A Pill Instead of CPAP for Sleep Apnea?

March 12, 2013

Here’s another study finding and accompanying article that offers hope of perhaps finding a “pill” for obstructive sleep apnea, rather than the conventional options the we currently have available (CPAP, dental options, and surgery). The researchers identified one of the main mechanisms of the switch that turns off muscle tone when you’re in REM sleep (the dreaming state). As mentioned in past posts and teleseminars, apneas and hypopneas are most common in stage REM, when your muscles are most relaxed. The study researchers found a way to reverse this process in rats.

The problem is that rats may have REM sleep, but they don’t have obstructive sleep apnea, since they can’t talk. Modern humans’ unique ability to talk and communicate created upper airway anatomy that predisposes to upper airway obstruction. The other problem is that REM sleep stimulates brain areas that are needed for learning and memory consolidation. Human infants spend 50% of their sleep time in REM sleep.

If you give a pill to block the muscle paralyzing process that happens in REM sleep, then you’ll end up moving around, talking and acting your your dreams. Your brain is wide awake during REM sleep, but with your muscle relaxed (except for the eyes and the diaphragm). This is probably not a good idea. There’s even a sleep disorder called REM sleep behavior disorder, where due to brain damage in areas that affect this particular switch, older men act out their dreams during REM sleep. This condition has a high association with developing Parkinson’s disease later in life.

Lastly many of the anti-depressant medications that are are prescribed diminish REM sleep, thereby lessening time spent in REM sleep. This could lead to improved mood, since you’re not having as many apneas.

Unfortunately, I don’t ever see a pill in the future that can truly compete with the three mainstream options already mentioned. As stated before, obstructive sleep apnea is an anatomic and craniofacial problem, and not directly a biochemical problem.

What’s the Link Between Erectile Dysfunction And Heart Disease?

February 1, 2013

Erectile dysfunction (ED) is a common condition that’s usually treated by urologists with medications. In the sleep medicine literature, there are numerous studies showing that many men with ED have undiagnosed obstructive sleep apnea (OSA) and that treating OSA can significantly improve or even cure ED. Here’s one of many papers (PDF). Even in my practice, men oftentimes comment that this is a positive side effect of CPAP. 

Here’s another study that reiterates the known association between ED and cardiovascular disease. There’s no mention of sleep whatsoever. We also know that obstructive sleep apnea is a major risk factor for heart disease. It’s frustrating to know that most of these men will never have their obstructive sleep apnea diagnosed or treated.

I’m not saying that all cases of ED are due to OSA. But even if 50% of patients are improved, wouldn’t it be worthwhile looking into this possibility? Not to mention that once you’re able to sleep better, things can begin looking up again :)

Ask Dr. Park: What You Can Do When CPAP Fails

December 31, 2012

In this teleseminar, I’ll go over all options when CPAP doesn’t work for you. 

• What other options are there when CPAP doesn’t work?

• Are dental devices effective?

• What are my surgical options?

• Do tongue exercises, acupuncture or didgideroo playing help to cure sleep apnea?

• What about Provent nasal plugs?

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Ask Dr. Park: CPAP Success Strategies

November 2, 2012

In this Ask Dr. Park teleseminar, I go over solutions to the top 10 CPAP problems that people have, as well as to answer questions from the live audience.

Click here to purchase MP3 recording ($17).

PDF of slides (free).

Expert Interview: Dr. Ira Shapira, Founder of IHateCPAP.com

October 10, 2012

In this Expert Interview I’ve invited Dr. Ira Shapira, founder of IHateCPAP.com. We’ll talk about the main reasons why people hate CPAP and what you can do about it.

He’ll answer the following questions:

• How did I HATE CPAP get its name?
• How did you become involved in treating sleep apnea in the early 1980′s? 
• How are Sleep Apnea and ADD and ADHD related?
• What percentage of patients love their CPAP?    How can you predict who will love their CPAP?
• Why do over 60% of patients reject CPAP when it is considered the Gold Standard?
• Are oral appliances indicated for severe sleep apnea?  WEhat are the exceptions?
• What are the most commonn complaints?
• How are Sleep Apnea and TMJ disorders related?
• What important medical information did the Shimshak studies on TMJ disorders show?
• Why do oral appliances cause bite changes?
• Why is sleep apnea frequently associated with postural problems?
• Can CPAP cause permenant bite changes?  Oral Appliances?  What is the difference in the changes?
• How is numbness and pain in the arm and fingers related to sleep apnea?
 

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*By clicking ‘submit’ above, you are agreeing to receive ongoing communications from Dr. Park including monthly newsletters, events alerts, and other such written correspondences. Your e-mail will remain strictly confidential and will not be disclosed to any third parties without your prior written consent. You may unsubscribe to any or all portions of our e-mail correspondences at any time. Thank you for your cooperation.

Teens With Metabolic Syndrome Have Smaller Hippocampuses

September 13, 2012

Here’s a not-too-surprising study: Teens with metabolic syndrome (hypertension, high cholesterol, obesity, insulin resistance) were found perform worse in school than their counterparts without metabolic syndrome. Even more telling is that their hippocampuses were significantly smaller. We know from another study that in patients with untreated sleep apnea, the hippocampus can be significantly smaller. The good news is that treatment with CPAP actually caused new brain cell growth in this area, with improved cognitive performance scores, but never catching up to baseline states.

Ask Dr. Park Anything About Obstructive Sleep Apnea

July 24, 2012

Please join me on Tuesday, August 7th at 8PM Eastern when I answer YOUR questions about obstructive sleep apnea.

Sorry, but this program has been canceled. Please look for more upcoming Expert Interviews and Ask Dr. Park programs.

Another Study Showing Apnea Treatment Can Alleviate Depression

June 25, 2012

Despite the medical community’s insistence that sleep apnea and depression are two completely unrelated conditions, it’s hard to ignore study after study showing that treating obstructive sleep apnea can significantly improve signs and symptoms of depression. Here’s another study that was presented at the SLEEP meeting in Boston last weekend.

Oftentimes,  a very high proportion of people with obstructive sleep apnea have clinical depression. It’s estimated that about 24% of men and 9% of women have undiagnosed sleep apnea, going as high as 64% in people over 65. It’s also estimated that only a small fraction of people with sleep apnea are ever diagnosed, with an even smaller fraction of those that are diagnosed being treated effectively. Given these numbers, the implications are huge.

Yes, there are multiple other reasons for clinical depression, but knowing what we know about the prevalence of obstructive sleep apnea, shouldn’t all mental health professionals first rule out obstructive sleep apnea before prescribing medications or long courses of psychotherapy?

Expert Interview: YOU As The Expert On CPAP

June 14, 2012

In this Expert Interview I invite expert CPAP users to share their experiences and wisdom to new CPAP users and those struggling with CPAP. 

Topic: Expert Interview: YOU As The Expert On CPAP

Speaker: Expert CPAP users (YOU)

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*By clicking ‘submit’ above, you are agreeing to receive ongoing communications from Dr. Park including monthly newsletters, events alerts, and other such written correspondences. Your e-mail will remain strictly confidential and will not be disclosed to any third parties without your prior written consent. You may unsubscribe to any or all portions of our e-mail correspondences at any time. Thank you for your cooperation.

My Interview With Sleep-Apnea-Guide.com

May 11, 2012

I was recently interviewed by the staff at Sleep-Apnea-Guide.com, which is a great resource for people with obstructive sleep apnea. It was a very in-depth interview where we talked about my work and various other issues important issues. You can read the full transcript here.

Some of the questions I get asked include:

  • How did you become interested in sleep apnea surgery?
  • As a busy surgeon, how do you have time to do run your website and do your programs?
  • How do you decide who can benefit from surgery?
  • Why do modern humans have more sleep apnea?
  • How do I find the right surgeon to treat sleep apnea?
  • Any advice for people who are considering surgery for sleep apnea?

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