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If Kid’s ADHD Continues Into Adulthood…

Here’s a study which reports that 29% of children with ADHD go on to have ADHD as adults. I’ve written extensively about how a significant portion of kids with ADHD have undiagnosed obstructive sleep apnea. In fact, in one study, taking out tonsils and adenoids cured 50% of children with ADHD. Clearly, not all ADHD is related to a sleep-breathing problem, but even if it’s due to sleep apnea in 50%, or 25%, or even 10%, wouldn’t it be worthwhile to at least screen for it? 

The Common Link Between Autism, ADHD, Bipolar, Depression, Schizophrenia: Genes or Upper Airway Anatomy?

Here’s an interesting study showing that there’s a common genetic basis to five common mental health conditions: autism, ADHD, depression, schizophrenia, and bipolar disease. In particular, single nucleotide polymorphisms (SNPs) in two genes involved in calcium-channel activity appear to play a role in all five conditions. This finding was reported in the Journal Lancet by doctors at the Massachusetts General Hospital. 

I’ve written about many of these conditions as it relates to obstructive sleep apnea in the past. There have been many published studies showing how damaging lack of oxygen is to the brain, especially in young developing brains. It’s not too far fetched to imagine how brain biochemistry can be radically changed when subjected to poor sleep and hypoxia.

I mentioned in my last post that even one week of insufficient sleep has been found to affect gene expression in areas of  chromatin remodeling, regulation of gene expression, and immune and stress responses. Perhaps the common mental health “gene” affects calcium channels as well as to determine the ultimate size of your jaws and upper airway.

Sleep Deprivation Can Affect Your Gene Expression

Conventional thinking states that your genes don’t change, but here’s a revealing study that shows how sleep can significantly affect levels of gene expression. In this study, even mild levels of sleep deprivation or circadian rhythm disruption were found to increase or decrease expression of up to 711 genes, based on a technique called transcriptome analysis.

Biological areas affected included the following: gene-expression regulation, chromatin modification, macromolecular metabolism, and inflammatory, immune and stress responses.

What this means is that poor sleep, whether it’s due to insufficient sleep, insomnia, or sleep apnea, can have a negative effect on your hormones, metabolism, immune system, and your stress response.

Expert Interview: Dr. Karen Bonuck on Pediatric Sleep-Breathing Problems and Developmental Issues

In this teleseminar, I interview Dr. Karen Bonuck about her landmark research linking snoring in infants and higher risk for developmental delays later in life. If you have children, or thinking about having children, you must listen to this interview.

 

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Why Does Early Surgical Menopause Cause Early Cognitive Decline?

Researchers found that the earlier a woman undergoes surgical removal of her ovaries, the more likely that there will be signs of early cognitive decline. These women had significantly higher rates of decline in memory, global cognition, and neuritic plaques. This study supports other findings that associate early surgical menopause to higher rates of heart disease, heart attack, stroke, cognitive decline, as well at all cause mortality (death from any reason). Typical for most studies of this type, no conclusions or reasons for the findings are made, except to say that it’s only an association.

My take on this study is that taking out a woman’s ovaries, whether or not there’s hormone replacement therapy, will cause a sudden decline in natural progesterone, which has a protective effect on the woman’s upper airway. Progesterone is an upper airway stimulant, tightening your throat muscles, helping to protect the upper airway from collapsing. Progesterone goes up significantly during pregnancy, which partially helps to protect the airway despite significant weight gain. It also drops just before a women’s monthly periods, and gradually drops slowly throughout menopause. 

Having more relaxed muscles in the throat can definitely lead to more frequent obstructions and arousals. If your breathing pause is over ten seconds, it’s called an apnea. Lesser rates of airflow obstructions are called hypopneas. You’ll need at least 5 apneas and/or hypopneas to say that you have obstructive sleep apnea. However, you can stop breathing 25 times every hour and not officially have obstructive sleep apnea on a sleep study. Regardless of your score, it’s important to treat the breathing problems to improve your deep sleep quality. Lack of continuous, deep sleep (in addition to lack of oxygen to your brain) has been shown the cause memory problems, focus and attention issues, as well as many other common conditions.

For those of you who underwent surgical menopause at an early age, did you suffer any memory problems?

Korean Versus North American Facial Beauty Standards

How do two different cultures view facial features when it comes to beauty? Here’s an interesting blog by a Canadian husband and wife team (living in Korea) who make some insightful observations on how Koreans view facial beauty. In particular, they comment on the fact that native Koreans prefer a V-Line face, with narrow jaws and smaller cheekbones. They even sell facial rollers to narrow your face. 

While reading this post and watching this video, I couldn’t help but to think about the airway implications with narrow jaws—the more narrow your face, the less room there is for your tongue, and the more likely you’ll have breathing problems when sleeping. There are reports of plastic surgeons performing jaw-line narrowing procedures, such as masseter muscle or jaw reduction, and even using botox to shrink the masseter muscles. There’s also a recent trend to perform maxillo-mandibular advancement procedures purely for cosmetic reasons. This procedure will actually enlarge your airways, if done properly.

Even in the United States, people’s preferences for facial beauty may be changing, with more popular celebrities having narrower faces and jawlines.

It’s surprising how far some people will go to improve their facial appearance, at the cost (unknowingly) of diminished sleep quality and accelerated aging.

What’s your perception of facial beauty? Do you prefer a round face with wide jaws, or a narrow, triangular face?

Does Your Child Have Sleep Apnea? My Interview with Dr. Ebrahimian, Holistic Dentist

Please join me tomorrow when I’m interviewed by  Dr. Ariana Ebrahimian, for her Healthy Child Show. She has a great list of expert guests who will talk about everything from nutrition and good eating habits to better sleep and orthodontic care. In this interview, I’ve been asked to talk about:

• How to know if your child may have sleep apnea
• Why and how sleep apnea happens
• The most effective way to end snoring
• 5 tips for children to breathe easier and sleep better
• And much more valuable information to improve your child’s health.

Please click here to listen to the interview at 1PM Pacific (4PM Eastern) on Tuesday, January 22.

An Interesting Snoring Demonstration

I just found an interesting YouTube video that demonstrates how snoring occurs. It’s made by an Israeli dentist, Dr. Dany Maor.

 

Flat-headed Children May Be Developmentally Delayed

Deformational (or positional) plagiocephaly (DP) is a commonly seen condition, especially since pediatricians began to recommend placing our infants on their backs to sleep. Here’s a study showing that children with DP have lower developmental scores at age 3 compared to those that didn’t have DP. The largest differences were seen in cognition, language, and parent-reported adaptive behavior.

This study doesn’t say anything about sleep positions, but I’m wondering if the children without PD were more likely to sleep on their sides. We know that back sleep, while it can lower your chances of developing sudden infant death syndrome, can potentially lower deep sleep quality, leading to less than optimal brain development.

Dentists are also saying that having an asymmetric or flattened skull in the back can translate to asymmetry of the facial skeletons in the front, leading to TMJ problems and crooked teeth.

How many of you have children that had PD?

100% Success Rate for Sleep Apnea Surgery?

Maxillo-mandibular advancement (MMA) surgery has been around a long time for obstructive sleep apnea. It has a good track record with high success rates raging from 80-95%. Here’s a study showing that that the success rate was 100%. In Dr. Prinsell’s 50 patients, the apnea hypopnea index (AHI) dropped from 59 to 5, and the apnea index (AI) dropped from 35 to 1. Success was defined as the AHI < 15, AI < 5, and the low oxygen saturation > 80%, and the AHI and AI dropping more than 60%.

MMA surgery is one of the bread and butter procedures for most oral surgeons. However,  different surgeons have different success rates for obstructive sleep apnea. If you’re considering this procedure, ask about results specifically for obstructive sleep apnea.

One thing to note is that just because the AHI dropped significantly doesn’t mean that you’ll always feel dramatically better, or that the results will last for a long time. These are issues that need to be addressed, like with any surgical procedure for obstructive sleep apnea.

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