May 20, 2013
As the baby boomer generation ages, it’s not surprising that more and more people complain of memory problems. Here’s an article that describes the results of a survey which revealed that nearly 13% of people 60 or over reported confusion or memory loss which has worsened over the past 12 months. So far there are no definitive studies that suggest that untreated obstructive sleep apnea can cause Alzheimer’s disease (no scientific study will ever propose cause and effect), but based on how prevalent obstructive sleep apnea is in our country, and knowing how much sleep apnea causes various types of brain damage, it’s not too far fetched to say that untreated obstructive sleep apnea may explain a significant number of cases of memory loss or dementia. Anecdotally, many of my patients do report improved memory after sleep apnea treatment.
May 16, 2013
Theravent looks like another potential new option for snoring, but upon further inspection, looks like technology that’s also found in Provent. These are nasal adhesives that allow you to breathe in normally, but provides partial resistance when you breathe out through your nose. Numerous studies have been published on the effectiveness of Provent for sleep apnea, but I’ve had mixed results in my practice. However, many patients do like them, so I continue to offer these devices. The website for Theravent offers a free trial, so it’s worth looking into if you want to try something different.
Have you tried Provent or Theravent? Please comment on your experiences.
May 13, 2013
Here’s another study showing a strong association between poor sleep and cancer: An Icelandic study found that men with problems falling asleep had a 70% increased risk of developing prostate cancer, and a 210% increased risk if they had trouble staying asleep. Associations were even stronger for more advanced prostate cancers. Note that I wrote about this possibility in my book, Sleep, Interrupted, which was published in 2008.
May 8, 2013
About 3% of teens in this country were found to experience extreme fatigue lasting 3 or more months not relieved by rest. This short article in US News & World Report highlights the importance of a small segment of teens who are severely debilitated. The vast majority go untreated. It’s also likely that many will sleep excessively long hours and still not feel refreshed.
I wonder how many of these teens have an untreated sleep-breathing disorder such as obstructive sleep apnea or upper airway resistance syndrome. It’s not too common to have teenagers’ fatigue explained by their poor sleep habits, hormonal changes, or just “being a teenager,” when in fact the source of their problem may be an undiagnosed sleep-related breathing disorder. For example, even a simple viral infection or allergy attack can enlarge lymphoid tissues in the throat, nose and tongue (palatine tonsils, adenoids and lingual tonsils), leading to more frequent partial to total obstructions and arousals. This can prevent quality deep sleep, leading to chronic, prolonged unrelenting fatigue.
What you’ll see that that these teens will oftentimes prefer to sleep on their sides or stomachs, and have a parent that snores heavily (obstructive sleep apnea).
Do you have a teen that’s overly fatigued, no matter how long they sleep?
May 2, 2013
There have been more and more studies showing an association between sleep duration or sleep apnea with increased cancer risk. In this study, longer sleep duration was associated with increased colon cancer risk in people who snored or were overweight. As we know from cancer research studies, hypoxia is a major mechanism of cancer progression. Whether you stop breathing repeatedly throughout the night, or have increased levels of stress from not sleeping long enough, lower levels of oxygen can result.
April 28, 2013
Here’s an important article that everyone should read in the New York Times. The author highlights the fact that in many cases of attention deficit hyperactivity disorder (ADHD), the real deficit may in your child’s sleep.
April 28, 2013
I wanted to announce that this month’s Expert Interview (with Dr. Borelli) will be my last Expert Interview, which also includes my Ask Dr. Park programs. My plan is to focus on future programs and educational resources to better serve your needs. Please stay tuned for more information.
Please look in my Expert Interview archives for a full list of past programs.
April 10, 2013
Here’s another chicken or egg question: Do poor sleep habits cause diabetes and lower melatonin levels, or does diabetes cause lower levels of melatonin? In this study out of Brigham and Women’s Hospital in Boston, having lower levels of melatonin was associated with a higher risk of diabetes. This does not prove that having lower levels of melatonin will give you diabetes, but only an association where directionality is not known.
One minor detail that’s important to remember is that when darkness stimulates brain neurons to produce melatonin, the signals goes through the cervical sympathetic ganglion, before reaching the pineal gland. A common side effect from any of the high blood pressure medications is that it lowers function of this ganglion, which is involved in the sympathetic nervous system. Blood pressure medications can lower activity of your sympathetic nervous system, which can in theory lower your melatonin levels.
So of you have high blood pressure, by taking blood pressure medications, you could be lowering your melatonin levels, which lead to poor sleep, which can result in weight gain, which can aggravate snoring and obstructive sleep apnea….and we know that obstructive sleep apnea can raise your sugar levels.
This example only shows that the human body can’t be reduced to one single molecule or chemical at a time. We need to look at multiple aspects of our physiology simultaneously.
April 3, 2013
Here’s an interesting study showing that the presence of heart disease may predict dementia better than cognitive tests. This finding is not surprising since we know that untreated obstructive sleep apnea can cause major injury to multiple areas of the brain. We also know that the older you get, the more likely you’ll develop sleep apnea. In fact, based on some recent population studies, more than half of people over 50 had some degrees of sleep apnea.
March 28, 2013
Dr. Weston Price showed that cultures that change from native to modern, Western diets produce jaws with more dental crowding, crooked teeth and more cavities. Others have shown that softer foods and even bottle-feeding can also promote dental crowding. Smaller jaws can lead to smaller airways, leading to a number of health problems due to poor sleep. Here’s an interesting perspective on how modern man’s bites have changed simply by eating in a more civilized manner: using table knives and forks.
Staff writer for the New Yorker magazine Jane Kramer reviews a book by Bee Wilson, “Consider the Fork: A History of How We Cook And Eat.” On the third page of the online version, there a section where the author describes the work of American anthropologist Charles Loring Brace, who specialized in the evolution of hominid teeth. He dates the onset of the modern Western overbite at around 250 years. Prior to this human incisors lined up edge to edge, like a guillotine. Then all of a sudden, human jaws, especially in the more civilized areas (who used forks and knives to cut meat into bite-sized pieces), started to develop an overbite. This change happened too quickly to be as a result of evolution. Here’s an excerpt from Kramer’s article:
By the late eighteenth century in Europe, people were slicing their food into bite-size morsels and carrying them to their mouths with forks—those formerly weird things, Wilson calls them. And they hardly needed to chew such tiny pieces, which in most cases were already softened by pounding, overcooking, or long, gentle braisings. At the same time, the modern overbite began to appear prominently in upper-class Western European jaws. Do not confuse this with the seriously inconvenient condition known to the world as buck teeth (without which we would have no orthodontists, and no mortified adolescents with mouthfuls of rubber bands and wire braces). Wilson’s modern overbite refers to “the way our top layer of incisors hangs over the bottom layer, like a lid on a box,” as she nicely puts it, and is “the ideal human occlusion” for the way we now eat. Why this happened and how long it took to happen is open to some debate, but it’s clear that until it happened most humans had the bite of other primates—“where the top incisors clash against the bottom ones, like a guillotine blade.”
Wilson’s favorite theory comes from the American physical anthropologist Charles Loring Brace, a specialist in the evolution of hominid teeth. In 1977, Brace published an article that put the age of the Western overbite at no more than two hundred and fifty years—which is to say that flatware and, with it, a significant change in how we chewed were all it took for the edge-to-edge occlusion that we inherited from the Neanderthals to be replaced by the bite we now call normal. Brace was haunted by overbites. He had long assumed them to be an incremental and selective evolutionary change that began with agriculture and the consumption of grains. But the jaws he studied, on his way to building a database on the evolution of hominid teeth—apparently the biggest in the world—changed his mind. The transformation he’d seen in those eighteenth-century-gentlemen jaws was too abrupt, and too radical, to qualify as evolution, especially given the rapidity with which it then followed the spread of flatware into the middle classes, in the nineteenth century. In 1914, in the run-up to war with Germany, a stainless-steel alloy—developed to prevent corrosion in gun barrels—went on sale in Sheffield, England. Once stainless appeared on the country’s dinner tables, the guillotine bite all but disappeared.
There have been further significant milestones in how to eat our food, what foods we eat, as well as how we feed our children. If you think about the implications of how quickly modern humans’ jaws have changed just in the past few hundred years, it’s a frightening thought. As our faces get smaller and our brains get bigger, what will we look like in 2000 years? Here’s a thought.
What do you think about Kramer’s article?