May 20, 2013
As the baby boomer generation ages, it’s not surprising that more and more people complain of memory problems. Here’s an article that describes the results of a survey which revealed that nearly 13% of people 60 or over reported confusion or memory loss which has worsened over the past 12 months. So far there are no definitive studies that suggest that untreated obstructive sleep apnea can cause Alzheimer’s disease (no scientific study will ever propose cause and effect), but based on how prevalent obstructive sleep apnea is in our country, and knowing how much sleep apnea causes various types of brain damage, it’s not too far fetched to say that untreated obstructive sleep apnea may explain a significant number of cases of memory loss or dementia. Anecdotally, many of my patients do report improved memory after sleep apnea treatment.
May 13, 2013
Here’s another study showing a strong association between poor sleep and cancer: An Icelandic study found that men with problems falling asleep had a 70% increased risk of developing prostate cancer, and a 210% increased risk if they had trouble staying asleep. Associations were even stronger for more advanced prostate cancers. Note that I wrote about this possibility in my book, Sleep, Interrupted, which was published in 2008.
April 10, 2013
In this teleseminar, I interview Dr. A. Joseph Borelli, who is President and Medical director of MRI at Belfair, in Bluffton, SC. He is a leading expert in brain imaging and has an interest in brain imaging in patients with obstructive sleep apnea. He’s going to show some eye-opening radiologic images of your brain after repeated apneas.
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March 12, 2013
Here’s another study finding and accompanying article that offers hope of perhaps finding a “pill” for obstructive sleep apnea, rather than the conventional options the we currently have available (CPAP, dental options, and surgery). The researchers identified one of the main mechanisms of the switch that turns off muscle tone when you’re in REM sleep (the dreaming state). As mentioned in past posts and teleseminars, apneas and hypopneas are most common in stage REM, when your muscles are most relaxed. The study researchers found a way to reverse this process in rats.
The problem is that rats may have REM sleep, but they don’t have obstructive sleep apnea, since they can’t talk. Modern humans’ unique ability to talk and communicate created upper airway anatomy that predisposes to upper airway obstruction. The other problem is that REM sleep stimulates brain areas that are needed for learning and memory consolidation. Human infants spend 50% of their sleep time in REM sleep.
If you give a pill to block the muscle paralyzing process that happens in REM sleep, then you’ll end up moving around, talking and acting your your dreams. Your brain is wide awake during REM sleep, but with your muscle relaxed (except for the eyes and the diaphragm). This is probably not a good idea. There’s even a sleep disorder called REM sleep behavior disorder, where due to brain damage in areas that affect this particular switch, older men act out their dreams during REM sleep. This condition has a high association with developing Parkinson’s disease later in life.
Lastly many of the anti-depressant medications that are are prescribed diminish REM sleep, thereby lessening time spent in REM sleep. This could lead to improved mood, since you’re not having as many apneas.
Unfortunately, I don’t ever see a pill in the future that can truly compete with the three mainstream options already mentioned. As stated before, obstructive sleep apnea is an anatomic and craniofacial problem, and not directly a biochemical problem.
February 27, 2013
There are probably millions of people in the US every year who drink a glass of wine or other alcoholic beverage just before bedtime. Reasons can include being able to sleep faster, or for red wine’s health benefits. Here’s a recent study that only repeats what’s already known about in sleep medicine for years: That alcohol can make you go into deep sleep faster, but later on, it cuts into your REM sleep, increasing the chances that you’ll have apneas or sleepwalk. The reason for this is that alcohol relaxes your throat muscles, so it’ll make you more prone to obstruction and arousals.
I disagree with the authors to moderate alcohol just before bedtime. I think everyone should stop any sort of alcohol (and food) within 3-4 hours of bedtime. Even if you don’t have sleep apnea, do you want to begin having apneas at night?
February 1, 2013
Erectile dysfunction (ED) is a common condition that’s usually treated by urologists with medications. In the sleep medicine literature, there are numerous studies showing that many men with ED have undiagnosed obstructive sleep apnea (OSA) and that treating OSA can significantly improve or even cure ED. Here’s one of many papers (PDF). Even in my practice, men oftentimes comment that this is a positive side effect of CPAP.
Here’s another study that reiterates the known association between ED and cardiovascular disease. There’s no mention of sleep whatsoever. We also know that obstructive sleep apnea is a major risk factor for heart disease. It’s frustrating to know that most of these men will never have their obstructive sleep apnea diagnosed or treated.
I’m not saying that all cases of ED are due to OSA. But even if 50% of patients are improved, wouldn’t it be worthwhile looking into this possibility? Not to mention that once you’re able to sleep better, things can begin looking up again :)
December 27, 2012
Here’s another study showing that a significant percentage of children are found to have sleep-disordered breathing. Researchers in Finland found that 1 in 10 children suffered from either obstructive sleep apnea or snoring. What was different about this study compared to other studies is that obesity wasn’t the main reason that correlated with a sleep-breathing disorder. Rather, it was their dental occlusion, or how their upper and lower teeth fit together, as well their facial shapes.
This is exactly what I’m seeing in young children with sleep-related breathing disorders. They are not usually overweight, but have narrow faces with recessed jaws, and a high arched hard palate.
Considering that resistance to airflow increases exponentially as the diameter decreases (inversely to the 4th power, see Hagen-Poiseulle equation), even minor changes in our jaw structures can have huge consequences when it comes to breathing, especially when our upper airways are susceptible to collapse in multiple areas.
October 28, 2012
The origins of autism is a very controversial subject, but I’ve always suspected that that there are a number of different ways that poor breathing and lack of brain oxygenation can be detrimental to optimal brain development. Here’s a study showing that pregnant women who are obese were 67% more likely to have children with autism compared to normal weight mothers. This study also revealed that mothers with diabetes were nearly twice as likely as healthy mothers to have children with developmental disorders. Their explanation is that diabetes and obesity causes inflammatory chemicals to cross the placenta to disrupt fetal brain development. While this could be true, having prolonged periods of hypoxia from untreated obstructive sleep apnea in pregnant women is an even better reason for a potential developmental brain disorders, as well as diabetes.
September 2, 2012
In this special Ask Dr. Park program (9/11/12), I summarize the latest sleep apnea research presented at this year’s annual meeting for otolaryngologists. I’ll also answer your general questions on anything related to sleep and sleep apnea.
Please click here to order the MP3 recording ($17).
August 7, 2012
On this Expert Interview program, Dr. Derek Mahony, a world renowned orthodontist from Australia, gives a special talk on:
Nasal Airway, Snoring/OSA & Malocclusion in Children
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