• Home
• About Dr. Park
  • Dr. Park’s Bio
  • My Mission
• Testimonials
• Articles
• Sleep Apnea Basics
  • Obstructive Sleep Apnea – A Primer
  • Upper Airway Resistance Syndrome
  • Surgery For Snoring & Sleep Apnea
  • Usual and Unusual Ways to Stop Snoring
• Expert Interviews
• Blog
• Press Room
• Resources
• Contact Us

Subscribe: Email RSS 

Do You Need To Treat Mild Sleep Apnea?

One of the more controversial issues in sleep medicine is whether or not you need to treat mild obstructive sleep apnea. Some people recommend treatment no matter how mild the condition, whereas others have a watch and see attitude. Here’s a study that suggests maybe you should treat people with mild sleep apnea: Researchers looked at two groups of people were initially given a diagnosis of obstructive sleep apnea for two years. The first group were given CPAP, and the other group had no treatment. At the two year mark, people who were on CPAP had a mean blood pressure that was almost two points lower than baseline, whereas the untreated group’s mean blood pressure went up by 9.6 points. Both of these numbers were statistically significant.

If you have mild sleep apnea, this one study doesn’t show that everyone with mild sleep apnea should be placed on CPAP, but what it does suggest is that you should do something about it, whether it’s weight loss, changing your diet or lifestyle, consider using an oral appliance, address your nasal congestion, or anything that will help you to breathe better so that you can sleep better. Remember that poor sleep quality promotes weight gain in the long term, so it’s important to get started now.

If you have mild sleep apnea, what have you done to address your condition?

Can Losing Weight Cure Sleep Apnea?

One of the most common questions I get asked is, “can sleep apnea be cured if I lose weight?” My usual response is, sometimes, but not too often. The more severe your sleep apnea, the less likely you’ll reach normal levels if you lose significant weight. If you start with mild sleep apnea, then there’s more of a chance that you may be “cured” of sleep apnea. A recent study published recently in the Journal of Clinical Sleep Medicine echoed my thinking. Researchers followed 44 obese people with obstructive sleep apnea who were enrolled in a 2 year weight loss program. The overall success rate (AHI < 20 and greater than 50% drop) was 15%. However, overall, the BMI, arousal index, and subjective scores all improved. They recommended weight loss programs as an adjunctive treatment in motivated obstructive sleep apnea patients.

What’s your experience with weight loss? Did your sleep apnea improve?

How Sleep Apnea Can Cause Asthma

You may be thinking that I’m stretching things a bit by suggesting that obstructive sleep apnea can cause asthma, but there are numerous published studies linking these two conditions. A recent study published in Chest showed that poorly controlled adult asthmatics had a much higher chance of having undiagnosed obstructive sleep apnea—almost 3 times higher.

Here are 3 ways that sleep apnea can aggravate or cause asthma:

1. It’s been shown that repeated apneas can cause a vacuum effect in the throat that can suction up your normal stomach juices into your throat. This “juice” contains not only acid, but also bile, digestive enzymes, and bacteria. Furthermore, these same juices can reach the nose, sinuses, ears and the lungs. Washings of these areas have demonstrated the presence of pepsin, one of the digestive enzymes, and H. pylori, a common stomach bacteria. Even small amounts of stomach juice in your lungs can definitely cause major inflammation.

2. Repeated obstructions and arousals can cause your involuntary nervous system to become hypersensitive to weather changes, such as temperature, humidity, and pressure changes. You can also be sensitive to chemicals, scents or odors. This condition in the nose is called nonallergic or chronic rhinitis. In the lungs, the equivalent is probably what we call reactive airway disease. Allergists and asthma researchers have stated that the nose and lungs are essentially one airway, and have coined the phrase, “one airway, one disease.”

3. If you’ve ever experienced dirt or dust in one of your eyes, the you’ll tear in the other eye as well. Similarly, if your nose is irritated, then by applying the concept of “one airway, one disease,” your lungs will become inflamed. Conversely, if you place some stomach acid in your lungs, then your nose will automatically become inflamed through this reflexive process. Having a stuffy nose can create a vacuum effect downstream, promoting even more frequent tongue collapse, leading to more obstructions, and to more reflex episodes.

How many of you with obstructive sleep apnea also have asthma?

Snoring Intensity As A Predictor Of Obstructive Sleep Apnea

Not everyone that snores has obstructive sleep apnea but in general, the louder you snore, the more likely you’ll have obstructive sleep apnea. This was confirmed in a study that recruited people undergoing sleep studies, and found that the louder you snore, the worse your degree of obstructive sleep apnea.

People have describe their bedpartner’s snoring a sounding like a chainsaw. There are reports snoring loudness that goes well over 100 decibels. How loud is your snoring, and how do people describe it?

ADHD & Sleep Apnea: The Controversial Connection

As the new school year begins, it’s only natural that there’s more awareness about learning and behavior issues. One of the most controversial topics that came up frequently is ADHD, or Attention Deficit Hyperactivity Disorder. It’s thought that 2-4% of children have this condition, and a shocking 50% of children with this condition are on some form of prescription medication. Not only is it seen in children, but adults can have it as well. Symptoms include inability to focus or pay attention, being easily distracted, and various behavioral problems in the classroom.

There are a number of proposed explanations for why ADHD occurs, including brain biochemical imbalances, environmental and dietary toxins, and allergic conditions. One possible explanation that never receives very much attention is from lack of deep quality sleep.

Poor Sleep Can Ruin Your Child’s Brain Health

It may be coincidence, but it’s estimated that about 2-4% of all children have obstructive sleep apnea. And we know from numerous studies that poor sleep, whether not enough sleep, or poor quality sleep, can adversely affect the brain in a number of different ways.

For one thing, lack of oxygen to the brain has been shown to cause lowered blood flow and metabolism in critical areas of the brain, including parts that involve memory and executive function.

There’s no doubt that hypoxia can cause significant alterations in the levels of neurotransmitters that regulate memory, focus, concentration, and other cognitive skills. If you pick any one out of dozens or hundreds of biochemical markers, you’ll find that there will be a deficiency or an elevation. Whether it’s dopamine, acetylcholine, or serotonin, if you look for abnormalities, you’ll find it. Not too surprisingly, the same can be said for depression, anxiety, and other mood disorders.

Admittedly, ADHD is a multifaceted condition. Sometimes, it’s mainly due to one condition, and in other cases, from a combination of different causes. Not breathing well at night while sleeping can present with the same clinical symptoms as toxic contamination such as lead poisoning. So it’s important to have the pediatrician or other health care professional to look at all possibilities before considering psychotherapy or prescription medications. Only after every treatable condition has been ruled out should the diagnosis of ADHD be given, since ultimately, it’s a diagnosis of exclusion.

First Check For Sleep Apnea, Then ADHD

One recent study found that 28% of children scheduled to undergo routine tonsillectomy had official ADHD. Once their tonsils were removed, the rate of ADHD dropped by about 50%. Since these children were selected from a pool of patients that are already predisposed to sleep-breathing problem, it’s only natural that sleep apnea is so common. In another contrasting study, there was no difference in the rate of obstructive sleep apnea between controls and children with ADHD.

One thing that’s for certain, many children with ADHD, even if they don’t officially have sleep apnea, will have major sleep breathing or sleep hygiene issues. This situation is similar to patients who don’t have obstructive sleep apnea but have upper airway resistance syndrome, where they still stop breathing multiple times during the night.

During the initial evaluation process, one of the first things to always consider is the possibility of a sleep-breathing problem. Snoring or breathing problems at night are always a good thing to look for, but you don’t have to snore to have significant obstructive sleep apnea. If your child has very large tonsils, or has frequent throat infections, then consider seeing an ENT surgeon. Chronic nasal congestion or a runny nose can suggest a problem with the upper breathing passageways as well. If one or both parents snore, then even more reason to suspect a possible sleep-breathing problem.

But before you take your child to see a sleep doctor or an ENT surgeon, first try these simple steps to improve their sleep quality.

1.  Take care of any allergies, whether food related or environmental. Allergies can cause inflammation of the upper air passageways that can cause swelling and further narrowing, leading to more obstructions and arousals. If conservative options fail, then see an allergist.

2.  Don’t eat or snack within 3-4 hours of bedtime. Eating close to bedtime allows more stomach juices to be suctioned up into the throat when you stop breathing.

3.  Deal with any nasal congestion. Having a stuffy nose for any reason causes a vacuum effect that allows your tongue to fall back easier when in deep sleep.

4.  Set a regular bedtime routine, with no media (TV, computers or phones) within one hour of going to bed.

5.  Make sure the bedroom is completely dark. Many bedroom appliances, clocks or other devices have exceptionally bright LED bulbs that can prevent proper sleep onset.

If you suspect that your child may have ADHD, the first thing to consider is to consider poor sleep quality as a major aggravator, if not the cause. Yes, you still need to address all the other issues that can aggravate ADHD, such as diet, stimulus control or allergies, but sleep should never be excluded from the list. Even if sleeping better doesn’t’ help with the ADHD, it can definitely help with various other health issues, such as obesity prevention, or lower incidence of asthma, depression, and anxiety. It could even help your child raise his or her test scores.

What Everyone Should Know About Mold

I was recently watching an HGTV program where a prospective home buyer was shown a house with obvious mold in the basement after flooding. The discussion that took place between the host and the guest was similar to talking about the black plague. Similarly, even in my practice, many patients are at their wits’ end trying to rid their houses or apartments of mold.

But as I look at it, molds, yeasts and fungal infestation or infection, although harmful, may not be as pernicious as the press and the media would like to have you believe. Here’s why.

Why Mold Is Not Our Enemy

Molds, funguses and yeasts, called collectively as fungi, are different from bacteria, plants or animals. They are widely present throughout the world, and are an important part of our earth’s ecosystem. However, just like bacteria, pollens, dust, gluten, or milk, modern humans have developed sensitivities to normal substances in our environment. There are a number of different explanations for this phenomenon, including living in relatively more sterile environments, or having toxic infiltration of chemicals into our food and water supply. Children growing up in farms or third world countries, for example, are found to have less allergies.

Our modern times have been called the “age of anxiety,” and this includes our body’s over-reaction to normal substances, situations or environments. To understand why this is so, it’s helpful to go over what happens in a stressful event. Robert Sapolsky, in his classic book, Why Zebras Don’t Get Ulcers, explains that when a zebra is running away from a lion, every aspect of the zebras’ physiology is being geared up to avoid being eaten by the lion.

This means that the nervous system and the immune system are extremely heightened thereby increasing reflexes and stimulating the immune system. This short burst of intense sympathetic activity, lasting seconds to minutes, is what’s called the “fight or flight response” by endocrinologist Hans Selye. You hear about mothers lifting cars to save their children, and other amazing stories. But what if this beneficial response is happening all the time, but at lower levels?

This is exactly what Sapolsky describes—that modern societies, with its’ constant and incessant little stresses, is what’s killing us—literally. Some examples include the honk behind you as soon as the traffic light turns green, the rude cashier at the store, deadlines, crisis management at home, and various other issues at work.

During a major stressful event, your cortisol levels (your stress hormone) and your sympathetic nervous system increases greatly, but once the stressful event is over, your hormonal and nervous system responses return back to normal levels. Actually, with the immune system, as it drops back to normal levels, it dips below normal for a short period of time before going back to normal levels. This may be one explanation why people get sick only after a major stressful event.

But if you have multiple small stressful events throughout the day, you don’t have time to recover, and your baseline stress levels remain constantly elevated.

If you add to this any form of sleep deprivation, than you’ll be adding to this chronic stress state even more. Moreover, if you have obstructive sleep apnea, it’s a given that you’ll have more physiologic stress, proven by numerous studies. Add any additional sources of emotional, psychological or physical stress, and it can make your internal stress levels even worse.

Coming back to the mold example, if you have an underlying sleep-breathing problem such as obstructive sleep apnea, you’ll be extra sensitive to molds compared with someone without sleep apnea. However, if you add to this the anxiety of media driven shows that multiply fears about the dangers of any kind of mold, then your baseline response to molds will be further increased.

Can Mold Cause Sinusitis?

One recent theory about the origin of chronic sinusitis is related to molds—that your nasal cavity is filled with normal mold spores that come in from your natural environment. Once it settles into your mucous membrane layer, it eventually gets slowly passed into your throat by the mucous blanket that gets pushed back into your throat. However, if you are overly sensitive to molds, then white blood cells are recruited from the surrounding blood vessels that eventually reach the mucous membrane layer, releasing toxic chemicals that end up destroying the molds. Phagocytic cells then come in to clean up the mess.

However, as a result of the release of toxic chemical, the underlying mucous membrane is damaged, and becomes “leaky”, allowing normal bacteria that live in your nose and other toxic substances to leak into the tissues of the nose and sinuses. This same concept has been used to describe food sensitivities that can lead to a “leaky gut” with its’ various gut-related symptoms.

I’m not discounting the legitimacy of mold hypersensitivites, but I do want to emphasize the fact that any kind of allergic reaction or hypersensitivity (pollen allergies, certain foods, weather, etc.) can be aggravated by an underlying sleep-breathing problem. If you do have a known sensitivity to molds, you have to either remove the mold, or remove yourself from the moldy environment. But at the same time, this should be a signal for you to investigate if there isn’t another stressor, like a sleep breathing condition, that’s aggravating your mold allergies even more.

As such, mold problems, like any other health problem, don’t occur in isolation. Just as a migraines is caused by a number of different triggers that can add up until you have your headache, your mold problem will worsen if you have a number of other factors that stimulate your nervous system, such as whether changes, allergies, sleep quality, emotional stress, nasal congestion, etc.

There’s no doubt that millions of people are suffering from mold or yeast related health problems unnecessarily. But at the same time, there are also many people who are taken advantage of by industries playing to their fears and anxieties about the dangers of mold. Whether or not you have potential mold problem, it’s important to evaluate your sleep quality. Knowing that a significant proportion of Americans have undiagnosed obstructive sleep apnea, treating this condition will not only improve your mold-related health problems, but improve numerous other aspects of your health as well.

Ask Dr. Park: Neurologic Complications of Obstructive Sleep Apnea

We already know that obstructive sleep apnea can cause stroke, but can it can also cause central sleep apnea or even Alzheimer’s? How can it lead to various other unexpected conditions such as migraines, headaches, dizziness, lightheadedness, various stomach ailments, and even ringing, hearing loss, or vertigo? Hear Dr. Park’s answers and what you can do to prevent it.

Topic: Neurologic Complications of Obstructive Sleep Apnea

Price: $17

Please click here to purchase the MP3 recording.

Central Sleep Apnea—A Simple Explanation

In sleep disorders, obstructive sleep apnea is the most common condition that’s seen, but a significant number of people with obstructive sleep apnea will also have central sleep apnea. Central sleep apnea is thought to be a condition that’s associated with a number of different neurologic problems, as well as heart or kidney failure. During the night, people with central sleep apnea stop breathing when signals in the brain that tells the body to breathe don’t work properly. No effort is even made to inhale. In contrast, with obstructive sleep apnea, an effort is made to breathe in, but because of collapse in the upper airways, air can’t get into the lungs.

One of the hallmarks of central sleep apnea is Cheyne-Stokes breathing, where after a long pause, due to gradually increasing levels of carbon dioxide (CO2), shallow breathing is triggered which gradually becomes deeper and deeper, and then once CO2 reaches a safer level, the breathing becomes more shallow again.

Unfortunately, treating central sleep apnea is more of a challenge than treating obstructive sleep apnea, and the best way of treating this condition is to use a variation of CPAP as a respirator. This is a servo-ventilator feature that’s found in machines that can treat this condition. When it senses that you’re not breathing, it literally breathes for you, rather than applying constant positive pressure for obstructive events. Some people will have a combination of obstructive and central events, which is called mixed or complex sleep apnea.

A number of different neurologic conditions can cause central sleep apnea, but here’s a simpler explanation:

We know that a HUGE number of people have undiagnosed obstructive sleep apnea. Up to 1/4 of all men and 1/10 of all women have it, and by the time you’re 60 or 70, the vast majority will have at least some degree of sleep apnea. If you’re human, and you can talk, then you’re susceptible to breathing problems at night, even if you don’t suffer from any apneas. The reason is that complex speech and language development unprotected our upper airways, and everyone’s tongue can fall back and obstruct your breathing at night, especially when you’re in deep sleep, due to muscle relaxation.

I’ve also talked about how modern humans’ jaws are shrinking, due to a radical change in our diets and the addition of bottle-feeding. This had lead to increased rates of dental crowding, with more and more people needing braces. The smaller the jaws, the less space there is for the tongue, which can take up too much space, ultimately crowding the airway.

We also know that there’s a linear correlation to complications of apneas, even in the very low range, where having an AHI of 4 is significantly worse than having an AHI of 2, although officially, you won’t have obstructive sleep apnea, since you come in below 5. Sleep apnea patients are also known to have thick or viscous blood that tends to clot easier when there are areas of low blood flow or small vessel constriction. People with obstructive sleep apnea by definition have smaller vessels and low blood flow simply due to the massive stress response that naturally constricts blood vessels and causes hypertension.

Numerous imaging studies also show that people with obstructive sleep apnea have much higher numbers of lacunar infarcts, which are small areas of dead brain tissue that’s normally seen in routine CT scans of the brain. Other studies reveal lower blood flow, metabolism and brain tissue density in certain critical parts of the brain that control memory, executive function, and autonomic function. Areas of the brain that address hearing, including the high frequency sound perceiving areas of the inner ear, are also extremely sensitive to instances of low blood flow or stagnation. One recent study showed that people with sleep apnea had lowered auditory brainstem reflexes, but after treatment with CPAP, or after thinning patients’ blood concentrations, these auditory reflexes improved.

One finding that’s fascinating is that parts of the brain that control breathing are also affected preferentially by these events. Knowing that even mild levels of sleep-breathing problems can aggravate various levels of clotting and vessel blockages, if you happen to clot off a small vessel that leads to this area, then your neurologic breathing patterns can be affected. These same areas also control autonomic function, which includes heart rate, temperature, digestion, sweating, and vascular reflexes. Damaging even a small part of the brain in this area can wreak havoc on your breathing patterns, as well as other regulatory functions that control your body’s organs.

Since we know that obstructive sleep apnea is strongly associated with heart disease, it makes sense that central sleep apnea is commonly seen in patients with heart disease. Not only can obstructive sleep apnea cause heart disease, by applying this model it can also cause central sleep apnea. Poor involuntary nervous system control, especially of the heart, can wreak havoc on heart function. It can also cause problems with digestion and even your hormones.

Although we have a way of treating central sleep apnea, the results are not as satisfying compared with treating obstructive sleep apnea. Ultimately sleep doctors don’t have very good answers to why this happens, or how to treat it effectively. Think of it as a permanent neurologic condition, where rather than having weakness of your lower legs, you have weakness of the nerves that control your breathing patterns. Treating the obstructive component probably won’t cure the central sleep apneas, but at least it could prevent it from getting worse.

7 Common Procedures That Can Worsen Sleep Apnea

Millions of surgical operations are performed every year to improve your health, beauty, and even your smile, but there’s a hidden danger in some of the most common procedures that can aggravate if not actually cause obstructive sleep apnea. Sleep apnea happens when your jaws are too narrow, which constricts the internal soft tissue layer that lines your upper breathing passageways, from your nose to your throat. More than a few times a week, I see patients that underwent procedures in the past that clearly was detrimental to the quality of their sleep. Here are 7 common and uncommon procedures that can affect the way you breathe and sleep.

1. Rhinoplasty

One of the most common procedures that’s performed today is your routine nose job, or rhinoplasty. In most cases a hump is taken down, or the tip is made more narrow. In the process, certain support structures are weakened, with flimsy nostrils resulting many years later. In the 1950, the Goldman tip was one of the more popular styles, where the tip of the nose was made very narrow and lifted up slightly. With any procedure that narrows the tip, a portion of the lower lateral cartilages have to be either removed or weakened. This cartilage is one of the main support structures that keeps your nostril from collapsing inwards.

Initially after the procedure, patients can breathe well, but years or decades later, with constant inspiration and vacuum forces from routine breathing, the nostrils slowly cave inwards, worsening nasal congestion.

We know that nasal congestion can aggravate or cause obstructive sleep apnea. This is why nasal packing after any surgery is a miserable experience, and why you’ll toss and turn whenever you have a cold (from a stuffy nose). If your jaws are already narrowed, you’re more likely to have a nasal hump and narrowed nasal cavity, so worsening nasal congestion can only aggravate breathing problems downstream. Underdevelopment of the midface pulls the upper lip and the lower cartilaginous nose down, creating the classic nasal hump.

Even with contemporary rhinoplasty techniques, it’s important to prevent this from happening using proper technique and by minimizing removal of excessive cartilage.

2. Orthodontics / Headgear

I’m sure you’ve seen children wear headgear in past years, with a brace around the head and wires pushing or pulling teeth. Children with overjets (overbite) were managed by pushing the upper teeth back, thus creating the illusion of a proper bite. The fact is that in these children, the lower jaw is underformed, and the best thing to do is to pull the lower jaw or teeth forward to match the upper teeth.

Additionally, some orthodontists still extract teeth to make room for the remaining teeth. Your smile may be nice, but in the process, your jaw just became smaller. Any amount of narrowing of your jaws creates less room for your tongue, and with muscle relaxation in deep sleep, you’ll stop breathing much more often. It’s bad enough that modern human’s jaws are shrinking more and more (due to a radical change in our diets and with bottle-feeding), but when you start to extract multiple teeth, you’re definitely going to have problems breathing. The back molars also act to support the soft tissues of your throat. So removing your molars can destabilize the soft palate, aggravating more soft tissue collapse, especially later in life.

3. Jaw Surgery

Once in a while, I’ll see patients that underwent lower jaw surgery to push back a prominent lower jaw. In this situation, the upper jaw should  have be pulled forward. Since the base of your tongue attaches to you back of your mandible, any backward movement of your jaw can push your tongue back, aggravating breathing problems while you sleep.

4. Thyroglossal Duct Cyst

The thyroid gland starts at the back of your tongue and migrates down your neck in front of your voice box, and then divides into your right and left thyroid lobes with a small connection between the two over the top of the windpipe. Sometimes, a remnant of that tract from your tongue to the voice box can remain, with cysts or tracts or even thyroid tissue along this pathway. When a cyst develops, you’ll have a midline ball or swelling that won’t go away. The treatment for this condition, called thyroglossal duct cyst, it surgical removal.

The procedure is classically called the Sistrunk procedure, named after the surgeon that originally described it. The critical part of this procedure involves removed the midline 1/3 of the hyoid bone, which is a c-shaped bone that sits on top of your voice box. Unfortunately, you’re also weakening and destabilizing the attachments to the tongue and voice box. Upon questioning the handful of patients that have undergone this procedure in past years (some by me and some by other surgeons), most have said that their sleep quality worsened. If you’re ever going to undergo this procedure, it’s important to reattached or reconstruct the tissues that help to support your tongue and voice box.

5. Hysterectomy

Total hysterectomy with or without removal of the ovaries is a common procedure for many women. We know that especially when the ovaries are removed, this creates a state of surgical menopause. I’ve described in past articles that as progesterone naturally drops in normal menopause, sleep quality can diminish, mainly due to the effects of progesterone on tongue and upper airway muscle tone. As the tongue muscle tone slowly drops, obstructions and arousals become more frequent, and you won’t sleep well.

This is also one of the main reasons why hormone replacement therapy (HRT) helps many women sleep better. However, with the recent finding that HRT can increase rates of cancer, it’s not generally recommended anymore. If you’re thinking about undergoing a hysterectomy, be prepared not to sleep as well.

6. Breast Implants

If you’re a woman and like to sleep on your stomach, then getting breast implants can definitely worsen your sleep quality. For a few weeks after this procedure, most surgeons will ask you to sleep on your back. The problem is that when on your back, your tongue will fall back more often, leading to more frequent breathing obstructions and arousals. Until you’re able to go back to stomach sleeping, be prepared to lose a lot of sleep. Unfortunately, some women are never able to sleep on their stomachs again, being forced to sleep on their sides or back.

7. Any Type of Surgery

No matter what type of surgical procedure you undergo, if you’re forced to sleep on your back, then your sleep apnea will be worse. If you never had sleep apnea or sleep-breathing problems, then being on your back may bring on your first experience, especially if you’re a natural side or stomach sleeper.

As you can see, millions of people undergo these procedures every year. Sometimes, the effect on sleep occurs immediately, whereas in others, it can take months or years to surface. If you’re planning any of the above procedures, or if you’ve undergone any in the past, think about how it can potentially affect your quality of sleep. It’s something you should definitely sleep on.

Can Sleep-Breathing Problems Cause Postpartum Depression?

A recent study recommended that all new mothers be screened for postpartum depression. This is not a bad idea, since so many women are likely to undergo some form of depression in the postpartum period. Even my wife Kathy experienced it after our first son, Jonas, was born.

There are many good explanations for postpartum depression, but here’s a simple, but unexpected reason that has to do with progesterone.

As women progress through pregnancy, they all gain weight. Significant weight gain can push most people into developing obstructive sleep apnea. Progesterone has been shown to be protective in obstructive sleep apnea by acting as an upper airway muscle stimulant—it increases muscle tone in the genioglossus muscle (the tongue, the largest upper airway dilator). During pregnancy, progesterone elevates significantly, but just after delivery, it drops, but you still have all that weight.

Modern humans are susceptible to breathing problems at night due to the fact that we can talk. As a result, our upper airways are unprotected. Add to this the documented shrinking of our jaws and dental crowding from a radical change in our diets, you end up with a tongue that takes up relatively too much space. Bottle-feeding, which is another modern Western invention, is also thought to cause malocclusion and dental crowding.

Sleep-breathing problems can be a major cause of postpartum depression. Biochemical changes in the brain due to sleep-breathing problems can look identical to classic depression findings. This is also a reason why many women say that they never sleep the same again after the last pregnancy. The good news is that with a proper examination and appropriate treatment, many women can begin to sleep better after having a child. In addition to screening for depression, you should also screen for sleep-breathing problems.

For the women reading this, has your sleep quality never been the same since your last pregnancy?

Next Page »

Copyright © 2012 Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring · Design by Fervent