ADHD, Dropping Grades, Bedwetting? It Could Be Poor Sleep and Breathing

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It’s estimated that 22 million Americans suffer from sleep apnea. As many as 25% of children have it. Sleep apnea can cause high blood pressure, heart attacks, stroke, diabetes, cognitive impairment, depression, poor performance in school and headaches. Do you have any of these health issues that your doctor can’t seem to find a cause for?

Join me and 23 other sought-after speakers on this free online summit called: The Functional Oral and Airway Health Summit 2020. It will start on Monday, 11/16/20 have 4 speakers every 24 hours until 11/22/20.

What you will learn during this summit:

  • The new alternatives to CPAP and the evolution of dental sleep medicine
  • The importance of Vitamin D for deep, REM sleep
  • How sleep affects the brain at all ages
  • Why straightening teeth with braces doesn’t address underlying problems 
  • Warning signs your child may have a sleep breathing disorder
  • The neurological implications of sleep disorders
  • Getting the sleep fundamentals right
  • Navigating the world of insurance for dental sleep medicine
  • How breastfeeding can prevent the need for braces
  • Why a healthy gut may give you better sleep and breathing
  • Why bedwetting after age 5 is a sleep problem
  • And much more!  

Click here to register.


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The Mouth Taping Controversy For Better Sleep

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Does It Work And Is It Safe?

My wife Kathy keeps making fun of me for using tape to fix all of life’s problems. For example, I take black electrical tape with me while traveling to cover up all electronic LED lights at night to sleep better. I have to admit that I’ve used duct tape on a number of occasions for temporary home repairs. More recently, I have been taping my lips closed at night for better sleep. I have to admit that overall, I do seem to be sleeping better.

Mouth taping has been promoted by dentists, myofunctional therapists and various holistic health practitioners for a number of years. During a cursory search for its origins, I could not see anything mentioned before the past 5 or 6 years, except for lip taping in children with a cleft lip.

Several societies and prominent physicians have cautioned against it. This myofunctional therapy website recommends avoiding lip taping. Dr. Kasey Li, a world-renown ENT and maxillofacial surgeon advises against it in this Forbes article. My specialties (ENT and sleep medicine) are generally against it. Up until recently, I was against it too, until I heard countless patients telling me that they sleep better with mouth taping.

My Personal Journey

About 3 months ago, I decided to take the plunge and try mouth taping for myself. I tried different types of tape and different ways of placing the tape. The most commonly recommended type of tape is the 1 inch 3M micropore paper tape, but I had no problems using other types of tape. It’s a personal preference. The other issue that I played with was tape placement. Most experts recommend a single horizontal position across your lips. There are several commercially available mouth tape options to keep your mouth closed. I’ve even seen some photos of people using nasal dilator devices (Breathe Right strips®) or a Band-Aid.® Remember to use lip balm if your lips get dry. 

One way of tape placement ended up working best for me: vertically from the upper lip (base of the nose) to under my chin. What I found was that if you stop just under your lower lip in front of your chin, your mouth can still open significantly. I see this happening all the time in the operating room during drug-induced sleep endoscopy. With the mouth closed, the space behind the tongue is relatively open (Photo 1), but if your mouth opens about 1/2 inch distance between your teeth, the tongue moves back severely with almost total obstruction (Photo 2). Try it yourself. While keeping …

Can CPAP Make You Gain Weight?

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Scanning through my daily schedule of patients, I noticed Mr. Johnson was on the schedule. I have been following him for over 10 years since diagnosing and prescribing CPAP for his severe obstructive sleep apnea. I last saw him 3 years ago. He was faithful in using his CPAP 100% of the time, and his adherence numbers were perfect, with an average AHI of 1, minimal leaks, and being used 8-9 hours every night. As I entered the exam room and greeted him, I was shocked to see how much weight he had gained (30 pounds) over the past few years.

One of the basic tenants of sleep medicine is that poor sleep leads to weight gain. It naturally follows that sleeping better with CPAP will lead to weight loss. It’s not uncommon to see patients losing weight after sleeping better with CPAP, dental appliances or even after surgery. However, I had seen a few studies over the years showing that a small proportion of people using CPAP may gain some weight, but what I discovered over the past few weeks studying basal metabolic rates and weight loss in relation to CPAP was surprising.

It turns out that overall, CPAP use has been found to increase weight significantly, in proportion to how long you use CPAP. The more hours you use CPAP every night and the more number of years, the higher the amount of cumulative weight gain.

  • Researchers from Harvard and Stanford Universities found that patients randomized to receive CPAP for 6 months gained 0.77 pounds, whereas people on sham CPAP lost 1.5 pounds. Of note, people who more highly compliant (using more than 4 hours/night, at least 4/7 days/week) had higher degrees of weight gain.
  • In another study, overall BMI did not increase in CPAP compliant patients after one year, but women and non-obese subjects did gain significant weight.
  • A Finnish study in 2016 found that CPAP compliant, more obese patients had higher levels of weight gain after 5 years.
  • Lastly, a meta-analysis of randomized only studies analyzed over 3181 patients from 25 studies, finding significant weight increase in compliant CPAP users.

A number of explanations are given as to why CPAP can promote weight gain. The one most reasonable proposal that I saw is that when you have obstructive sleep apnea, your basal metabolic rate (BMR) in higher.  Due to the extra energy demands of having sleep apnea, you burn up more calories. It’s been shown that using CPAP reduces your BMR.  Since dietary intake and

5 Unexpected Causes of Autoimmunity

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Jennifer had tried everything to get rid of her psoriasis. She made major changes tp her diet and lifestyle with only modest improvements in the red, scaly patches on her hands and elbows. A 45 year old woman with 2 school-aged children, she always wore long-sleeved shirts, even in the summer. Powerful prescriptions medications did help, but only temporarily. She stopped taking these medications due to their side effects. Three months after using CPAP for her moderately severe obstructive sleep apnea, she was ecstatic to let me know that her psoriasis was finally gone. Even her joint pains were mostly gone. 

Autoimmune disease is a condition when the body attacks its own tissues mistakenly, unlike a reaction to viruses, bacteria or toxins. As a result, inflammation occurs. This can happen in any part of the body.  Symptoms are too numerous to list, but can can range from fatigue and lack of energy to rashes, to poor digestion, or memory loss. Various autoimmune conditions include psoriasis, rheumatoid arthritis, lupus, celiac disease, thyroiditis, multiple sclerosis, inflammatory bowel disease, and even Ménière’s disease. 

The most commonly blamed reasons for autoimmune disease are genetics, toxins, certain foods, and infections. I distinctly remember learning about autoimmune diseases during medical school, and even now, the explanations by doctors for the causes and treatment for autoimmune conditions are not very satisfying. Back then, in the early 1990s, autoimmunity was relatively rare, but now it’s more common than not. 

If you look up information about this on your typical medical website, you’ll see that there’s no specific pattern, explanation, diagnostic test or standard way of treatment. It’s all over the place. Notice that nowhere in the treatment section does it mention removal of potentially offending food, toxins, or irritants, but only lists various medications. 

Why Traditional Explanations Fail

In our textbooks, the most common reason for autoimmune disease is stated to be from your genes. There are a myriad of genetic predispositions to various conditions, such as genes for Sjogren’s disease or HLA-DRB1 for Meniere’s disease. But notice that for most studies that link certain genes to classic autoimmune conditions, there’s a wide range of different genes, with no one certain gene. Since emphasis is placed more on your genes (rather than your environment), medical and biochemical treatment tends to be favored over environmental modifications.  If most autoimmune conditions are due to our genes, then why was autoimmunity so rare even 50 years ago? This observation supports the suspicion that what’s in our environment may be a better explanation. Epigenetics is a concept that supports this idea, that your environment can modify how your …

Welcoming Dr. Marie Dibra to Our Team

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We’re excited to welcome Dr. Marie Dibra to the Sleep Dallas team! Newly arrived to Texas, Dr. Dibra joins our team from Florida where she was a clinical professor with the division of pulmonary, critical care, and sleep medicine at the University of Florida in Gainsville.

Board-certified in sleep medicine, Dr. Dibra specializes in the diagnosis, treatment, and management of sleep disorders such as obstructive sleep apnea, narcolepsy, insomnia, restless leg syndrome, and shift work disorder, among others. In addition to her focus in sleep medicine, Dr. Dibra is also a board-certified internist with a background in nutrition. Her unique professional background and experience allow her to take a comprehensive and compassionate approach to addressing our patients’ sleep issues and their underlying contributors.

When not in the office, Dr. Dibra enjoys playing tennis, traveling, and spending time with her husband and two young sons.

We’re so excited to have Dr. Dibra on board as we work to help patients restore their sleep, health, and overall quality of life!

Learn more about Dr. Dibra here.

The post Welcoming Dr. Marie Dibra to Our Team appeared first on Sleep Dallas Blog.

from Sleep Dallas Blog…

Am I a TYPICAL person with narcolepsy?

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“Am I a TYPICAL person with narcolepsy?”

No, I’m not. Here’s why:

The majority of people living with narcolepsy are undiagnosed. Up to 75% of “us” are currently either undiagnosed or misdiagnosed with other conditions.

So the most TYPICAL person with narcolepsy is walking around unaware of the true nature of their symptoms, questioning their strength, thinking they aren’t cut out for their education or career. “If only I got MORE sleep, was LESS stressed, exercised MORE, ate LESS, surely I wouldn’t be so tired…”

Or maybe the TYPICAL person w/ narcolepsy has realized something is wrong & brought this to a healthcare provider. Maybe they were told their sleepiness isn’t unusual for [insert any age group or life stage, it doesn’t matter, we’ve heard it all].

Or maybe their medical provider took their concerns seriously (yoohoo!) BUT only studied sleepfor less than 2 hours in their medical education (bummer), so sleep disorders are not top of mind, and certainly not narcolepsy, that’s so rare (oh fudge!).

Perhaps the doctor thinks of thyroid issues or depression! Or if muscle jerking/collapsing is mentioned, epilepsy. Or if hearing voices, schizophrenia. Maybe the most TYPICAL person is down one of those paths right now, taking meds that make their symptoms worse (double whammy).

Therefore, I am in the minority who got lucky, got a sleep study, diagnosis & access to treatments in a somewhat timely fashion. For me, this was 6 years.

We say: “Average delays from symptom onset to diagnosis are 8 to 15 years.”

But that’s misleading, when you think about it, capturing the experiences of only those who get a diagnosis at all. I’m no mathematician, but shouldn’t this be: “from 8 years to a lifetime” to capture 100% of people with narcolepsy’s experiences?

So, no, I am NOT typical, which is exactly WHY I am raising my voice for World Narcolepsy Day. Because I know what it feels like to fight an invisible heaviness thinking it was within my power to control.

Thinking back to those years brings tears to my eyes, even now. I wish I could reach out to younger self in Brown University’s Rock library and say, “Julie, this isn’t normal & won’t go away, go see a sleep doctor now.”

Am I a TYPICAL person*diagnosed* with narcolepsy? I’ll answer that soon. 💗

from Blog – Julie Flygare…

Interview with James Nestor, Author of NY Times Best-Seller, Breath: The New Science of a Lost Art [Podcast #92]

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Please join me as I welcome James Nestor, author of the New York Times, Wall Street Journal,  and LA Times best-selling book, Breath: The New Science of a Lost Art.

He will reveal the following:

  • How and why did you write this book?
  • How did you end up volunteering for a Stanford experiment to plug your nose for a few days?
  • How do you deal with doctors and other patients that don’t see poor breathing as a serious problem, especially if you’re younger or thin?
  • What’s the one thing that you’ve implemented after writing this book?
  • What are some tips for our listeners to improve their breathing and well-being?
  • And much, much more.

Download mp3  |  Subscribe

The post Interview with James Nestor, Author of NY Times Best-Seller, Breath: The New Science of a Lost Art [Podcast #92] appeared first on Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring.

from Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and SnoringBlog – Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring…

How to Stop Mouth Breathing and Get Better Sleep

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My Comments on CNN

Here’s a great article on CNN, with an interview with James Nestor, author of the New York Times best-seller, Breath: The New Science of a Lost Art


The post How to Stop Mouth Breathing and Get Better Sleep appeared first on Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring.

from Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and SnoringBlog – Doctor Steven Y. Park, MD | New York, NY | Integrative Solutions for Obstructive Sleep Apnea, Upper Airway Resistance Syndrome, and Snoring…

Is There A Gene for Crooked Teeth?

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It’s commonly accepted that your face will look like your parent’s faces. The same goes for your teeth. So if you have crooked teeth, then it’s assumed that your parents must have given you their genes for crooked teeth. However, In this blog post, I’m going to argue that there’s is no gene for crooked teeth.

Numerous sources and research papers have shown that even a few hundred years ago, most Americans did not need their wisdom teeth removed.  If you look at Native American skulls from these times, you’ll see that they had wide jaws and perfectly straight 32 teeth, and essentially no cavities. Dr. Weston Price found the same thing in the early to mid-1900s in all 5 continents, if people ate naturally, with no Western influences. George Catlin the American painter in his book, Shut Your Mouth and Save Your Life, observed that Native Americans who had wide jaws and perfect teeth were healthier, stronger, and more resilient.

Both observed that as we start to adopt Western diets (soft/processed foods, refined sugars, canned foods, etc.), people’s teeth came in more crooked and crowded, with more narrow jaws. Bee Wilson, in her book, Consider the Fork, A History of How We Cook and Eat, cites anthropologic studies showing that only the rich in old England could afford newly invented metal cutlery. As a result, the aristocracy was found to have overbites (upper front teeth in front of the lower teeth) long before the poor peasants. The same was found in Chinese culture as well.

Yes, genes give you a blueprint for a range of possible genetic expressions, but it’s your environment while developing inside the womb, and what you’re exposed to after birth that determines how your mouth and teeth develop. This process is called epigenetics. So far, the known risk factors for crooked teeth (malocclusion) are prematurity, soft foods, bottle-feeding, thumb sucking, pacifier use, toxins, and nasal congestion. I’ve also speculated that perhaps even fluoride may have an influence as well.

Here are two examples of how your environment can be a significant factor in how crooked your teeth become. One of the residents that work with me recounts that her grandmother was born in Vietnam and immigrated to the United States at the age of 5. She was the firstborn and had 9 subsequent siblings, all born in the US.  She is the only one with straight teeth, as well as being the healthiest of all her siblings, even the youngest one. 

One of my operating room nurses grew up in St. Kitts, a small island in the Caribbean Sea.…

Ready for Awareness? World Narcolepsy Day 2020 is one month away!

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Less than one month until World Narcolepsy Day on Sept. 22, 2020, and I cannot wait for this second annual day dedicated to raising narcolepsy awareness on a global scale. World Narcolepsy Day 2020 is co-led by 26 non-profit patient advocacy organizations on six continents around the world. See all the orgs listed here.

Last year,  you raised narcolepsy awareness from Finland to Australia, Kenya to Argentina, Canada to Japan, and many places in between!

World Narcolepsy Day 2020

Of course, 2020 hasn’t been the year anyone expected, and in-person events are unlikely. However, in a year marked by isolation and calls for social justice —the importance of fostering community and celebrating our diverse international community is more important than ever.

Take Action Today! 

First things first, the two things I’d ask you to do today are:

  1. Order your official Project Sleep World Narcolepsy Day t-shirts by Sept. 5th to get your shirt by Sept. 22nd in the USA.
  2. Participate in our new CLOUD campaign sharing your message and taking photos for socials! (Don’t forget to use the hashtag #WorldNarcolepsyDay and tag: @project_sleep in posts so we can see and re-share.)


New Awareness Tools

In addition, Project Sleep has new infographics, Spanish-language resources and a Facebook profile frame. Soon we will unveil our schedule of (online) activities for September leading up to World Narcolepsy Day on Tuesday, Sept. 22nd. Check out our webpage and stay tuned for announcements!

Use New Narcolepsy Gifs on your FB and IG Stories!

We developed some awesome new narcolepsy gifs that you can use on your Instagram and Facebook stories. Fun example with Watson, Dr. Mignot’s dog with narcolepsy:


Thank you to the 26 organizations around the world co-leading this day alongside Project Sleep. Each will celebrate World Narcolepsy Day and we cannot wait to cheer for their efforts too!

A huge thank you to Project Sleep’s World Narcolepsy Day 2020 volunteer committee for developing and implementing our organization’s communications plan. This has been a “dream team” effort and I’m so so grateful to everyone who is giving precious time, energy and spoons to raise awareness. I truly believe that together, we are building a brighter future!

from Blog – Julie Flygare…