, like, I'm still on these journey.

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I'm, I'm discovering this myself, which I think, again, I'm not meaning to overstate it, but I think that just is really helpful for people listening because it allows you, so Yeah. Right. It makes it accessible and you're helping to guide us and really share what you're discovering and the conversations you're having, and it just makes a huge difference.

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So appreciate you and appreciate you taking the time to. Thank you so much, Molly. You've been listening to The Sleep Is A Skill Podcast, the number one podcast for people who wanna take their sleep skills to the next level. Every Monday, I send out something that I call Molly's Monday Obsessions containing everything that I'm obsessing over in the world of sleep.

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Head on over to sleep as a skill.com to sign up.

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