DoctorStevenPark.com!

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1 ! DoctorStevenPark.com!!!

2 Subscribe in doctorstevenpark.com/itunes Show doctorstevenpark.com/001!

3 Sleep & Breathing: The 2 Keys to Optimal Health

4 What I ll Cover Why only humans have sleep apnea How you can choke and die 5 Simple tips to breathe better and sleep better tonight

5 Obstructive Sleep Apnea Repetitive pauses in breathing while sleeping Loud snoring Unrefreshing sleep MOOSE (male, older, overweight, snoring, excessive sleepiness) > 70 Million with OSA 90% undiagnosed

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7 Associated Medical Conditions High blood pressure High cholesterol Diabetes Heart disease Heart attack Stroke Depression Anxiety Dementia Liver disease Kidney disease Nocturia Cancer Pregnancy related Preeclampsia Diabetes hypertention Prematurity Death ADHD Car accidents Chronic pain Weight gain

8 Sleep Related Breathing Disorders Young, thin women (and men) that don t snore can have significant obstructive sleep apnea You can stop breathing 20 to 30 times every hour and not officially have OSA

9 Sleep Related Breathing Disorders Very common in all ages and both sexes OSA is not due to being overweight The airway keeps changing

10 Sleep Disordered Breathing & Evolution Only humans have: sleep disordered breathing complex speech true orophayrnx

11 4 Evolutionary / Anatomic Changes

12 Klinorynchy Miles AE. The evolution of dentitions in the more recent ancestors of man. Proc R Soc Med. 1972;65(4):

13 Anterior Migration of Foramen Magnum Miles AE. The evolution of dentitions in the more recent ancestors of man. Proc R Soc Med. 1972;65(4):

14 Laryngeal Descent and Loss of Epiglottic - Soft Palate Lock-Up

15 Vertical Descent of Larynx Aronson, E and Bless, D, Clinical Voice Disorders

16 3 Dental Concepts

17 Weston A. Price,DDS Price, WJ. Nutrition and Physical Degeneration. 6th ed. La Mesa: Price-Pottinger, 1945.

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21 Robert Corruccini, PhD How Anthropology Informs the Orthodontic Diagnosis of Malocclusion's Causes

22 Brian Palmer, DDS brianpalmerdds.com brianpalmerdds.com

23 Click to edit Master title style A8 Otorhinolaryngology Otorhinolaryngology Neck Surgery Head andhead Neck and Surgery Demonstrates position and action of tongue during breastfeeding (Woolridge)

24 Click to edit Master title style Otorhinolaryngology Otorhinolaryngology Neck Surgery Head andhead Neck and Surgery

25 Click to edit Master title style Otorhinolaryngology Otorhinolaryngology Head and Head Neck and Surgery Neck Surgery

26 Click to edit Master title style Otorhinolaryngology Otorhinolaryngology Head and Head Neck and Surgery Neck Surgery

27 Facial Profiling

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30 Facial Wrinkles

31 As our brains get bigger As our face gets smaller What will we look like in 50,000 years?

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33 Sleep Disordered Breathing Primary Snoring Upper Airway Resistance Syndrome Obstructive Sleep Hypopnea Syndrome Obstructive Sleep Apnea-Hypopnea Syndrome Obstructive Sleep Apnea Syndrome Mixed Sleep Apnea Syndrome Complex Sleep Apnea

34 Sleep-Breathing Paradigm Airway Obstruction Throat Swelling Vacuum In Throat Laryngo- Pharyngeal Reflux

35 Sleep-Breathing Paradigm Obesity Age Dental 3 URI Allergies 8 Snoring Anatomy 5 Airway Obstruction Cancer? 18 Hypoxia Diabetes CRP Cholesterol 19, 20 14,19 Hypertension Heart Attack Heart Disease Stroke Sleep Apnea Preeclampsia Throat Swelling CV Sequela 21 Stress Chronic Sinusitis Chronic Rhinitis Otitis Media Eustachian Tube Problems 8 Nasal Congestion AM Headaches 3 Throat Pressure Sensor Desensitization 8 Pharyngeal Muscle Tone Sinonasal Inflammation Pulmonary Inflam. 2,8 Nasal Obstruction Intrinsic Pharyngeal Inflammation GERD Laryngo- Pharyngeal Reflux Physiologic Sequela Arousal 16 Sleep Deprivation Obesity Vacuum in Throat ,12,17 Drowsiness Chronic Fatigue Diet Depression ADHD, CFS, IBS Fibromyalgia Chronic Pain? Idiopath. Hypersom. Migraine Cold Extrem. Low BP Asthma Bronchitis Reflux Symptoms Extrinsic Insomnia Limb Movements TMJ Sleep Depriv. Pain other Car Accidents

36 How Common is OSA? 4% in men, 2% in women using strict criteria 24% in men, 9% in women using loose criteria Based on population studies in 80s Recent study in women ~50% Elderly (>65 y.o.) 62% (AHI>10) UARS?

37 Sleep-Breathing Continuum (Obstructions & Arousals) / Hour OSA UARS Normal Mild Moderate Severe Signs & Symptoms

38 Practical Applications & Implications Neurologic effects / dementia Depression / anxiety ADHD PTSD Chronic insomnia Peri-menstrual disorders Pregnancy-related issues Menopause Cancer

39 Treatment Conservative Diet, lifestyle, behavioral, allergies, etc. Full medical evaluation Sleep Study Treatment CPAP Dental appliances Surgery

40 Other Complementary Options Acupuncture Orofacial myology Didgeridoo

41 New Options Provent Winx Tongue nerve stimulation Functional dental appliances

42 5 Practical Tips Don t eat or drink alcohol within 3-4 hours of bedtime Improve nasal breathing Adjust sleep / head position Avoid migraine triggers Practice relaxation techniques and deep breathing exercises

43 Reader Question

44 Sleep Tip of the Day

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