What do you think about my hypothesis?

I recently had a woman who told me she gets sore throats when it rains or if she gets wet. How many you have this particular condition?

This morning, I woke up with a really sore throat, which traveled up into my ears. Most people would consider this to be the start of your typical cold or allergy attack, but knowing what I know, and based on the timing of events last night, my throat pain was definitely due to reflux. As I write this post later in the morning, my throat pain is completely gone, which proves my point even further.

Imagine if you typically eat close to bedtime, and you have reflux every night. Chronic inflammation and swelling due to normal stomach juices cases narrowing of your nose and throat, which can aggravate more frequent obstructions and arousals. Poor sleep over the long term causes weight gain, and weight gain narrows the throat, aggravating sleep-breathing problems. Whether or not you have obstructive sleep apnea, everyone is susceptible to this process. If this continues for days or weeks, it can set you up for the routine bronchitis or sinus infections that are so commonly seen.

How many of you have a sore throat in the morning? Please enter your answer in the text area below.

Regardless of the implications of this study, what caught my eye were the pictures. In the article, the two children and woman's faces were nice and wide. I went on to google other pictures of Hutterites, and by a wide margin, most of the adults and children have very wide jaws and facial structures. This is in contrast to regular urban people (especially younger adults and children) with more narrow faces and small jaws. Small jaws means less room to breathe at night due to narrowing of the space behind the tongue.

This makes sense since secluded communities like the Hutterites tend to eat off the land and breastfeed for extended periods of time. It's expected that they'll have proper dental development, and as a result, will be more immune to the effects of any viral infection, even the influenza virus. 

Any degree of inflammation in the upper airways can aggravate further narrowing, leading to more frequent pauses in breathing, leading to aspiration of stomach juices into the lungs and nose, aggravating a vicious cycle into more obstructions. This is why people with sleep-breathing problems suffer more complications such as pneumonia, sinus and ear infections.

We know that some people who catch the flu experience it just like a common cold, whereas for others, it can be deadly. It's one thing to show that giving immunizations can prevent infections, but what's the rate of complications in Hutterites that do contract the flu? I'm willing to bet it's much lower than normal. With this in mind, it it even worth vaccinating this particular population?

What's your opinion about my theory? 

Any time I see patients in the office that come in with any of these classic symptoms or one of the more severe complications such as sinusitis, I always ask about the few days or weeks prior to the onset of the throat symptoms. With few exceptions, most of you will have either increased stress (out of the ordinary), a history of eating later than normal, or drinking alcohol later in the evening. Sudden weather fluctuations such as pressure or humidity changes is another common trigger.

If you’re susceptible to sleep-breathing problems at all (most modern humans are to some degree), any degree of inflammation in the throat will cause further swelling, starting up a vicious cycle that brings up more stomach juices into the throat, which causes more obstructed breathing and stomach juice reflux. It’s important to realize that whatever comes up from your stomach includes not only acid, but also bile, digestive enzymes, and bacteria. Even microscopic amounts will cause irritation to your delicate voice box, giving you a scratchy throat, cough or hoarseness. This is why these symptoms are most obvious when you first wake up in the morning.

It’s also been shown that these same stomach juices can then travel down into the lungs or up into the ears of the sinuses. Pepsin, a digestive enzyme, and H. pylori, a common stomach bacteria, have been found in lung and sinus washings. This is also why the ears are usually affected before the sinuses—it’s a direct line from your throat to the eustachian tubes, whereas you have to take right angled turn to reach the sinus passageways in the nose.

You may now be asking, "but what about the fever and the chills?" Any sudden, or abrupt change in your sleep-breathing status can cause an autonomic nervous system imbalance that can bring about these same fevers, hot flashes, chills and sweating.

How does your typical cold start? Please enter your experiences below in the comments box.

If you look at this connection through the perspective of my sleep-breathing paradigm, there’s a much better explanation. Studies have shown that acid reflux is linked to gingivitis and cavities. What’s acid reflux linked to? Right! Obstructive sleep apnea. I also mentioned in a past post that these same juices also contain bile, digestive enzymes, as well as bacteria. Imagine bathing your gums and teeth in acid, bile, digestive enzymes and bacteria all night. What do you get? Gingivitis and cavities.

In his book Nutrition and Physical Degeneration, Dr. Weston Price showed that in certain cultures with wide and spacious jaws, the presence of cavities was almost nonexistent. However, in cultures with narrow jaws dental crowding, cavities were rampant.

There are also  tons of studies strongly linking obstructive sleep apnea with heart disease, hypertension, diabetes, stroke, and heart attack. 

So is obstructive sleep apnea the common link? What’s you opinion on this theory? Please enter your comments in the text box below.

In our over-stressed, over-weight, sleep-deprived society, there’s a tendency for experts to offer you the latest, greatest, high-tech, and usually expensive advice when you want to get better sleep. From the new Zeo (which measures your brain waves while you sleep), to $3,000 mattresses with reclining features and NASA engineered memory foam, there’s an unlimited number of gadgets and devices that promise to give you a better nights’ sleep.

But before you consider these expensive options, try the following 5 quick and easy tips to help you sleep better for free, or at a relatively low cost.

Tip #1: Avoid Acid Reflux

Acid reflux is a major cause of poor sleep, especially if you eat just before going to bed. If you have a sleep-breathing problem, this condition becomes even worse, since stomach juices are actively being suctioned up into your throat every time you stop breathing. In sleep apnea patients, vacuum forces are created in the throat with each obstruction, which forces normal stomach juices into the throat.

Two of the most common ways of treating this condition is to either take acid reflux medications, or sleep inclined, with your upper body angled up. Before you invest in an expensive adjustable bed that can incline your body upwards, just stop eating close to bedtime. Make sure you stop eating at least 3-4 hours before you go to bed. This way, even if you do stop breathing, you won’t have as much stomach juices that can come up into your throat (which also includes bile, digestive enzymes, and bacteria).

Take Power Naps

There are tons of research studies that tout the benefits of taking short naps in the mid to late afternoon. Our bodies naturally have sleepy tendencies during this time, so why not take advantage of it? It’s been shown that not only will you have more energy for the remainder of the day, but your chances of heart disease and dying early can be lowered if you nap regularly.

If you have a sleep-breathing problem, like obstructive sleep apnea, make sure you don’t sleep longer than 30 to 45 minutes. Sleep-deprived people tend to go into REM sleep earlier than the 90 to 120 minutes it normally takes to reach REM sleep. This is when your muscles relax the most and you’ll be more likely to have obstructive events.

Take Breathing Lessons

Deep breathing exercises have been shown scientifically to calm your nervous system. Thy is why people who engage in yoga, tai chi, or any other discipline that teaches proper breathing techniques feel so much more relaxed.

If you don’t have time or the funds to take classes on a regular basis, make it a point to take 4-5 slow deep breaths every 1-2 hours, especially when you’re transitioning from one activity to another, or if you’re feeling stressed. You can also make it a habit to meditate on your deep breathing anytime you’re waiting on the phone, standing inline, walking somewhere.

Take A Media Vacation

Modern humans are inundated with too much information. Too much news coming from too many sources can lead to information overload, not to mention anxiety-provoking states that keep your mind racing before you go to sleep at night. Turn off the TV, don’t read the paper, check email only once a day, and limit surfing the internet. Think of it as a cleansing that empties your mind of needless clutter. The world will go on without you if you don’t know what’s going on.

Undergo Natural Phototherapy

Rather than investing in bright light boxes or suntan sessions, expose yourself to more sunlight. Early morning sunlight is the best time since it’s not as intense, and exposing your eyes to light at this time helps to strengthen your sleep clock. This is also the best time to exercise outdoors, if you have the time.

If you’re already supplementing with vitamin D and calcium, exposing yourself to more natural sunlight can help to optimize theses supplements’ beneficial effects. Don’t worry too much about skin cancer, since sleeping better can help to fight off cancer.

These 5 tips are some of the many free or inexpensive ways that you can get better sleep. Without laying the foundations for these fundamental sleep habits, sleeping pills, beds, pillows, and gadgets won’t ultimately help you sleep better in the long run.

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Click here to find out the secrets of using ancient Chinese herbal medicine to get better sleep quickly and easily from , Dr. Maoshing Ni (AKA: “Dr. Wow” from Sex and the City).

One of the most common pieces of advice that I give is that you should try not to eat within 3-4 hours of bedtime. There are lots of explanations for why this can lead to weight gain and poor sleep. One such explanation is that having food in your stomach diverts energy and blood to the stomach, depriving the rest of the body the energy needed to rest and regenerate. Another is that it slows down your metabolism. What most people (and doctors) don’t realize is that the more juices you have in your stomach when you go to sleep, the more likely it’ll come up into your throat, leading to poor sleep. 

As mentioned in my sleep-breathing paradigm (in my book, Sleep, Interrupted), all modern humans stop breathing once in a while when sleeping, due to our unique upper airway anatomy and our ability to talk. Muscle relaxation during deep sleep leads to these partial to total obstructions. If these episodes happen very often, for longer periods, then this is what we describe in medicine as obstructive sleep apnea. But obstructive sleep apnea is not something you develop suddenly in your 50s or 60s. All of us have minor variations of it at certain times in our lives (during colds, when we gain weight, or during pregnancy for women). All of us are on a continuum.

Once you stop breathing (but before you wake up and turn over), a vacuum effect is created in your throat, which can literally suction up your normal stomach juices into your throat. This not only causes you to wake up from deep to light sleep, but also causes the all-too-common symptoms of post-nasal drip, throat clearing, chronic cough and hoarseness, usually worse in the morning.

When I woke up in the morning the night after I ate my apple pie, my throat was a little sore, but what really got my attention was the fact that I felt like I only slept for 5 hours, rather than the 7 that I got that night. I was also more tired than usual all day long.

It’s not too surprising that sleep length, sleep efficiency, energy, appetite, and weight loss are all directly or indirectly connected. Yesterday, I saw a child in the office who stated that his sleep quality improved dramatically once he stopped eating ice cream before bedtime.

If any of you eat close to bedtime, and don’t sleep well are tired during the day, I challenge you to make it a regular habit to eat earlier for the next 4 weeks. Then let me know on this blog when you feel better. I’m confident that you’ll sleep better and feel better. 

By the way, if you want the recipe for my apple pie, just let me know. It’s from a Mrs. Fields recipe book.

In our current age of economic recession and flu epidemics, experiencing hoarseness or a sore throat can conjure up worst-case scenarios. What I’ve noticed in more recent months is that more and more people with these two symptoms are coming in concerned about throat or lung cancer. If you feel a lump in your throat, the word lump itself can cause feelings of stress or anxiety. If you’re a smoker or a past smoker, the situation is even worse. 

The other day a man came in complaining of an itchy, scratchy throat 4 days prior, with loss of his voice the next day. He didn’t have any other viral symptoms such as fever, chills, or muscle aches. Upon further questioning, he normally eats dinner early, but the night before all this happened, he went out to eat dinner late and also had some drinks. 

Here’s the explanation to the sequence: Because of his upper airway anatomy, he was predisposed to acid reflux at night due to occasional obstructions and arousals. I talk about who may be predisposed and why this occurs in my book, Sleep, Interrupted. During an obstruction, vacuum forces can suction up small amounts of stomach juices into the throat, leading to various throat symptoms such as scratchiness, pain, hoarseness, post-nasal drip, lump sensation, and chronic cough. More often than not, doctors will give oral antibiotics in this situation, "just in case."

Many typical "colds" start of  with a scratchy or sore throat, with no other viral symptoms. Later, it can "travel" up into the nose and sinuses, leading to nasal congestion and sinusitis. What’s happening here is that there was an initial episode of acid reflux, which first irritates the throat, leading to more swelling and congestion, aggravating the vicious cycle. It’s also been shown that your normal stomach contents (acid, bile, digestive enzymes, bacteria) can travel up into your nose and ears. Chronic inflammation can predispose any part of the body to true viral or bacterial infections. 

The typical fevers, chills and sweats that are seen in this situation may suggest a viral infection, but you can also have all these symptoms from an involuntary nervous system reaction, which is called vasomotor symptoms. This happens when your involuntary nervous system becomes imbalanced due to a sudden change in your sleep-breathing status. 

Even if you start off with allergies or a runny nose from a cold, eventually, the tongue will collapse more and perpetuate this vicious cycle.

So the next time you have a sore throat and are convinced that you have an infection, think again. In many cases, you’ll find that either you must have eaten late or drank alcohol the previous night. If not, then you may have a true cold. But since it’s been shown that having colored nasal mucous of throat phlegm does not necessarily mean you have a bacterial infection, things are not always what it seems.

How do your typical "colds" begin? I’d like to know.