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I Confess—I Broke My Own Rule

I admit it—I broke my own rule. I had apple pie just before going to bed Sunday night. My 6 year old son and I made apple pie from scratch. We made two pies—one for the family and one for our friends that were coming over that evening. We waited patiently as it cooled after taking it out of the oven. My two boys were salivating and eying it all evening. When it was eventually served, it was a hit. But I literally didn’t have time to taste my own pie, since I was too busy making arrangements for our guests. Later that evening, after our guests had left and we finished cleaning up, I just had to have a slice of my pie. I knew that I was going to turn in to go to sleep within 30 minutes, but I still had to eat it. The next day, I paid the price.

 

One of the most common pieces of advice that I give is that you should try not to eat within 3-4 hours of bedtime. There are lots of explanations for why this can lead to weight gain and poor sleep. One such explanation is that having food in your stomach diverts energy and blood to the stomach, depriving the rest of the body the energy needed to rest and regenerate. Another is that it slows down your metabolism. What most people (and doctors) don’t realize is that the more juices you have in your stomach when you go to sleep, the more likely it’ll come up into your throat, leading to poor sleep. 

 

As mentioned in my sleep-breathing paradigm (in my book, Sleep, Interrupted), all modern humans stop breathing once in a while when sleeping, due to our unique upper airway anatomy and our ability to talk. Muscle relaxation during deep sleep leads to these partial to total obstructions. If these episodes happen very often, for longer periods, then this is what we describe in medicine as obstructive sleep apnea. But obstructive sleep apnea is not something you develop suddenly in your 50s or 60s. All of us have minor variations of it at certain times in our lives (during colds, when we gain weight, or during pregnancy for women). All of us are on a continuum.

 

Once you stop breathing (but before you wake up and turn over), a vacuum effect is created in your throat, which can literally suction up your normal stomach juices into your throat. This not only causes you to wake up from deep to light sleep, but also causes the all-too-common symptoms of post-nasal drip, throat clearing, chronic cough and hoarseness, usually worse in the morning.

 

When I woke up in the morning the night after I ate my apple pie, my throat was a little sore, but what really got my attention was the fact that I felt like I only slept for 5 hours, rather than the 7 that I got that night. I was also more tired than usual all day long.

 

It’s not too surprising that sleep length, sleep efficiency, energy, appetite, and weight loss are all directly or indirectly connected. Yesterday, I saw a child in the office who stated that his sleep quality improved dramatically once he stopped eating ice cream before bedtime.

 

If any of you eat close to bedtime, and don’t sleep well are tired during the day, I challenge you to make it a regular habit to eat earlier for the next 4 weeks. Then let me know on this blog when you feel better. I’m confident that you’ll sleep better and feel better. 

 

By the way, if you want the recipe for my apple pie, just let me know. It’s from a Mrs. Fields recipe book.

Tongue exercises for sleep apnea?

When CPAP Doesn’t Help Your Sleep Apnea

Can Sleeping Too Long Cause Dementia?

Nutritional Lessons From Africa

 

Traditional cultures in certain parts of the world practice contraception by breast-feeding. Most doctors will tell you that breast-feeding is not a reliable form of birth control. However, the way a woman breast-feeds is vastly different in the developed areas versus underdeveloped parts of Africa. 

 

In the US, most women who breast-feed on demand begin to taper off to intermittent feedings after a few months or at most 1-2 years, either supplementing with solid foods, or pumping and giving the milk through a bottle. I’ve written about how bottle-feeding is thought to aggravate dental crowding and malocclusion. 

 

In certain parts of Africa (such as in Batswana), women breast-feed on demand, with the child strapped in slings to the mother’s chest, feeding on demand until he or she becomes too heavy or becomes more independent. Typically, this lasts about 2-3 years. My patient confirmed that women would typically have 3-4 children evenly spaced over a span of 10-12 years. Repeated, short bursts of breast-feeding promotes prolactin release, which is an effective form of contraception. In developed countries, the interval between feedings lengthen over the first year, increasing the odds that pregnancy may occur.

 

He also noted that for the most part, the natives are very healthy, with few stresses, and they generally eat off the land, without too much processed foods or refined sugars. He even feels stronger and healthier when he lives and eats there. The main health problems that he sees are mainly infectious: malaria and HIV. 

 

Dr. Brian Palmer, a dentist that has spent his entire career researching the link between bottle-feeding and obstructive sleep apnea, has stated that in some areas of the world, people can’t afford infant formula, let alone regular food. The only source of nutrition for infants and toddlers is breast milk. Notice that despite the fact that the children are stick thin, they all have nice smiles and bright teeth.

 

Compare this with pictures of young children (in Dr. Weston Price’s book) who eat lots of sweets and processed foods—you’ll see crooked, stained teeth with lots of cavities, along with narrowed jaws and faces.

 

Take note of a native rural African’s jaw structure, and compare the facial width and jaw structures against multiple generation African-American faces. It’s a pretty stark difference.

New School Year Causes Major Sleep Problems

Q: If You Need Your Tonsils, Why Take Them Out?

Q:
If You Need Your Tonsils, Why Take Them Out?

A: Tonsils are part of the immune system, but when they are too large or are prone to frequent infections, then surgical removal is a consideration. One or two infections every year is not too worrisome, but having an infection every month can be debilitating for most people. For many children (and some adults), very large tonsils can lead to breathing problems at night.

For more information on tonsils visit: http://doctorstevenpark.com/what-everyone-should-know-about-tonsillectomy

The Facts About Anti-Aging: Science or Scam?

 

September for those of you who weren’t aware is Healthy Aging Month. This brings to mind my father who just turned 77 this August even though my wife says that he looks like he’s 10 years younger. Everyone who knows him agrees. But the funny thing is my father is the antithesis of what most would consider “Anti-Aging”. He doesn’t take any supplements or vitamins, nor does he undergo cleanses or detox regimens. Yet he looks and acts like a man who’s in his 50s or 60s, and not someone who’s in his 70s.

So why doesn’t my father look and act more like his age? He’s living the life of his dreams.

Live, Not Strive

It’s widely known that the longest living people are in Japan, and I’m willing to bet that these 90 and 100 year olds aren’t taking multiple vitamins, detoxing, cleansing, or paying lots of money for the latest exercise trend.

Similarly, my father, as far as I can see, doesn’t do anything special to maintain his youthful exuberance. He simply eats a healthy diet (mostly vegetables), is physically active, and has a very health-promoting lifestyle.

Take for instance my father’s routine weekly schedule: He takes courses with undergraduates at Hunter college, plays tennis, performs in musicals and plays, sings in his church choir, hikes some very challenging trails in the Catskills, and regularly takes in the opera and the symphony on the weekends. He also jokes that when he wears his baseball cap on the subway or on the bus, no one offers him a seat.  But when he takes off his hat, he’s offered a seat instantly. Much to the chagrin of his peers, who are confined to walkers, and need the aid of home health aids to get by, my father is one of the most active people I know even amongst my peers.

The only thing that my father has that would be considered “typical” for a man his age is that he has prostate cancer. Since 10 years ago when he was first diagnosed with the disease, he has had a persistently elevated PSA. And after multiple treatments for prostate cancer, for which no source can be found, he has received estrogen-like hormone treatments once in a while, but his youthful appearance is more pronounced now than when he was on a more intensive anti-testosterone regimens in the past.

Also, despite his cancer, his blood pressure and his glucose levels are better than most of his doctors and he doesn’t take any prescription medications. 

Your Age Is A Matter of Chronology Not Biology

If you read the magazines or surf the internet, you’ll see various buzz words such as anti-aging, youth-promoting, regeneration, and age-reversal. It seems that the search for the fountain of youth is still alive and the secret is out. It’s not about how old you are that matters. It’s more a matter of how young you want to look and feel.

There’s even a medical specialty called Anti-Aging Medicine to assist people in their quest for agelessness.  It’s almost as if we’re engaged in some sort of mythical battle for immortality. Yet unlike most battles of this sort, our enemies don’t have three heads, or turn you into stone. It just makes you look and feel that way.

Anti-Aging or Anti-Living?

The word Anti-aging to me is an oxymoron since you can’t literally change your chronological age. This also implies that the deterioration in the way you feel or the way you look can be slowed, or even sometimes reversed. There’s definitely value in looking and feeling younger (even for me), but what most of these programs tout is that one pill or supplement that can make you look and feel younger, without addressing the big picture. Yes, there are programs out there that are more “holistic,” but essentially, you’re told you have to replenish what your body is missing in order so that you don’t miss out on all that life has to offer.

The problem is, no one seems to have figured out what that missing ingredient is. Who do you believe if you want to stay healthy or maintain your vitality? Are you not drinking enough water, or are you eating nutritionally deficient foods, or is your water laced with toxins and chemicals? Is it a vitamin B12 deficiency or lack of calcium? Are you eating too many acidic foods or too much alkaline foods? How can you figure out if you’re allergic or sensitive to nuts, gluten, or milk?

Recent studies are now suggesting that vigorous exercise doesn’t really help you lose weight, since you’ll eat more. More confusion. Studies are published almost routinely giving conflicting results on any potential benefits of herbal or nutritional supplements, including valerian for sleep, echinacea for colds, and multi-vitamins for health in general.

With all the different opinions on how to stay young and healthy, it can be a maddening process that can actually make you age faster. Honestly, I don’t have a good answer for you. Even as a physician, I’m stuck in the same conundrum within the medical fields as well, with conflicting studies and vastly differing opinions.

But here’s my personal advice – do what feels right. If you truly believe in something, do it with all your might. Science actually invalidates one individual’s experiences and can only generalize based on large population studies. Since everyone responds differently, your only way to know whether or not it’s going to work is to try it (within reason, of course). Rather than trying to exclude the placebo effect that most studies try to do, take advantage of your body’s natural ability to heal itself, no matter which option you choose.

However, realize that that one pill, supplement or exercise regimen is not going to make you younger.  Eventually, something will work for you, but without changing your mindset and daily habits, your health problems will return and you’ll be back to square one.

One plausible explanation to why people who take vitamins feel healthier is that they are naturally health conscious, eating the right foods and making healthy lifestyle choices. But when vitamins were tested in a prospective, randomized, placebo-controlled, double-blinded study, no benefit is found. Not too surprising. Rather than using the vitamin as the cure-all for all their ailments, healthy people use vitamins as part of a well-balanced, nutritionally smart, and stress free lifestyle, where youth and vitality is a state of mind as well as a continuing process, rather than an end point.

After all, you can draw infinite possibilities in the finite period of time that you have if you want it to. Take my 77 year old father as an example.  Perhaps the best secret to living a long life is just this: Just live.

 

Why Your Child Can’t Sleep

Whenever I get together with other families with young children, almost invariably, there will be one or two parents who struggle with their child’s sleep. Issues range from frequent awakenings to too frequent feedings to sleeping in the parent’s bed. It’s no surprise then why so many adults in this country suffer from a myriad of sleep problems. Perhaps this is also the reason why sleep aids are one of the most popular drugs in this country and why children as young as 7 years old are being prescribed sleep aids to help them fall asleep. Although it’s difficult to admit, America has become the land of the free and the home of the… sleepless.

Resources For Getting Your Child To Sleep

These days,  many households with young children endure daily battles with sleep. It’s not that the parents aren’t equipped with the right information. in fact, the number of resources and books that focus on how to get your child to sleep has doubled if not tripled over the last 2 to 3 years. Sleeplessness is no longer the problem reserved for the old and restless. It’s now one of the most serious problems that parents of young children face each and every night.

Ten years ago, with our first child Jonas, we only had about a third of the resources we have now on getting your child to sleep.  At that time, Dr. Richard Ferber’s technique was in vogue. Despite its slight overtone of 50’s style rigidity and inflexibility, his concepts made the most sense to us and we agreed with his primary principle that children should and can be taught how to soothe themselves back to sleep. Essentially,  “Ferberization” is a gradual desensitization process. Using this technique, we were able to teach Jonas to sleep through the night (10 hours) around 4 months. Since then, this method of teaching our other two children to sleep has been a lifesaver both for their health and our sanity.

Of course just because this method worked for me doesn’t mean that it will work for everyone. Every baby and what appeals to parents are different. Even for us, there were nights when my wife would cry outside the bedroom door, along with the baby, conflicted by her instinct to burst right in to comfort our child and her desire to teach the baby to soothe himself back to sleep as prescribed by Dr. Ferber.

What ultimately did it for us was that we believed and desperately needed a good nights sleep. As simple as that sounds, we knew back then what so much research and study are telling us now: That poor sleep can lead to a host of health problems if not managed early on.

As parents of young children it’s hard to tell sometimes how much sleep your child needs. Some people say that it’s better to let nature take its course—for the child to determine for him or herself how long or short they need to sleep. In my case, this would have never worked, as our oldest would only sleep, prior to Ferberization, 10 to 15 minutes at a time.

With children, going natural, like breast-feeding rather than bottle-feeding, cooking your own baby food rather than giving them processed foods in jars is infinitely better. Yet, sometimes, given certain situations, parents need to assess now and then it costs to hold on to those ideals. It’s important, in other words, not to lose sight of the forest for the trees.

When Sleep Evades

When my brother had his first child, the situation was vastly different. In the four years since I had my oldest son, the pro-baby movement was in full swing. At that time, it was considered okay by most pediatricians to suggest that their child sleep in two to three hour spurts even at night. What was more important was that the child be nursed on demand—even at 9 to 12 months when solid foods should have diminished the frequency of these late night feedings.

His older daughter, as a result often slept in their bed until the age of 3-4. It was much easier for my sister- in-law to nurse her right then and there, to get in a few minutes more sleep, rather than getting up every 2 to 3 hours to get the baby out from the crib. Even now, at age 6, my niece is not a “good sleeper”. Even worse, her sister, who just turned 3 has recently been waking up multiple times during the night.

Another woman I met is experiencing similar problems with her 8 month old. Her baby has recently been waking up two to three times at night to nurse even though he was sleeping through the night at 3 months. Yet another couple I recently met complained that their 5 year old still wakes up 3-4 times every night. In general, children should be able to sleep through the night after 3-6 months. It’s obvious that these guidelines are not the norm.

Pediatric Problems Linked with Poor Sleep

Believe me when I say that I’m the last person to make any moral judgments about parents with sleepless children. If anything, I wrote a whole book explaining why and how adults and children alike are getting less and less sleep (find out more at, www.sleepinterrupted.com).

It’s not that what they’re doing is wrong, but that bad sleep habits for the child eventually affects not only the parents, but studies have shown that sleep problems as a young child has been linked to various serious health issues later on in life.

One such study showed that the presence of sleep problems at age 3-8 strongly predicted the onset of alcohol, cigarette and marijuana use later in life for boys and alcohol use for girls. Another Finnish study showed that perceived tiredness was related to use of psychoactive substances in teens. Other studies have shown that sleep problems are related to anxiety and depression in teens. Children with sleep-breathing problems also had a higher incidence of inattention and hyperactivity.

How to Get Your Child To Sleep

The most important thing to begin with when helping your child develop good sleep hygiene is to develop a sleep routine that both of you can keep consistently. Feeding times, nap times, and bed times should be kept as close to schedule as possible. As any parent of young children can tell you, one late night out with the baby or a severe cold can severely throw off not only the child’s sleep patterns, but the entire family’s as well. Last month when Kathy and I were at the movies (our children were with our baby sitter) I was disturbed to see so many infants and young toddlers out with their parents watching an action-packed movie at 11:30 at night. What’s worse was that they were eating popcorn and drinking caffeinated soda.

These days, cutting down on any form of stimulation just before bedtime can be a challenge. Cell phones, computers, cable TV, and all the noisy and annoying children’s toys can be difficult to control entirely. But even the activities they engage in during the day can affect their sleep. One recent study showed that for every hour a child is sedentary during the day, either watching TV or on the computer or even reading, it takes an additional three minutes to fall asleep at night. A related ad hoc study showed that children who were more active during the day, playing outside or involved in sports activities, fell asleep faster and slept longer throughout the night than children who were more inactive. Simply put, turn off the TV if you want your child to sleep better.

Sugar is also blamed for various health and sleep issues today. It’s common sense to avoid a brownie or a soda just before bedtime. Eating healthier in general can promote better sleep overall.

Once your child has passed the infant stages, she should be able to sleep through the night after a good dinner. But don’t feed him just before bedtime. Eating too close to bedtime affects  hormones that affect weight, appetite and metabolism. This is true even for grown ups. In these situations if you have even a slight sleep-breathing problem (24% of men and 9% of women), then juices get suctioned up into the throat, not only waking you up, but causing various throat symptoms like throat pain, post-nasal drip, chronic cough, and hoarseness.

An underlying sleep-breathing problem can also be a major cause of sleep problems especially between the ages of 3-6. Large tonsils and adenoids are very common at this age, and if your child’s breathing is labored in any way, or if he snores, or is a mouth breather, see your pediatrician about it, especially if your child seems tired all the time, or has difficulty staying focused or concentrating during the day. If either of the parents snore or stop breathing, then there’s even more reason to suspect an underlying sleep-breathing problem.

For the many other various issues that can arise, help is available. Go beyond the generic information that’s available on sites like WebMD, or the Mayo Clinic’s site. Invest in books, DVDs, or professional counseling for your child’s sleep needs, as well as for your own sleep needs. Set a good example by following good sleep habits yourself. Ask your friends who have succeeded what works for them, and don’t give up. Believe me, being able to get a good night’s sleep consistently is well worth the effort.

What Everyone Should Know About Tonsillectomy

Tonsils are one of the most misunderstood structures in the throat, not only by patients, but by many doctors as well. Traditional teaching states that tonsils are glands in the throat that help to fight infection. Because they are blamed for most cases of repeated throat infections, tonsillectomy is one of the most commonly performed operations in the United States. As I’ll reveal in the remainder of this article, many tonsillectomies today are being performed unnecessarily. Simultaneously, there are too many tonsils still left in place when in fact they should be removed. Here’s the reason why.

 

What Are Tonsils?

Before I can clear up the contradictory statement above, I must first explain what tonsils are and what they do to merit removal, if at all.

Tonsils are lymphoid tissue, like glands in your neck, armpits or groins. They are part of the immune system and are involved in learning what’s foreign and helping to make antibodies to help fight off infections. In young children, lymphoid tissues are very sensitive and can become greatly enlarged even after a simple cold or infection. If you have young children, I’m sure you’re familiar with their complaints of sore throats whenever they have colds.

It’s also important to note, however, that tonsils can swell up not only after viral or bacterial infections, but also from allergies and acid reflux. Any degree of irritation or inflammation can cause the tissues to swell up. This is normal, and will happen to various degrees in people after any type of infection, irritation or inflammation. As such, not all complaints of a sore throat are viral or bacterial in origin. There are many factors for an enflamed tonsil—this is the reason why antibiotics are not as effective in curing sore throats.

What Do Tonsils Do?

Tonsils are part of Waldeyer’s ring, which is a complete circle of lymphoid tissue that is made up of both tonsils in the side walls of your throat, the adenoids, which are in the midline back of your nose, and your lingual tonsil, which is located at the base of your tongue in the midline. In some cases, you’ll see small connections between all four glands, forming a complete circle. Anything that you breathe in or swallow has to go through this “ring”, so that the body can learn what’s coming into the body. This process is most active around ages 3 to 6.

It’s common knowledge what happens when your tonsils become infected: your throat hurts, you have a fever, your neck glands hurt (lymphoid glands that drain your tonsils), and you don’t sleep well. Anything from simple cold viruses to bacteria, and even allergies can cause your tonsils to swell. Streptococcal bacteria are very common, but there’s one particular strain called Group A beta-Hemolytic Streptococcus (GABHS) that tested for and treated, since toxins produced by this strain can potentially damage the heart or the kidneys. In theory, non-GABHS bacteria can also give you similar miserable symptoms, but if severe, doctors will typically give you oral antibiotics, which will make you feel better in most cases.

When Tonsils Mean More Than Sore Throats

But there’s one more variable that occurs during a tonsil infection that’s usually not appreciated—the fact that the tonsil can swell significantly. As I’ve mentioned in my book, Sleep, Interrupted, and in other related articles, humans have relatively narrowed upper airway breathing passageways to begin with, and even mild inflammation and swelling in the throat can narrow this airway even further, almost always leading to various degrees of obstruction and arousal from sleep.

What this means is that, your enlarged tonsils not only affect how sore your throat feels, they can also cause you to sleep poorly. Here’s the reason why.

If the inflammation and swelling caused by an infected tonsil causes your airway to narrow or obstruct entirely and this in turn, causes you to stop breathing, you’ll either wake up to light sleep immediately, or stop breathing for 10 seconds or longer and then wake up. In this latter situation, you would have experienced what’s called an “apnea” or “loss of breath." Most people will have lots of short obstructions and arousals—this is why if you have a simple cold, you won’t sleep as well, since you’ll toss and turn more often than normal. Luckily, in most situations, once the infection goes away, you’ll return to normal.

However, there’s one more piece to the puzzle that can prevent you from feeling better: This is the piece that many patients and even many doctors overlook as well. If you stop breathing, even temporarily, you’ll create a vacuum effect in your throat, where your stomach juices literally get suctioned up into your throat. Small amounts of acid, bile, digestive enzymes, and bacteria can cause your tonsils to stay swollen, aggravating this vicious process. Even worse, your stomach juices can then travel up into your nose or down into your lungs, wreaking more havoc. Add to this a stuffy nose, then another vacuum effect is created downstream, and the tongue can fall back even further.

Certain viruses such as the Epstein-Barr virus (that causes mononucleosis) attack lymphoid tissues specifically, and as a result, keeps the tonsils abnormally large.

This is one reason why patients with this condition have prolonged bouts of chronic fatigue.

Misleading Throat Pain

Most people (and doctors) naturally assume that if your throat hurts, it means that you have a throat infection. If the antibiotics that you’re given works, then it means that it was an infection after all, right? Not necessarily. One of the most commonly prescribed oral antibiotics is called azithromycin (brand name is Z-Pak), which is a convenient 5 day course. One of the lesser known beneficial side effects from this medications is that it empties your stomach faster. So by keeping your stomach juices from coming up, your throat will feel better relatively quickly, sometimes working faster than what you’d expect from typical antibiotics. The problem with this medication is that it only works sometimes in some people, and the effect begins to wear off after a few doses.

Notice how for many people, cold and sinus “infections” always start in the throat, with a tickling, sore throat, mucous accumulation, hoarseness, cough and post-nasal drip, all of which are symptoms of throat acid reflux. Then as swelling in the throat worsens, more and more juices are brought up into the throat, causing more swelling. If you have larger than normal tonsils, then the narrowing in your throat will be more severe and you’ll stop breathing more and more often. If this process continues, the end result will be the classic bronchitis or sinusitis.

Normally, tonsils shrink down to very small glands by the time you’re an adult, but for some people, they stay enlarged. One possible explanation is that they are subjected to repeated bouts of inflammation from stomach juices, and the large tonsils can bring up more stomach juices.

A Rite of Passage?

In the 50s to 70s, it was a given that if you had tonsils, they were removed. The number of tonsillectomies has dropped significantly since then, but more recently, it’s climbing back up. The main reason for tonsillectomy back then was for recurrent infections, but now obstructed breathing is the most common indication.

We now know that even mild degrees of sleep-breathing problems in children can cause a wide range of problems, from bed-wetting and ADHD to behavioral issues and asthma.

A recent study published in the journal Pediatrics showed that about 50% of children with ADHD could be cured with adenotonsillectomy (this is when you remove both the adenoids and tonsils). Countless studies report significant improvement in children’s cognitive, behavioral, memory and sustained attention scores, after tonsillectomy. Even my son Jonas had dramatic improvements after his tonsillectomy.

Not all children with ADHD have a sleep-breathing disorder, but since it’s such a common condition that can be treated, it’s worthwhile to at least consider it if your child has ADHD. People are always asking why a stimulant medication such as Ritalin helps children focus and remain calmer. The answer is that they’re sleepy.

Poor quality of sleep can also heighten a child’s senses and cause abnormalities in their involuntary nervous system, making him or her have balance problems or become hypersensitive to certain sensory forms of input, such as touch, sounds or odors.

The Truth About Tonsillectomy

Unfortunately, not all children who undergo tonsillectomy improve. A recent meta-analysis combining multiple tonsillectomy studies showed that overall, about 2/3 had significant benefit. Some children do somewhat well, but not as well as some others. The explanation here is that the tonsils are not the only part of the equation. By definition, if your tonsils are large, then your jaws will be smaller. I’ve mentioned in my book, Sleep, Interrupted that modern humans have smaller jaws than our ancestors even a few hundred years back, mainly due to a change in our diets (from organic foods off the land or oceans to processed foods with refined sugars). Bottle-feeding is another modern Western phenomenon that has been shown to aggravate this process. If you have smaller jaws to begin with, you’ll have more inflammation in your throat via the mechanism that I described earlier, which will predispose your tonsils to become enlarged. Having large tonsils will cause more obstructions, causing a vacuum effect, which can also narrow your jaws, especially since a young child’s jaws are relatively soft and malleable.

A recent study showed that compared with tonsillectomy alone, orthodontic palatal expansion was equally effective. When both procedures were performed, the results were additive. This study goes to show that dental and orthodontic issues may be important considerations long before parents consider braces for their teens.

Outgrowing Your Tonsils

Some of you may be asking, if the tonsils are an important part of the immune system, why take them out? Most of the early education of your immune system occurs before age 6. Either during this time, or even long afterwards, if your tonsils are so large that they literally obstruct your breathing at night, then wouldn’t you think that this is a more important issue that needs to be dealt with? Doctors will also say that children will “grow out of it.” Yes, in most cases, they will, but based on all the recent studies, there’s plenty of evidence that before they “grow out of it,” there can be potential long-term consequences, including your risk for developing obstructive sleep apnea, heart disease, heart attack and stroke later in life.

I once heard a presentation at a national sleep meeting, where they showed children who underwent tonsillectomies all improved dramatically. The disturbing finding from this study was the fact that compared with children who did not have sleep-breathing issues, the children who underwent tonsillectomies never fully caught up to the control children in terms of cognitive and behavioral measures. What this implies is that there’s some degree of permanent brain damage. Fortunately, children’s brains are highly adaptable, and can compensate very well.

By no means am I advocating routine tonsillectomies for all children. But if your child has any of the issues that I talked about in this article, or if you’re on the fence about whether or not your child should undergo some type of treatment, these issues are definitely worth thinking about.

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