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Insomnia Significantly Raises Your Heart Attack Risk

Millions of people have chronic insomnia. Billions are spent on pharmacologic and natural treatment options every year. Now a study shows that if you have chronic insomnia, you have up to a 45% increased risk of having a heart attack. 

This study followed over 52,000 Norwegians who initially complained about insomnia. After 11 years of follow-up, those that said they had trouble falling asleep daily for over one month were 45% more likely to have suffered a heart attack. Those that couldn’t stay asleep all night had  a 30% increased risk, and those that reported unrefreshing sleep had a 27% increased risk. After adjusting for age, sex, marital status, education, blood pressure, cholesterol, diabetes, weight, exercise, shift work, depression and anxiety, people with sleep troubles were found to have the highest risk of having a heart attack.

Something to sleep on.

Taking The Sleep Medicine Board Examination On 2 Hours Sleep

After months of studying, I finally took my sleep medicine board examination yesterday. I felt well-prepared for this 4-part, 8 hour test. But one thing that always seems to happen to me before every major exam is that I suffer from severe insomnia. The same thing happened to me before my SAT, MCAT, and otolaryngology board exams.

The night before this test, I went to bed at my normal 10:30 PM time, but was unable to fall asleep unto about 4AM! What made it worse was that my mind was filled with thoughts of studies showing memory loss and poor recall  in sleep-deprived individuals. Imagine a sleep doctor having major sleep problems before a major sleep test. This temporary, stress-induced insomnia is called adjustment (or acute) insomnia as defined by the International Classification of Sleep Disorders (Second Edition). Fortunately, it goes away once the stressor resolves.

I got a refreshing 8 hours of sleep last night, and now with the test over, I can get back to a normal life again. 

Teens & Sleep Deprivation: An Epidemic

Everyone knows that teens are under intense pressure to not only produce stellar grades, but also excel in numerous extracurricular activities as well. The problem is that there’s only 24 hours in a day. Add to this 4-6 hours of homework in the most competitive private and public high schools, and the first thing to get sacrificed is sleep. 

In this New York Times article on the stresses of too much homework in independent schools, one student newspaper at a prestigious private school published an article last year showing that upper school students slept an average of 6.5 hours per night. I was shocked to see this.  You may think that this is not too bad, but consider this: A teenager should be sleeping 9 to 10 hours per night. 

There are tomes of research showing what chronic long-term sleep deprivation does for people in general, but these negative effects are even more magnified in developing teens’ brains and bodies. It’s not surprising that rate of anxiety and depression are are at already too high levels, and a lot of students are just burning out (mentally and physically). Many of these problems will ultimately manifest when they get to college, where sleep deprivation and poor eating and sleep habits become even worse. This is why the incidence of depression peaks in the college years. 

I realize there’s no easy solution to this problem, but someone has to take a stand and say enough is enough. What do you think about this issue?

Dr. Park’s TV Segment On Black Enterprise

I was recently interviewed by Sonia Alleyne of Black Enterprise Business Report on the importance of a good night’s sleep. Take a look at this 3 minute video segment.

Missing Teeth = Poor Health?

Ever since I began seeing patients in my new position at Montefiore medical center, I’ve been surprised by how many patients have missing teeth. In fact, many have no teeth at all, and often have to wear dentures, especially if they’re in the elderly years. Not too surprisingly, these same patients also have a number of chronic medical conditions, such as hypertension, diabetes, high cholesterol, heart disease, as well as numerous medications for these respective conditions. Many are obese.

Being in a major tertiary-care referral-based hospital, it’s expected that patients will have complex medical issues. But this observation only supports what dentists have been saying for years—that poor dental health equals poor general health. Not only do I see multiple missing teeth, there’s also significant jaw narrowing and crowding of the soft tissues of the mouth. Having smaller airways due to missing teeth and smaller jaws can aggravate significant medical problems, such as hypertension, diabetes, high cholesterol, and heart disease.

We’re seeing an epidemic of jaw underdevelopment these days, with dental crowding and numerous orthodontic and airway issues that arise as a result. The rise in premature babies, modern feeding habits, nutritional factors, and various toxins in our environment can prevent proper facial growth and development. It’s no wonder that we’re seeing increasing rates of ADHD, autism, and various other developmental delays. These are the same kids that will go on the develop high blood pressure, diabetes, obesity, high cholesterol, and heart disease later in adulthood.

You could argue that having bad teeth is a consequence of the particular population that we serve, but knowing what we know about the importance of proper jaw development and dental health, it’s likely that poor dental issues also predisposes people to chronic medical problems.

 

What do you think about my observations? 

Deep Thoughts on Fluoride, Otosclerosis, and Sleep Apnea

Otosclerosis is a relatively common condition we see in our field, typically leading to early hearing loss. It leads to stiffening of one of the middle ear bones (the stapes), preventing sound waves from reaching the inner ear. Surgery can result in a dramatic hearing improvement. Over the past few decades, it’s been noted by prominent otologists that the rate of otosclerosis has dramatically declined, presumably due to fluoride supplementation in our water supply. This element is thought cause increased resorption of bone, and cause early maturation and calcification. One of the conservative treatments for otosclerosis is to give fluoride tablets. 

I was thinking if fluoride can affect the middle ear bones, can’t it also affect a developing fetus or infant’s jaw development? Premature hardening and early maturation could lead to suboptimal jaw growth, which can predispose to obstructive sleep apnea. This is in addition to all the other various risk factors that can prevent proper jaw development (soft food consistency, bottle-feeding, etc.). Almost every younger patient I see today has significant dental crowding and narrowed arches. Having smaller jaws leaves less room for your regular sized tongue and other soft tissues of the throat, leading to more frequent breathing problems while you sleep. No wonder why most modern humans these days can’t sleep on their backs.

Sure enough, if you comb through the research literature, there are a number of studies that directly or indirectly support my suspicion. For example, rats fed fluoride were found to have significantly diminished horizontal mandibular dimensions. Another study showed that addition of sodium fluoride to explants of embryonic rat palates lead to retardation of the palatal shelf growth and lack of fusion. I’m sure there are dozens, if not hundreds of other similar commonly used chemicals that can retard proper growth and development in all age groups.

Doing some more research on the internet, there seems to be a growing grass-roots movement to remove fluoride from our drinking water. Here’s a site that lists 50 reasons why fluoride is dangerous to our health. One of their main arguments is that the original studies cited to make the argument for adding fluoride were flawed and that there’s no convincing proof that it prevents dental caries. I take all these arguments with a grain of salt, but these are serious issues that need further discussion. I always wondered why a dangerous chemical that I used in my organic chemistry class is so commonly used for every-day purposes (water, toothpaste, etc.).

Am I being overly paranoid, or is there some merit to this argument?

Expert Interview: Buteyko Breathing with Patrick Mckeown

In this month’s program, I’ve invited Buteyko breathing instructor Patrick Mckeown to talk to us about how this breathing technique can improve symptoms of obstructive sleep apnea.

 

 

 

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Are CEOs with Wide Faces More Successful?

It’s been suggested that being tall is a pre-requisite for being elected president. Now, a recent study has shown that effective CEOs tend to have wider faces and broader facial features. Communications professor Elaine Wong from the University of Wisconsin-Milwaukee studied 55 CEOs by analyzing their facial geometry. Those that had wider facial features had companies that performed about 10% better that those with more narrow features. They site possible correlations with increased testosterone, aggression and a sense of power. 

Here’s a better explanation: Wider jaws mean wider airways, better breathing, better sleep, and better physical and cognitive performance. Decades ago, popular male movie and television stars tended to have wide jaws. If you search for centenarian pictures in Google, you’ll see that most people who live long lives have relatively wide jaws. Take a look at healthy natives that live in remote areas of South America or Africa—notice the width of their jaws, and typically nice natural teeth.

It’s been stated over and over again that a radical shift in our eating and feeding habits has caused an epidemic of jaw narrowing and dental crowding in Western countries, and we’re now paying the price. No wonder almost everyone needs braces these days.

Teens Are Using More ADHD Medications

Attention deficit hyperactivity disorder seems to be an epidemic these days. A new study revealed that the rate of children using stimulant medications increased from 2.4% to 3.5% from 1996 to 2008. However, in teens aged 13 to 18, it rose from 2.3% to 5%. The article also mentions that 9% of all children have been diagnosed with ADHD at some time in their lives. 

My question is, why do stimulant medication help to calm already hyperactive children? A study published in the journal Pediatrics in 2006 showed that about 27% of children who were scheduled for routine tonsillectomy had ADHD by official criteria (compared to 7% in controls). After surgery, the rate of ADHD in these children dropped 50%. Clearly, there are a number of other possible aggravating factors involved with ADHD, but I’m willing to bet that problems breathing at night is a major factor, if not the the most important factor. 

It’s clear that the reason stimulants work in most children with ADHD is because they’re chronically sleep deprived. Many parents will agree with my experiences with my 2 year old—if he’s overly tired or skips a nap, he’s “bouncing off the walls,” It’s not surprising that many of the children that I see who are on ADHD medications also tend to be mouth breathers, have an elongated face, and has an “adenoid facies” appearance.

If you have a child with ADHD, what is the quality of his sleep? Can she sleep on her back? Which of the parents of a child with ADHD snore heavily?

 

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