The Real Secret To Living Past 100

October 19, 2010

The New York Times had an uplifting story about centenarians—people who live past 100. After looking at the faces of all the pictures, I made my comment in Post #26. Here’s what I wrote:

One thing that I’ve noticed in almost every person over 90 that I see in my practice is how wide their jaws are. If you look at the facial structures of all the interviewees, all have well-shaped and wide jaws, good cheekbones and wide nasal widths. Whenever I look at these people’s upper airways, they all have wide open spaces behind their tongues.

Most younger modern people have smaller, recessed jaws, narrow cheeks, and pinched in nasal structures. Invariably, they all have very small upper airways, and difficulty sleeping on their backs. They’re also much more prone to various illnesses such as migraines, headaches, TMJ, back problems, heart disease, anxiety and depression.

The smaller the jaws, the less room there is for your tongue, which grows to it’s normal size. When on your back, the tongue falls back due to gravity, and when you add deep sleep (due to muscle relaxation), you’ll stop breathing and wake up to turn over. Most people with dental crowding will naturally prefer to sleep on their sides or stomach. The problem is that it’s not good enough. Poor sleep quality leads to a physiologic stress state that can cause or aggravate many of the modern health conditions that we have today (anxiety, depression, diabetes, hypertension, heart disease, memory loss, etc.).

Yes, your genes, your diet, your lifestyle and luck are all important factors, but the size of your upper airway is a critical factor in your potential for long life. As we all age, not only do we sag on the outside, we also sag on the inside. What I propose is that all humans are on a sleep-breathing continuum, where only the end extreme is called obstructive sleep apnea. Even if you’re “normal”, you’ll still stop breathing once in a while, which explains why you’ll toss and turn when you have a cold, or you’ll have a sore throat in the morning after you eat later. As you gain weight later in life, you’ll slowly move up the continuum.

Dr. Weston Price in his book Nutrition and Physical Degeneration describes this deterioration of our jaws and facial structures in modern times due to a radical change in our diets.

Written by Steven Park · Filed Under Blog | Leave a Comment

A Gene For Longevity? Think Jaws Instead

July 4, 2010

Every time I see a study about longevity, I can't help but to chuckle inside. We've been searching forever for the fountain of youth, and characterizing genes that determine how long you'll live is just another high-tech version of our quest. The New York Times reported on a study out of Boston University that found a set of genes that can predict extreme longevity with 77% accuracy. I have to admit—I'm a bit skeptical about any study what promises potential cures or longer life based on genetic research.

Yes, there's been significant strides in our knowledge and understanding of our genes, but even the most experienced researchers admit that they've hit a wall in terms of actually making significant differences in improving people's lives using gene therapy. Sequencing the entire human genome was like going to the moon—it was an incredible accomplishment, but now what? The benefits of gene sequencing will probably show up indirectly, where the techniques that are learned will be incorporated into other scientific areas.

One thing that I've noticed whenever I see patients in their 90s or above is how wide their jaw are, with generally good dentition. Typically, these people grew up eating naturally, and in undeveloped parts of the world, where they didn't have access to modern, Western diets. It's amazing how many of these people are on minimal to no medications, and live healthy, vibrant, independent lives. I'm sure that if they can find a gene for large jaws, then that will be found to correlate with longevity even more significantly.

The next time you see a centenarian, take a look at his or her jaws. You'll see what I mean.

Written by Steven Park · Filed Under Blog | Leave a Comment

Sleep Apnea Lessons From Africa

March 26, 2010

Here's a great example of how our diets literally affect the way you breathe and sleep at night. A patient who happened to have grown up in Rwanda told that there are three major ethnic groups in his home country: The Tutsi, the Hutus, and the Twa. The Tutsis are generally tall, pastoralists, and eat mainly soft foods, usually milk products, beans and sweet potatoes. It's also known that the Tutsi have severe cavities, dental crowding and crooked teeth. The Hutus are generally agrarians, but hunt occasionally. The Twas are pygmies, and are true hunter-gatherers, eating nuts, fruits, meat, roots, and grains. They also have the reputation of having great looking teeth.

This what Dr. Weston Price described in his classic book, Nutrition and Physical Degeneration: What you eat leads to certain predictable jaw and dental structures. This phenomenon is seen across all cultures throughout the world. Smaller jaws and crooked teeth means smaller airways behind the tongue, with more frequent arousals and less sleep efficiency. It's not surprising that my patient, who happens to be a Tutsi, has obstructive sleep apnea.

What type of foods do you eat? Do you eat like an agrarian farmer, or a hunter-gatherer? Please answer in the comments box below.

pictures?

Written by Steven Park · Filed Under Blog | 2 Comments

Health Consequences of Routine Medical Procedures

January 28, 2010

The New York Times recently ran an exposé on the lack of quality control systems that have lead to a surprisingly high number of radiation overdoses, in some cases leading to death. This reminded me of what they used to do in the 1950s to 60s, where they used x-rays to treat everything from pimples to large tonsils to ringworm. Many women's ovaries were irradiated for depression. What they did in the past may seem barbaric by today's standards, but I'm confident that many of the things we do today may seem barbaric to future generations.

There are two procedures that are still being routinely performed that have negative consequences years, if not decades later, and these are rhinoplasty, and dental extractions for orthodontic work. I see at least 4-5 patients a week that come to see me for routine problems, only to find that their "routine" procedure 10 to 25 years ago probably aggravated their current condition.

During routine rhinoplasty, especially when you're trying to narrow a wide tip, surgeons by definition have to weaken or remove a portion of the support structures (or cartilages) that keep the nostrils open. Current surgical methods take this into consideration to compensate for this fact, but many surgeons are still weakening the lower lateral cartilages without strengthening the remaining structures. This leads to flimsy nostrils that cave in with every inspiration.

As a result of this weakening, patients will have stuffy noses, unrelieved by allergy medications or decongestants. Medicines won't work for structural problems. Sometimes, someone with this condition accidentally tries a Breathe Rite nasal dilator strip, and swears by how wonderful it is.

Dental extractions are still being performed as part of routine orthodontic treatment. If there's too little space for the teeth, then it's logical that removing a few teeth can create enough space for the remaining teeth, right? What's missed entirely is that the jaw's too small. The teeth, especially the molars, act as support structures for the soft tissues of the throat. Once removed, the space behind the tongue collapses, leading to significantly lessened quality of sleep. Even simple orthodontic adjustments can have a major impact on sleep quality, since the space that that the tongue is contained in can change dramatically.

Fortunately, forward-thinking dentists are recognizing the fact that the position of your teeth and size of your jaws have a major impact on your breathing, and your health. Some of these dentists have leapfrogged ahead of the medical profession in terms of understanding the holistic implications of proper facial form and function.

Did you have rhinoplasty years ago, only to have continued nasal congestion, or did you undergo dental extractions before undergoing braces? If so, please describe your experience below.

Written by Steven Park · Filed Under Blog | 1 Comment

Solutions for Your Bed Partner’s Worst Sleep Problem

March 24, 2009

Anthony Burgess, the novelist, once said: "Laugh and the world laughs with you. Snore and you snore alone". Suffice it to say, there’s nothing worse than trying to sleep next to someone who snores. Snoring is also a common reason why many married couples sleep apart. Besides the whole host of health problems that snoring is associated with, like high blood pressure, heart disease, diabetes, snoring is even linked to erectile dysfunction in men (see our feature article: What the Makers of Viagra Missed). Fortunately, snoring is something you can get rid of. The problem is in knowing how.

Why Snore?

Snoring is probably one of the most frustrating conditions not only for the snorer, but for spouses and bed-partners as well. It’s also one of the least understood medical conditions by most doctors. One of the main reasons for this is that there are a lot of myths perpetuated both by the media and pop culture about snoring. It’s oftentimes seen as something of a farce. The truth is, however, snoring is a sign that the person who snores is most likely struggling to breathe at night, and therefore, is at a much higher risk of having a heart attack or stroke.

Moreover, textbooks and internet resources further mislead people to think that snoring originates at the soft palate, since that’s where most of the vibrations occur. However, the soft palate doesn’t flutter all by itself: the nose as well as the tongue can be involved. Even most doctors focus way too much attention on the soft palate.

The challenging part of eliminating snoring is in figuring out what’s actually causing the snoring. The vibrations of the soft palate is only the end result and not, as many people think, the thing that causes the snoring. Imagine your upper airway as a long, thin tube that has three main areas that can either narrow or collapse when a slight vacuum pressure is applied. Like a flimsy straw that would collapse in the middle if you pinch the tip, or would collapse at one end if you pinched the middle, your airway is also affected by how well you can breathe through your nose not to mention how tone or relaxed your muscles become as you drift off in to deep sleep. Gravity can also play a part in obstructing your airway, since your tongue, as well as the excess tissues around the back of your throat can naturally fall back partially obstructing the airway, as you lie down on your back to go to sleep.

It’s All In Your Jaw Size

Another major factor that determines how well you breathe at night, or how susceptible you are to snoring, is the size of your jaws. It’s been shown that modern human’s jaws are slightly smaller than what we had hundreds of years ago. Various reasons are proposed, but one major reason is thought to be due to a major change in our diets. (For a more complete description of this process, take a look at my book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.) If your jaw is slightly smaller, then your tongue which grows to its’ normal size, takes up too much space, sitting higher and more backwards in your throat. As a result, when you lay flat on your back, due to gravity, your tongue will fall back partially, and when you breathe in, a mild vacuum effect is created upstream at the palatal level, which constricts the soft palate closed, which then causes the free edge of the soft palate to flutter and vibrate causing the snoring noise. On the other hand, if your nose is stuffy for any reason, then a vacuum effect is created downstream, which forces the palate and the tongue to slide backwards towards the airway making it narrower and therefore creating sounds we call snoring when the air seeps through the small opening. So this is how a simple cold or an allergy attack can aggravate temporary snoring.

Furthermore, if your muscles relax more than usual (like after alcohol ingestion), then you may even stop breathing altogether. In this circumstance, if these breathing pauses last longer than 10 seconds, then it’s called an apnea (or loss of breath). In those people who have 5 or more of these apneas every hour on average, then are diagnosed with a serious sleep breathing condition called obstructive sleep apnea. Untreated obstructive sleep apnea can then lead to depression, anxiety, weight gain, diabetes, sexual dysfunction, high blood pressure, heart disease, heart attack and stroke.

The really bad news for snorers is that a significant number of heavy snorers have obstructive sleep apnea (about 30-40%, and much higher as you get older or heavier). It’s true that not all snorers have sleep apnea, and not all people with sleep apnea snore. However, if you’re not snoring, then you may also not be breathing. It’s also been shown that neither you nor your bed-partner can tell if you stop breathing—it can just be silent pauses, without any audible gasping, coking or snorting. When some people say, I used to snore a lot, and now I don’t anymore, but I’m still tired, then there’s cause for alarm since even those that state with certainty, "I know I don’t have sleep apnea" are more often than not, wrong.

What Can I Do To Stop The Snoring?

So, once you’ve found out where the snoring is coming from, the next step to solving your snoring problem is to find the right solutions. Of course you can start by doing the most obvious like:

    • lose weight
    • don’t drink alcohol before bedtime
    • don’t take any medications that are sedating or relaxing
    • sleep on your side
    • sew a sock stuffed with a tennis ball to behind your back to prevent sleeping on your back.
    • use nasal dilator strips.

Sometimes, any of these options may work to various degrees, but for most, the problem will usually come back. The most important issue here, however, is that if you snore heavily, you have to find out if you have obstructive sleep apnea. Even if you are successful in covering up your snoring, you could still have untreated obstructive sleep apnea. And if this is the case, you’re putting yourself at serious risk for heart disease, heart attack and stroke. The best thing to do to avoid this from happening is to see a sleep doctor and undergo an overnight sleep study if you snore.

If you are found to have obstructive sleep apnea, then treating this condition definitively should take care of your snoring. Not only will your snoring improve, you’ll also feel much better in the morning, and have much more energy during the day. In addition, your increased risk for many chronic health problems mentioned above will be improved as well. You may also lose weight. (you may even feel like having sex again-see What the Makers of Viagra Missed).

So lets say that you don’t officially have sleep apnea. What can you do? Before I go into this discussion, sleep apnea is not something that you either have or don’t have. Everyone is on a continuum. As mentioned before, if your AHI is 5.1, you’re told you have it, whereas if your score is 4.9, do don’t have it, and because you don’t officially meet the formal criteria, it’s not a good enough to cause to ignore your snoring. It’s still a problem that should be addressed as it can make you lose sleep, not to mention put a damper on your love life in more ways than one.

All Those Snoring Treatments

There are over 300 patented devices and gadgets for snoring (refer to ). Sometimes they work, but with a few exceptions, most of these devices either cover up your snoring without getting to the root cause of your condition, or keeps you awake so that you don’t snore. Three popular anti-snore aids were recently tested for effectiveness in a prospective study: a throat spray, nasal dilator strips and a pillow. None of these three were found significantly better than controls when tested prospectively. There are even devices that wake you up as you enter deeper levels of sleep to prevent muscle relaxation. Regardless of what treatment options you choose, it’s imperative that you first get a proper evaluation from a sleep specialist or a medical professional about your snoring. Doing so could not only help with the snoring, it can help you foster a healthy relationship with your loved ones.

Written by Steven Park · Filed Under Articles | 1 Comment