The Insiders Guide to Herbs and Supplements

[panacea]

Have you ever wanted a short and to the point guide for herbs that do things and actually work? Well here you go, this is from my research into the subject over some years. I learned most of this from someone who has spent their entire life teaching about herbs, none of this is my opinion or insight, just copied from various internet sources. One thing I've noticed is that a lot of herbs are bull, they do nothing, and they especially aren't for curing things, they are more for 'supplementing' alongside an already balanced diet, to get some nice effects.

Skin Care:

The best secret to skin care you will ever find, besides the obvious good diet (like Wai), get some sunshine, exercise, cold showers, don't use make up or creams, etc, is taking food grade silica internally by diluting it in a large container of water. The silica will bind to the water molecules and you'll take in a little, or you can just eat a tiny amount if you want, though this doesn't get absorbed as well. You need good stomach acidity to really absorb silica. This is one of the main factors of aging skin for people, as we age, our stomach acidity level lessens, and we absorb less silica because of this. You can buy 1 lb silica (diatomaceous earth) off amazon.com for really cheap, and it should last you 2-3 years if using the diluting water method. This internal skin treatment, if everything else is done properly like diet and not using creams etc, will make you look and stay looking younger than anything else you can imagine.

Brain Enhancement:

There's a ton of supplements out there for brain enhancement, mostly they are standardized pills like piracetam or other 'nootropics', which might or might not do anything, but always have negative side effects and are pretty costly. A simple herb which really helps with concentration is periwinkle (vinca minor not the madagascar stuff) (which is the best mental effect you can ask for, since everything is about concentration and focus, solving that hard math problem is just a matter of following a longer series of steps - aka more concentration, the same with solving any other problem in life). Periwinkle increases blood flow to the brain significantly, and it works in just 20 minutes, unlike some nootropics out there which can take weeks or months before you are supposed to feel an effect. Periwinkle does have one draw back, the alkaloids can dry up the intestines, so it's best to take periwinkle (powder or tincture) with some yucca root, as yucca root holds moisture in the intestines. Yucca root is also anti inflammatory and good for you in a lot of other ways such as with dealing with allergies.

Euphoria, legally:

Ever wanted to feel a euphoric high, without having to do something illegal or harmful? While I don't think weed is that bad for you with minimal use, it's illegal, so a better option would be clary sage essential oil. 20 drops of this stuff put into your own homemade capsule and swallowed will make you feel euphoric very quickly, for about an hour. You can buy just a few oz container off amazon, it also makes a really good 'social cologne'. People will really like being around you if they are near you long enough

Getting some sleep:

The most potent legal herb for inducing sleep is lady's slipper. You want the tincture/extract. You can find it on amazon, but this is becoming more and more rare as this herb is hard to grow. This is one of the few things that's sure to knock you out and give you a nice deep sleep, without the horrible side effects from things like lunesta. However, that being said, it's most useful to use this while retraining yourself to sleep sitting up in a very comfortable armchair. There's nothing really uncomfortable about sleeping in an armchair except the neck support problem (so find a great neck pillow), it's just that so many years of habit of sleeping laying down makes it seem uncomfortable. Lady's slipper can make you feel very drowsy, so that you can forcefully train yourself to get used to sleeping sitting up. Sleeping sitting up will fix dry mouth problems, you won't feel fatigued in the morning, and before long you won't need as much sleep and you'll feel even more rested with less hours of sleep! It's like buying time, and that's the most valuable thing of all isn't it?

Getting more bang for your buck:

Yucca root besides being helpful with periwinkle is also very good at increasing absorption of nutrients from food and supplements. So you will actually get more of an effect by taking yucca root along with any of these herbs and also along with normal diet.

Building muscle and keeping it:

This one is mostly for guys, if you'd like some extra help bulking up because you're 'genetically skinny and frail' like me, and can't put on weight it seems like no matter how much you eat, then what you're missing, assuming you have good diet and lifestyle habits, and are doing heavy weight lifting with low reps, and for short periods (you don't want to have a sore feeling for days after working out), then you might just be low on testosterone! But it's not as simple as just taking a herb like tribulus terrestris to increase testosterone, you also should take saw palmetto and nettle root, as these block testosterone from converting into estrogen and DHT, which can both lead to problems such as hair loss in the case of DHT. Taking these three herbs together, along with yucca root, should boost your testosterone enough to where you start putting on and keeping muscle.

Hope this helps somebody!

I have herbal solutions for a bunch of other stuff (mostly vain stuff, like hair, skin, nails, etc, herbs are NOT a substitute for a good diet and are NOT for maintaining health! they are supplemental for aesthetic purposes, such as feeling better, bulking up, and getting some help sleeping, thinking, etc.

That being said, don't underestimate the power of herbs. For example, having some clary sage oil after a hard days work relieves SO much stress for me, and it just gives me something to look forward to while slaving away at work. Things like this really make ones life easier, and this 'stress reduction', having things to rely on that make you feel good, and sometimes even just having the knowledge about what stuff to get if you ever need it, can really make a difference in your health!

[Oscar]

Interesting. I'm not inclined to try it out, but it might be helpful for someone.

[dime]

Any suggestion for something that would keep you awake and functional for an hour for example, even if you're really tired/sleepy?

[panacea]

Anything that does that isn't good for you, because you should always go to sleep when really tired/sleepy. The only way to solve this in a healthy manner is to change your sleeping habits, diet habits, and lifestyle habits so that you need less sleep, and have more energy all day in the first place. Easiest solution... start sleeping sitting up in a chair, or incline your bed as much as is comfortable and sleep on your left side or stomach... and tape your mouth shut if you wake up with dry mouth still because it means you're mouthbreathing.. And also try to sleep in a non-carpeted room.

you could just do what everyone else does and use caffeine to stay awake when you 'really' need to but it's so immensely unhealthy for you that I'm shocked caffeine is legal - there's probably nothing more damaging to society than habits of alcohol, caffeine, and nicotine, which are all legalized

Seriously people should use kava kava to replace alcohol, fruit juices to replace caffiene, and clary sage oil to replace nicotine. Would be SO much better and still fun.

[dime]

Well none of the above herbs are really helpful if you're healthy. They are helpful and might be good for your health in certain situations only.

Something natural which keeps you awake for a certain time without the bad effects of caffeine and similar things, would be useful when you need to retrain your sleeping patterns for example. Changing your sleep takes some time, and it's better if you can avoid feeling dead until you adapt.

[panacea]

the herbs in the first post are very helpful if you're healthy, periwinkle for example for brain enhancement and yucca root to absorb almost all nutrients better (saves money by needing to eat less), etc.. And people who sleep sitting up, and can correctly nasal breathe with about 3-8 breaths per minute only, and get a lot of cardio (they build up to running about an hour a day usually, always nasal breathing), only need to sleep for 3-4 hours per night, and feel more rested and more energetic than people who sleep for 5-8 hours, they don't need coffee to get them going in the morning or to stay awake through the day and night. If you still don't have enough time in the day by only sleeping 3 hours a night then I'm sorry you've just got to learn some time management/multi tasking tricks

by the way your body gets tired because it needs to rest (usually), if you are feeling a solely mental tiredness, like the kind you can get from things like not getting enough sunlight, sleeping too much (which makes you more sleepy sometimes), etc, then this is more of an 'artificial' need for sleep, and you probably just need to fix the problem by getting sunlight, a little exercise, and balance your blood sugar better by eating small frequent meals (with sugar added), and not big 3 meal a day kind of thing. but these are all wai diet and common sense health principles herbs can't help with this kind of thing, I mean, I'm sure there's something out there that can wake you up, lots of herbs are stimulants, but it throws off your body, when you can 99% of the time fix it without herbs, there's no need to...

[HelenaD]

What about colloidal metals like silver? Are these considered supplements or vitamins? Are these similar to the silica diluted in water? I know I've read articles of people not only drinking the colloidal waters but also using them on their skin.

[panacea]

Well it's a mineral 'supplement', I guess. It doesn't really matter since it's not safe or effective. Most 'colloidal silver' supplements are actually 90% ionic silver (they don't mention that, and it's not good). And colloidal silver is just not worth it..

[RRM]

Well none of the above herbs are really helpful if you're healthy. They are helpful and might be good for your health in certain situations only.

the herbs in the first post are very helpful if you're healthy, periwinkle for example for brain enhancement and yucca root to absorb almost all nutrients better

So, you are suggesting that naturally there are some faults in our body's design that we need to fix by taking those herbs?
The periwinkle will contain some ingredients that may inhibit the breakdown of certain neurotransmitters,
or stimulate the sensitivity of receptor(s), or similar.
But do you really think that changing this balance between neurotransmitters is 'healthy'?
And do you really think that its better to increase the permeability of the intestinal mucosa?
You should keep in mind that the body not only needs to absorb nutrients, but desperately needs to keep out other stuff.
It will absorb as much as and what it needs.
If you force it to absorb more, this is not at all healthy...

...people who sleep sitting up, and can correctly nasal breathe ... only need to sleep for 3-4 hours per night, and feel more rested and more energetic

That does not mean its better for you.
Sleep is required for lots of recovery activities.
"needing less sleep" may mean that you are inhibiting daily recovery.

[dime]

...people who sleep sitting up, and can correctly nasal breathe ... only need to sleep for 3-4 hours per night, and feel more rested and more energetic

That does not mean its better for you.
Sleep is required for lots of recovery activities.
"needing less sleep" may mean that you are inhibiting daily recovery.

I don't see how it wouldn't be better?
If by sleeping that way for 4 hours you feel the same as if you would when sleeping in bed and breathing incorrectly for 8 hours (i.e. you're not sleepy/tired when awake) then it's definitely better, because you cut sleep time quite a bit. I guess recovery somehow goes on faster when sitting and doing that "proper" breathing?

[panacea]

So, you are suggesting that naturally there are some faults in our body's design that we need to fix by taking those herbs?

Technically there are faults in all animals design which is why we constantly evolve slowly to try and keep up the pace with the fast changing world, and especially the human 'world' or environment is very fast changing. But no, I'm saying that these things help get beneficial effects, just like how marijuana can make people feel less stressed, and is actually a lot safer if just eaten and is high quality instead of smoked - I stated that these herbs weren't a replacement for good diet or a cure for anything.

The periwinkle will contain some ingredients that may inhibit the breakdown of certain neurotransmitters,
or stimulate the sensitivity of receptor(s), or similar.

So do a lot of things though, this is a natural thing, as long as you don't abuse something then I don't see how this is a problem. But take for example eggs and the protein therein effect on dopamine. Periwinkle doesn't to my knowledge inhibit the breakdown of certain neurotransmitters or stimulate the sensitivity of receptors any more than common food. It's main action on helping with memory/mental focus is by increasing blood flow to the brain. The second main effect it has, which is a con, is that it 'dries out' the intestinal mucosa. This is why yucca root which acts like a sponge holding water in the intestines is a good idea to take a long with periwinkle to prevent constipation. Taking these two together on a big test day, might help just enough to change someones life, which will have a far greater impact on them than the 'risk' of single dose of some very safe herbs used on rare occasions...

But do you really think that changing this balance between neurotransmitters is 'healthy'?

This balance is affected by diet even more which is why I said a good healthy diet is required, these herbs are not replacements for that, and there is no way that a single dose is going to really mess up neurotransmitter balance - everything has a cost. If you buy a tiny sportscar you have a greater risk of dying in an accident than buying a really bulky safe SUV, but then you lose money from mpg compared to a prius, etc. That's what life is you have to assume SOME risks/dangers even in diet/supplements to get where you want to go, and risking a tiny thing like 'maybe' it messes up neurotransmitter balance a little, temporarily at best, is by far the safest warning I've ever heard for any 'drug' or herbal supplement that increases mental focus/memory/etc, which is something some people will find highly valuable especially if they have very long tests to take for credentials to get a job or maybe they need help one day to really focus on a big architectural project for a big firm and cram one night or they'll get fired, etc.

And do you really think that its better to increase the permeability of the intestinal mucosa?

Can you show me that yucca root has any danger at all in this manner? Or any of the other herbs? There is no recorded dangers from yucca root besides diarrhea (if you take too much) or mouth/throat irritation. But yes to answer your question I see increasing permeability of the intestinal mucosa as a great thing as long as you are not ingesting tons of poisons or are on medications like steroids, as these effects are prolonged by yucca root I think.

You should keep in mind that the body not only needs to absorb nutrients, but desperately needs to keep out other stuff.
It will absorb as much as and what it needs.
If you force it to absorb more, this is not at all healthy...

It will only absorb as much as and what it needs if you give it enough to absorb and give it all it needs. This can be a real problem for people financially on the wai diet as fruit can get expensive and so can the high quality raw fish etc. So if they can increase the bio availability of these foods they may not need to eat as much, and they can feel more assured that they are getting enough of what they need. It would be nice if the body could 'absorb more of everything if there is little of it in the diet' for every nutrient needed so we could just eat peanut shavings but this isn't reality.

That does not mean its better for you.
Sleep is required for lots of recovery activities.
"needing less sleep" may mean that you are inhibiting daily recovery.

Sleeping sitting up helps with breathing, this is what makes it better for you, the beneficial 'effect' is that you need less sleep and feel more rested. Yes, the beneficial side effect of sleeping more optimally isn't the evidence for it being better, it could be evidence for anything short term, but the fact is that studies have shown this helps with asthmatics and breathing patterns in all people (sleeping sitting up or inclined as opposed to almost completely or completely horizontal). I guess if you have a broken back this would be an exception or something, but for most people sleeping sitting up is better for you, since it prevents mouth-breathing and promotes a better breathing pattern (not as rapid).


http://www.normalbreathing.com/l-6-best ... omment_box

Asthma

Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):499-503.
Influence of posture and sustained loss of lung volume on pulmonary function in awake asthmatic subjects.
Ballard RD, Pak J, White DP.
Departments of Medicine, Denver Veterans Administration Medical Center, CO 80220.
Abstract
Nocturnal worsening occurs commonly in the asthmatic patient population and contributes substantially to the morbidity and even mortality of asthma. However, no physiologic process has yet been identified as the major contributor to this pattern. Sleep is typically associated with both the supine posture and substantial decrements in lung volume, and both have been proposed to have a role in the pattern of nocturnal worsening. To assess the effects of posture and sleep-associated reductions in functional residual capacity on pulmonary function, eight asthmatic patients were first monitored overnight in a horizontal volume-displacement body plethysmograph to determine mean FRC during sleep for each subject. We then compared, during wakefulness, the effects on FEV1 and methacholine responsiveness from chest wall and abdomen strapping (to maintain FRC at mean sleep levels) for 6 h in the supine and upright postures. FEV1 was significantly decreased after strapping in the supine posture (2.54 +/- 0.36 versus 3.38 +/- 0.29 L on control day, p = 0.0001) but was not affected by strapping in the upright posture (3.07 +/- 0.30 versus 3.34 +/- 0.31 L on control day, not significant, NS). Bronchial responsiveness to methacholine was not altered after strapping in either posture. These observations suggest that the supine posture, in conjunction with the reduction in lung volume associated with sleep, may contribute to the nocturnal worsening of asthma.

Asthma and allergies in wheezing children

Pediatrics. 2004 May;113(5):1216-22.
The bedding environment, sleep position, and frequent wheeze in childhood.
Ponsonby AL, Dwyer T, Trevillian L, Kemp A, Cochrane J, Couper D, Carmichael A.
National Centre for Epidemiology and Population Health, Australian National University, Canberra ACT, Australia. anne-louise.ponsonby@anu.edu.au
Abstract
OBJECTIVE: Synthetic quilt use has been associated with increased childhood wheeze in previous studies. Our aim was to examine whether the adverse effect of synthetic quilt use on frequent wheeze differed by usual sleep position.
DESIGN, SETTING, AND PARTICIPANTS: A population-based cross-sectional study of 6378 (92% of those eligible) 7-year-olds in Tasmania, Australia, was conducted in 1995. Exercise-challenge lung function was obtained on a subset of 414 children from randomly selected schools. EXPOSURE
MEASURES: Child bedding including pillow and overbedding composition and usual sleep position by parental questionnaire.
OUTCOME MEASURES: Frequent wheeze (>12 wheeze episodes over the past year), using the International Study of Asthma and Allergies in Childhood parental questionnaire, and baseline and postexercise forced expiratory volume in 1 second lung-function measures.
RESULTS: Frequent wheeze (n = 117) was positively associated with synthetic quilts, synthetic pillows, electric blankets, and sleeping in a bottom bunk bed but did not vary by sleep position. In a nested case-control analysis, the association between synthetic quilt use and frequent wheeze differed by sleep position. Among children who slept supine, synthetic (versus feather) quilt use was associated with frequent wheeze (adjusted odds ratio: 2.37 [1.08, 5.23]). However, among nonsupine sleepers, overlying synthetic quilt use was not associated with frequent wheeze (adjusted odds ratio: 1.06 [0.60, 1.88]). This difference in quilt effect by sleep position was highly significant. Similarly, synthetic quilt use was associated with lower postexercise forced expiratory volume in 1 second measures among supine but not nonsupine sleeping children.
CONCLUSION: An increasing focus on the bedding environment immediately adjacent to the nose and mouth is required for respiratory disorders provoked by bedding, such as child asthma characterized by frequent wheeze.

Asthma (nocturnal)

Curr Opin Pulm Med. 1996 Jan;2(1):48-59.
Nocturnal asthma: physiologic determinants and current therapeutic approaches.
D'Alonzo GE, Ciccolella DE.
Temple University Health Sciences Center, Philadelphia, PA 19140, USA.
Abstract
Asthma has a tendency to destabilize at night in patients that are diurnaly active and try to sleep at night. As asthma worsens, the expression of this disease seems to increase at night. Additionally, nocturnal asthmatics have increased airway hyperresponsiveness and likely more active inflammation at night as compared with the daytime. Although the cause of nocturnal asthma cannot be completely explained, there do appear to be a variety of internal body circadian rhythms that play a role in this disease. Also, noncircadian rhythmic influences such as sleep, supine posture, snoring, and gastroesophageal reflux cannot be dismissed. Directing therapy, perhaps in unique ways, may be essential for the control of nocturnal asthma. Patients on inhaled corticosteroid therapy or nonsteroidal anti-inflammatory agents often persist in asthmatic disease expression at night. Long-acting bronchodilator therapy, either by inhalation or with sustained-release tablets, is often added to inhaled anti-inflammatory therapy for more complete 24-hour disease control. Using existing therapies but employing chronotherapeutic strategies is likely to improve the overall asthma management. By focusing on nocturnal asthma, we may be able to improve our understanding of this disease and more effectively control it over each 24-hour period.

Back pain in pregnancy

Am J Reprod Immunol. 1992 Oct-Dec;28(3-4):251-3.
Nocturnal low back pain in pregnancy: polysomnographic correlates.
Fast A, Hertz G.
Department of Physical Medicine and Rehabilitation, St. Vincent's Hospital and Medical Center, New York, NY 10011.
Abstract
Thirteen women in late stages of pregnancy underwent a polysomnographic study. Eight women (61%) complained of mild nocturnal back pain or back discomfort. Five women (39%) did not complain of nocturnal back pain. The two groups did not differ in total bed time, total sleep time, sleep latency, and wake after sleep onset (WASO). A significant decrease in rapid eye movement (REM) sleep and an increase in stage 2 were observed in the pain group. The same group had a statistically significant decrease in the basal O2 saturation level. The pain group also spent a longer time sleeping in the supine position. We hypothesize that a prolonged stay in the supine position leads to obstruction of the vena cava. In the presence of inadequate collateral circulation, increased pressure and venostasis in combination with a decrease in basal oxygen saturation may lead to hypoxemia, compromise the metabolic supply of the neural structures, and result in pain. It appears, therefore, that the vascular system plays an important role in the pathogenesis of pain. The role played by the disturbed sleep architecture in the production of pain remains to be established. It is possible that the changes observed in sleep architecture result from pain rather than contribute to pain production.

Bruxism and swallowing

Sleep. 2003 Jun 15;26(4):461-5.
Association between sleep bruxism, swallowing-related laryngeal movement, and sleep positions.
Miyawaki S, Lavigne GJ, Pierre M, Guitard F, Montplaisir JY, Kato T.
Facultés de médecine et de médecine dentaire, Université de Montréal, Québec, Canada.
Abstract
STUDY OBJECTIVE: To describe the relationships of sleep bruxism to swallowing and sleep positions.
DESIGN: Controlled descriptive study.
SETTING: Polysomnography and audio-video recordings were done in a hospital sleep laboratory.
PARTICIPANTS: Nine patients with sleep bruxism and 7 normal subjects were matched for age and sex. Interventions: n/a.
MEASUREMENTS AND RESULTS: During sleep, patients with sleep bruxism showed a higher frequency of rhythmic masticatory muscle activity episodes (6.8 +/- 1.0 [SEM]/h) than did normals (0.5 +/- 0.1/h, p < 0.01). Swallowing-related laryngeal movements occurred more frequently in sleep of patients with sleep bruxism (6.8 +/- 0.8/h) than in normals (3.7 +/- 0.3/h, p < 0.01). In both groups, during sleep, close to 60% of rhythmic masticatory muscle activity episodes were associated with swallowing. In sleep bruxism patients, 68% of swallowing events occurred during rhythmic masticatory muscle activity episodes, while only 10% of swallowing events were associated with rhythmic masticatory muscle activity in normal subjects. Sleep bruxism patients and normals spent 95.5% and 87.3% of sleeping time in the supine and lateral decubitus positions, respectively. In both groups, up to 96% of rhythmic masticatory muscle activity and swallowing were observed in the supine and lateral decubitus position. In sleep bruxism patients, although sleeping time did not differ between the 2 sleeping body positions, 74% of rhythmic masticatory muscle activity and swallowing events were scored in the supine position compared to 23% in the lateral decubitus position.
CONCLUSIONS: During sleep, rhythmic masticatory muscle activity is often associated with swallowing. In sleep bruxism patients, most of these oromotor events are observed in the supine position. The physiologic link between rhythmic masticatory muscle activity and swallowing and the clinical relevance of sleep position in sleep bruxism management need to be investigated.

Bruxism, clenching episodes and gastroesophageal reflux

Am J Orthod Dentofacial Orthop. 2004 Nov;126(5):615-9.
Relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions.
Miyawaki S, Tanimoto Y, Araki Y, Katayama A, Imai M, Takano-Yamamoto T.
Department of Orthodontics and Dentofacial Orthopedics, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Abstract
The purpose of this study was to examine the relationships among nocturnal jaw muscle activities, decreased esophageal pH, and sleep positions. Twelve adult volunteers, including 4 bruxism patients, participated in this study. Portable pH monitoring, electromyography of the temporal muscle, and audio-video recordings were conducted during the night in the subjects' homes. Rhythmic masticatory muscle activity (RMMA) episodes were observed most frequently, with single short-burst episodes the second most frequent. The frequencies of RMMA, single short-burst, and clenching episodes were significantly higher during decreased esophageal pH episodes than those during other times. Both the electromyography and the decreased esophageal pH episodes were most frequently observed in the supine position. These results suggest that most jaw muscle activities, ie, RMMA, single short-burst, and clenching episodes, occur in relation to gastroesophageal reflux mainly in the supine position.

Chronic respiratory insufficiency patients

Intensive Care Med. 2009 Feb;35(2):306-13. Epub 2008 Sep 16.
Sleep and non-invasive ventilation in patients with chronic respiratory insufficiency.
Ambrogio C, Lowman X, Kuo M, Malo J, Prasad AR, Parthasarathy S.
University of Torino, Turin, Italy.
Abstract
OBJECTIVE: Noninvasive ventilation with pressure support (NIV-PS) therapy can augment ventilation; however, such therapy is fixed and may not adapt to varied patient needs. We tested the hypothesis that in patients with chronic respiratory insufficiency, a newer mode of ventilation [averaged volume assured pressure support (AVAPS)] and lateral decubitus position were associated with better sleep efficiency than NIV-PS and supine position. Our secondary aim was to assess the effect of mode of ventilation, body position, and sleep-wakefulness state on minute ventilation (V(E)) in the same patients.
DESIGN: Single-blind, randomized, cross-over, prospective study.
SETTING: Academic institution.
PATIENTS AND PARTICIPANTS: Twenty-eight patients.
INTERVENTIONS: NIV-PS or AVAPS therapy.
MEASUREMENTS AND RESULTS: Three sleep studies were performed in each patient; prescription validation night, AVAPS or NIV-PS, and crossover to alternate mode. Sleep was not different between AVAPS and NIV-PS. Supine body position was associated with worse sleep efficiency than lateral decubitus position (77.9 +/- 22.9 and 85.2 +/- 10.5%; P = 0.04). V(E) was lower during stage 2 NREM and REM sleep than during wakefulness (P < 0.0001); was lower during NIV-PS than AVAPS (P = 0.029); tended to be lower with greater body mass index (P = 0.07), but was not influenced by body position.
CONCLUSIONS: In patients with chronic respiratory insufficiency, supine position was associated with worse sleep efficiency than the lateral decubitus position. AVAPS was comparable to NIV-PS therapy with regard to sleep, but statistically greater V(E) during AVAPS than NIV-PS of unclear significance was observed. V(E) was determined by sleep-wakefulness state, body mass index, and mode of therapy.

Cough (nocturnal) and coughing attacks

Chest. 1995 Aug;108(2):581-5.
Intractable cough associated with the supine body position. Effective therapy with nasal CPAP.
Bonnet R, Jörres R, Downey R, Hein H, Magnussen H.
Loma Linda University, Division of Pulmonary and Critical Care Medicine, CA 92354, USA.
Abstract
We describe five patients with severe nocturnal cough and daytime somnolence in whom the coughing attacks are triggered by assuming the supine body position. Quantity and quality of the nocturnal cough were evaluated in the sleep laboratory with and without nasal continuous positive airway pressure (N-CPAP). Air flow characteristics were assessed using flow volume and airway resistance loops. Airway anatomy was evaluated bronchoscopically. In all five patients, the cough had a barking quality. Flow-volume loops showed an expiratory collapse phenomenon in two of the patients. Endoscopically, all five patients had signs of airway collapse. All patients had difficulty falling asleep because of coughing and were awakened by it frequently. Sleep times ranged from 2.5 to 4.5 h per night. With N-CPAP pressures ranging from 5 to 13 cm H2O, all five patients had clinically significant improvement in their symptoms. Their sleep times increased to a range of 5 to 7.5 h per night and the daytime somnolence markedly improved or resolved. All five patients requested a N-CPAP unit for home use. We conclude that a cough that is predominantly associated with or exacerbated by the supine body position may be treated effectively with N-CPAP.

GERD (gastroesophageal reflux disease)

Am J Gastroenterol. 1999 Aug;94(8):2069-73.
Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease.
Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO.
Department of Medicine, Graduate Hospital, Philadelphia, Pennsylvania 19146, USA.
OBJECTIVE: Body position has been shown to influence postprandial and fasting gastroesophageal reflux (GER) in patients and normal volunteers when they are assigned to lie in a prescribed position. No published studies have evaluated the effect of spontaneous sleeping positions on recumbent reflux in patients with GER.
METHODS: Ten patients, three female and seven male (mean age 47.6 yr, range 30-67 yr) with abnormal recumbent esophageal pH <4 on 24-h pH-metry participated. A standardized high fat dinner (6 PM) and a bedtime snack (10 PM) were administered to all patients. GER during spontaneous sleep positions was assessed with a single channel pH probe placed 5 cm above the lower esophageal sphincter (LES) and with a position sensor taped to the sternum. Data were recorded with a portable digital data logger (Microdigitrapper-S, Synectics Medical) and analyzed for recumbent percent time pH <4 and esophageal acid clearance time in each of four sleeping positions. Time elapsed between change in sleeping position and GER episodes was also calculated.
RESULTS: Right lateral decubitus was associated with greater percent time pH <4 (p < 0.003) and longer esophageal acid clearance (p < 0.05) compared to the left, supine, and prone. GER episodes were more frequent in the supine position (p < 0.04) and occurred within 1 min after change in sleeping position 28% of the time.
CONCLUSIONS: The left lateral decubitus position is preferred in patients with nocturnal GER. Measures to aid patients in sleeping in this position should be developed.

Zhonghua Wai Ke Za Zhi. 1999 Feb;37(2):71-3, 3.
[Can esophagogastric anastomosis prevent gastroesophageal reflux]
[Article in Chinese]
Wang Q, Liu J, Zhao X, Lei J, Cong Q, Li W, Li B, Wang F, Cao F, Zhang X, Zhang H, Zhang H.
Depatment of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011.
Abstract
OBJECTIVE: To investigate the possible anti-reflux function of esophagogastric anastomosis in the patients after receiving resection of cardiac cancer.
METHODS: One hundred and ninety-two patients were studied by video-assisted gastroscopy, manometry, 24-h pH esophageal monitoring, radioscintigraphy and scanning electron microscopy.
RESULTS: Abnormalities were found in 90.2% of patients through endoscopy. Resting pressure in esophageal body was higher than that in normal controls, and in the stomach, lower. Twenty-four hour pH monitoring demonstrated that gastroesophageal reflux (GER) did not occur when the patients slept in semi-reclining position, and occurred in all patients when slept in supine position. Scintigraphic study showed that 2/3 of the patients had reflux, occurrence of which was not affected by the length of postoperative period. Scanning electron microscopic examination showed that degeneration, exfoliation of esophageal mucosal epithelial cell, and derangement of micro-fold and inflammatory oedema of cytomembrane may be directly caused by reflux.
CONCLUSIONS: GER exists in the majority of the patients after esophagogastrectomy and esophagogastrostomy for cardiac cancer. The occurrence of GER is not affected by the length of postoperative period. Some detecting methods fail to show the existence of GER, and 24-h pH monitoring is the most reliable method for detecting GER. Sleep in semireclining position is an effective method of preventing GER in postoperative patients.

Geriatric inpatients

Age Ageing. 2008 Sep;37(5):526-9. Epub 2008 May 16.
Severe nocturnal hypoxaemia in geriatric inpatients.
Hjalmarsen A, Hykkerud DL.
Department of Medicine, Pulmonary Division, University Hospital of North Norway, N 9038 Tromsø, Norway. audhild.hjalmarsen@unn.no
Abstract
BACKGROUND: Oxygen levels are decreased in older people especially in the supine position, and during sleep. Geriatric inpatients often suffer from stroke and heart disease. Respiratory control may be substantially affected.
OBJECTIVE: the aim of this study was to examine oxygen levels during night in inpatients on geriatric medical wards to find out if they needed nocturnal oxygen therapy.
DESIGN: prospective observational study. Setting/Participants: we consecutively examined 133 patients with SpO(2) >or=92% in sitting position by an overnight -8-h pulse oximetry. Patients with severe obesity, dementia or pulmonary disease were excluded. The test was performed at least 4 days after the event in stroke cases. Outcome Variables: ninety two patients, m/f 43/49, with mean age 78.3 +/- 6.9 SD completed the test. Sixty six patients suffered from stroke; 34 left-sided and 19 right-sided stroke. Nine patients suffered from a heart disease only, and 17 patients suffered from other diseases.
RESULTS: according to the guidelines for long-term oxygen therapy recommendations for nocturnal oxygen therapy, we found that 26% of the patients fulfilled the criteria of SpO(2) <or=90% for >or=30% of the time. There was a significant positive correlation between age and the amount of time with SpO(2) between 80 and 84% (0.215, P < 0.05). Diagnosis or severeness of disease did not significantly affect nocturnal SpO(2) %. The 1-year survival rate was 75% in group I (hypoxaemic) versus 84% in group II (normoxaemic) (NS).
CONCLUSION: nearly 30% of the inpatients in geriatric medical wards suffered from severe oxygen-requiring nocturnal hypoxaemia irrespective of diagnosis.

Heart failure patients with central sleep apnea/Cheyne-Stokes (irregular) respiration

Sleep Med. 2010 Feb;11(2):143-8. Epub 2010 Jan 21.
Impact of sleeping position on central sleep apnea/Cheyne-Stokes respiration in patients with heart failure.
Joho S, Oda Y, Hirai T, Inoue H.
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan. sjoho@med.u-toyama.ac.jp
Abstract
BACKGROUND: The present study determines the influence of sleeping position on central sleep apnea (CSA) in patients with heart failure (HF).
METHODS: The apnea/hypopnea index (AHI) during different body positions while asleep was examined by cardiorespiratory polygraphy in 71 patients with HF (ejection fraction <45%).
RESULTS: Twenty-five of the patients having predominantly CSA (central apnea index 10/h) with a lower obstructive apnea index (<5/h) were assigned to groups with positional (lateral to supine ratio of AHI <50%, n=12) or non-positional (ratio > or = 50%, n=13) CSA. In the non-positional group the BNP level was higher, the ejection fraction was lower and the trans-tricuspid pressure gradient was higher than in the positional group. Multiple regression analysis revealed more advanced age (p=0.006), log(10)BNP (p=0.017) and lung-to-finger circulation time (p=0.020) as independent factors of the degree of positional CSA. Intensive treatment for HF changed CSA from non-positional to positional in all eight patients tested. Single night of positional therapy reduced CSA (p<0.05) and BNP level (p=0.07) in seven positional patients.
CONCLUSION: As cardiac dysfunction progresses, severity of CSA also increases and positional CSA becomes position-independent. Positional therapy could decrease CSA, thereby having a valuable effect on HF.

Sleep.2006 Aug 1;29(8):1045-51.
Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration.
Szollosi I, Roebuck T, Thompson B, Naughton MT.
Department of Allergy Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia.
Abstract
INTRODUCTION: The influence of sleeping position on obstructive sleep apnea severity is well established. However, in central sleep apnea with Cheyne Stokes respiration (CSA-CSR) in which respiratory-control instability plays a major pathophysiologic role, the effect of position is less clear.
STUDY OBJECTIVES: To examine the influence of position on CSA-CSR severity as well as central and mixed apnea frequency.
METHODS: Polysomnograms with digitized video surveillance of 20 consecutive patients with heart failure and CSA-CSR were analyzed for total apnea-hypopnea index, mean event duration, and mean oxygen desaturation according to sleep stage and position. Position effects on mixed and central apnea index, mean apnea duration, and mean desaturation were also examined in non-rapid eye movement sleep.
RESULTS: Data are presented as mean +/- SEM unless otherwise indicated. Group age was 59.9 +/- 2.3 years, and total apnea-hypopnea index was 26.4 +/- 3.0 events per hour. Compared with supine position, lateral position reduced the apnea-hypopnea index in all sleep stages (Stage 1, 54.7 +/- 4.2 events per hour vs 27.2 +/- 4.1 events per hour [p < .001]; Stage 2, 43.3 +/- 6.1 events per hour vs 14.4 +/- 3.6 events per hour [p < .001]; slow-wave sleep, 15.9 +/- 6.4 events per hour vs 5.4 +/- 2.9 events per hour [p < .01]; rapid eye movement sleep, 38.0 +/- 7.3 events per hour vs 11.0 +/- 3.0 events per hour [p < .001]). Lateral position attenuated apnea and hypopnea associated desaturation (supine 4.7% +/- 0.3%, lateral 3.0% +/- 0.4%; p < .001) with no difference in event duration (supine 25.7 +/- 2.8 seconds, lateral 26.9 +/- 3.4 seconds; p = .921). Mixed apneas were longer than central (29.1 +/- 2.1 seconds and 19.3 +/- 1.1 seconds; p < .001) and produced greater desaturation (6.1% +/- 0.5% and 4.5% +/- 0.5%, p = .003). Lateral position decreased desaturation independent of apnea type (supine 5.4% +/- 0.5%, lateral 3.9% < or = 0.4%; p = .003).
CONCLUSIONS: Lateral position attenuates severity of CSA-CSR. This effect is independent of postural effects on the upper airway and is likely to be due to changes in pulmonary oxygen stores. Further studies are required to investigate mechanisms involved.

Irregular or periodic breathing

J Appl Physiol. 1993 May;74(5):2198-204.
Pattern of breathing and upper airway mechanics during wakefulness and sleep in healthy elderly humans.
Hudgel DW, Devadatta P, Hamilton H.
Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44109.
Abstract
Elderly subjects are known to be prone to periodic breathing in sleep. Because periodic breathing may be associated with changes in upper airway caliber, we hypothesized that oscillations in upper airway caliber contribute to the increased prevalence of sleep-related periodic breathing in the elderly. We tested this hypothesis by measuring upper airway resistance, ventilatory variables, and the pattern of variation of these variables in groups of body size-matched young and elderly healthy individuals during wakefulness and stage 2 non-rapid-eye-movement sleep. No major differences existed between the two groups during either wakefulness or sleep in mean upper airway resistance or ventilation values. However, ventilation was more variable during sleep in the elderly; this variability was oscillatory in the majority of elderly subjects at an average rate of 0.04 breaths/cycle or one cycle approximately every 24 s. Oscillations in upper airway resistance during sleep were associated with reciprocal oscillations in tidal volume and/or minute ventilation at the same frequency. Those subjects who had significant oscillations in upper airway resistance had more apneas and hypopneas than those subjects without such oscillations. Oscillations in resistance and ventilation occurred in the supine but not in the lateral body position. We conclude that the wide oscillations in upper airway resistance present during sleep in supine healthy elderly subjects produce a fluctuating mechanical limitation of ventilation, which may contribute to periodic breathing.

Pregnancy

Eur J Obstet Gynecol Reprod Biol. 2003 Aug 15;109(2):128-32.
Normal pregnancy and oxygenation during sleep.
Trakada G, Tsapanos V, Spiropoulos K.
Division of Obstretrics and Gynecology, University of Patras Medical School, Patras 26 500, Greece.
Abstract
Pregnancy is associated with significant alterations in respiratory function. Changes during pregnancy include reduced functional residual capacity (FRC) and residual volume (RV), increased alveolar-arterial difference for oxygen (A-alphaPO2) and in the supine position, reduced cardiac output. In conjunction with sleep-related apneas or hypopneas, these could lead to maternal oxygen desaturation during sleep. Because of the conflicting data from sleep studies in late pregnancy, we performed complete polysomnography on 11 pregnant women at 36 weeks of gestation and again postpartum. We also measured the PaO2, every 2h. The frequency of apneas and hypopneas was significantly lower during pregnancy compared with that on the postpartum control night. PaO2 levels in the supine position, during sleep, were also significantly lower during pregnancy compared to the postpartum period. No correlation was observed between PaO2 levels and apneas or hypopneas or percent of REM sleep.

Sleep apnea

Eur J Orthod. 2004 Jun;26(3):321-6.
Cephalometric comparison of pharyngeal changes in subjects with upper airway resistance syndrome or obstructive sleep apnea in upright and supine positions.
Ingman T, Nieminen T, Hurmerinta K.
Department of Pedodontics and Orthodontics, Institute of Dentistry, Biomedicum Helsinki, University of Helsinki, Finland.
The aim of the present study was to cephalometrically compare pharyngeal changes between upright and supine positions in patients with upper airway resistance syndrome (UARS) or obstructive sleep apnea (OSA). Eighty-two OSA patients, 70 men (mean age 49 +/- 11.8 years) and 12 women (45.9 +/- 8.3 years), underwent cephalometric sleep apnea analysis. One upright and one supine radiograph were taken of each patient (a total of 164 cephalometric radiographs). The results showed no significant changes either in naso- or hypopharyngeal soft tissues between the two positions. In contrast, the shortest distance from the soft palate (ve1-ve2) and the tip of the soft palate (u1-u2) to the posterior oropharyngeal wall was significantly narrower (P < 0.001) in the supine position. Furthermore, in the supine position a slight thickening in the soft palate (sp1-sp2, P < 0.05) was detected with no change in the length of the soft palate (PNS-u1). The form of the tongue changed significantly: it was shorter (Tt-Tgo, P < 0.001; Tt-va, P < 0.001) and thicker (Ts/Tt-Tgo, P < 0.05) in the supine position. The present results suggest that OSA patients are prone to significant narrowing of their oropharyngeal, but not of their naso- or hypopharyngeal, airways in the supine position. Thus, treatment of OSA and UARS patients should mainly be aimed at preventing further oropharyngeal airway narrowing as a result of supine-dependent sleep.

Fortschr Neurol Psychiatr. 2000 Feb;68(2):93-6.
[The relationship between sleep position and therapeutic effect of the Esmarch-Scheine appliance in sleep apnea syndromes]
[Article in German]
Yoshida K.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Japan.
Recently an oral appliance is being used increasingly for the treatment of sleep apnea syndrome. But the success rate of oral appliance therapy shows large interindividual difference, and which factors influence its efficiency remain uncertain. To elucidate the influence of the sleep posture on the therapeutic effect of the Esmarch device, 58 patients with sleep apnea syndrome were investigated polysomnographically before and after insertion of the device. The sleep position during each apnea was classified into three types; supine, lateral and prone. The mean apnea index (25.6 +/- 18.7) decreased significantly (p < 0.0001) after insertion of the device (11.5 +/- 12.6). The number of apneas (in the supine and prone) positions was significantly reduced from 18.0 +/- 16.7 and 2.0 +/- 3.6 to 5.0 +/- 11.2, p < 0.001, and 0.3 +/- 0.4, p < 0.005, respectively, but that in the lateral position was slightly increased from 5.6 +/- 9.4 and 6.2 +/- 8.9. The percent of apneas was 70.3% for supine, 21.9% for lateral, and 7.8% for prone before therapy and 43.5%, 53.9% and 2.6%, respectively after therapy. The results indicated that the effectiveness of oral appliance therapy can differ greatly with the sleep posture. The sleep posture recorded polysomnography may be important for choice of oral appliance therapy and its prognosis.

Intern Med. 1995 Dec;34(12):1190-3.
Effect of prone position on apnea severity in obstructive sleep apnea.
Matsuzawa Y, Hayashi S, Yamaguchi S, Yoshikawa S, Okada K, Fujimoto K, Sekiguchi M.
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto.
We describe a patient with obstructive sleep apnea (OSA) whose apnea-hypopnea index (AHI) improved remarkably in the prone position accompanied by an improved sleep quality, despite a higher AHI in the supine position and even in the lateral position. Magnetic resonance imaging revealed the most dilated upper airway in the prone position, which suggests the role of anatomical narrowing of the upper airway as an important component in the pathophysiology of positional apnea patients. Further studies are needed to determine the therapeutic efficacy of a prone sleeping position in patients with OSA.

Thorax. 1992 Jul;47(7):524-8.
Effects of posture on flow-volume curves during normocapnia and hypercapnia in patients with obstructive sleep apnea.
Miura C, Hida W, Miki H, Kikuchi Y, Chonan T, Takishima T.
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Abstract
BACKGROUND: A high ratio of forced expiratory to forced inspiratory maximal flow at 50% of vital capacity (FEF50/FIF50) may identify upper airway dysfunction. Since hypercapnia increases the motor activity of airway dilating muscles its effects on the maximum expiratory and inspiratory flow-volume curves (MEIFV) in patients with obstructive sleep apnea and in normal subjects in different postures was studied.
METHODS: The effects of posture on the maximum expiratory and inspiratory flow-volume curves during the breathing of air and 7% carbon dioxide in 11 patients with obstructive sleep apnea were compared with those in nine normal subjects. Measurements were made in the sitting, supine, and right lateral recumbent positions. Forced expiratory flow at 50% vital capacity (FEF50), forced inspiratory flow at 50% vital capacity (FIF50) and FEF50/FIF50 were determined.
RESULTS: In the normal subjects FEF50, FIF50, and FEF50/FIF50 were not affected by change in posture or by breathing carbon dioxide. In the patients there was a fall in FIF50 and an increase in FEF50/FIF50 when breathing air in the supine position compared with values in the seated and lateral position. While they were breathing carbon dioxide there was a slight increase in FEF50 when patients were seated or in the lateral position compared with values during air breathing. Hypercapnia abolished the effects of posture on FEF50/FIF50. Values for FEF50/FIF50 in the supine position while they were breathing air correlated with the apnoeic index but not with other polysomnographic data.
CONCLUSION: In patients with obstructive sleep apnea the upper airway is prone to collapse during inspiration when the patient is supine, even when awake; this tendency can be reversed by breathing carbon dioxide.

Am J Otolaryngol. 1985 Sep-Oct;6(5):373-7.
Sleeping position and sleep apnea syndrome.
Kavey NB, Blitzer A, Gidro-Frank S, Korstanje K.
Four patients who were evaluated for hypersomnia-sleep apnea syndrome were found in all-night sleep studies to have obstructive or mixed apneas related to their sleeping positions. All four were available for comprehensive follow-up and were subsequently restudied while avoiding the supine position. Supine, prone, and lateral decubitus apnea indices were calculated for each patient for each night. The supine sleeping position was associated with significantly more apneas than the non-supine positions. Keeping these patients off their backs when they slept was effective treatment. Additionally, when results of surgical or pharmacologic treatments of apnea are evaluated, positional apnea indices should be considered.

Sleep paralysis and terrifying hallucinations

J Sleep Res. 2008 Dec;17(4):464-7. Epub 2008 Aug 5.
'The devil lay upon her and held her down'. Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664.
Kompanje EJ.
Department of Intensive Care, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands. e.j.o.kompanje@erasmusmc.nl
Abstract
Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664, the Dutch physician Isbrand Van Diemerbroeck (1609-1674) published a collection of case histories. One history with the title 'Of the Night-Mare' describes the nightly experiences of the 50-year-old woman. This case report is subject of this article. The experiences in this case could without doubt be diagnosed as sleep paralysis accompanied by hypnagogic hallucinations. This case from 1664 should be cited as the earliest detailed account of sleep paralysis associated with hypnagogic illusions and as the first observation that sleep paralysis and hypnagogic experiences occur more often in supine position of the body.

J Sleep Res. 2002 Jun;11(2):169-77.
Situational factors affecting sleep paralysis and associated hallucinations: position and timing effects.
Cheyne JA.
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
Abstract
Sleep paralysis (SP) entails a period of paralysis upon waking or falling asleep and is often accompanied by terrifying hallucinations. Two situational conditions for sleep paralysis, body position (supine, prone, and left or right lateral decubitus) and timing (beginning, middle, or end of sleep), were investigated in two studies involving 6730 subjects, including 4699 SP experients. A greater number of individuals reported SP [with terrifying hallucinations] in the supine position than all other positions combined. The supine position was also 3-4 times more common during SP than when normally falling asleep. The supine position during SP was reported to be more prevalent at the middle and end of sleep than at the beginning suggesting that the SP episodes at the later times might arise from brief microarousals during REM, possibly induced by apnea. Reported frequency of SP was also greater among those consistently reporting episodes at the beginning and middle of sleep than among those reporting episodes when waking up at the end of sleep. The effects of position and timing of SP on the nature of hallucinations that accompany SP were also examined. Modest effects were found for SP timing, but not body position, and the reported intensity of hallucinations and fear during SP. Thus, body position and timing of SP episodes appear to affect both the incidence and, to a lesser extent, the quality of the SP experience.

Snoring, hypopneas and apneas

Am J Respir Crit Care Med. 1994 Jan;149(1):145-8.
Effect of posture on upper airway dimensions in normal human.
Jan MA, Marshall I, Douglas NJ.
Respiratory Medicine Unit, University of Edinburgh, United Kingdom.
Abstract
Posture has a major effect on breathing during sleep. Snoring, hypopneas, and apneas are all more common lying than sitting and more common supine than in a lateral lying position. Because the effect of the lateral lying position on upper airway caliber has not previously been studied, we examined this in 20 normal awake subjects and also determined the effect of neck position. The acoustic reflection technique was used. Pharyngeal cross-sectional areas (CSA) fell significantly from the sitting to supine position (oropharyngeal junction, from 1.65 +/- [SEM] 0.6 cm to 1.31 +/- 0.07 cm), but there was no difference in CSA between the supine and lateral positions for oropharyngeal junction (1.36 +/- 0.06 cm), mean pharyngeal area, maximal pharyngeal area, or pharyngeal volume. Neck hyper-extension significantly increased pharyngeal CSA (e.g., oropharyngeal junction null position 1.51 +/- 0.08, hyper-extension 1.94 +/- 0.11 cm), but there was no significant effect of neck flexion on airway CSA. These results confirm that in normal awake subjects, pharyngeal areas are smaller lying than sitting but also showed no significant difference between CSA in the supine and lateral lying positions. The study also demonstrates that the upper airway caliber increases with neck extension in conscious adults.

Stroke patients with sleep apnea

Stroke. 2008 Sep;39(9):2511-4. Epub 2008 Jul 10.
High prevalence of supine sleep in ischemic stroke patients.
Brown DL, Lisabeth LD, Zupancic MJ, Concannon M, Martin C, Chervin RD.
Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA. devinb@umich.edu
BACKGROUND AND PURPOSE: Sleep apnea is very common after stroke and is associated with poor outcome. Supine sleep is known to exacerbate apneas in the general sleep apnea population. We therefore investigated the pattern of sleep positions in the acute stroke period.
METHODS: Inpatients with acute ischemic stroke underwent full polysomnography that included continuous monitoring of sleep positions. Sleep apnea severity was measured using the apnea-hypopnea index (AHI). Stroke severity was measured by the NIH Stroke Scale (NIHSS) at the time of study enrollment by certified study personnel. Percent total sleep time spent in the supine position was calculated and compared by stroke severity based on a median split of NIHSS using a Wilcoxon rank-sum test.
RESULTS: Of the 30 patients, the median age was 67. The median AHI was 23 (IQR: 6, 47). Twenty-two patients (73%) had sleep apnea with an AHI >/=5. The vast majority of sleep time among the stroke cases was spent supine, with a median percent sleep time spent supine of 100 (IQR: 62, 100). The majority (63%) of subjects spent no time asleep in any of the nonsupine positions (prone, left, right). Median percent sleep time supine was 100 (IQR: 100, 100) in those with a higher NIHSS and 63 (IQR: 51, 100) in those with a lower NIHSS (P<0.01).
CONCLUSIONS: Given the high prevalence of supine sleep identified, research into positional therapy for stroke patients with sleep apnea seems warranted.

Stroke (elderly patients)

Age Ageing. 1994 Sep;23(5):405-10.
The effects of pressure and shear on skin microcirculation in elderly stroke patients lying in supine or semi-recumbent positions.
Schubert V, Héraud J.
Department of Geriatric Medicine, Huddinge University Hospital, Sweden.
Abstract
The effects of external pressure and shear on the skin microcirculation over the sacral area, which is known as a high risk area for pressure sore formation, were studied in 30 elderly patients. The skin blood cell flux (SBF) was measured using the laser Doppler technique, with the patient first at rest in lateral position, then lying for 30 minutes in supine or semi-recumbent 45 degrees position, and finally in lateral position. Elderly high-risk patients (G2), most of them more than two years post-stroke, had a lower body mass index and a reduced sacral skin-fold compared with non-risk patients (G1). The SBF in G2 decreased 28% in supine and 14% in 45 degrees position, whereas the SBF in G1 increased 35% in supine and 13% in 45 degrees position. Spontaneous movements up to seven times per 30 minutes were registered, even during sleep, and were evident by direct observation of the recorded charts as a temporary SBF increase. The risk for skin ischaemic damage over the sacral area of elderly risk patients was evident in both positions, especially with the patients lying in supine position. When increasing the upper body slope in G2 from horizontal to 45 degrees, an inability to recover a satisfactory blood supply after the ischaemic insult was found. Discomfort from compressive and shear forces initiates changes in posture, even in elderly patients prone to tissue breakdown. Occasional relief of pressure was in most patients followed by temporary increase in skin blood flow with concomitant temperature increase. This most probably protected them from developing skin lesions.

Tuberculosis (pulmonary) treated by thoracoplasty

Respiration. 1993;60(6):325-31.
Nocturnal oxygen saturation and sleep quality in long-term survivors of thoracoplasty.
Brander PE, Salmi T, Partinen M, Sovijärvi AR.
Department of Pulmonary Medicine, University of Helsinki, Finland.
Abstract
The extent and the predictors of nocturnal hypoxemia were studied in 9 men and 11 women treated for pulmonary tuberculosis by thoracoplasty 30-54 years previously. The patients had a scoliotic (Cobb) angle of 4-53 degrees. Median values for pulmonary function were: forced expiratory volume in 1 s 1.2 liters (49% of the predicted value), vital capacity 1.9 liters (54%), total lung capacity 3.6 liters (62%), and supine waking partial pressure for arterial oxygen 9.7 kPa. Four patients were hypercapnic. The patients' mean nocturnal SaO2 ranged from 83 to 94% (median 91.8%), and the SaO2 level below which the patients spent 10% of the total nocturnal recording time ranged from 78 to 92% (median 89.4%). A multiple stepwise linear regression analysis identified supine waking SaO2 as a significant predictor of nocturnal O2 desaturation, accounting for about 80% of the variability in nocturnal SaO2 levels; lung function values and Cobb angle were not significant independent predictors. The sleep quality, assessed by EEG, was good. It is concluded that in thoracoplasty patients with mild hypoxemia during wakefulness, the degree of sleep-related oxygen desaturation was modest and closely related to the waking level of SaO2.

[RRM]

...people who sleep sitting up, and can correctly nasal breathe ... only need to sleep for 3-4 hours per night, and feel more rested and more energetic

That does not mean its better for you.
Sleep is required for lots of recovery activities.
"needing less sleep" may mean that you are inhibiting daily recovery.

I don't see how it wouldn't be better?
If by sleeping that way for 4 hours you feel the same as if you would when sleeping in bed and breathing incorrectly for 8 hours (i.e. you're not sleepy/tired when awake) then it's definitely better, because you cut sleep time quite a bit. I guess recovery somehow goes on faster when sitting and doing that "proper" breathing?

If you feel the same / better, does not at all mean it IS the same / better.
Not all repair that needs to be done (evoked by hormones) is somehow directly related to how you breathe.
There are so many aspects about sleeping, that (to me) cutting sleeping time and feeling well is too simplistic for a guideline.
Also, short term effects sometimes totally oppose long term effects.
Starving yourself, for example, may temporarily make you feel very good.
And in countries where average bone strength in young people is greatest, eventual bone health at old age is worst.

[RRM]

So, you are suggesting that naturally there are some faults in our body's design that we need to fix by taking those herbs?

Technically there are faults in all animals design which is why we constantly evolve slowly to try and keep up the pace with the fast changing world

I dont think animals evolve because they have faults, technically.
Animals evolve to adapt to a changing environment.
Any relative weakness is solely the consequence of another relative strength, and not a fault.
If you suggest that we may need 'natural drugs' to compensate for a changing environment,
then i suggest to change the environment (food, air, exercise etc) to fit our design.
Using drugs is fighting symptoms.

just like how marijuana can make people feel less stressed

good example: marijuana is not at all healthy.
Yoga or something different might be a much better solution.

So do a lot of things though, this is a natural thing, as long as you don't abuse something then I don't see how this is a problem.

Virtually all drugs produced by pharmaceutical companies are based on natural drugs.
Natural or not does not make any difference in that respect.

But do you really think that changing this balance between neurotransmitters is 'healthy'?

This balance is affected by diet even more ...

Sure, but that is not the point.
The point is: using drugs is fighting symptoms with something that will cause other symptoms.
Natural drugs are drugs, only to be taken when somebody is ill in such a way that you have no other option than to use those drugs.
Healthy people dont get healthier by taking drugs.

And do you really think that its better to increase the permeability of the intestinal mucosa?

Can you show me that yucca root has any danger at all in this manner?

You are talking like the pharmaceutical companies; you cannot change our design without adverse effects.
ALL drugs have side effects. Including natural drugs.
Do you think its healthy to increase the permeability beyond what it is naturally designed to be?
Logically, this will result in the absorption of greater molecules for which the body currently does not need any defense mechanism as they cannot enter the blood anyway.

There is no recorded dangers from yucca root ...

Does that mean it has no adverse effects? Of course not.
All the safe drugs made by pharmaceutical companies have side effects.
ALL of them.
Natural drugs are no exception.

I see increasing permeability of the intestinal mucosa as a great thing as long as you are not ingesting tons of poisons

Everybody ingest toxins on a daily basis.
All foods contain minor toxins.
Increasing the permeability increases the uptake of those toxins / anti nutrients.

You should keep in mind that the body not only needs to absorb nutrients, but desperately needs to keep out other stuff.
It will absorb as much as and what it needs.
If you force it to absorb more, this is not at all healthy...

It will only absorb as much as and what it needs if you give it enough to absorb and give it all it needs.

We already gave it enough and what it needs.
Increasing the permeability, it will absorb more.
And it will not be you who can decide what molecules will get absorbed extra, and what not.

That does not mean its better for you.
Sleep is required for lots of recovery activities.
"needing less sleep" may mean that you are inhibiting daily recovery.

Sleep is not just about breathing.

the fact is that studies have shown this helps with asthmatics and breathing patterns in all people

I believe you, but that does not at all mean that breathing differently makes you require half as much sleeping time for all activities.

[dime]

Healthy people dont get healthier by taking drugs.

Exactly, so many people just don't realize this. Should be written somewhere on the website with huge letters :-)

[Kasper]

Do you really sleep 3/4 hours a day panacea ?