You may be asking, what is an ear nose throat doctor doing talking about better breathing, better sleeping and better living? Like all my colleagues, I started practicing 15 years ago with the idea that if I studied hard and learned the latest information, I’d be a good physician and surgeon. I’d eagerly learn and apply the latest discoveries and surgical techniques, with good results initially, but for most people, their problems returned sooner or later. I checked and rechecked everything to make sure I was doing everything properly, and by all measures, I was a “successful” ENT doctor practicing in midtown Manhattan.
But I was not happy. I was not satisfied with the number of people returning over and over with similar problems. I finally realized that what I was practicing was a temporary form of medicine—sort of a Band-Aid. I saw this not only in my own field but in every other field of medicine and surgery. We were treating chronic conditions that are more related to diet, lifestyle and stress factors, with temporary measures that don’t really get to the root of the problem. We were applying models that are more appropriate for acute trauma and infectious diseases for conditions that are more influenced by what we eat and how we behave.
I then began to question traditional Western, allopathic medicine—not the methods or techniques per se, but how and when and why we apply these methods. Just like with the legal profession, how and why we do things is always based on tradition and precedent. Medical journals also rely on tomes of other past related studies that back up or support what you’re writing about. The problem is that what’s in the journals is based on research that’s sometimes 20-30 years old. Physiologically, and as a society, by the time a “recent” study is applied in any practical matter, we’ve changed. Research is not and will never lead to “real time” medicine. And what happens when there’s an erroneous precedent? For how many centuries did people believe that the world was flat? I think it’s safe to assume that a significant percentage of our current knowledge of medicine will be disproven in the future.
Around this time, I happened to notice that many of my patients with chronic recurrent sinus or throat conditions had various degrees of sleep problems. When examined further, I discovered that all these people had very narrow upper airways, and when this narrowing was treated appropriately, many of their ear, nose and throat problems improved significantly. What was more surprising, however, was the fact that many other unrelated medical problems, such as cold hands, high blood pressure, weight issues, anxiety, depression, stomach problems, and even night-sweats, improved as well.
When I approached my colleagues about this incredible finding, they were mostly skeptical and refused to believe that such a simple problem could explain such a wide variety of health problems. We physicians are trained to question everything, which leads to a permanent form of cynicism that prevents productive forms of imagination and wonder. I then considered undertaking research to “prove” my hypothesis, but logistically, I didn’t have the time or the resources to do the research to prove this health-disease paradigm. This is when I made the decision that I had to take my message directly to the public.
There are millions of people in this country that can never get a good night’s sleep, no matter how hard they try. Some eat healthy, exercise regularly, take their vitamins and supplements, and still feel exhausted no matter how long they sleep. What I noticed was that when younger, these people are otherwise healthy (except for the chronic fatigue), but later on in life, they are more prone to developing high blood pressure, heart disease, depression, anxiety problems, heart attacks and strokes. What this shows is that no matter how well we eat, manage stress or exercise, there’s something else that’s preventing many people from achieving optimal health.
Most people take it for granted that they breathe well while sleeping, but this is not necessarily true. The basis of my sleep-breathing paradigm, which I describe in my book Sleep, Interrupted, states that all modern humans are susceptible to various degrees of breathing problems, particularly due to our unique upper airway anatomy. Because of our ability to talk, our tongues can fall back more easily, especially while on our backs and when in deep sleep (due to muscle relaxation). This leads to unrefreshing sleep. Furthermore, there’s evidence that our jaws are more narrow these days than they were centuries ago. All this information is not new. The problem is that all the various health-related disciplines, whether traditional or alternative, are generally working independently, without being able to see the real big picture. All the great tips and recommendations for good health also assume that we have normal sized jaws and air passageways.
If you accept the fact that we modern humans are more susceptible to breathing problems at night, then by definition, we can’t sleep as efficiently anymore. This can cause a low-grade chronic stress response, leading to a whole host of hormonal, metabolic, neurologic, immunologic, physiologic, and biochemical changes. I think you’ll agree that breathing is the most important physiologic function there is for us humans. It then naturally follows that frequently interrupted breathing, especially while sleeping, can create various degrees of multiple medical issues.
My philosophy is that EVERY modern human is susceptible to breathing problems while sleeping to various degrees on a continuum. What most of modern medicine deals with is the the extreme end state. The extreme end of the sleep-breathing continuum that I describe is called obstructive sleep apnea. Despite everything we know about obstructive sleep apnea, it’s estimated that about 80-90% of people with it are never diagnosed. We end up treating many of the end result complications instead, such as high blood pressure, depression, and heart disease. But the vast majority of people don’t have obstructive sleep apnea, but what’s called upper airway resistance syndrome. Because of the positive/negative mentality that doctors and patients have with modern tests, it’s only natural that we have this problem.
What I’ve also discovered is that in addition to addressing the breathing problems, one must also simultaneously address the person as a whole, especially the environment, the diet, physical activity, life stresses, emotional state, and anything else that interacts to upset the body’s intricate equilibrium. I also try to integrate complementary healing modalities to help people achieve their goals of sleeping better and ultimately feeling better. Another very important aspect of true “healing” is a strong, trusting and long-term patient-doctor relationship, something that’s essentially nonexistent in today’s dysfunctional health care system.
What compelled me to write my book and to develop this website is that the vast majority of medical conditions that I see in patients in my practice could have been prevented, if only they had the right information. The word “doctor” was derived from the word for teacher. Hopefully, you’ll learn this material and make a serious effort to follow the recommendations so that you can finally breathe better, sleep better, and live better.