Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring » snoring

How Infections Can Raise Stroke Risk In Children

Steven Park — Thu, 02 Feb 2012 08:57:08 +0000

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.

Expert Interview: Dr. Shelby Harris on Sleep Hygiene

Steven Park — Sat, 21 Jan 2012 03:17:53 +0000

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

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

Steven Park — Sat, 21 Jan 2012 02:54:15 +0000

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?

Shortage Of ADHD Medications Creates An Uproar

Steven Park — Wed, 04 Jan 2012 08:11:41 +0000

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.

Ask Dr. Park: Sleep & Breathing: The 2 Keys to Optimal Health

Steven Park — Fri, 30 Dec 2011 02:28:49 +0000

In this teleseminar, I reveal:

Why all modern humans stop breathing intermittently while sleeping
3 key anatomic concepts that makes everyone susceptible to sleep apnea
7 common surgical procedures that can worsen or uncover obstructive sleep apnea
5 simple steps to better breathing and better sleep
5 ways to treat obstructive sleep apnea.
What you MUST do first before trying to lose weight.

Topic: Ask Dr. Park: Sleep & Breathing: The 2 Keys to Optimal Health

Please enter your information below to register and access your free MP3 recording and PDF of the slides:

33% of All Cops May Have Sleep Apnea

Steven Park — Wed, 21 Dec 2011 12:16:18 +0000

I’ve always wondered about police officers—just like the rest of the population, many are generally overweight. A new study published in the Journal of the American Medical Association revealed that about 40% of police officers screened positive for at least one major sleep disorder. Sleep apnea was the most commonly found condition, at 34%. Insomnia and shift word disorder were the two other conditions seen. About 80% were overweight or obese. And 26% reported falling asleep while driving at least once or twice per month.

These findings are not too surprising, since police officers frequently work odd hours that include night shift and weekends. Their poor eating habits can contribute as well. We also know that poor sleep can promote weight gain. The irony is that police officers probably need to be outdoors, walking or driving around, since an indoor desk job will not be stimulating enough. The question is which comes first: poor sleep habits and lifestyles that lead to weight gain and sleep apnea, or anatomic predisposition to sleep apnea that leads to choosing these type of occupations that promote weight gain, which leads to sleep apnea? I’m sure that if you studied fire fighters, you’ll find similar results, and that you’ll agree with me that this is a potentially major public health issue.

Based on these findings, do you think mandatory screening for obstructive sleep apnea should be required on a periodic basis for all police officers?

How Bulldogs Are Similar To Humans

Steven Park — Wed, 30 Nov 2011 03:42:25 +0000

I just came across an interesting article in the New York Times about the problem with bulldogs. The articles focuses on Uga VII, who would rather take naps than perform his official duties as the school mascot for Georgia. In short, the bulldog’s face is too short—just like humans. One of the sought-after features in bulldogs is a flat face, something that experts speculate may mimic humans faces, thus adding to their appeal. In fact, bulldogs are now the 6th most popular breed in America, just behind golden retrievers.

The problem with bulldogs is that they’re much more prone to medical ailments than many other breeds. They can suffer from ear and eye problems, skin infections, respiratory problems, immunological and neurological problems. They also have the highest rate of hip dysplasia of any breed. Bulldogs are also notorious for very loud snoring, and a variation of the uvulopalatopharyngoplasty procedure is commonly performed for this condition.

Having a flat face can cause major breathing problems, as evidenced by the very high rate of obstructive sleep apnea in modern humans. The ability to talk made things even worse for us. Shrinking of the jaws is known to cause crowding of the soft tissues in the upper airway, as well as facial wrinkling. Could it be possible that bulldogs have excess facial skin due to significant shrinkage of the underlying facial bones, that would normally stretch out the facial skin?

Ask Dr. Park About Sleep About Sleep Apnea (11/8/11)

Steven Park — Mon, 07 Nov 2011 02:51:03 +0000

For this month’s Ask Dr. Park teleseminar, I answer the following questions:

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).

How Diabetes, Dementia and Sleep Apnea are Linked (or Associated)

Steven Park — Tue, 20 Sep 2011 17:17:48 +0000

Here’s a new study out of Japan showing that people with uncontrolled diabetes had about a 35% increased risk of developing dementia. The article talks about how diabetes can cause clogging and blocking of the arteries, leading to lack of oxygen and brain damage. But guess what else causes lack of oxygen? Obstructive sleep apnea. Hypoxia has been shown to cause brain damage in numerous sleep apnea as well as Alzheimer’s research studies. As always, researchers are careful to point out that association never implies causality.

Expert Interview: Psychology of Sleep Apnea

Steven Park — Mon, 19 Sep 2011 16:07:22 +0000

In this Expert Interview program, Ms. Lisa Brateman will talk to us about the psychology of obstructive sleep apnea. This is an important topic that affects not only those of you with sleep apnea, but also your loved ones, your friends, and family members.

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