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How Your Jaws Affect The Way You Breathe

Just a final reminder that tonight at 8PM Eastern, I’ll be interviewing Dr. Raymond Silkman, an holistic dentist who will reveal his unique perspective on how our diets have ruined our health, mainly by causing our jaws to shrink. In this fascinating discussion, Dr. Silkman will reveal:

- How modern orthodontics can ruin your sleep quality

- How dental crowding can lead to nasal congestion

- The real cause of TMJ (it’s not from grinding or clenching)

- Why modern humans have more facial wrinkles

- and much, much more…

Click here to register.

Spontaneous Arousals And Sleep Apnea

You just got your brand new CPAP machine for your newly diagnosed severe sleep apnea diagnosis. You use it religiously for one month every night, but you don’t feel any better. If anything, you may feel worse. You take your CPAP data card to your sleep doctor that tells you that your numbers are perfect: It shows that your AHI went from 35 to .9, you had no leaks and you used it 8 hours every night.

Although I have many people who swear by CPAP, there will always be some others that just can’t either tolerate or benefit from it. The problem with CPAP is that during titration in a sleep lab, for the most part, it only addresses apneas and hypopneas. Some sleep labs treat the lesser forms of obstruction and arousals, but in general, most only titrate the pressure to treat apneas or hypopneas.

What this means is that everything else that can cause you to wake up doesn’t get treated, including snoring, flow limitations, and RERAs (respiratory event related arousals). Studies have shown that even if you’re about to stop breathing, pressure sensors in your throat pick up the fact that the airways are beginning to collapse, and it’ll send signals to your brain to wake you up to a lighter stage of sleep, to prevent your muscles from relaxing. Most of these signals stay in the deeper levels of the brain, so you won’t be able to detect any “cortical arousals” through your EEG scalp leads on a sleep study.

If you have an apnea, it’s also likely that you’ll suction up normal stomach juices into your throat. The presence of acid in your throat is enough to activate chemoreceptors which sends signals to your brain to wake you up to a lighter stage of sleep, so that you can swallow your stomach juices and prevent aspiration into your lungs. Many of the “spontaneous” arousals are probably reflux related.

Furthermore, not sleeping effectively can cause your entire nervous system to become en garde, edgy,hypersensitive, and over-reactive. Having any acid in the throat or impending obstruction is enough reason to keep waking you up often throughout the night. Sometimes, having a mask on your face is enough stimulation to keep waking you up, especially if you’re in a lighter stage of sleep.

Are you fully compliant with CPAP, but don’t feel any better? Please enter your responses in the text box below.

I Confess – I Ate Late Last Night

I have to admit that for the most part I don’t eat close to bedtime, but it does occasionally happen. Last night, we had a late afternoon event, and ending up eating Korean food at a local restaurant. Not only did I order something spicy, but we ended up eating about 2 hours later than normal. The big mistake I made was in eating a delicious nectarine around 9 PM after we got home, which was a big mistake.

This morning, I woke up with a really sore throat, which traveled up into my ears. Most people would consider this to be the start of your typical cold or allergy attack, but knowing what I know, and based on the timing of events last night, my throat pain was definitely due to reflux. As I write this post later in the morning, my throat pain is completely gone, which proves my point even further.

Imagine if you typically eat close to bedtime, and you have reflux every night. Chronic inflammation and swelling due to normal stomach juices cases narrowing of your nose and throat, which can aggravate more frequent obstructions and arousals. Poor sleep over the long term causes weight gain, and weight gain narrows the throat, aggravating sleep-breathing problems. Whether or not you have obstructive sleep apnea, everyone is susceptible to this process. If this continues for days or weeks, it can set you up for the routine bronchitis or sinus infections that are so commonly seen.

How many of you have a sore throat in the morning? Please enter your answer in the text area below.

Expert Interview: Dr. Raymond Silkman, Holistic Dentist

In this Expert Interview, I talk with Dr. Raymond Silkman, a holistic dentist, who will reveal his unique perspective on how our diets have ruined our health, mainly by causing our jaws to shrink. Dr. Silkman reveals:

9/11 And Obstructive Sleep Apnea

As I was riding the subway, I noticed an ad by the New York City Health & Hospitals Corporation promoting services for victims of the World Trade Enter disaster on  9/11. It asked about common symptoms that are seen after this tragedy, including chronic upper respiratory or breathing problems, poor sleep, depression, anxiety, and post-traumatic stress syndrome (PTSD).

This add reminded me of a conversation I had with a patient a few years ago that worked as an official for the city in helping people with these illnesses. She did agree with me that many people were affected, but there were others that didn’t suffer the same degree of physical or emotional problems, despite being in the same environment.

My suspicion is that if you have undiagnosed obstructive sleep apnea, you’ll be much more susceptible to these medical issues. Massive amounts of inflammation caused by inhaling dust, fumes, toxic chemicals and smoke can be a major irritant to the upper airways. The emotional trauma of going through such an event can lead to PTSD.

I’ve written in the past about how a sleep-breathng problem can heighten your nervous and immune systems, making you over-react to any form of stimulation or irritation. Additional inflammation in the nose or throat causes more swelling, aggravating more breathing stoppages, leading to more stomach juice reflex, leading to more frequent obstructions. The hypersensitivity that results in the nose leads to increased nasal congestion, aggravating even more obstructions downstream. Poor sleep can then lead to weight gain, leading to even worse sleep apnea.

Notice how many of the symptoms of people suffering from 9/11 trauma are very similar to some war veterans returning from battle. In many cases treating veterans with PTSD by addressing any underlying sleep apnea can help PTSD dramatically. The same concept can and should be applied to 9/11 victims as well.

Do you suffer  from these medical conditions since 9/11? If so, do you snore, and are tired all the time no matter how long you sleep? Are you not able to sleep on your back?

Sleep Apnea Treatment Cures Migraine For NFL’s Percy Harvin

Minnesota Vikings’ Percy Harvin was carted off the practice field last month due to a migraine attack that caused him to vomit and collapse. After being diagnosed with obstructive sleep apnea and undergoing treatment, he reports that he no longer suffers from migraines. Migraines are a major potential complication of any condition that prevent good, efficient sleep, including obstructive sleep apnea. Since we know that football players are much more susceptible to obstructive sleep apnea, Harvin’s experience is not surprising.

Did your migraines go away after starting treatment for sleep apnea? Please enter your comments below.

Migraines, LED Lights & Sleep Apnea

This past Sunday, my family ate at Penang, one of our favorite restaurants on the Upper West Side of Manhattan. Immediately after our meal, my wife complained of a queazy stomach and a headache. We thought it was indigestion from eating too much and didn’t think much of it. After sleeping it off, she felt better.

In retrospect, I also had a peculiar symptom as well: sensitivity to bright LED lights. As I was driving home from the restaurant, while stopped behind a car with very bright LED tail lights, I do remember wincing, with a slight headache and a bit of nausea. Even the red and green LED traffic lights were bothering me.

Looking back at what happened, both my wife and I must have suffered from a temporary migraine attack. Both of us were sleep deprived from various events from over the weekend, and the naturally occurring MSG in the restaurant food that we ate must have triggered our migraine “episodes.”

I wrote a year ago about my episode of vertigo shortly after our third son, Brennan, was born, due to major sleep deprivation. In both these scenarios, sleep deprivation of any kind heightens your nervous system which makes you over-respond or become over-sensitive to certain forms of stimulation or triggers, whether it’s MSG, bright lights, or alcohol. Of course there are a number of other various triggers, when combined, which makes you much more susceptible to migraine attacks.

Even the hotel room  where I stayed last week had light that were just too bright to sleep with. I covered everything up with towels or books. Even in my bedroom, I used black electrical tape to cover up all the green and red LED lights so that I can sleep better.

Are you bothered by the newer brighter LED lights? Please enter your experiences in the comments box below.

Traumatic Brain Injury & Sleep Apnea

Here’s a tragic story of Owen Thomas, a talented University of Pennsylvania football lineman that recently committed suicide. An autopsy revealed early stages of chronic traumatic encephalopathy (CTE), a brain disorder that’s typically seen in football players who suffer repeated head trauma. Typically, findings are similar to what’s seen in Alzheimer’s disease, with neurofibrilary tangels and amyloid plaques. The surprising thing about Thomas’ condition was his age—he was only 21.

Former Tampa Bay Bucaneer Tom McHale died at age 45 of CTE last year. McHale was the 6th former NFL player to be discovered post-mortem to have CTE since 2002. If you add to these findings that football player in general (especially linemen) have a much higher incidence of obstructive sleep apnea, this could explain the high incidence of degenerative brain disease in football players.

It’s a given that you’ll hit your head repeatedly while playing football. Having played football and and rugby in school, I’ve taken a number of hits to the head myself.

The human brain has an amazing ability to heal and regenerate, but when place in adverse conditions, scarring and inflammation occurs. It’s been proven that chronic intermittent hypoxia (from obstructive sleep apnea) causes major brain damage in critical areas of the brain, including parts that are responsible for memory, executive function, motor skills, and autonomic function. Hypoxia can also induce amyloid plaques to build up in brain tissues. Damage to the brain, in the presence of hypoxia, can only lead to bad things.

I realize all this is pure speculation, but is there justification for routine screening for obstructive sleep apnea in all football players? I’d like to hear your opinion about this.

PTSD, Sleep Apnea, & Dementia

Post Traumatic Stress Disorder (PTSD) has gained a lot of attention recently, especially in light of so many war veterans coming home with this debilitating disorder. In a recent study involving over 10,000 subjects, researchers found that the risk of dementia later in life for soldiers with PTSD was twice that of people who didn’t have it, even if they weren’t wounded in battle.

Not too surprising, since both are linked to obstructive sleep apnea. In fact, it’s more likely that untreated obstructive sleep apnea is responsible for PTSD and dementia (and cardiovascular disease). Sleep apnea is known to cause brain damage via various mechanisms, including vascular insufficiency, micro-strokes and diminished brain metabolism, leading to lower brain tissue density and volume in critical areas of the brain. Obstructive sleep apnea also causes generalized over-reactivity of your involuntary nervous system. There are numerous reports of PTSD being cured years later after obstructive sleep apnea is found and treated. Since obstructive sleep apnea is so common, at least look for it before starting medications or psychotherapy. Dr. Barry Krakow is doing some cutting edge research in this area.

Did your symptoms of anxiety or panic attacks go away after treating your sleep apnea?

Sleep Apnea and Childhood Obesity

Here’s another study that reinforces how important sleep is (quantity and quality) when is comes to your weight. Researchers reported in the Archives of Pediatric and Adolescent Medicine that too little sleep in children younger than 5 to being more likely to be overweight or obese five years later. It’s very commonplace for young children to stay up late because they want to or to accommodate the parents’ schedules. Routinely I see toddlers and preschool children being taken to the movies and staying up past 11PM.

What this study reports about is a lack in the hours of sleep, but with sleep, quality usually goes hand in hand with quantity. Staying up later usually means that you’re more likely to snack closer to bedtime, or eat a late meal. This causes increased inflammation in the throat and the entire upper breathing passageways, leading to more obstructions and arousals. Eating close to bedtime is one of the most common habits that leads to poor quality sleep. Fortunately, it’s the first and the most obvious thing you can do to improve your child’s sleep quality.

I realize that for some parents, eating earlier and putting their child to bed can be challenging, but if you look at the long-term health implications of continuing this habit, it’s too important to ignore.

How many hours do your children sleep? Please enter your responses in the comments box below.

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