Sleep Interrupted

Steven Y. Park MD argues that a large number of common, poorly explained complaints — persistent fatigue despite adequate hours in bed, morning headaches, reflux, poor concentration, anxiety, frequent night waking — can trace back to breathing problems during sleep that routine care overlooks and standard criteria may not capture.

The proposed mechanism is anatomical. Human jaws and upper airways have narrowed over generations, leaving less room behind the tongue and soft palate. During sleep, muscle tone falls and that space narrows further. Park describes a spectrum rather than a single diagnosis: from simple snoring, through upper airway resistance syndrome, in which increased breathing effort causes repeated brief arousals without the oxygen drops or full apnoeas that define classic sleep apnoea, to obstructive sleep apnoea itself. He argues the middle of that spectrum is where symptomatic people are most often missed, and that it can affect people who are neither older, male, nor overweight. The book covers contributing factors including nasal obstruction, sleep position and reflux, and reviews treatment options from positional and nasal measures to CPAP, oral appliances and surgery.

It is for people who sleep enough hours and still wake unrefreshed, who snore heavily or wake gasping, or whose partner has noticed pauses in their breathing.

On the evidence: the core warning is sound. Obstructive sleep apnoea is common, substantially underdiagnosed, associated with cardiovascular and metabolic risk, and effectively treatable — so prompting people to consider it is genuinely useful. Two qualifications matter. Upper airway resistance syndrome is a recognised concept but less standardised in diagnosis than apnoea, and the book extends the airway model to a wider range of symptoms than current evidence supports. More importantly, this is not a self-management topic. Suspected sleep-disordered breathing warrants clinical assessment and a diagnostic sleep study — in-laboratory polysomnography or a validated home test — with treatment decisions made alongside a clinician.