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Gavin Guard: Part 2: Five Unexpected Reasons You Might Have Fatigue

  • Written by Gavin Guard

In part 1, we discussed how your gut health may be impacting your energy levels and how dysfunctional digestive health can lead to symptoms such as fatigue. Let’s pick up with reason #2 of why you may be experiencing low energy levels and fatigue.

Reason #2: Sleep disordered breathing

Sleep disordered breathing includes conditions such as sleep apnea that characterize the restriction of air into the lungs during sleep. It is an often overlooked cause of fatigue and excessive daytime sleepiness (e.g. feel like you have to fall asleep at a business meeting).

It affects 15-30% of males and 10-15% of females. Being overweight or obese increases the odds that you might have sleep disordered breathing. For example, a 10% increase in weight is associated with a 6x increased risk of sleep apnea. Sleep disordered breathing is also found at higher rates in those with atrial fibrillation (up to 60%), hypothyroid, family history of sleep apnea, and smokers.

Symptoms of sleep disordered breathing include:

Daytime sleepiness/ fatigue


Apnea (choking)

Morning Headache (found in 10-30%)

Dry mouth

Drool on pillow

Validated questionnaires (here and here) can also be helpful to identify this condition. More rigorous ways to evaluate sleep disordered breathing include sleep tests. This includes a physician-attended sleep study inside a sleep center. However, this can be especially difficult for those in remote areas like the San Juan Islands. The good news is that a home sleep test shows good accuracy when compared to in-clinic sleep tests for diagnosing sleep disordered breathing (but may miss other sleeping issues). These home sleep tests are cheap, portable, and the best news is that you can sleep in your own bed!

The gold standard for addressing sleep apnea and sleep disordered breathing is a CPAP machine which some of my patients have referred to as “wearing an octopus on your face while you try to sleep.” This refers to the uncomfortability associated with this intervention.

Fortunately, there are other options to sleep disordered breathing, especially for mild-to-moderate cases. This includes the following:

Weight loss can be a powerful strategy to help sleep apnea. One study found that even a reduced calorie diet can improve sleep apnea independent of weight loss.

Improving your gut health can improve sleep issues through the gut-sleep connection. For example, those with IBS report worse sleep and higher rates of insomnia. One study found that probiotics can improve insomnia.

Another therapy is called myofunctional therapy and is practically like physical therapy for your mouth. This is where you strengthen the muscles around your oral cavity to prevent the collapse of your airway when you sleep. It is supported by a few studies.

A “smart pillow” has also shown to be effective in two studies. This smart pillow senses when you are snoring (a sign of sleep disordered breathing) and adjusts your airway to prevent the collapse of your airway.

Finally, oral devices (AKA mandibular advancement devices) are similar at improving symptoms when compared to CPAP therapy. In addition, more patients prefer them over CPAP therapy.

Don’t let sleep disordered breathing go unaddressed. There are many therapies and options at your disposal to help you solve this issue.

The Bottom Line

That’s it for part 2. Stay tuned in the next few weeks for the rest of the series.

Don’t let these issues go unaddressed and unsolved. Get a comprehensive assessment and personalized medical care plan today. You can schedule a free 15-minute appointment with me today to review your health concerns and create a game plan for you moving forward.

I hope you found this information useful and helpful in your journey back to a healthier and happier life.

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Last modified onSunday, 28 November 2021 03:25

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