Podcast #001: Why Only Humans Have Sleep Apnea

July 3, 2014 by  

Podcast #001 Show Notes

Welcome to the relaunching of my Breathe Better, Sleep Better, Live Better podcast. In this episode, I will reveal:

1.  Why only humans have sleep apnea
2.  How you can choke and die
3.  5 simple things you can do to sleep better tonight.

Download the PDF of the slides here.
Download the MP3 file here.

Acronym for obstructive sleep apnea: MOOSE Male Older Overweight Snoring Excessive Sleepiness.

4 Evolutionary / Anatomic Changes:

1.  Klinorynchy
2.  Anterior Migration of the Foramen Magnum
3.  Laryngeal descent and loss of epiglottic and soft palate lockup
4.  Vertical descent of the larynx.

As a result of complex speech and language development, only humans can choke and die.

3 Dental Important Concepts

1.  Transition to soft, processed foods lead to dental crowding and malocclusion
2.  Eating soft vs. hard foods and aggravate dental crowding
3.  Bottle-feeding can cause dental crowding and crooked teeth.

Changes in our eating and infant feeding habits created more dental crowding and more narrow airways. All these concepts are described in more detail in my book, Sleep Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.

Facial profiling. Younger people have more triangular jaws and flatter faces. If our brains get bigger and our jaws get smaller, what will we look like in 50,000 years?

Sleep-breathing continuum. All chronic health conditions can be directly or indirectly connected to poor breathing and poor sleep.

Conventional treatment options for obstructive sleep apnea:

1.  Conservative
2.  CPAP
3.  Dental appliances
4.  Surgery

Other options:

1.  Acupuncture
2.  Oral exercises
3.  Didgeridoo
4.  Provent
4.  Winx
5.  Tongue nerve stimulation / pacemaker
6.  Functional dental appliances.

5 Practical Tips to Sleep Better Today

1.  Avoid eating or drinking alcohol late
2.  Improve nasal breathing
3.  Adjust head position to improve the airway
4.  Avoid migraine triggers
5.  Practice relaxation / deep breathing techniques.

Reader Question: Dry mouth after starting CPAP. What to do?

Sleep Tip of the Day: How blue light can ruin your sleep and what you can do about it.

Resources mentioned in podcast:

Dr. Brian Palmer’s website
Dr. Weston Price: Nutrition and Physical Degeneration

Subscribe in iTunes @ doctorstevenpark.com/itunes. Thanks for reviewing my podcast and rating me.

Download the PDF of the slides.
Download the MP3 file here.

2014 Reader Survey Results

June 13, 2014 by  

Since I stopped doing my teleseminars, I felt a bit out of touch with you.  As a result, within the next few weeks, I’ll be re-launching my podcast, which will feature specific topics related to obstructive sleep apnea and upper airway resistance syndrome. My older teleseminars are already on my podcast. The ideas for future topics will come from you. This is why I recently sent out a reader survey, and the response was overwhelming. I got over 140 people who filled out the online questionnaire, when I was only expecting anywhere from 20 to 30 responses. It was truly gratifying to see how many people not only filled out the survey, but they also took the time to make some very helpful comments and suggestions. Here’s a summary of the major findings:

  • Slightly more men than women (57% vs. 43%)
  • Well over 90% are over age 40
  • People responded from all over the United states
  • 19 people from Canada, UK, Australia, Mexico, Jordan, France and Holland
  • About 50% have graduate or higher level degrees
  • About 1/2 read my book
  • Most people liked accessing my information online, and video was #2
  • About 2/3 of respondents initially found me through search engines or surfing
  • The most popular future book title was tied between The Ultimate Sleep Apnea Manual and The 7-Day Sleep Apnea Solution
  • 57% were using Windows, 29% on a Mac, 28% on a Mobile device using Safari, and 1% using Linus.

The range of suggested topics was so broad that I can’t print everything. However, the three most common frustration/suggestion themes were:

  • Your doctors don’t listen, or they don’t take your sleep concerns seriously
  • Massive frustration with CPAP
  • Life and work stress issues

I’m going to cover these three topics in my upcoming podcasts, so please subscribe now in your podcast player or on iTunes. If you have any other topics that you want me to cover, please feel free to respond to this post in the space below.  

A Must Read Interview If You Have Obstructive Sleep Apnea

June 9, 2014 by  

Things are a bit crazy as I ramp up my efforts to restart my podcast series as well to continue production of my second book, Your Ultimate Sleep Apnea Solution: Dr. Park’s Complete Guide to Getting the Sleep You Need and the Life You want

As I was searching for information on the internet, I stumbled across an old interview that I gave for Sleep-Apnea-Guide.com. I highly recommend that you read the entire article. It give a great summary of the reasons why we have sleep apnea, my general treatment philosophy, and what you can do to help you get the help that you need to breathe better and sleep better.

If you have any comments or questions about it, please come back to this page to post your response or question.

If Your Child Has ADHD, You Must See This Video

May 5, 2014 by  

If you’re at your wit’s end with a young child who has major behavioral problems, you’re not alone. Before you consider placing him on medications, here’s something that you should know: Your child’s attention deficit hyperactivity disorder (ADHD) may actually be a problem breathing while sleeping.  Here’s a powerful video of a young boy whose parents struggled for years before finding the right team of doctors to help their son.


Connor’s mom is organizing a cycling fundraiser to help donate $10,000 to Lurie Children’s Hospital of Chicago’s Sleep Medicine Department. 

Do you have similar struggles with your child? Please feel free to comment below.

5 Things You Can Do When Your Doctor Doesn’t Listen

April 22, 2014 by  

One of my friends was worried about his health. He was getting sick all the time, and felt exhausted no matter how long he slept. His wife told him he was snoring and stopped breathing once in a while at night. He told his doctor that he suspected that he may have obstructive sleep apnea. His doctor told him that he’s too thin and doesn’t fit the typical profile.

This went on for many years. Finally, he came to see me, and sure enough, he had moderate to severe obstructive sleep apnea. He started using CPAP and felt like a new person. Needless to say, he went to a different doctor after this.

Patients will often tell me various symptoms that may initially seem unlikely, or even whacky. But one thing I learned over the last 15 years in practice is that usually, the patient is right. You as the patient will know your own body much better than your doctor.

What I found was that there was usually another more important issue that stood underneath the main symptom or complaint. If you feel like your doctor isn’t listening to you or understanding you, here are 5 thing you can do or say:    

   1. Try to rephrase your concern or symptom. Sometimes reframing your statement can not only get your doctor to listen, but it’s a gentle way of reminding him or her that you have something important to say.    

   2. Be direct and state that you feel like he is not listening. Different people will have different comfort levels with this, but in general, honesty is the best policy.    

   3. Explain in much more detail why this issue is so important to you. My friend’s father had similar health issues when younger and died early of a heart attack.    

   4. Be understanding and bring it up again the next time. Maybe she’s having a bad day, or he’s running late. Don’t take it personally.    

   5. Move on to another doctor. If this pattern continues despite multiple attempts to relay your concerns, then it’s time to find another doctor.

Have you ever been in this situation? If so, what did you do or say?

Sleep Apnea May Have Caused Metro North Train Crash

April 15, 2014 by  

It’s now official: The train engineer from last year’s deadly train derailment was found to have severe obstructive sleep apnea, where he stopped breathing 65 times per hour. To date, there’s no conclusive proof that the crash was a direct result of his untreated sleep apnea, since he was also taking a sedating antihistamine and had changed shift hours two weeks prior. However, federal transportation officials are convinced that driver fatigue may have played a role in crash that killed four and injured 70 people. 

In an article about this incident, a transportation union official was quoted as saying the crash was a “tragic accident,” and that “there isn’t enough awareness of sleep apnea within the transportation industry.” This is an interesting comment, in light of the fact that recently, the National Transportation Safety Board (NTSB), Federal Motor Carrier Safety Administration (FMCSA), American Trucking Association (ATA), Federal Aviation Administration (FAA), and even Congress have worked tirelessly to bring more awareness about sleep apnea to the public. 

Congress just passed a law (H.R. 3095) requiring investigation, data collection and gathering expert opinion into screening requirements for sleep apnea in various transportation industries. The FAA recently announced that they will be more vigilant about screening for OSA, especially in severely overweight pilots. In this press release, the FAA noted that there are almost 5000 pilots with OSA on treatment that have been issued special issuance certificates. Interestingly, the NTSB database reports 34 accidents, 32 of which were fatal, involving people who had sleep apnea and 294 incidents involving another type of sleep disorder. 

Around 170,000 individuals are injured in trucking accidents each year. About 5,000 semi-trucks per year are involved in fatal traffic accidents in the United States. In a study conducted by the University of Pennsylvania and sponsored by the FMCSA and the American Trucking Association, almost one-third (28%) of commercial truck drivers were found to have OSA.

Given that the incidence of obstructive sleep apnea is so high in these industries, perhaps there should be universal screening. What do you think? Is it invading privacy to force mandatory sleep apnea testing, or does public safety take priority over individual rights?


Can Sleep Apnea Be Cured?

April 7, 2014 by  

During college, one of the most influential coursers that I took was called “Paradigms of Health and Disease.” It was taught by my advisor in the biophysics department. This course looked at how we define what is is to be healthy or sick, and compare and contrast our definitions with other cultures and societies. One important concept that stuck with me from this course is that no disease can ever be truly “cured.” We as physicians can help to alleviate the severity of disease, but we can never completely eradicate conditions like cancer, Alzheimer’s disease, or asthma. The same concept also applies to obstructive sleep apnea. 

Obstructive sleep apnea is a distinct clinical condition that can only be made based on a formal sleep study. However, I’ve argued that all modern humans are susceptible to partial or totally obstructed breathing, leading to various degrees of deep-disordered breathing. Only the more severe extreme is called obstructive sleep apnea. All of us are on a continuum, with various degrees of obstructed breathing that generally worsens with age and various other factors such as menopause, weight gain, and sleep position. This is due to our ability  to talk, which unprotected our upper airways. Modern diets and infant feeding patterns may have accelerated this problem by causing more dental crowding and smaller oral cavity dimensions. 
Unfortunately, as we all age, not only does our skin sag on the outside, but also sags and relaxes on the inside of your upper airway. It’s only natural that as your ability to breathe or sleep gradually goes downwards, the more rapidly your body will get sick or not function properly. The major treatment options we have for sleep apnea only help to alleviate this blockage using air pressure, dental gadgets or surgery, but they never really “cure” the problem. At one extreme, a tracheotomy (making a surgical hole in your windpipe below your voice box) can be described as a “cure”, but not too many people will be happy with this option.
One way of looking CPAP and dental appliances is to think of it as a cane, or a wheelchair. As you get older, many people will require one of these devices to help get around. Similarly, these nonsurgical options for OSA will help you breathe and sleep better, but it’s never an ideal situation. Throat surgery is similar to undergoing a facelift. Sooner or later, your face will continue to sag, and you may require another facelift. The same issues can rise with throat surgery, no matter how good the initial results. This “relapse” happens slowly and may take years or decades to occur. You may then ask, what’s the point of doing surgery if it’s going to come back? 
Even with CPAP or dental appliances, you’ll have to make constant adjustments and modifications every few months to years. The same goes with surgery. Ultimately, it’s a choice between using a device on your face or in your mouth for the rest of your life, or undergo surgery every few decades. Some people will need a combination of CPAP, dental appliance and surgery to achieve optimum results.
Regardless of which option you choose, what’s most important is that you think of OSA as a lifelong condition, like diabetes or even cancer. You’ll have to be vigilant and constantly monitor your condition, or be on the lookout to make sure it’s not slowly coming back. Not only do you have to make significant lifestyle changes but also a mindset shift. It’s not like a broken leg that’s treated and never have to worry about it after it’s been fixed. Unfortunately, there’s no quick “fix” for OSA.
For those of you with obstructive sleep apnea, what kind of lifestyle changes have you made? Has this condition altered the way you look at health or wellness? 


Peripheral Neuropathy and Obstructive Sleep Apnea

March 16, 2014 by  

I just saw a patient 5 weeks after major tongue and soft palate surgery for obstructive sleep apnea, and as expected more often than not, his sleep quality was significantly improved. He did not suffer from brain fog anymore, and was able to think clearly again, something he was not able to do for more than 30 years. He was very happy with the results. As he was leaving the exam room, he wanted to show me something. He took off his shoes, and then his socks, and asked me what I thought.

I was a bit confused by his request, but then I remembered that he showed me his feet many months prior to his procedures. Compared to his right foot at that time, his left foot was more dusky, red and scaly, and not too healthy looking. He had peripheral neuropathy with pain, burring and numbness, for which he was being treated by another doctor. On the post-operative visit, his left foot looked much healthier. He also noted proudly that although he still had some numbness, his burning and pain were completely gone.

Peripheral neuropathy is a common condition seen usually in diabetics, but can also occur in non-diabetics. I wasn’t surprised by his result, but it was a bit unexpected. It not something that’s routinely described as a potential benefit of treating obstructive sleep apnea. We know that sleep apnea causes a stress response that clamps down on blood vessels of the distant extremities. 

I did a quick literature search of the connection between obstructive sleep apnea and peripheral neuropathy and found a handful of studies. One report found that patients with obstructive sleep apnea without any symptoms in the feet had objective measures of diminished nerve function, which improved significantly after CPAP therapy. Another paper described resolution of peripheral neuropathy pain (but not numbness) in a non-diabetic after CPAP. 

Knowing that obstructive sleep apnea and diabetes frequently go hand in hand, and that diabetes and peripheral neuropathy also go together, there’s a good possibility that the first and the last can also be linked as well. The real question that needs to be asked is, how many people with peripheral neuropathy have obstructive sleep apnea, and if treated adequately, how many can be helped or even cured? Another question that follows is, should all diabetics be routinely screened for obstructive sleep apnea? Knowing that obese diabetics can have up to an 80% chance of having obstructive sleep apnea, perhaps the answer should be yes.

If you’ve been diagnosed with obstructive sleep apnea, did your foot pain or numbness get any better after using CPAP, dental appliances or surgery?


Inflammation, PTSD and Sleep Apnea

March 5, 2014 by  

Post traumatic stress disorder, or PTSD, is a commonly seen condition, especially in victims of sexual abuse, or in military personnel after deployment. For the most part, it’s categorized as a mental health disorder that’s treated with medications and/or psychotherapy. Personal or family history of anxiety or depression is though to increase your risk of developing PTSD.
In this new study, the presence of inflammation was found to predict later development of PTSD. In particular, each 10 fold level of C-reactive protein (CRP) was associated with a 51% increased likelihood of showing at least one PTSD symptoms after deployment to Iraq or Afghanistan.
When I came across this study, the first thing that came to mind was the numerous previous studies showing that having obstructive sleep apnea (OSA) is strongly associated with elevated levels of CRP, and that treating OSA with CPAP can lower CRP levels. 
In addition to higher levels of CRP, OSA is also associated with elevated levels of IL-1, IL-6, and TNF-alpha. CRP is a general marker of inflammation and can even be elevated after surgery.
A good analogy is to say that having a fever increase the chances that you have a cold. Your temperature can also go up if you have pneumonia. There’s nothing special about having an elevated temperature, since it’s a general marker of inflammation. In a similar way both obstructive sleep apnea and PTSD are both associated with elevated levels of CRP. 
But what if obstructive sleep apnea increases your chances of developing PTSD? Not too coincidentally, there’s a study showing that veterans with PTSD have up to 50% rate of OSA. Treating OSA can oftentimes improve PTSD symptoms. I’ve had numerous veterans report that their PTSD was completely gone after starting CPAP.
Something to always think about when you’re dealing with PTSD.

If You Sleep Less Than 6 Hours, You Must Read This…

February 26, 2014 by  

I haven’t talked a great deal about sleep deprivation, so when I came across this article on Medscape, I thought the overview of the various epidemiologic findings related to sleeping less than 6 hours was worth reviewing:

“Sleep deprivation has a profound impact on multiple disease states. For example, if you sleep less than 6 hours, epidemiologic studies show the following:

• Stroke is increased by a factor of 4 times.

• Obesity is increased by an increase in ghrelin, which is a hunger hormone.

• Diabetes is increased because sleep deprivation increases insulin resistance.

• Memory loss is accelerated. Epidemiologic studies show that there is not only permanent cognitive loss but also evidence of early brain deterioration.

• Osteoporosis is increased, at least in an animal model, with changes in bone mineral density. Even changes in bone marrow are evident within 3 months of a study in a rat model.

• Cardiac disease is increased. There is a 48% increase in early cardiac death, as well as increased cardiac-related mortality.

• A 4-fold overall increase in mortality.

As it relates to gastrointestinal disease, there is an increased risk for colon cancer, and at least 1 epidemiologic study shows an association between sleep deprivation (or lack of sleep) and an increase in the likelihood of precancerous (adenomatous) polyps.”

The author also summarized the results of this finding that sleep deprived mice had higher rates of tumor growth.

More and more studies are linking sleep deprivation and obstructive sleep apnea with numerous medical conditions, including cancer.

If you sleep less than 6 hours, something else to sleep on…

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