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Post-Thanksgiving Sleep-Breathing Disturbances

Just as I predicted in my 11/28/09 post, many more people will experience various ear, nose, throat and sleep-breathing disturbances in the immediate days just following Thanksgiving. Just today, I saw a number of patients that developed sinus pain and congestion or throat pain along with ear pain. Of course, they all indulged in seconds helpings during Thanksgiving dinner, and many stayed up later than usual.

 

Since my sleep-breathing paradigm predicts that all modern humans are susceptible to various degrees of disturbed breathing while sleeping, any massive amounts of late-night food will by definition promote increased swelling in the throat, which aggravates more frequent obstructions and arousals.

 

Intense vacuum forces created in the throat can literally suction up normal stomach juices into the throat. It’s not only acid that comes up, but also includes bile, digestive enzymes, and bacteria. This can lead to the classic throat reflux symptoms, which include throat clearing, throat pain, post-nasal drip, chronic cough, hoarseness, lump sensation, or even difficulty swallowing. These materials can then migrate into the lungs, causing or aggravating asthma, bronchitis, and chronic cough. If these juices go up into the ears or the nose, then you’ll get ear fullness or pain, nasal congestion and sinus headaches.

 

Are you suffering from any of the above symptoms in the days following your Thanksgiving dinner? If so, are you more tired than usual? Please enter your responses in the comments box below.

CPAP Success Secrets Revealed

Why Sleep Apnea Increases During the Holidays

It’s the Saturday after Thanksgiving, and I have to admit, I’m not feeling too well today. I had my usual two servings of turkey Thursday evening. For some strange reason, I had three pieces my other sister-in-law’s coconut cake, and as usual, this Thanksgiving dinner was much later than my usual dinner time. The next morning, I slept in a little later, but still didn’t feel as refreshed as I normally would. Later that day, I spent the day with my two older boys, Jonas and Devin at the Intrepid Museum. For some odd reason, I was craving toffee that Devin had brought, I was was eating one every 30 minutes. This morning, I was feeling even more tired than normal, and during lunch, I was craving soda or some other sugary drink, which I normally don’t drink.

I finally realized that eating sugar, and over-eating later than normal on Thanksgiving lessened my sleep efficiency that night, which raised my craving for sugar the following day. This just goes to show how powerful even mild sleep deprivation can cause a rise in sugar cravings, which if chronic, can lead to unhealthy eating habits, ultimately leading to weight gain. Stress (emotional, physical or mental), is also known to increase cravings for sugary, fatty, or "comfort" foods. And weight gain is known to worsen sleep apnea. (To listen to an interview I did with Peter Lappin on how you can Beat the Sugar Habit Before It Beats You, click here.)

The holiday season is known to be the most stressful time of the year, with all the over-eating due to holiday parties and late night dinners. This is why the rate of heart attacks is also the highest during this time of the year. Knowing what I’ve described, we should all take appropriate measures to eat more sensibly (and earlier), drink alcohol in moderation (and earlier during the evening), and do everything that’s reasonably possible to reduce your stress levels. Find out how you can do this by joining me on December 15th, when I interview Dr. Niloo Dardashti, an integrative psychologist and holistic healer on 10 simple ways to reduce stress.

I’m sure if we had a collective sleep apnea meter that measures the total amount of sleep apnea in this country, it will most likely be at its’ peak level during the next month.

How are you going to address this issue, if any, this holiday season? Please enter your response in the comments box below.

 

 

How to Go From Fatigued To Fantastic

 

 

Can H1N1 Cause Sleep Apnea?

You may be thinking that I’m stretching things a bit by making the suggestion that H1N1 can cause sleep apnea, but in my mind, there’s no doubt that whether it’s H1N1, the common cold, allergies, or strep throat, any degree of inflammation and swelling in the nose and the throat can aggravate sleep-breathing problems. If you didn’t have sleep apnea to begin with, then you may go into sleep apnea territory temporarily, and come back to normal once the infection is gone. This is why you’ll toss and turn when you have a simple cold. If you already have some degree of sleep apnea, then any infection or inflammation will only make things worse. Some people will recover, whereas others will be stuck in a continuous vicious cycle, leading to various other medical complications.

 

As I detail in my book, Sleep, Interrupted, most modern humans have narrowed jaws that lead to dental crowding and a predisposition to breathing problems while sleeping at night. My sleep-breathing paradigm proposes that all modern humans are on a continuum, where the upper extreme is formally called obstructive sleep apnea. But even if you don’t have sleep apnea, you can still stop breathing multiple times every hour. This disrupts your sleep and causes more inflammation and swelling due to suctioning up of your stomach juices into your throat. More swelling causes more upper airway narrowing, leading to more obstruction, which leads to more swelling.

 

The most dramatic example is what happens with mononucleosis. The Epstein-Barr virus which is thought to cause mono preferentially attacks lymphoid tissues. Your tonsils are made of lymphoid tissues, like the glands in your neck, armpits and groins. When your tonsils swell up for whatever reason (infection, irritation, inflammation), it narrows the throat, aggravating more frequent collapse, perpetuating the vicious cycle described above. This is why it takes a long time for mono to go away. In some people, the cycle never stops, leading to chronic fatigue syndrome. The physiologic consequences of this process can lead to hormonal, biochemical, and neurologic changes which may or may not show up on blood tests.

 

In this situation, it’s not that the tonsils are too big, but the jaws are too small, causing chronic inflammation and swelling, which keeps the tonsils larger than normal. This leads to further narrowing of the upper airways. It’s also been shown that you can have persistently enlarged lingual tonsils, which are lymphoid tissue at the base of the tongue in the midline. The size of lingual tonsils has been correlated to the level of reflux material in the throat. Your adenoids, which are lymphoid tissue in the back of your nose, can also become inflamed from colds or allergies, aggravating nasal congestion, which creates a vacuum effect downstream in the throat.

 

Ultimately, what’s more important than what’s infecting you is the size of your upper airway and how well your body is able to handle these infections. An underlying sleep-breathing problem can definitely aggravate your symptoms. This is why living by the principles that incorporate my sleep-breathing paradigm will help you to minimize or even prevent serious complications from any infection this winter season. My wife and I live by these principles and so far (knock on wood), so good.

 

Do simple colds lead to prolonged symptoms or repeated infections for you? If so, please explain in the comments box below.

The Politics of Sleep Apnea (Tuesday, 11/24)

Over the years, many of you who suffer from obstructive sleep apnea have asked me why so many physicians and healthcare providers are clueless about this devastating disease and why after 40 years of knowing what OSA can do to people’s health, awareness about this disease is still lagging compared to chronic diseases like heart disease and diabetes.

 

Well, I have just the person who can answer those questions and more.

 

Be sure to join me on my next Expert Interview titled:

 

The Politics of Sleep Apnea

 

I’ll be interviewing the Executive Director of American Sleep Apnea Association, Mr. Edward Grandi on:

 

Tuesday, November 24th @ 8:00-9:00 PM Eastern Time

 

Mr. Grandi will be sharing loads of information you won’t get elsewhere. He is frequently quoted in local and national media on the prevalence of sleep apnea and diagnostic and treatment options available to address this chronic disease.

 

Can’t make it to the LIVE session? Register anyway. Anyone who registers will get a time limited access to the MP3 downloadable recording of the call a few days after the event. That way you can listen to the recording afterward.

 

Here’s what you’ll learn during this 60 minute call:

 

=> What is the American Sleep Apnea Association and how it can help you

=> What is the ONE key question to ask your healthcare provider to get the proper diagnosis and treatment of your sleep apnea.

=> What are the pros and cons of the new healthcare reforms affecting those with sleep apnea

=> What the government is doing to prevent sleepy pilots, truckers and bus drivers

=> How you can get involved to make a difference

 

And like all of Dr. Park’s Expert Interview teleseminars you’ll learn much, much more.

 

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Be sure to register by clicking on the link below and get exclusive access to the complimentary MP3 download (good for 7 days).

 

 

https://jodevpress.infusionsoft.com/link/5dcb536a0/325aa0

 

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Sign up now! The deadline to register is 11/24.

 

I’ll talk to you on the 24th.

 

Dedicated to helping you Breathe Better, Sleep Better, Live Better,

 

Dr. Park

 

Register below to download and listen to this FREE recording.

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Sleep Apnea and Breast Cancer: Is There A Connection?

There’s been a lot of press coverage recently about the new mammography screening recommendations for breast cancer. The United States Preventive Service Task Force recently recommended that women begin routine mammography screening at age 50, rather than 40. This is an important issue for me as my aunt died from metastatic breast cancer in her early 40s. 

 

One thing that I see over and over again is how obstructive sleep apnea can affect every aspect of your health, from your mood, to diabetes, to heart disease. You may think that cancer and sleep apnea are totally separate conditions, but with the human body, everything is ultimately connected in one way or another. This lead me ask the question: Do sleep apnea and cancer have a common origin?

 

In my practice, anytime I see a patient with a history of breast cancer, I almost consistently see the following: cold hands or feet, unrefreshing sleep, an inability to sleep on their backs, and a severely snoring parent, typically with cardiovascular disease. What’s remarkable is that when I examine their airways with a fiberoptic camera, the space behind the tongue is usually very narrow, especially when they lie flat on their backs. This anatomy leads to repeated obstructions and arousals, especially when sleeping on their backs and in deep sleep, when muscles relax the most. For this reason, these women prefer not to sleep on their backs.

 

In my book, Sleep, Interrupted, I describe a process where due to poor breathing and inefficient sleep, a physiologic stress state is created, which leads to lack of proper blood flow to certain parts of the body that are considered unimportant when you’re in a fight or running from a tiger. These areas include the digestive system, reproductive organs, your hands and feet, and your skin, amongst others. 

 

During periods of stress (whether internal/physiologic or external/emotional), there can be severe blood flow restriction to any of these body areas. As an example of how dramatic this can be, there’s a description of a man who was severely injured during battle, and most of his abdominal wall was missing, with his bowels clearly visible. While he was recovering in bed, his doctors noticed that whenever he was angry or in pain, his bowels were dark and dusky, whereas when he was happy, his bowels looked pink and healthy. Similarly, there can be dramatic fluctuations in blood flow to the breasts depending on the woman’s mood and stress-inducing states.

 

One common finding in both cancer and sleep apnea research fields is that hypoxia (lack or oxygen) in tissues can lead to production of signals that tell the body to bring in more blood and nutrients. As a result, a number of inflammatory mediators are released, including the well-known vascular endothelial growth factor (VEGF). VEGF promotes local growth of blood vessels in oxygen-poor areas. Imagine if this process happened all the time, with slow but gradual growth of local tissues, with activation of genes and proteins that promote more inflammation and more cell reproduction. 

 

We know that chronic overstimulation of any tissue can lead to cell replication that can go out of control. Chronic overstimulation of breast tissue can initially lead to localized benign growths or cysts, and some of these can end up transforming into malignancies. Perhaps some women with certain genes may be more susceptible to this transformation. This same process can also be described for prostate cancer.

 

Most younger breast cancer survivors probably won’t have obstructive sleep apnea if tested. But what they most likely will have is upper airway resistance syndrome, which results in multiple microscopic obstructions and arousals that prevents deep, efficient sleep. This can cause the nervous system to become hypersensitive, with increased physiologic states of stress. As they gain weight later on in life, many will progress into formal sleep apnea. 

 

Studies show that breast cancer survival is poorer in obese patients. Similar findings are also found with prostate cancer. This is possibly explained by the fact that the more obese you are, the more likely you’ll have obstructive sleep apnea. Having obstructive sleep apnea significantly increases your risk of dying in general.

 

Granted, what I’m describing here is a very different perspective in explaining breast cancer, and is sure to be controversial in some people’s minds. However, rather than trying to explain breast cancer from a molecular, genetic, or organ level, wouldn’t you agree that it’s much more satisfying when you can explain this illness from a whole-person perspective? As much as Western medicine tries to deny it by fragmenting care to different specialties, we know intuitively that whether it’s the breast, the heart, the mind or the prostate gland, everything is ultimately connected.

 

What’s your opinion on this important issue? Please enter your comments in the box below.

Snoring As Your Internal Smoke Alarm

When we used to live in a house many years ago, our carbon monoxide alarm would keep going off in the basement. We checked the alarm and all the various possible sources of carbon monoxide leakage, with no obvious leaks. On a routine maintenance call for our furnace, the technician found that whoever installed the unit did it improperly, and it wasn’t vented properly. Needless to say, my wife and I were shocked.

 

Similarly, snoring is your internal alarm telling your spouse or bedpartner that there’s a problem. Snoring means that there’s partial or total obstruction with your breathing and that it could mean something much more dangerous lurking underneath that can literally kill you in your sleep. I commented in a previous blog how there’s no such thing as "benign snoring." If you snore, you have a 35% chance of having obstructive sleep apnea, which increases your chances of having a heart attack or a stroke by 3-5 times. Even if you don’t have official sleep apnea, you’ll still have a higher chance of suffering from depression, insomnia, or getting into a car accident.

 

In this country, we routinely screen for dozens of medical conditions that have 1-2% incidence that are much less riskier than having untreated obstructive sleep apnea. With up to 24% of middle-aged men and well over 50% of seniors having this condition, it’s a travesty that snoring is not taken too seriously by the medical community. The snorer’s health is potentially at risk, but what about the snoree that has to suffer and lose hours of sleep due to his or her snoring bedpartner?

 

Do you suffer from sleep loss due to a snoring significant other? If you are the snorer, and haven’t done anything about it, what are you waiting for? Please respond with your comments in the box below.

10 Tips for Better Sleep: A Chinese Medicine Doctor’s Perspective

 

 

 

 

Ancient Chinese Secrets for Getting Better Sleep Without Drugs or Horomones…

• Get a restful sleep without drugs, hormones, or surgery.
• Use what alternative medicine has to offer to help you wake up energized after a night of sleep.
• Live a long, rested, and healthy life by utilizing the natural secrets of the Chinese medical tradition.

Sleep Apnea and Rat Sperm Flow Dynamics

Some of my patients have asked me how I got interested in sleep apnea. I’ve always thought that it was a gradual process that began early in private practice, culminating in my eureka moment that I describe in my book after our first two children were born. But recently, I finally realized what gave me the background to be able to appreciate the complexities of sleep apnea: my training in biophysics. 

 

I majored in biophysics during my undergrad years at Johns Hopkins. Essentially, I was a physics major with an interest in solving biological problems. For my undergraduate research experience, I spent some time in a research lab that studied shear stress on rat sperm during ejaculation. Air or fluid with various densities or viscosities have very different flow characteristics depending on the nature of the channel. There tends to be more turbulence at the periphery of the tube, which can shear and damage sperm bodies, making them immobile. Soft or malleable passageways can collapse depending on the structural characteristics of the wall, as well as the material that flows through this channel.

 

These basic science principles have given me an appreciation for how our upper airways work. Our breathing passageways are not just channels that funnel air into the lungs. The air is filtered, moisturized, heated and smoothed before it even reaches the lungs for oxygen extraction. The entire upper airway is dynamically changing constantly in multiple areas, affected by your anatomy, any allergies, the weather, what you just ate, or even your emotions. Even slightly narrowing one part can significantly affect another part, either upstream or downstream.

 

This is why simple colds or an allergy attack can wreck havoc on your sleep quality. Additional narrowing due to inflammation of an already narrowed passageway (due to smaller jaws) can aggravate further collapse in other areas. At first glance it may seem a little complicated, but if you look at the big picture, it’s a beautiful and simple explanation for what happens when our nasal and throat air passageways become inflamed or narrowed for any reason.

 

 

 

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