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Did Adam Yauch of the Beastie Boys Have UARS?

The hip-hop and pop music world was saddened to hear that Adam Yauch of the Beastie Boys died at at the age of 47. He had been battling parotid gland cancer. As you may know, one of my hobbies is to analyze facial features, particularly jaw configurations in relation to one’s ability to breathe and sleep properly at night. I came across this picture on MSNBC, showing Mr. Yauch’s narrow and recessed mandible, along with a very narrow and pinched in nose. Having small jaws leads to airway crowding, predisposing to breathing problems while in deep sleep during muscle relaxation. 

There’s nothing more public about his health status besides his cancer, but one of his hallmark features was his raspy voice. If  he had upper airway resistance syndrome, it’s likely he also had laryngopharyngeal reflux disease. Besides aggravating hoarseness, reflux can also cause chronic oral cavity, nasal and lung inflammation, potentially leading to a multitude of health problems. It’s also very likely that he didn’t like to sleep on his back, and had unrefreshing sleep. Studies are beginning to show that lack of good sleep may also be a risk factor for cancer. 

All this is speculation, but celebrities are also modern humans, being susceptible to craniofacial features that can lead to sleep-related breathing disorders. Do you know of other celebrities that have small jaws or facial features?

 

 

 

Expert Interview: Dr. Emerson Wickwire On Cognitive Behavioral Therapy for CPAP

 In this interview, Dr. Wickwire shares his wisdom about comprehensive approaches to managing sleep apnea, including cognitive-behavioral treatment to maximize success with CPAP .

 Some of the questions include: 

 What are cognitive-behavioral treatments (CBT)?

 Have cognitive-behavioral treatments been applied to sleep disorders?

 What is the psychology of sleep apnea?

 What factors influence PAP use?

 What are Wickwire’s Four Pillars of CPAP Success?

 What is a PAP adherence risk profile?

 What CBT interventions have been tested to improve PAP adherence?

 And much more…

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Hotels That Promote Better Sleep

There’s been a trend in recent years by hotels to cater to people who have sleep problems during their stay. One hotel in particular is the Benjamin Hotel in New York City, which employes a sleep concierge. A New York Times journalist chronicled his odyssey of trying to get some shut eye over the course of the night. After reading the entire article, I’m not sure if the journalist actually got a better night’s sleep.

Sleep problems while traveling are a major source of sleep deprivation, from time zone changes to unfamiliar surrounding, and disrupted sleep routines. Having a sleep program such as what the Benjamin offers is a step in the right direction, but seems limited in what they can offer (different pillow selections, higher quality bed sheets, eye masks, etc.). It seems that a hotel guest is the perfect opportunity to diagnose obstructive sleep apnea, using some of the simpler screening tests that are available. They could also do a better job of emphasizing better sleep hygiene, such as not eating close to bedtime or not watching TV just before going to bed.

How well do you sleep when you travel?

The Most Sleep-Deprived Occupations

Here’s a top 10 list of the most sleep deprived and most well rested occupations. Although there are exceptions to the rule, it seems that occupations that involve heavy physical activities performed outdoors during the day are more conducive to better sleep. More sedentary jobs that are done indoors are more likely to lead to to less sleep. It’s important to note that this list only shows the total number of hours slept, not the quality of sleep. 

Are you on one of these two lists, and do you think it’s accurate? 

Today Is World Sleep Day

In celebration of World Sleep Day, let’s give others the gift of sleep. If you have a loved one, a friend, or even a colleague that snores heavily or has problems sleeping, refer that person to a sleep medicine doctor. Most common sleep conditions are easily treatable. Here’s a press release by the World Sleep Federation describing their mission.

The “Top 10 Influencers Of Online Sleep Discussion”

I’ve always taken ratings with a grain of salt, but after being recently alerted that Sharecare placed me on their list of the “Top 10 Influencers of Online Sleep Discussion,” I was happy to see that my message is being heard and read around the world. I’m honored to be amongst great company, including Dr. Michael Breus (The Sleep Doctor), Anahad O’Connor (New York Times health columnist), and various other prominent sleep physicians. I strongly recommend that you bookmark all these great sites for timely and important information for better sleep and health:

Ask Dr. Park: Women’s Sleep Issues

In this Ask Dr. Park teleseminar, I talk about common sleep problems that occur in women: insomnia, prementrual issues, pregnancy, and menopause.

Some of the questions I answer include:

- Why are women light sleepers?

- How is sleep different in women compared to men?

- How can I go back to sleep if I wake up in the middle of the night?

- Will estrogen supplements help with sleep?

- What’s the difference between bio-identical and synthetic hormones and how do they affect sleep?

- How does estrogen dominance cause sleep problems?

- What causes throat pain just before your periods?

- How can hypertension and diabetes be prevented during pregnancy?

- Which hormone is responsible for sleep problems during menopause?

- And much more….

 

Purchase MP3 recording ($17)

PDF of slides (free)

 

 

 

 

Do Sleeping Pills Increase Your Risk Of Dying?

Here’s a stunning statistic: A prescription for just a few sleeping pills per year was associated with a 3.6 times increased risk of dying (from any cause) compared to those who didn’t have any prescriptions for these medications. It jumped to 5.32 if more than 152 doses per year were prescribed. The authors of this British Medical Journal article estimate that in 2010, hypnotics may have been associated with 320,000 to 507,000 excess deaths in the US alone. They came to this conclusion by combing through more than 10,000 records of people who were prescribed at least one prescription for a hypnotic and looked at mortality over 4 years compared to matched controls who didn’t have a hypnotic prescription. 

They were careful to note that association does not imply causality. While it’s temping to interpret this study implying that sleeping pills can kill people, it’s important to realize that there are numerous studies showing that people with sleep problems are known to have a higher risk of dying from various reasons. For example, people with insomnia have higher rates of depression, suicide, and cancer. In addition, a significant number of insomniacs on sleeping pills will have obstructive sleep apnea, and untreated obstructive sleep apnea can increase your risk of car accidents, heart attack and stroke. 

It’s likely that increased risk of dying is already elevated in people with sleep problems, and those that are given sleeping pills are found to have increased rates of death. This may be the classic case of being true, true, but unrelated. To really determine what causes what, you’ll have to look at mortality in a large prospective study in people with insomnia and randomize to be given sleeping pills versus a placebo. 

33% of All Cops May Have Sleep Apnea

I’ve always wondered about police officers—just like the rest of the population, many are generally overweight.  A new study published in the Journal of the American Medical Association revealed that about 40% of police officers screened positive for at least one major sleep disorder. Sleep apnea was the most commonly found condition, at 34%. Insomnia and shift word disorder were the two other conditions seen. About 80% were overweight or obese. And 26% reported falling asleep while driving at least once or twice per month.

These findings are not too surprising, since police officers frequently work odd hours that include night shift and weekends. Their poor eating habits can contribute as well. We also know that poor sleep can promote weight gain. The irony is that police officers probably need to be outdoors, walking or driving around, since an indoor desk job will not be stimulating enough. The question is which comes first: poor sleep habits and lifestyles that lead to weight gain and sleep apnea, or anatomic predisposition to sleep apnea that leads to choosing these type of occupations that promote weight gain, which leads to sleep apnea? I’m sure that if you studied fire fighters, you’ll find similar results, and that you’ll agree with me that this is a potentially major public health issue.

Based on these findings, do you think mandatory screening for obstructive sleep apnea should be required on a periodic basis for all police officers?

Why Most Doctors Know Almost Nothing About Sleep

Studies in the past have shown that when someone complains about not being able to sleep to a doctor, more often than not, a sleeping pill is prescribed. The reason is that young doctors are taught in training that pharmaceuticals like Zolpidem (Ambien) stimulates GABA receptors in the brain, promoting sleep. There’s essentially no mention that cognitive behavioral therapy for insomnia works just as well for insomnia in the short term, but is superior to drugs in the long term.

You’d think that medical students would get at least some education about a part of patient’s lives that they spend 1/3 of their lives doing, which is sleep. Well, not really. 

I remember getting only about 2-3 hours of lectures on sleep during medical school. I’m told by a medical school professor that due to stiff competition between various subjects such as molecular biology, anatomy, pathology and pharmacology for student’s time in classes, sleep gets squeezed out in the end. 

This problem was brought to light by a study in a major sleep journal (Sleep Medicine) which showed that the quality and quantity of sleep education varied tremendously between various international countries. For example, the average number of hours on time spent on sleep education was 2.5 hours. In 1990, a survey reported that medical students received about 2 hours of sleep education, and not much has changed recently. In fact, 27% of respondents reported no training in sleep at all. Pediatric sleep topics grabbed a mere 17 minutes on average.

Even now, despite knowing that untreated obstructive sleep apnea can significantly increase your risk of heart attacks and stroke, doctors are still prescribing blood thinning medications and high blood pressure medications, while ignoring the patient’s severe snoring problem. We also know that poor quality and quantity of sleep is strongly linked to increased rates of cancer, sudden death, and motor vehicle accidents.

I think it’s time that physicians finally wake up to the importance of a good night’s sleep. Sadly, most mainstream physicians and surgeons that I know still don’t take sleep very seriously.

How can you as the patient better educate your doctor about the importance of a good night’s sleep?

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