The Connection Between MS And Fatigue

June 8, 2011

It’s a given that if you have multiple sclerosis (MS), you’ll be tired all the time. It’s thought to be a normal part of having this condition, just like many other chronic medical conditions. But here’s an interesting study that suggests that fatigue can precede MS by up to 3 years. The researchers found that many MS patients complained of fatigue to their doctors months or even years before the first clinical signs of MS.

Here’s my take on this: I’ve written in the past about how the vast majority of people with MS that I see in my office have small jaws and narrowed upper airway anatomy. In an informal poll I conducted on Medhelp.com’s MS forum, a very high number of people had an excessive number of dental extractions, couldn’t sleep on their backs, and many of their parents snored heavily. Having excessive dental extractions causes the oral cavity to become much smaller, making the tongue take up too much space.

I’m not discounting current thinking about the origins of MS, but it’s extremely interesting that most patients with MS have very narrowed upper airway breathing anatomy which prevents achieving deep sleep. Lack of quality deep sleep can lead to various neurologic, hormonal, metabolic and digestive problems. Many patients with MS also have obstructive sleep apnea, but most will most likely have upper airway resistance syndrome, which I’ve described extensively here and in my book.

For those of you who happen to have MS:

What’s your favorite sleep position (back, side or stomach)?
Did you have any teeth removed besides your wisdom teeth, and if so, which ones and how many?
Do either of your parents snore heavily?

Written by Steven Park · Filed Under Blog | 1 Comment

Do All Pregnant Women Have Sleep Apnea?

February 25, 2010

We know that significant weight gain is a common aggravator of obstructive sleep apnea. If you already have narrowed jaws and gain some weight, then you'll move up the sleep-breathing continuum that I describe in my book, Sleep, Interrupted. But why is it that when women become pregnant, sleep apnea is the last thing that's considered whenever they develop depression, high blood pressure or extreme fatigue?

Two recent published studies perpetuate this myth amongst doctors that sleep apnea can't happen in pregnant women. One study showed that about 2/3 of pregnant women responded to depression using acupuncture. Another study showed that antidepressant use during pregnancy led to small, but measurable developmental delays at 19 months. Depression (during pregnancy or post-partum) is a major problem with many women. But rather than saying that it's pregnancy-related depression, it should be looked at as a sleep-breathing problem, since one major reason for depession is lack of deep, quality sleep that's common with all pregnant women. Pharmaceutical companies promoting anti-depression medications to replace deficiencies in brain biochemistries doesn't help either.

One reason why not every woman that's pregnant goes into depression during or after pregnancy is due to the effects of progesterone, which has been called the "feel good" hormone. One of the interesting properties of progesterone is that it's an upper airway muscle stimulant. It increases tongue muscle tone and tension. During pregnancy, progesterone goes through the roof, since it's needed for maintaining the uterus and development of the baby. But if the weight gain is too much, or if your jaw is too narrow, then the effects of progesterone won't be as helpful. Once you deliver, progesterone drops, but you're still left with all that weight. This is one major revelation that I had when my wife experienced severe post-partum depression after the birth of our first son, Jonas.

We also know that many women who develop pre-eclampsia (dangerous high blood pressure) during pregnancy have various degrees of sleep-breathing problems, which can be treated effectively with standard sleep apnea treatment options.

For the women that's reading this blog, did you have any significant depression during or after pregnancy? How did you deal with it, and if your saw a doctor about it, what did they recommend? Please enter your answer in the comments section below.

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Under The Weather Or Depressed?

June 25, 2009

For whatever reason, until today, I’ve been feeling really run down with no energy or motivation to do anything. My sleep’s been OK, but I felt more tired than usual. My ability to focus and concentrate was definitely affected, and my wife even called my mood "morose." Ouch. I hope my bad mood didn’t rub off on my three boys.

The reason for bringing this up is that today, I feel great all of a sudden. The only difference that I can think of is that the sun shined in New York City for the first time in days, maybe even over one week. We’ve had either rain or overcast weather most of June.

I realize now that I was probably suffering from a mild case of seasonal affective disorder (SAD), which affects susceptible people who either don’t get enough sunlight or during the winter season, when there’s much less sunlight. I didn’t think I could have this, but I guess things change as you get older.

For prolonged cases of SAD, bright light therapy is one way to treating this condition. Another way is to spend more time outdoors, even with the overcast skies.

How many of you were also under the weather this past week?

Written by Steven Park · Filed Under Blog | 5 Comments

A Surprising Finding About Women and Heart Attacks

March 31, 2009

Men who suffer from heart attacks typically complain of chest pain, shortness of breath, and radiating pain from the neck to the left arm. But for women, it’s completely different. A recent study financed by the NIH (and summarized in the New York Times) showed that in the weeks before their heart attacks, 70% of women complained of severe fatigue and 48% reported sleep disturbances. Less than 50% had shortness of breath, anxiety, or indigestion.

Post-menopausal women have a much higher risk of developing heart disease compared with their pre-menopausal peers. We know that obstructive sleep apnea can cause heart disease, and menopause can aggravate sleep-breathing problems. We also know that 90% of women with sleep apnea are not diagnosed. I think it’s safe to assume that many if not most of the women in this study had some degree of a sleep-breathing problem. It’s not surprising that the initial symptoms by women who were about to have heart attacks had mainly sleep-related symptoms. Oddly, these symptoms were called "atypical." Sadly, 90% of women with sleep apnea will continue to go undiagnosed.

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Can Snoring Help You Lose Weight?

December 22, 2008

A recent study published in the Journal Archives of Otolaryngology – Head & Neck Surgery showed that snorers burn more calories while sleeping than nonsnorers. For obvious reasons, the press and the internet is buzzing with this new finding. For those of you who think that you can lose more weight by continuing to snore, the study authors did note, however, that this does not mean that you can continue snoring away without any sort of treatment.

Most people who snore will have some degree of sleep apnea, and this is a serious medical condition. Untreated sleep apnea can lead to high blood pressure, depression, diabetes, heart disease, heart attack or stroke.

If you snore (or have simultaneous apneas) your body is in a stress state, more commonly known as the fight-or-flight response. This increases your metabolism, as well as keeping you from staying in the lowest metabolic state, which is the deeper stages of sleep. We know from numerous studies that inefficient sleep, due to whatever reasons, will promote weight gain.

There are even studies that suggest that the vibrational trauma can cause carotid artery plaque formation.

Do you snore, and if so, are you overweight?

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