Health Chats
Sleep Breathing Disorders
Wednesday May 13, 2009, 08:00PM - 09:00PM (EST)
Steven Y Park, MDBlank
Private Practice
New York, NY
Are you tired all the time no matter how long you sleep? Do you keep waking up at night, or have to go to the bathroom too often? Are you told that you snore or stop breathing at night while sleeping? Most people take it for granted that we are able to breathe properly at night, but for most modern humans, this is not necessarily the case. Poor breathing while sleeping can aggravate or cause a variety of health problems from anxiety and depression to heart disease and strokes. There are also many myths and misconceptions about snoring and obstructive sleep apnea that even most physicians still believe. Join Dr. Steven Y. Park, expert forum physician for Medhelp's sleep-breathing forum, as he answers your questions on anything related to better breathing and better sleep.<br><br> Dr. Steven Y. Park is a board certified otolaryngologist (ear, nose and throat physician and surgeon), specializing in helping people sleep better by helping them breathe better. He is the author of the book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. It was endorsed by New York Times best-selling authors Christiane Northrup, M.D., Dean Ornish, M.D., Mark Liponis, M.D., Mary Shomon, and many others. He received his undergraduate degree from The Johns Hopkins University, and his medical degree from Columbia University's College of Physicians & Surgeons.
MedHelp:
Welcome to the MedHelp Sleep Breathing Disorders Health Chat.  Thanks for joining us today.  This chat will begin at 8 pm EST, but feel free to submit your questions earlier.
Dr. Steven Y. Park:
Dr. Park here. Hi everyone.
MedHelp:
Hello Dr. Park and thank you for joining us here today!
Dr. Steven Y. Park:
Cindy, Does her husband have a problem with her CPAP's noise, or does he have a sleeping problem?
Cindy:
A friend of mine who was dx'd with Sleep Apnea, uses a CPAP mask every night.  She can sleep, but her husband cannot.  What if any, alternatives are available for people with severe sleep breathing issues?  
sunsine:
What is a sleep breathing dr, and is there anything besides a cpak for sleep apnea if you can't use this machine?
Dr. Steven Y. Park:
I'm a board-certified otolaryngologist, who specializes in sleep-related breathing disorders. Since we deal mainly with the upper airway, and since snoring and sleep apnea are upper airway breathing problems, it's a natural fit.
Dr. Steven Y. Park:
Other options besides CPAP are dental devices and surgery. But in many cases, due to poor education, support or follow-up, the patient never has the benefit of using CPAP effectively.
DeniseApril:
I often awaken at night feeling like I had been unable to breathe, like something had been preventing me to ... I don't know if this is a dream or real, this happens frequently... I hope this doesn't sound silly.
Dr. Steven Y. Park:
This is one of the most common symptoms of obstructive sleep apnea. If you're tired during the day or have any medical problems such as anxiety, depression, weight gain, high blood pressure or heart disease, get it checked out with your doctor.
BleepingBeauty:
In general, if a patient is compliant and is having no issues with mask comfort or high leak rates, how long should it take to feel the benefits of treatment?
Dr. Steven Y. Park:
That's a great question. It depends. Some people feel a massive difference right away. Others can take 4-6 month, or rarely up to a year. Think about the sleep debt that's accumulated over years of decades.
nickhart66:
I believe I have sleep apnea. I can not sleep on my back or on my stomach because I can not breathe right. Only on my left or right side, and even then some times can not breathe. I wake up jumping out of my bed feeling like suffocating and gasping for air. It is a terrible feeling. I thought it was reflux because I have had that in the past. I took prilosec for few weeks but did not help. When I drink alcohol or have late dinner it gets worse. Could this be an Allergic reaction or what is it caused from? When I am stressed it feels worse too? What can I do to feel better? I have done a test where you sleep and your breathing is monitored with an equipment 4 years ago and that's when my doctor told me I have severe case of sleep Apnea. Is this really dangerous? Can I get Stroke or Heart attack when I am in sleep? Can anything other than hooked up to oxygen unit while sleeping help me?
Dr. Steven Y. Park:
nickhart66, what you are describing is classic obstructive sleep apnea. If you have severe sleep apnea, you have a 3-5 x increased chance of having a heart attack or stroke. Get it treated. If you haven't tried CPAP, be open minded about it and at least give it a try. After you've given it an honest try, other options are dental devices and surgery. There's no perfect answer. BTW, CPAP uses positive air pressure—it's not oxygen.
BleepingBeauty:
There needs to be some form of advocacy on behalf of new patients, to educate them about SDB before they receive a prescription or see a DME for equipment, about what to expect and what to demand of their healthcare treatment plan.  Newbies are easy marks for an unscrupulous DME industry whose primary interest is the bottom line and NOT the customer's well-being.  What can be done about this?
Dr. Steven Y. Park:
I agree. With a few exceptions, it's shameful how poorly DME vendors in general are in helping patients use their CPAP devices effectively. Ideally, there needs to be an interdisciplinary team under one roof: A sleep doctor, an RT, an ENT, a dentist, and maybe even a social worker and psychologist. Maybe even patient advocates or a "buddy" system. It needs to be treated life a lifelong chronic disease, like diabetes or cancer. Unfortunately with our fragmented health care system, this is not allowed.
Cindy:
My friend's husband cannot sleep because the CPAP machine is noisy
Dr. Steven Y. Park:
Ask your DME vendor for a quieter model.
sk123:
Is snoring considering a sleep breathing disorder? Is there any way to prevent snoring, such as sleeping in certain positions or avoiding certain foods?
Dr. Steven Y. Park:
Yes, definitely. It means that there partial resistance to breathing. Although you can have "benign" snoring, I believe in most cases, it's unhealthy and should be treated, rather than being "covered up." The initial conservative recommendations include sleeping on your side, losing weight, don't eat or drink alcohol 3-4 hours before bedtime, exercise and treat any nasal congestion for any reason. If this doesn't work, see your doctor.
KristieN:
Hello Dr., my husband can't sleep well.  he often awaken at night, and  sometimes he is unable to breathe.  he said it hurts right at the heart, but when the doctors checked his heart, they all said it was okay.  Should he see the specialist?
Dr. Steven Y. Park:
If his heart is OK, then sleep apnea is one thing he definitely be checked for. Look for a sleep specialist.
Michael:
I hope it's OK for me to ask this question  - it's not specifically about sleep breathing, but might be.  Anyway, I often wake up very early in the morning - usually about 4-5 AM with a mind numbing headache. After about 20 minutes or so, I am able to go back to sleep for a few hours and then when I wake up, the headache is usually gone.  Any idea why I would be getting horrendous headaches about 4 nights out of 7?
Dr. Steven Y. Park:
There are many reasons for waking up with a headache. The first thing is to see your doctor for a complete medical evaluation and then to a neurologist if necessary. If everything comes back normal, then the next step is to check for sleep apnea. Waking up with severe headaches is one common symptom.
ChitChatNine:
Dr. Park - I have friends who feel they are hypothyroid but their TSH is within normal limits.  Is there a correlation between these hypo-type feeling symptoms and improper sleeping when one's thyroid is, indeed, normal ?
Dr. Steven Y. Park:
This is a controversial issue. Many doctors say the lower level of "normal" is too high. But the general consensus is that you can have normal thyroid levels and still be clinically hypothyroid. Many holistic doctors will empirically treat with Armour thyroid and titrate until you get results. Additionally, poor quality sleep (either quantity or quality) can suppress your thyroid levels.
ChitChatNine:
Why does it seem that my husband snores excessively during times of stress?
Dr. Steven Y. Park:
For  a number of reasons...during times of stress, his eating habits may dow downhill, or eat later, or drink more alcohol to de-stress. Also lack of sleep can cause REM rebound, which means that you'll go into REM sleep faster and for longer periods, then you're most likely to snore, since your muscles are most relaxed.
sfkaos:
I have recently decided to quit smoking.  My first night was extremely restless either due to Nicorette or withdrawal symptoms of Nicotine. I have never had any occurrence of sleep apnea that I am aware of.  I would get to sleep, but wake up with a gasp, after realizing that I had stopped breathing.  I was exhausted, and it was easy for me to get back to sleep, but it seemed as soon as I fell asleep, I would gasp and wake myself up again.  Does this sound like sleep apnea? Is this a normal effect of either Nicorette or Nicotine withdrawals? Should I be concerned?
Dr. Steven Y. Park:
When you're not smoking anymore, you're going to go through withdrawal symptoms. This heightens your nervous system and makes you "jump" at any little thing, especially if you stop breathing, even for a slight second. It's possible you stop breathing all along, but your quitting smoking may have exacerbated the symptoms, making you wake up more violently.
Andrew0089:
Hi doctor, this is very general but what can you tell me about sleep walking at 15-16 years old. I feel stuck in dreams sometimes and I talk while interacting with what I see. I also have these dreams where I always think something is going to fall behind my loft bed and I'm trying to grab it but then I realize its not there as my vision starts to "clear up" and I see none of these objects were really there.
Dr. Steven Y. Park:
Sleepwalking is in the category of parasomnia, where you'll have a confusion in transitions from one sleep stage to another. There are various theories to why people sleepwalk, but I vaguely remember a recent study that showed that treating sleepwalkers with CPAP eliminated it altogether.