Ask Dr. Park: Top 10 Questions About Sleep Apnea
January 31, 2011
This month, I’ll be answering the top 10 questions I get asked about obstructive sleep apnea. Of course, I’ll also leave plenty of time for me to answer your other questions at the end of the program.
1. What’s the difference between snoring and apnea, and where is each coming from?
2. What’s the best CPAP – mask combination?
3. Is snoring itself harmful or do you need to have sleep apnea to have adverse health effects?
4. How effective are mouthpieces for sleep apnea?
5. How can the source of airway blockages be determined?
6. What’s the best operative solution after UPPP fails and what is it’s success rate?
7. Does sleep apnea cause permanent brain damage?
8. Can CPAP convert OSA into UARS?
9. Do you have any suggestions for what to do for patients who just cannot sleep in a sleep lab?
10. What’s the best sleep apnea treatment?
Please click here to purchase the 60 minute MP3 recording for $17.
Click here to purchase the PDF transcript for $7.
The Real Reason Why College Students are Stressed
January 27, 2011
College officials are saying that the rate of stress and emotional health problems for incoming Freshmen are on the rise. The New York Times did an article recently about the epidemic of mental health problems in our college campuses. They blame the typical reasons such as stress during high school and the poor economy.
As expected, the one thing that they didn’t touch on is the importance of poor sleep as a major aggravator of stress, anxiety, and depression. Even when sleep is sometimes mentioned, it’s usually assumed that poor sleep is a consequence of depression or stress. While that may be true, college is a time of major disturbances in sleep from a physiologic and behavioral standpoint, so it’s no wonder that college students are not only majorly sleep deprived, but are also prone to common conditions such as anxiety, depression, or even eating disorders.
It’s safe to assume that college students don’t get enough quality sleep. This is not surprising, since with newfound freedom, young adults will stay up longer, eat at irregular times, or even pull all-nighters. Not to mention drinking more alcohol later at night. While at home, teens have more regular, structured meal and sleep times, but in college, this is almost nonexistent. Lack of sleep is a major aggravator of physiologic processes that can promote anxiety, overwhelm, and depression.
(Sleep physicians have even stated that teens’ sleep times are shifted later, leading to what’s called delayed sleep phase syndrome. This means that they go to bed later and wake up later. I sometimes wonder if this is a real problem or a consequence of modern society. From what I can tell, hundreds of years ago, teens went to bed at the same time that their parents did.)
But one thing that’s never even considered is the fact that anatomically, the transition from teenage years to adulthood (puberty) also changes your upper airway anatomy. As the voice box drops down in your throat, your voice changes or deepens. Physically, as the voice box drops lower, a larger space is created between the soft palate and the epiglottis, which is called the oropharyx. The more the voice box drops, the more the back of the tongue can rotate back, causing breathing problems when sleeping on your back, especially when you’re in deep sleep, with muscle relaxation.
It’s during the tail end of this transition when teens are let loose on their own at college. I’m guestimating that if some simple sleep hygiene and sleep-breathing principles were followed at your typical college, you can have about 25 to 50% less mental health issues, as well as achieving higher test scores and better academic performance.
In retrospect, if I had implemented what I know now during my freshman year in college, I wouldn’t have had such a hard time adjusting or have had so much trouble handling the coursework.
Do you think this is a feasible proposal, or am I fooling myself in thinking that college students will ever change their habits? What do you think?
An Embarrassing Admission
January 25, 2011
I was flipping through the channels this past weekend and just happened to land on PBS, where they were doing a special on the Lawrence Welk Show. I have to admit that I used to watch this show in the 70s, and still to this day, if I ever stumble upon this show, I’ll watch it for the great big band music and singing.
I initially began watching to listen to the music, but as I observed the singers, I was truly impressed by their wide jaws and fully developed cheek bones. If you look at younger adults these days, you’ll see how narrow their facial structures are, with many having underdeveloped lower jaws. It’s a frightening thought that this situation is now pandemic throughout the modern Western world. What this means is that having smaller jaws can lead to smaller breathing passageways, leading to less efficient sleep, with all the various medical, psychological, and emotional consequences of not ever being able to obtain deep, quality sleep.
How many of you observe people’s faces and analyze their jaw structures?
Obstructive Sleep Apnea And Hearing Loss
January 22, 2011
I’ve always suspected that nerve deafness may be one of the consequences of obstructive sleep apnea, but there’s been little research in this area. However, a new study out of Korea shows that in the elderly, having obstructive sleep apnea significantly increases your chances of have nerve deafness, particularly due to a problem in the central nervous system.
This finding is not surprising, since sleep apnea causes a hyper-coagulable state, with blood being more stagnant and tending to clot, in addition to additional inflammatory factors that can cause damage. It’s also been shown that blood is thicker and more viscous in people with sleep apnea. In fact, a recent study showed that people with obstructive sleep apnea had thicker blood than normal, and by diluting the blood concentration with saline, auditory brainstem reflexes improved to the point of being normal. Placing these people on CPAP also normalized hearing reflexes.
Recent brain imaging studies have shown that hypoxia in the brain from sleep apnea can cause major vascular and tissue damage, affecting critical areas of the brain, including the brainstem. The risk of stroke is also increased by more than 3 times if you have sleep apnea. Knowing all this, it’s not surprising that you can have either brainstem damage or peripheral inner ear vascular damage from untreated obstructive sleep apnea. One study showed that people with sudden one sided hearing loss from nerve damage have a higher risk of having sleep apnea.
I think that nerve deafness is part of the cardiovascular-metabolic process, going along with hypertension, diabetes, hypertension, high cholesterol, and heart disease. What you you think? If you have sleep apnea, do you have any hearing loss?
Expert Interview: Dr. Mack Jones on Neurologic Complications of Sleep Apnea
January 20, 2011
In this month’s Expert Interview, I talk with Dr. Mack Jones, neurologist, sleep physician, and author of the book, Deadly Sleep: Is Your Sleep Killing You? about some of the major neurologic complications of obstructive sleep apnea. In this fascinating and provocative discussion, Dr. Jones and I talk about:
- How sleep apnea can cause Alzheimer’s disease
- The link between multiple sclerosis and sleep apnea
- How ADHD and autism can be caused by sleep-breathing problems
- Seizures and sleep apnea
- And much more….
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Less Hot Flashes With An Antidepressant?
January 18, 2011
Can taking an antidepressant diminish menopause symptoms such as hot flashes and night sweats? A study just published in JAMA showed that menopausal women who were given Lexapro had small, but significantly less number of hot flashes per day compared to women given placebos.
Many antidepressants can diminish REM sleep, which is when you’re dreaming, and also when your muscles are most relaxed. Mirtazapine, another antidepressant, was shown to lower the AHI in sleep apnea patients by about 50%.
Women who are going through menopause are also going to have more frequent breathing pauses, due to a gradual lowering of progesterone levels. Progesterone is a powerful upper airway muscle dilator or stimulant. So if you lower this hormone, you’ll have more frequent breathing pauses, which will cause you to wake up all of a sudden, which can be a surprise to your nervous system.
It’s also been shown that many of the symptoms of menopause, including hot flashes and night sweats, are autonomic nervous system reactions (vasomotor symptoms) that can occur whenever your nervous system is shocked or in a state of major imbalance. I described young men having hot flashes and night sweats, mainly due to slowly progressing obstructive sleep apnea during rapid weight gain. These nervous system reactions can also occur during the daytime. Whenever your nervous system is en garde or edgy, it’s going to over-react to any form of stimulus. I vaguely remember reading another study what showed that women don’t wake up from hot flashes themsleves, but rather from breathing pauses. This is similar to why people get up to urinate at night (from breathing pauses).
Since even Lexapro can lower REM sleep qualtity, it’s not surprising that taking this drug can also lower the rate of hot flashes. If you have obstructive sleep apnea, do you suffer from hot flashes or night sweats?
Are Kidney Stones Caused by Sleep Apnea?
January 17, 2011
One of my patients who is doing well after sleep apnea surgery emailed me a list of all the improvements just a few weeks out, and at the end, just happened to mention that he expects his kidney stones to be eradicated as well. I didn’t give it much thought, since treating sleep apnea and UARS can help almost anything, but when I went to the literature, I found a study which showed that that sleep apnea can be a direct cause of kidney stones. What the authors showed was that uric acid excretion by the kidneys is increased in people with kidney stones. After treatment with CPAP, uric acid levels normalized.
This finding is not surprising at all, since obstructive sleep apnea is linked directly or indirectly to almost every chronic medical condition that modern people suffer from.
You would think that all patients who suffer from kidney stones would get screened for obstructive sleep apnea, but as far as I can tell, doctors haven’t changed their thinking about kidney stones at all. The same thing happened after a study showed that frequent nighttime urination could be cured by treating an underlying sleep-breathing problem. Again, no major changes in the way nocturia and urinary frequency is handled.
Is there anyone out there whose kidney stone frequency improved after sleep apnea treatment?
High-Tech Elbow To Prevent Snoring
January 14, 2011
Here’s an interesting device that reportedly helps prevent snoring. It’s called the and it works by analyzing your snoring levels and through wireless technology, helps to increase your throat’s muscle tone, lessening the chances that you’ll snore. It’s made of two components: There’s a device under your mattress, and there’s a wrist band. Presumably, whenever it detects that you’re snoring, it sends a signal to your wrist device, causing some sort of mild stimulation, which will wake you just enough to lighten your sleep stage, but not enough to wake you up completely. It’s known that lighter stages of sleep can promote throat muscle tension.
In theory, it sounds great. But there’s a downside to this: it prevents you from staying in deep sleep. It’s just a high-tech version of getting your bedpartner’s elbow shoved in your ribs every time you snore.
Like most-anti-snoring gadgets out there, all it does is to cover up the snoring, with various degrees of success. In most cases, it ends up only delaying the diagnosis and treatment of obstructive sleep apnea.
Do you suffer from the “bruised rib syndrome”?
Kindle Version of Sleep, Interrupted Price Cut 50%
January 12, 2011
In the interest of getting my important message about breathing and sleep out to as many people as possible, I’ve worked out a deal with my publisher to lower the price of the electronic version of my book, Sleep, Interrupted from $19.99 to $9.99, which is a 50% drop. Click here to order from Amazon.
Here’s the latest Amazon review about my Kindle e-book (reviews for the hardcopy version are found here):
One of the Most Influential Health Titles I Have Ever Read, December 11, 2010
Reading this book showed me how to take a huge step forward in my overall health.
I feel tired all the time. Worn out. I don’t want to live this way and have been investigating all possibilities about its cause. Fatigue and sleep are obviously related, and I researched many sources trying to learn to improve my rest. I found Dr. Park’s internet postings, and became very intrigued by his approach to diagnosing sleep problems, and the number of different solutions he could recommend. I pursued more of his writing on the net, and came across this Kindle book.
I categorically recommend that everyone, everyone, read this book. Kindle books are often impulse purchases, and yeah, maybe the price of this book is higher than most Kindle Books. But I’m absolutely positive that the information in this book will help you (or someone who will listen to you!) in an invaluable way. Get it, read it. It’s like a “CPR course” for sleeping. Someday you will really help someone with what you know.
This book shows that, although we only have one word for “sleep”, sleep itself is a vast array of different of mental and physical processes. All these processes must work together in order for me to wake up feeling good. If one of these processes malfunctions, symptoms show up, not only as short term fatigue, but also in many other long term, seemingly unrelated, aches and pains.
“Sleep Interrupted” describes entire chain of sleep processes, and how sleep malfunctions show up. Dr. Park writes with great clarity and detail, and describes therapies specific to my problems. These aren’t “warm milk” remedies. I sought a doctor’s care to move forward. But even before I found the right doctor, learning what might be happening to me was a huge boost to my mood. I understood that I might have reasonable, measurable problems which can be fixed. I wasn’t defective in some way, and doomed to eternal fatigue. Doctors’ examinations since I finished the book have confirmed that I suffer from many of the phenomena Dr. Park describes. I’m very grateful for having found, and for being willing to spend the money to buy this book.
Click here to order the Kindle version of Sleep, Interrupted now.
Can Didgeridoo Playing, Tongue Exercises, Or Breathe Rite Strips Help Cure Sleep Apnea?
January 10, 2011
In this Ask Dr. Park teleseminar I reveal which of the following over-the-counter devices and programs for snoring and sleep apnea really work:
- Didgeridoo
- Tongue exercises
- Chin straps
- Boil-and-Bite anti-snore mouth guards
- Tongue retaining devices
- Sleep positioners
- Breathe Rite strips
- And many others…
Price: $17.
Click here to purchase the 60 minute MP3 recording.
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