Description

In November 2020  Dr. Rosalba Courtney presented her online workshop, Integrative and Functional Treatment of Sleep Disordered Breathing to a small group of attendees.

Sleep Apnea is becoming a major health concern with research showing increasing prevalence across the lifespan. Recent studies have shown that 1 in 10 Australians suffer from undiagnosed sleep apnea and prevalence in males over the age of 40 appears to be as high at 49% (Simpson et al., 2013).

Untreated OSA can cause short term health issues like impaired neurocognitive function, metabolic dysfunction, and daytime fatigue. Long term OSA has been linked to diabetes, a range of cardiovascular diseases, depression, Alzheimers disease, and other chronic illnesses (Senaratna et al., 2016).

However, there are many challenges to the effective management of OSA. The gold standard treatments such as continuous positive airway pressure and mandibular advancement devices are often unsuccessful or poorly tolerated. These treatments which only target anatomical aspects of OSA may only be successful in 50% of patients. Non-anatomical causes of OSA including neural control of the upper airway dilating muscles, arousal threshold, and stability of breathing control are important contributing factors in at least 60% of patients with OSA (Eckert, 2016).

Treatments that address these functional or physiological drivers of OSA may be the key to the successful treatment of OSA. Examples of these types of treatment include functional training of upper airway muscles, breathing mechanics, and tongue function, reduction of systemic inflammation, and improvement of chemoreceptor flexibility. These types of treatments have been shown to reduce OSA severity and may be key solutions or important adjunctive treatment in patients with mild or moderate anatomical deficit. (Courtney, 2020).

After listening to this 2 hour workshop, you will:

• understand treatment options for sleep apnea beyond CPAP and mandibular advancements
• understand key anatomical and functional phenotypes of OSA
• recognize the impact of dysfunctional breathing on treatment outcomes for OSA
• understand how improving nasal breathing and upper airway function reduces sleep apnea

Courtney, R. (2020). Breathing retraining in sleep apnoea: a review of approaches and potential mechanisms. Sleep Breath. doi:10.1007/s11325-020-02013-4

Eckert, D. J. (2016). Phenotypic approaches to obstructive sleep apnoea–new pathways for targeted therapy. Sleep medicine reviews.

Senaratna, C. V., English, D. R., Currier, D., Perret, J. L., Lowe, A., Lodge, C., . . . Dharmage, S. C. (2016). Sleep apnoea in Australian men: disease burden, co-morbidities, and correlates from the Australian longitudinal study on male health. BMC public health, 16(Suppl 3), 1029-1029. doi:10.1186/s12889-016-3703-8

Simpson, L., Hillman, D. R., Cooper, M. N., Ward, K. L., Hunter, M., Cullen, S., . . . Eastwood, P. (2013). High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls. Sleep Breath, 17(3), 967-973. doi:10.1007/s11325-012-0785-0

About Rosalba Courtney ND, DO, PhD

Rosalba is an osteopath and naturopath with over 40 years’ experience as a practitioner, teacher, researcher, and writer. She has a Ph.D. in breathing and a deep interest in the ways that breathing and airway function affect health.

She was one of the first practitioners trained in the Buteyko Method 1990s, was the founding chairperson of the Buteyko Practitioners Association and trained practitioners in this method in Australia, the USA, and the UK. This led to a broad interest in breathing therapy in general.  She received her Ph.D. from RMIT University for her research on the topic of “Dysfunctional Breathing: Its Parameters, Measurement and Clinical Relevance” in 2011.  She is internationally recognized for her work in this field, having published over 20 peer-reviewed articles and several book chapters on this topic.

Rosalba has also completed training in orofacial myology and integrates this into her clinical practice.   Rosalba has presented at many national and international conferences. She is actively involved in research and mentoring of osteopathic students. Rosalba is renowned for her ability to synthesis complex information from the scientific literature to extract its practical significance for the clinician. Rosalba conducts training programs for practitioners and patients in Integrative Breathing Therapy in Australia and internationally. She practices in Sydney, Australia.