April 28, 2016 by Steven Park
As part of my show notes from my last podcast about the dangers of mouth breathing, I referenced a website that gave a great summary of George Catlin’s book, “Shut Your Mouth to Save Your Life,” published in 1882. Caitlin was an American painter in the latter half of the 19th century whose paintings of Native Americans are found at the Smithsonian museum in Washington, DC. Here’s an even more in-depth article about Catlin’s discoveries and how it relates to sleep apnea breathing.
April 25, 2016 by Steven Park
In this episode, Kathy and I will reveal 7 ways that mouth breathing can cause sleep and health problems.
Interview with Dr. Michael Mew on Breathing and the Modern Melting Face
Interview with Patrick McKeown on Buteyko Breathing
Shut Your Mouth to Save Your Life, by George Catlin
April 6, 2016 by Steven Park
Erica was a young woman who I saw yesterday for sleep apnea. She commented to me that despite eating healthy meals, limiting her calorie intake, and exercising regularly, she’s still gaining weight. This seems to be a very common problem for many people today, whether or not you have obstructive sleep apnea. Although it’s been shown that you can still have sleep apnea even if you’re thin, the vast majority of people in the United States with sleep apnea are overweight. A JAMA article in 2012 estimated that about 35% of Americans are obese (BMI > 30), and 69% are considered overweight or obese (BMI > 25).
Here are 5 proven strategies to lose weight, wether or not you have obstructive sleep apnea:
1. Sleep longer
Study after study reveals that the shorter you sleep, the more pounds you’ll pack on. In general, sleeping less than 6 hours per night is associated with being much heavier. This effect was found to be more important in younger people in a study by Patal and Hu from Case Western and Harvard Universities. In fact, a number or studies show a U-shaped pattern, with higher rates of obesity with too little or even too much sleep. Ohkuma and colleagues from Kyushu University found that in type 2 diabetics, excessively short and long sleepers where found to be more obese, as well as having higher levels of hemoglobin A1c (a marker of poor diabetes control).
Americans now sleep on average of 6.8 hours per night, which is about one hour less than what we used to get in the 1940s. Today, about 40% of people get less than 7 hours of sleep. In an unscientific study by Glamour Magazine, 7 overweight readers were asked to sleep for 7.5 hours every night, without making any other changes to their diet or exercise routines. After 10 weeks, 6 women lost on average over 8 pounds, with a range between 6 to 15 pounds. One woman who was only partially able to follow the recommended sleep schedule didn’t lose any weight, but she did lose 2.5 inches off her waist, bust and hips.
2. Don’t eat anything within 3-4 hours of bedtime
I may sound like a broken record, but this is the single most important piece of advice I give to all my patients. Having extra stomach juices due to a late night snack will predispose to regurgitation into your throat, causing more swelling and more obstructed breathing. It’s not only acid that’s coming up, but also includes bile, digestive enzymes and bacteria. It’s also been shown that these juices can reach your sinuses and ears, as well as go down to your lungs, causing major inflammation. If you normally don’t eat late, then this won’t apply to you, but if you’re a late snacker, this is the single most important step to take if you want to breathe better, sleep better, and begin to lose weight.
I know some of you are going to tell me that this is impossible. You’re so hungry a few hours after dinner, or you get home really late after work so it’s not even an option. This is understandable, since we know that poor sleep will cause you to be hungry and you will preferential crave sugary, fatty or starchy foods. Poor sleep in general is known to to lower leptin, a hormone made by your fat cells telling you that you’ve had enough food. Obese people are found to be leptin resistant. Poor sleep also raises ghrelin, a hormone made in your stomach that makes you more hungry.
What patients tell me is that despite being difficult in the beginning, once you get started, it gets easier and easier, since better quality sleep will make you less hungry and less likely to crave unhealthy foods during the day. In general, eating an early, healthy dinner using ingredients with a low glycemic index will prevent you from being hungry 3 hour after dinner. Listen to nutritionist Maria Alexandra Bella‘s advice on how to avoid getting hungry after dinner. Instead of just trying harder, have a plan of action.
3. Don’t drink alcohol close to bedtime
Many people know not to drink alcohol close to bedtime, since it ruins their sleep quality. But some people enjoy their night caps since it helps them to relax and fall asleep faster. The problem is that alcohol is not only a sedative, it also relaxes your throat muscles. Alcohol may help you to fall asleep better, but it will definitely cause more apneas and arousals, leading to significantly worse sleep quality. Red wine, in particular, has additional properties that can aggravate migraines and headaches.
4. Keep your nose clear and open
One major reason why I emphasize good nasal breathing is based on a old study showing that a combination of a nasal decongestant and a pill to help empty the stomach lowered snoring levels significantly. This is also why I’m against eating close to bedtime. Since so many people with strong and sleep apnea have nasal congestion to various degrees, it’s important to make sure that you’re able to breathe fully through your nose. Many people who are chronic mouth breathers deny that they have nasal congestion, since they don’t know what normal nasal breathing is. Whenever I spray a decongestant and lift up the nostrils, oftentimes the patient has a WOW experience. Whether you need to treat any allergies, use saline irrigation, use nasal dilator strips, or even undergo surgery, do whatever it takes to breathe better through your nose. Read my free e-book, “How to Unstuffy Your Stuffy Nose,” for more helpful tips.
5. Exercise outdoors
This recommendation is probably the most anecdotal, but there’s value to exercising outdoors. A few years ago, I saw a middle-aged overweight woman who came to see me for her sinus problems, chronic fatigue, and headaches. I recommended addressing her allergies, but also to avoid eating late and to exercise outdoors in the sunlight. After 6 months, she emailed me saying that her life was changed completely: She began jogging outdoors in the mornings, lost 30 pounds, and recently ran the New York City Marathon. She has much more energy and no more headaches.
My rationale for exercising outdoors is that most modern people don’t get enough sunlight exposure to create healthy levels of Vitamin D. Yes, we do get some Vitamin D though our food sources, but not enough to maintain healthy levels. It’s important to realize that Vitamin D is not just a vitamin to help develop strong bones. Rather, it’s a hormone that has important effects on your entire body, from your brain to your metabolism. There are lots of studies showing a strong association between low D levels and obesity. For a fascinating discussion about the importance of Vitamin D, listen to my interviews with Dr. Stasha Gominak.
Make a goal to start losing weight today
March 23, 2016 by Steven Park
In this podcast episode, Kathy and I will talk about the 20 top ways of getting rid of your snoring. We’ll cover 15 non-prescription and over-the counter options, as well as 5 prescription/surgical options.
- How snoring and ADHD are linked
- How snoring can cause stroke
- A better way to lose weight
- Your best sleep position
- How to choose the right pillow
- Why mouth breathing is bad for your health
- 3 proven non-surgical / alternative ways to stop snoring
- The best surgical options for snoring
- Which dental device works best for snoring
- The pros and cons of surgical options
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Dr. Karen Bonuck’s interview on snoring and behavioral problems
New York Times article on spouses sleeping in separate bedrooms
Snoring demonstration video
Reflux causes sensory damage
Snoring causes sensory damage
Snoring and carotid artery plaques
Lingual tonsils and reflux
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March 15, 2016 by Steven Park
March 2, 2016 by Steven Park
- always chronically tired
- daily headaches
- increasing anxiety attacks
- frequent nighttime urination.
February 23, 2016 by Steven Park
In this podcast, Kathy and I talk about 7 Ways Doctors Can Ruin Your Sleep:
1. How this one type of surgery can sometimes cause nasal congestion years later
2. Which dental treatments can create smaller airways
3. How modern orthodontics and jaw surgery can aggravate sleep problems
4. Why medical or surgical menopause can ruin your sleep
5. Find out which commonly prescribed medications can prevent you from sleeping
6. What types of surgery can aggravate apneas during your hospital stay overnight
7. The pros and cons of the Back to Sleep campaign to prevent SIDS
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If you enjoyed this podcast, please rate and leave a review on iTunes.
February 18, 2016 by Steven Park
One of the foundational principles of medicine is, Primum non nicer, a Latin phrase that means “first, do no harm.” No physician wants any harm to come to their patients. But in this day and age, it’s a given that patients may sometimes be injured, even if you practice high-quality, evidence-based textbook medicine.
A frightening revelation that I had a few years ago is how often doctors can cause long-term harm, despite initial short-term benefits. This can be found in almost every area of medicine. These practices are considered “standard of care,” supported by research and top leaders in our field. Here are 5 ways (3 types of medications and 2 types of surgical procedures) doctors are making you gain weight, and eventually, more sick in the long term.
1. Medications that cause weight gain
Many commonly prescribed medications for allergies, diabetes, high blood pressure and depression are known to cause weight. Some of the more common offenders are:
- paroxetine (Paxil) for depression
- fluoxetine (Prozac) for depression, short term weight loss, long term weight gain
- the atypical antipsychotics, such as olanzapine (Zyprexa) and clozapine (Clozaril)
- mirtazapine (Remeron)
- amitriptyline (Elavil, Endep, Vanatrip)
- valproic acid (Depakote) for bipolar disorder
- chlorpropamide (Diabinese and Insulase) for type 2 diabetes
- fexofenadine (Allegra)
- and prednisone.
2. Medications that lower melatonin
Many of the high blood pressure medications that lower sympathetic tone can lower melatonin production by blocking the sympathetic nerve pathways that contribute to melatonin production by the pineal gland. There aren’t many studies on this on humans, but one study on pigs found significantly lower levels when administered Alpha-methyl-p-tyrosine (AMPT), an enzyme blocker that lowers sympathetic activity. Lower levels of melatonin is associated with poor sleep quality.
3. Medications that cause nasal congestion
Medications that lower your blood pressure, by lowering sympathetic tone, can also cause nasal congestion. Since blood flow in your nose is regulated by a delicate balance between the sympathetic (fight or flight response) and parasympathetic (rest, digestion and reproduction) nervous systems, lowering sympathetic tone can cause pooling of blood in your nasal tissues. Nasal congestion can aggravate sleep-breathing problems.
4. Surgery that prevents you from your preferred sleep position
Imagine if you naturally prefer to sleep on your stomach or side, and after surgery, you’re told to sleep on your back. Oftentimes, you don’t have a choice, such as after hip or abdominal surgery. Being prevented to sleep in your normal position will aggravate more breathing problem, especially on your back, since your tongue and throat structures can fall back more easily due to gravity. Again, lack of sleep due to any reason can cause weight gain.
5. Surgery that causes nasal congestion
Nasal surgery is usually done to open your nasal cavity so you can breathe better. However, some surgeons will use nasal packing or splints, which can aggravate #4. Fortunately, nasal packs are temporary and are usually removed within one week. Another common side effect after nasal rhinoplasty is that if your tip is narrowed, your nostril sidewall cartilage may need to be trimmed, potentially weakening the support structures. In most cases, the effect won’t be seen for years, if not decades. The can present at nasal congestion many years later.
Notice that with all these treatment options there will be initial benefits. But over many years, poor breathing and poor sleep will take a toll on your body. Once you start gaining weight, you can get caught up in a vicious cycle of worsening sleep-breathing problems that can potentially cause even more weight gain.
So before you consider taking certain medications long-term, or before you undergo any surgery, think about any potential long-term consequences, related to sleep and breathing. Anything that lowers your ability to breathe will diminish your ability to sleep, leading to a number of various potential health problems.
February 1, 2016 by Steven Park
In this podcast, I have a fascinating discussion with Dr. Ronald M. Harper, Professor of Neurobiology at the University of California, Los Angeles. Dr. Harper shares some profound insights about why brain damage goes hand in hand with obstructive sleep apnea. In this interview, you’ll learn:
- Why Obstructive Sleep Apnea (or OSA) can cause brain damage but how this brain damage can further perpetuate sleep apnea
- Eye-opening insights about why OSA is so often associated with memory loss, brain fog, balance issues, hypertension, and even diabetes
- Besides traditional OSA treatment options, which simple exercise method can help reduce OSA severity.
Download MP3 file
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January 19, 2016 by Steven Park
In this podcast, Kathy and I will reveal “Everything You Wanted to Know About Nasal Surgery.” Topics include:
1. Septoplasty: Why packs are not needed
2. Turbinoplasty: How much removal is enough?
3. Nostril surgery: Why it’s better than Breathe Right strips
4. Sinus surgery: Myths and misconceptions
5. Reconstructive surgery: When you may need this.