• 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 

How Azithromycin Can Help COPD

Here’s a study showing that taking azithromycin can help to cut the rate of acute exacerbations in people with COPD. The anti-inflammatory properties of the macrolide antibiotics are well described. However, one thing that’s usually not addressed is the fact that the macrolides have anti-reflux properties. In general surgery, we used to give intravenous erythromycin to help speed gastric emptying after abdominal surgery. So by helping to empty the stomach faster, less juices are around to reflux up into the throat and then to the lungs. It’s important to realize that what comes up not only includes acid, but also stomach enzymes, bacteria and sometimes bile. Imagine even small amounts of these substances in your lungs. 

Even if you don’t have significant obstructive sleep apnea, juices from your stomach can come up with any of the smaller obstructive events that aren’t classified as apneas or hypopneas. Not only do these same juices go into your lungs, it can also reach your nose and sinuses. 

The ADHD & Autism Spectrum Disorder Epidemic

A recent guest post on KevinMD’s blog points out that the rate of autism spectrum disorders (ASD) has increased 57% from 2002 to 2006. Currently, about 1 out of every 100 children born are thought to have ASD. It’s estimated that about 60 to 70% of ASD are from environmental factors, whereas 30-40% are due to genetic issues. The writer, Philip Landrigan, focuses on the possible environmental causes of autism and ADHD (attention deficit hyperactivity disorder), arguing that there are now over 80,000 synthetic chemicals that have been developed over the past 50 years. Many of these compounds have been shown to be toxic to developing brains in children. Currently 200 are toxic in adult humans, and another 1,000 are toxic in experimental models.

I have no doubt that many synthetic chemicals can be toxic to childen and adults, including some pharmaceutical products. In the world that we live in, with all the conveniences of modern life, we’re inundated to a multitude of synthetic chemicals, many of which are safe, but some are not.

However, one area that ASD and ADHD researchers almost never bring up during discussions is the fact that sleep-breathing problems are also progressing over time. Having smaller jaws and dental crowding leads to smaller airways, with leads to frequent breathing problems during sleep, with fragmented sleep. Lack of continuous, deep, efficient sleep has been shown to cause a number of biochemical, hormonal, and neurologic changes in the brain, usually for the worse. Countless times, I see children on stimulants for ADHD come off their medications after their large tonsils are taken out. Almost invariably, one or both parents of children with ASD or ADHD have major snoring or sleep apnea. 

Clearly, not everyone with ADHD or ASD has sleep-breathing problems, and not all areas of obstruction are due to large tonsils. However, even if 1/3 of these children have an underlying sleep-breathing problem (some have suggested 50%), wouldn’t it make sense to routinely screen for snoring and sleep apnea in any child with ADHS or ASD? 

Is Nocturnal Asthma Really Sleep Apnea?

Having an asthma attack in the middle of the night can be a frightening and terrifying experience. Typically, these attacks happen in the early morning hours, just before awakening. 

Now there’s research showing that poorly controlled asthma during pregnancy can increase a woman’s chances of developing preeclampsia (50%) and premature births (25%). Furthermore, infants born to mothers with poorly controlled asthma delivered babies that were about 0.2 pounds less than those born to mothers without asthma.

We typically think of asthma being a separate, distinct condition from obstructive sleep apnea, and it’s treated in completely different ways. However, it’s not just coincidence that nocturnal awakenings from asthma and the most intense periods of apnea occur at the same time in the middle of the night—the early morning hours. The early morning hours are when REM sleep is most prominent, and this is the time when throat muscles are most relaxed. Having an apnea also is known to cause reflex, which is known to reach the throat as well as the nose and the lungs. In one small study in people with sleep apnea and asthma, treating sleep apnea with CPAP significantly improved nocturnal asthma symptoms. 

We know that any degree of stress on the mother’s body can lead to a higher rate of pregnancy-related complications and low birth rates. Even snoring by the mother alone was found to result in lower Apgar scores in newborn infants. Apneas are also known to raise blood pressure and promote insulin resistance. Stress hormones are also known to increase when you have apneas.

In light of all these findings, it’s not surprising that pregnant women with poorly controlled asthma have higher complications rates. This is another great example of “connecting the dots” between two seemingly unrelated conditions, which only adds to support my sleep-breathing paradigm.

 

 

Update On My Blue Light Screen Filter Experiment

I commented two weeks ago on how modern computer displays (particularly LED backlit monitors) emit a very high amount of blue light, which can be very stimulating. Any kind of light in the hours just before sleep can delay the circadian clock, as well as to suppress melatonin levels, which can delay sleep onset. I installed a program on my laptop called F.lux, which removes the blue tinge on my screen only in the evening hours. 

I’m happy to report that I’m able to fall asleep much earlier now. Overall, I’m feeling more refreshed when I wake up, and generally have more energy during the day.

If you have to work on your computer late in the night, try downloading and testing out this free and simple program. In this age of overstimulation and too many distractions, we can use any help that we can get. After using it for a few weeks, please report back to me your experiences. 

Why Having Depression Can Raise Stroke Risk in Postmenopausal Women

Here’s another study that shows an interesting observation, but an explanation using my sleep-breathing paradigm is much more satisfying. Researchers found that postmenopausal women who have a current history of depression, past history of depression, or use of antidepressant medications had a significantly higher overall risk of stroke (29% over 6 years). Having a current history of depression alone increased your risk to 41%. The authors speculated that this increased risk may be due to medication use, weight gain, or increased cardiovascular complications that’s seen in people with depression. It’s been already shown in a past study that depression increases your risk of sudden death and fatal coronary heart disease.

It you accept the fact that postmenopausal women will have a higher likelihood of developing obstructive sleep apnea, then it’s likely that they will also be at higher risk of having depression, anxiety, hypertension, heart disease, etc. The researchers have done a great job in linking two of the end consequences of untreated obstructive sleep apnea, but failed to look at the common root of both conditions. 

CPAP Can Help Lower Lipid Levels

The effect of untreated obstructive sleep apnea on lipid profiles is not well publicized, but there are tons of studies that show that it can significantly affect your triglyceride, HDL, and LDL levels. Here’s a study that showed that CPAP use can significantly lower post-prandial lipid levels, which is a strong marker of cardiovascular risk.

Dr. Park is Moving His Practice

I’m just letting everyone know that I’ve accepted a full-time academic position in the Department of Otolaryngology at Montefiore Medical Center, which is the university hospital for the Albert Einstein College of Medicine. I’m going to focus mainly on integrative medical and surgical treatment options for obstructive sleep apnea. Not only will I continue seeing patients and to teach, I’m also expanding my research activities. I’ll also be taking most insurances, including Medicare.

My new practice location is (as of 9/1/11):

Department of Otolaryngology
Montefiore Medical Center
3400 Bainbridge Avenue, 3rd Floor
Bronx, NY  10467

(718) 920-4646

My dotorstevenpark.com website and email addresses will remain the same, and I will continue my online actities and monthly teleseminars. 

Thanks for your continued support, feedback, and participation.

 

 

Researchers Discover That Stopping CPAP Causes Sleep Apnea Recurrence

I had to do a double take when I can across this article, which proudly announces that if you’re a successful CPAP user, stopping CPAP all of a sudden will cause your sleep apnea to return. That’s like saying if you stop drinking water, you’ll become thirsty. The original point of the study was to show that the physiologic consequences of sleep apnea can return once CPAP is withdrawn, but the title makes it sound like it’s a new discovery. 

Sleep Apnea Worsens Dementia In Elderly Women

Here’s an important study that must be taken seriously. Researchers from UCSF and various other institutions showed that in elderly women, having sleep apnea significantly increases your risk of developing mild cognitive impairment or dementia compared to those women who don’t have sleep apnea. In a study of 298 women as part of an osteoporosis study that underwent sleep studies, 105 (32%) were found to have significant obstructive sleep apnea (AHI >15). After 5 years, women with sleep apnea had a higher rate of cognitive impairment or dementia (44.8%) than those without sleep apnea (31.1%).

Knowing what we already know about sleep apnea and how it can ravage the brain, these results are not surprising.

Expert Interview: Eric Cohen on How to Achieve 89% CPAP Aderence Rates

In this Expert Interview, I talk with Mr. Eric Cohen and Mr. Jake McCabe of National Sleep Therapy on how their company achieves an 89% CPAP adherence rate. 

Besides revealing their secret to getting very high adherence rates, here are some other questions we covered:

 - Define compliance or adherence, and medicare criteria
- What’s the national CPAP adherence rate average?
- Being compliant or adherent doesn’t necessarily mean that you’re sleeping better, right?
- How does the patient, doctor, and DME work together to raise adherence rates?
- How long do you stay with the patient?
- Do you have any special tools to help the patient?
- What would you say are some of the top things patients can do?

Please enter your information below to access your free MP3 download link:

Person Information
First Name *
Last Name
Email *
*By clicking ‘submit’ above, you are agreeing to receive ongoing communications from Dr. Park including monthly newsletters, events alerts, and other such written correspondences. Your e-mail will remain strictly confidential and will not be disclosed to any third parties without your prior written consent. You may unsubscribe to any or all portions of our e-mail correspondences at any time. Thank you for your cooperation.

 

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