This is so frustrating. Surely millions or billions of humans having terrible sleep is not just some genetic abnormality, and we did not evolve to have terrible sleep only fixed by modern technology. There must be some underlying issue that can be addressed for the majority of people.
I got diagnosed with sleep apnea and asked about this, since I'm not overweight. The doctor said it's more about the structure of the mouth and throat than obesity. There is an area at the back of the tongue that gathers more fat and can block the throat, but palette structure is a big factor. Along with jaw size and throat size.
This absolutely makes sense to me. It explains why it affects anyone, not just overweight people or people who do not exercise. Our mouths evolved to masticate much larger amounts of low calorie and high fiber food. If this theory is correct, it is still unfortunate that it is not easily solved with something like exercise alone and often requires either braces or CPAP.
YES! Read "Jaws" by Kahn [1] to find out why. If you're are familiar at all with Jared Diamond's books (Guns, Germs, and Steel) or have read Sapiens, it should be a piece of cake to understand. I bought this book for 4 people with sleep apnea or unresolved dental problems.
This book was published in 2018, and it's not yet common knowledge. Doctors I have been to don't get it, I have doctors in my family that don't get it.
It's historical and scientific, but it has a lot of practical implications for raising children too. A child's facial structure is surprisingly malleable (by lifestyle), and it determines how they breathe, which in turns affects everything else. Just like food, breath is at the base of your physiology, and affects all aspects of your health (dental health, mental health, and more!)
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Summary:
Agriculture and diet are fundamental reasons behind recent and huge changes in our jaw and airway development. They change us faster than our genes do. (epigenetics)
Another profound change that is faster than evolution is the development of speech.
In other words, apes and dogs don't have sleep apnea because they don't have agriculture, and they can't vocalize like we do. It's a crazy problem that requires an explanation -- your throat and neck tissue literally strangles you while you're sleeping, giving you heart attacks and many other problems.
There are a lot of practical implications, like breathing through the nose rather than the mouth (another article about this was recently on the front page of HN), and what foods you and your children eat.
I was interested to discover fairly recently that human jaws don't develop fully if you don't work them by chewing tough stuff growing up. Hence not enough space for wisdom teeth requiring surgical removal and other issues.
The chewing issue is part of it, but far from the whole picture. I recommend reading Jaws, as it's relevant to anyone whose kids will have dental work (which is basically everyone).
Part of the thesis is that braces and wisdom tooth removal are overapplied. People who disagree with that have to answer why ancient people and animals don't need similarly large amounts of dental work (answer: their jaws are a lot healthier than ours due to their environment.)
A related but separate issue in children is mouth breathing, and the chain of causation is also explained in the book.
My impression (from briefly skimming papers about this a few years ago) was that there is clear evidence that myopia is strongly related to not spending enough time outside as a child, but it’s not clear to what extent the effect being outside has on eye development is from focusing the eyes far away vs. being in very bright surroundings.
I believe that someone did some studies involving outdoor schools or similar, that was considered to differentiate between those factors - being outdoors and reading was better than being indoors and reading.
