The Use of Matrix Repatterning in the Management Upper Airway Obstruction (Snoring and Sleep Apnea)

by Dr. George B. Roth, B.Sc., D.C., N.D.

Abstract

Introduction: Upper airway obstruction (UAO) may be partial, in the case of snoring, or complete, in the case of obstructive sleep apnea. This often serious condition, affecting millions of people worldwide, is caused by narrowing of the upper airway while asleep. The uvula and soft pallet may come into partial or total contact on the back wall of the upper airway. When the contact is partial or intermittent, snoring (a loud vibration of these soft tissues) may result. The tongue may also drop posteriorly onto the back wall of the upper airway, coming into contact with the uvula and soft pallet, thus forming a tight blockage, preventing any air from entering the lungs. Respiratory effort on the part of the diaphragm, and chest may cause the blockage to seal tighter. In order to breathe the person must arouse or awaken, causing tension in the tongue, and thereby opening the airway, allowing air to pass into the lungs. Apnea, sleep apnea or obstructive sleep apnea is defined as the cessation of breathing for 10 or more seconds while asleep.

Purpose: To investigate the effect of Matrix Repatterning techniques in a ten cases of long-standing, moderate to severe cases upper airway obstruction.

Methods: Matrix Repatterning uses a manual scanning procedure to determine the location of primary structural restrictions, followed by mechanical testing to determine specific vectors of fascial tension. Treatment is generally applied manually with light force directed into the resistance barriers. In cases of upper airway obstruction, a specific airway obstruction test (AOT), developed by the author, was also used to verify partial or complete obstruction. Certain common dysfunctional structural patterns have been found to be associated with snoring and sleep apnea. A maximum of four treatments to resolve these patterns were administered over a maximum period of two months for ten patients with moderate to severe upper airway obstruction. Two of these cases were previously diagnosed with significant sleep apnea, as verified by sleep studies.

Key Terms: Matrix Repatterning, primary restriction, indicator, resistance barrier, induction, directional recoil, Upper Airway Obstruction (UAO), Airway Obstruction Test (AOT), Respiratory Distress Index (RDI), Continuous Positive Airway Pressure (CPAP)

Introduction

Partial upper airway obstruction and obstructive sleep apnea (obstructive sleep apnea) are caused by the narrowing of the upper airway while asleep. The uvula and soft pallet may come into partial or total contact on the back wall of the upper airway. When the contact is partial or intermittent, snoring (a loud vibration of these soft tissues) may result. The tongue may also drop posteriorly onto the back wall of the upper airway, coming into contact with the uvula and soft pallet, thus forming a tight blockage, preventing any air from entering the lungs. Respiratory effort on the part of the diaphragm, and chest may cause the blockage to seal tighter. In order to breathe the person must arouse or awaken, causing tension in the tongue, and thereby opening the airway, allowing air to pass into the lungs. Apnea, sleep apnea or obstructive sleep apnea is defined as the cessation of breathing for 10 or more seconds while asleep.

Obstructive sleep apnea causes a drop in one's blood oxygen saturation (SaO2) and an increase in the blood's carbon dioxide (CO2). When the SaO2 drops the heart will start pumping more blood with each beat. If the SaO2 continues to drop the heart will start beating faster and faster. As the CO2 increases the brain will try to drive the person to breathe. The effort and action of the abdomen and chest will increase. Eventually that action can become severe enough to cause an arousal, clearing the upper airway blockage, allowing the person to breathe. Then you go back to sleep and it happens all over again.

The American Academy of Sleep Medicine (AASM) rates the average number of obstructive sleep apnea events per hour as your Respiratory Distress Index (RDI). An RDI of 0 to 5 in normal; 5 to 20 is mild; 20 to 40 is moderate; over 40 is considered severe. An apnea event must last at least 10 seconds to be considered an event. It is not uncommon to see RDIs well above the 40. In some cases RDIs were well above 100, with events lasting as long as 90 to 120 seconds and SaO2s going below 70% when normal is 95% to 100%.

Symptoms:

Most prominent symptoms are snoring, not breathing while asleep, excessive daytime sleepiness and obesity. Other symptoms include lack of concentration, forgetfulness, uncharacteristically irritable, anxiety, depression, mood and/or behavioral changes, morning headaches, disorientation at awakening and loss of sexual interest.

Diagnosis:

Diagnosis is made by a physician specially trained in sleep medicine. After a physical examination of the upper airway and an interview with lots of questions, if it is determined that you might have a sleep disorder, you will be asked to take a polysomnogram (sleep test). Most sleep centers and labs monitor 16 different sleep parameters including EEG, EKG, eye movement, chin movement, air flow, chest effort, abdomen effort, SaO2, snoring and leg movement. Each parameter serves to help the physician make a correct diagnosis.

Tests are conducted in a sleep room much like a motel room. A technician will paste electrodes at certain points on your head, face, body and legs. Those electrodes will be hooked to monitoring equipment that will record the entire night study. Most patients do not experience anxiety or difficulty in going to sleep. They are extremely sleepy and will be asleep in just a few minutes.

At the conclusion of the test the elect odes will be taken off and you will be free to go. A scoring technician will score your sleep study and the physician will review it. A day or two later you will meet with the physician to review your study. At that time you and the physician will determine the next course of action. Usually the sleep physician will recommend a second sleep test to determine if your sleep disorder can be treated with continuous positive airway pressure (CPAP). You will be fit with a CPAP breathing circuit, hooked up with the electrodes and put back in bed. While you are asleep the technician will adjust the CPAP pressure trying to eliminate all obstructive sleep apnea and snoring. A day or two later you will again meet with the physician and review you CPAP titration study. Usually you will be referred to an equipment provider that will supply the equipment and fit you with a regular breathing circuit. Then you will be on your way to a normal life.

Treatment:

Continuous Positive Airway Pressure (CPAP) appears to be the best and most effective treatment for obstructive sleep apnea. CPAP flow generators develop a constant, controllable pressure to keep your upper airway open so that you can breath normally. CPAP is effective on 95% of the patient with obstructive sleep apnea. The units are reliable, quiet and efficient and come in a variety of sizes and shapes.

Controlled pressure is induced through the nasal passage, holding the soft tissue of the uvula and soft palate and the soft pharyngeal tissue in the upper airway in position so the airway remains open while you descend into the deeper stages of sleep and REM sleep. The pressure acts much in the same way as a splint, holding the airway open.

There are typically three methods of inducing the pressure and airflow into the nasal cavity: nasal masks, nasal pillows and nasal seals. The most common used is the nasal mask. Nearly all CPAP manufactures make at least one style of nasal mask, most make two or three different ones. Nasal pillows are small, oval shaped latex rubber prongs that fit into the opening of the nostril. They are held in place by a shell that is attached to the headgear. When fit properly they are very comfortable and seldom leak. Nasal seals fit against the opening of the nostril and are held in place by a special frame attached to the headgear.

Results:

AOT was improved significantly in 80% of the cases. Patients (and spouses, or sleeping partners) reported a cessation or significant improvement in snoring in 70% of the cases. The two individuals, diagnosed with sleep apnea, reported they were able to sleep through the night without the assistance of a CPAP machine, on which they were previously dependant.

Conclusions:

These findings suggest that structural dysfunction may play a role in the development of upper airway obstruction and that Matrix Repatterning procedures may be beneficial in the management of these conditions. The findings suggest that a randomized controlled trial within a broader population base might be indicated.

Dr. George Roth, D.C., N.D. is a practitioner with over 25 years experience in the field of energy medicine. He has developed a number of leading-edge technologies to assist individuals in the achievement of optimal wellness. He lectures extensively to various groups and educational institutions and is a published author.

For more information, or to make an appointment, please contact

Dr. George B. Roth,
The Matrix Wellness Centre,
67 Prospect St., Newmarket, Ontario, Canada, L4G 1R1
Phone: 905 836-WELL (9355)
1-877-905-7684
Fax: 905 726-8575
Email: info@matrixrepatterning.com
Web site: www.MatrixRepatterning.com