We know that untreated obstructive sleep apnea can suppress reproductive hormones. External artificial hormones such as the xenoestrogens that mimic estrogen can also aggravated this problem. I’ve written extensively in the past about fertility issues in women in the past and how undiagnosed  sleep-breathing problems can be a major aggravating factor. No wonder there are so many couples having trouble conceiving. 

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It’s likely that if you already have narrowed breathing passageways, any additional inflammation and swelling will cause even more narrowing, leading to more severe episodes of snoring or apneas. We know that obstructive sleep apnea can significantly increase your risk of stroke. Furthermore, blood in patients with obstructive sleep apnea is found to be much thicker and more prone to clotting. 

I’m willing to bet that these children already had some sort of sleep-breathing problem, and the infection tipped them over the edge. Oftentimes, you’ll see large tonsils or adenoids, dental crowding, a high arched hard palate, nasal congestion, and an inability to sleep on their backs. Parents of these children are more likely to snore in this scenario.

Fortunately, this condition is rare (5/100,000), but the consequences can be devastating. This is why it’s important to pick up and address any underlying sleep-breathing issues before complications arise.

Again, there’s not one mention of the likelihood that there’s any chance of obstructive sleep apnea. 

It’s been shown that apneas create conditions in the esophagus and throat which can cause your stomach juices to reach your throat. Furthermore, pepsin and bile have been found in lung and sinus washings. What this means is that your stomach juices are still coming up into your throat, especially if you have obstructive sleep apnea. However, what’s coming up is just less acidic juices, but still includes bile, digestive enzymes, and bacteria. We know that proton pump inhibitors and H2 blockers such as cimetidine don’t really do anything to prevent reflux into the throat. 

My hypothesis is supported by studies that show that pro-motility agents such as domperidone and clarithromycin can help lower asthma symptoms. There are also numerous studies showing that treating obstructive sleep apnea can help with symptoms of asthma and reflux. 

For those of you who didn’t know, until 2007, the board exam was administered by the American Board of Sleep Medicine. After 2007, it stopped giving the exam and a new board was created under the auspices of the American Board of Medical Specialties, an umbrella organization that covers most major medical specialties. Five specialties joined to co-sponsor this board: neurology & psychiatry, family practice, internal medicine, pediatrics and otolaryngology (ENT). Each member board administers the same sleep medicine exam test to their own candidates, but only after general certification is obtained. Beginning in 2007, this test was given every two years—2011 was the last year in which candidates could take the exam without doing a one year fellowship, as long as you demonstrated that you’ve seen a minimum number of sleep patients and interpreted a certain number of polysomnograms.

A recent article published in the Archives of Otolaryngology – Head & Neck Surgery found that people with sudden sensorineural hearing loss were more likely to have obstructive sleep apnea. The authors combed  through insurance records and found that, after adjusting for various confounding factors, male patients with this type of hearing loss were 1.4 times more likely to have prior OSA than controls. This was statistically significant. The fact that women didn’t have this finding could be explained by the fact that the overall numbers of people with sudden sensorineural hearing loss is very small, and men have a much higher rate of obstructive sleep apnea than women. Just like all other medical journal articles, it concludes by saying this doesn’t prove that sleep apnea causes sudden sensorineural hearing loss, and that further studies are needed.

The authors’ explanation is that plaque buildup in blood vessels that reach the inner ears can clog up and create blockages. I’ve written in the past that people with OSA have much thicker blood, which can also clot more easily. Untreated obstructive sleep apnea causes massive inflammation in blood vessels and the brain, which can lead to a variety of medical ailments.

If you’ve ever suffered from sudden sensorineural hearing loss, can you sleep on your back at all? 

Here’s a small study out of India showing that CPAP significantly lowered various markers for metabolic syndrome (high blood pressure, high cholesterol, and insulin resistance). Eighty-six volunteers (87% had metabolic syndrome) with were randomized to be given CPAP or sham CPAP therapy for 3 months. After 3 months, the two group were reversed. People treated with CPAP had an overall drop of 3.9 mm Hg systolic (top number) blood pressure, and 2.5 mm Hg in the diastolic (bottom) number. Total cholesterol went down 13.1 points, and  LDL dropped 9.6 points. Triglycerides also dropped, by 18.7 points. Thirteen percent no longer had metabolic syndrome.

On a side note, this study was funded by Pfizer, which makes many of the popular medications for high cholesterol and high blood pressure. It’s interesting that they would fund a study that would make it less necessary to use their prescription medications. We know that they don’t manufacture CPAP machines, so I wonder why they funded this study. Could they be interested in entering the sleep apnea market?

In this Ask Dr. Park Teleseminar, I answer the following questions:

• Do people with sleep apnea really die 20 years earlier?

• How effective is home sleep testing? Is it covered by insurance?

• How does sleep apnea lead to serious conditions like heart disease?

• Would fixing a deviated septum help with sleep apnea?

• Tell me more about Provent therapy for sleep apnea.

• If one is successful with CPAP, is surgery an option?

• How successful is the Pillar Implant for sleep apnea?

• What ‘s the difference between hypoglossal nerve stimulation therapy vs. a tongue stabilizer device such as the AveoTSD?

• Are you aware of data in the US regarding OSA and traffic accidents?

• What are the risks to patients whose doctors have untreated OSA?

• What’s the difference between snoring and obstructive sleep apnea?

• Are surgical procedures for UARS covered by insurance?

• Why don’t sleep labs recommend oral appliances as an option?

And much more….

Please click here to purchase the MP3 recording ($17).

1. Does sleeping with your head propped up help with sleep apnea?

2. Why is UARS so hard to define?

3. What do you think about all the latest publicity about thyroidectomy in helping with sleep apnea?

4. Can using tape over the mouth help with sleep apnea?

5. As we age how can we gauge whether we have sleep-related breathing issues, or circadian rhythm problems?

6. What if you are using a cpap machine and STILL wake up about every 2-3 hours?

7. How low should one seek to lower the AHI and the AI?

8. Is there a place for hyperbaric oxygen in the treatment of OSA?

9. Does a dental positioning device work for mild sleep apnea?

10. How does the future look for sleep apnea patients£ Will something replace CPAP as the gold standard?

11. Is there a clear distinction between central and obstructive sleep apnea? What are the alternatives if your apnea is primarily classified central?

12. If patient’s airway is examined with camera inserted through nose while patient is sitting upright and airway is found to be clear, is this enough to indicate airway would also be clear if patient was lying down? Should patients be checked in both positions?

And many more questions from the live audience.

Click here to purchase the MP3 recording ($17).