The Missing Link Between Gum Disease and Heart Disease

April 19, 2012

It’s medical dogma that having gum disease can cause heart disease. The most common explanation is that bacteria from your mouth can spread through the bloodstream and infect your heart valves (called endocarditis). The problem with this explanation is that endocarditis is a tiny fraction of people who have heart disease. Just because there’s an association, it doesn’t mean that one causes the other.

The American Heart Association recently reviewed 537 articles on this subject and published a review, stating that there’s no scientific evidence that gum disease causes heart disease, heart attacks, or stroke. Past studies were mainly observational, and not based on prospective studies. They also state that there’s no evidence that treating periodontal disease can prevent heart disease.

What’s the missing link? You guessed it: Obstructive sleep apnea. We know that obstructive sleep apnea can cause reflux and inflammation in the mouth. Mouth breathing due to craniofacial narrowing and inflammation also dries out saliva, which helps to protect your mouth from pathogens. If you’re missing teeth, then your mouth gets smaller, narrowing your airway even further. We also know that obstructive sleep apnea significant increases your risk of heart disease, heart attack, stroke, and death.

So it makes sense that if you treat sleep apnea, you’ll have less gum disease, and less heart disease. Obviously a prospective, randomized, placebo-controlled, double-blinded study is needed to prove this point.

Written by Steven Park · Filed Under Blog | 2 Comments

Read AJ Jacobs’ Drop Dead Healthy: One Man’s Humble Quest for Bodily Perfection

April 15, 2012

AJ Jacobs, a senior editor for Esquire Magazine, interviewed me last year while working on his latest book project, Drop Dead Healthy: One Man’s Humble Quest for Bodily Perfection. The book is now out and was favorably reviewed by the New York Times. We talked extensively about his snoring and sleep apnea, and he underwent the entire diagnosis and treatment protocol, including CPAP. I just read sections of his book (including parts with me in it) and it’s hilarious!

If you’re not already familiar with Mr. Jacobs, he’s also the author of The Know-It-All: One Man’s Humble Quest to Become the Smartest Person in the World and The Year of Living Biblically: One Man’s Humble Quest to Follow the Bible as Literally as Possible. His current book, Drop Dead Healthy, is already #31 on Amazon’s best-seller list.

His book was endorsed by Dr. Mehmet Oz, and Timothy Ferriss (author of The 4-Hour Body). I strongly recommend that you read Mr. Jacobs’ book. But don’t stay up too late reading it—sleep deprivation can lead to premature aging.

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My Quote in More Magazine About Alcohol and Sleep

April 7, 2012

Look for my quote in More Magazine about the effects of alcohol on sleep (under #3).

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Listen To My Interview About Snoring With Dr. Sosenko

April 6, 2012

Dr. Lydia Sosenko, a dentist specializing in sleep-breathing disorders in Illinois, interviews me for this 34 minute segment on snoring. You can listen to it or download it here. We talk about about the many dangers of snoring, how it’s a “dealbreaker” in many relationships, why sleep tests are very important, how common undiagnosed apnea really is, and much more!

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Can Snoring As A Baby Predict Behavior Problems?

March 5, 2012

Here’s a new study which reinforces what I’ve been saying about sleep-breathing problems and children: That it’s a major undiagnosed cause of developmental and behavior problems in childhood. Researchers from Albert Einstein College of medicine followed over 11,000 children over a 6 year period. Parents were asked about snoring in sleep surveys from 6 months on, and at 7 years, they filled out a behavioral assessment. Not too surprisingly, children who snored as early as 6 months of age had a 50% increased risk of developing behavior problems by age 7 compared to controls.

We know that children who are sleep deprived become paradoxically hyperactive. In contrast, adults get sleepy (there are always exceptions to this observation). This study supports another study which I mentioned in the past showing that in children with ADHD who undergo tonsillectomy, about 50% can be cured for their ADHD condition. It’s no wonder that stimulants like Ritalin can help to calm a hyperactive child.

It’s important to note that I’m not saying all cases of ADHD are due to sleep-breathing disorders. However, it’s been estimated that a significant number of children (25 to 50%) with an ADHD diagnosis could have a treatable sleep-breathing problem. With these numbers in mind, wouldn’t it make sense to routinely screen for obstructive sleep apnea or a sleep-breathing problem before being given an ADHD diagnosis?

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How Infections Can Raise Stroke Risk In Children

February 2, 2012

Here’s an article showing that children who suffer from stoke had some sort of infection in the days leading up the event. Researchers from UCSF found that 29% of children who suffered a stroke had an infection within 2 days of the stroke, whereas only 1% had infections in the control group.

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.

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Expert Interview: Dr. Shelby Harris on Sleep Hygiene

January 20, 2012

This month, we’re privileged to have with us Dr. Shelby Harris, who answers your most pressing questions about sleep hygiene. Dr. Harris has been quoted numerous times in the New York Times, The Wall Street Journal, The Huffington Post, and the New Yorker. She has also appeared on the Today Show, World News with Diane Sawyer, Good Morning America Health, ABC7-NY’s Eyewittness News and ABC’s Primetime: Live.

Some of the topics and questions she covers are:

“If I sleep in on the weekend, does it make up for the lost sleep over the week?”
“I’m so tired when I’m on the couch at night, but when I hit the pillow, my mind starts racing and I can’t fall asleep. Why?”
The importance of scheduling in time for sleep as well as wind-down time beforehand
Proper timing of exercise to help with better sleep
Misuse of alcohol as a sleep aid
Smoking – effects on sleep
Caffeine – how/when to use it and when not to
And lots more

Please enter your contact information below to register and to receive your free MP3 download:

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Sleep Apnea & Sudden Hearing Loss: Is There A Connection?

January 20, 2012

I’ve been saying all along that people with sudden sensorineural hearing loss have higher rates of sleep-breathing problems. Almost 100% of the time, whenever I see someone with sudden hearing loss that’s not explained by a brain tumor, the upper airway looks exactly like someone who has obstructive sleep apnea. These people typically can’t or prefer not to sleep on their backs. Many will also snore, and have parents that snore heavily.

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?

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Shortage Of ADHD Medications Creates An Uproar

January 4, 2012

A recent New York Times article reports on the shortage of medications for people with ADHD, or attention deficit hyperactivity disorder. There’s a lot of speculation about why this is happening. One explanation that was put forth was that the FDA (Food and Drug Administration) is limiting the available supply, due to the high rates of possible abuse of these stimulant medications. My response was a little off-topic, but I just had to comment. Here’s a reprint of what I wrote:

“There’s no doubt that ADHD medications can be lifesaving for millions of Americans, but there’s another dimension to this issue that’s being ignored by the mainstream media and the general public, despite growing evidence in published studies.

It’s a general consensus in sleep medicine that sleep deprived adults get drowsy, whereas children become fidgety and hyperactive. Not only are todays’ children sleep deprived (homework, TV, etc.), many are not able to breathe properly at night, due to narrowed airways.

In a study published in Pediatrics in 2006, 28% of children scheduled for tonsillectomy were found to have undiagnosed ADHD, compared to 7% in controls. After tonsillectomy, 50% of the ADHD group were cured. Another study showed that children with ADHD are more likely to snore, and that about 25% of children with ADHD could be treated effectively by treating their sleep apnea.

Notice all the typical findings in a child with sleep-breathing problems that are also found with ADHD: inability to sleep supine, snoring, nasal congestion, mouth breathing, snoring parents, unrefreshing sleep, frequent urination, inability to focus or concentrate, history of needing braces, and bottle-feeding. You don’t have to be obese or snore to have sleep apnea.

It’s clear that in some children with ADHD, stimulants like Ritalin or Adderall work because they’re sleepy. My feeling is that all children with ADHD should be screened for obstructive sleep apnea.“

Let me make it clear that I’m NOT saying that all children with ADHD have obstructive sleep apnea. But even if it’s only 25% (a very conservative number), the implications are huge. If you look at the CDC’s website on ADHD statistics, it’s frightening.

9.5% or 5.4 million children 4-17 years of age have ever been diagnosed with ADHD, as of 2007
Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 [Read article ] and an average of 5.5% per year from 2003 to 2007
Prevalence of parent-reported ADHD diagnosis varied substantially by state, from a low of 5.6% in Nevada to a high of 15.6% in North Carolina
As of 2007, 2.7 million youth ages 4-17 years (66.3% of those with a current diagnosis) were receiving medication treatment for the disorder
Rates of medication treatment for ADHD varied by age and sex; children aged 11-17 years of age were more likely than those 4-10 years of age to take medication, and boys are 2.8 times more likely to take medication than girls.

Remember that these are 2007 statistics. Ten percent of the pediatric population has ADHD, and 6-7% are on medications! As a population, we’re much heavier than we were 5 years ago, which means that these figures are probably an underestimation. The children that we’re medicating now are mostly likely the ones that we’re going to have to give even more medications to later in life after they develop the medical complications of untreated obstructive sleep apnea (diabetes, depression, anxiety, hypertension, high cholesterol, obesity, heart disease, heart attack and stroke). In my mind, all these conditions are connected. They are all one and the same disease, but with different manifestations.

Look into several drug rehab centers and choose the one that fits you best!

Written by Steven Park · Filed Under Blog | 2 Comments