Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring » genioglossus

Ask Dr. Park: Cutting Edge Surgical Options for Sleep Apnea

Steven Park — Thu, 02 Feb 2012 17:58:53 +0000

Please join me on Tuesday, February 22nd at 8 PM Eastern for my next Ask Dr. Park Teleseminar. This month, I’m going to do a presentation on the latest in surgical treatment options for obstructive sleep apnea.

Registration details will be made available about one week prior to the event.

Can Eating Canned Foods Cause Sleep Problems?

Steven Park — Sat, 26 Nov 2011 03:27:38 +0000

The next time you eat anything out of a can, think about this study: Researchers at Harvard found that levels of BPA (bisphenol-A) had a 1,221% increase in urine levels after eating canned soup once daily for 5 days. BPA is commonly found in the lining of bottles and cans. Recently, manufacturers have voluntarily removed this substance from baby bottles, but not from commonly used containers such those used for canned foods.

BPA is a known endocrine disruptor, as well as being linked to increased rates of cancer. These molecules mimic estrogen and stimulate estrogen receptors artificially. In the process, it can also suppress progesterone levels, which can alter one’s sleep-breathing status by lowering your upper airway muscle tone, particularly the genioglossus muscle of the tongue.

Since the combination of estrogen and progesterone have protective effects on upper airway muscle tone, any disruption of this delicate balance can affect how well you breathe at night. Having artificial levels of a synthetic estrogen can suppress natural estrogen function as well. The end result can have a subtle, but significant effect on your sleep quality.

Another good reason to eat organically.

Acupuncture Lowers Sleep Apnea By Almost 50% After One Treatment

Steven Park — Thu, 31 Mar 2011 02:59:13 +0000

In a follow-up study (PDF) to their previous paper (PDF) showing that 10 acupuncture treatments can lower the AHI by 50%, the same authors performed sleep studies just before and after one acupuncture treatment, and found a 49% improvement in the apnea hypopnea index. The apnea index improved by 86%, and the hypopnea index dropped 39%. This was in the traditional, manual acupuncture group. In the group that received electrical stimulation acupuncture, the results were slightly better. The study authors proposed that acupuncture somehow alters the serotonergic pathways that are related to the caudal raphe neurons that control the muscles of the upper airway. One of the needles was also inserted into the genioglossus muscle, which is the main upper airway dilator muscle.

Personally, I’ve had mixed results using the same protocol for sleep apnea. But when it works, it works really well. Regardless, there’s minimal risk of complications, and even if your sleep apnea doesn’t improve, you’ll get the relaxing benefits of acupuncture treatment.

Has anyone experienced better sleep after acupuncture treatment?

New Sleep Apnea Treatment: Hypoglossal Nerve Stimulation

Steven Park — Thu, 12 Nov 2009 14:27:55 +0000

Here’s a radically new approach to treating obstructive sleep apnea: hypoglossal nerve stimulation. I read about initial successful pilot studies many years ago out of Johns Hopkins, but thought the concept never took off since I didn’t hear anything more. I was wrong. ImThera recently announced their aura6000 Targeted Hypoglossal Neurostimulation (THN) device for obstructive sleep apnea at the Annual Meeting of the American Academy of Otolaryngology – Head & Neck Surgery in San Diego last month. There are two other companies rushing to come out with similar products. Apnex is one company and Inspire is another.

It turns out that this company’s been busy developing this product and is about to undergo clinical trials in Europe before trying it out here the US. The technology’s not new—it’s basically a nerve stimulation device that’s been used on other areas of the body before. In this case, activation of the rib cage muscles causes the device to stimulate the hypoglossal nerve, which tenses the genioglossus muscle of the tongue.

During non-REM deep sleep, all the muscles in the body relax partially, whereas in REM sleep, all the muscles are relaxed completely. In sleep apnea patients, this partial and total muscle relaxation leads to repeated obstructions and arousals. By sensing that the ribs are moving, it stimulates the tongue muscle, preventing eventual collapse of the throat tissues.

In the original Johns Hopkins article from 2001, eight patients underwent this procedures on one side of the tongue, and the AHI dropped from 52.0 to 22.6 in non REM sleep and 48.2 to 16.6 in REM sleep. The final results aren’t great, but significantly improved. Additional procedures may need to be performed, since the tongue isn’t the only area of obstruction.

If this procedure became available in the US, would you consider undergoing this procedure? Please enter your answers below in the comments box.