LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Sleep Apnea

Children, Gluten, Sleep Apnea and Headaches, Oh My!

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gluten sensitivity in children
duckman76 /Dollar Photo Club

Here’s the reality of human physiology; we will NEVER understand how complicated it is.   Gluten sensitivity’s effect on the brain falls under this category.

There’s no doubt that many of us has a grasp on small amounts of how the body works, but the big picture is just too big for any one of us to understand fully.  It’s kind of like–I can drive around here in Phoenix quite well and know where I’m at or at least how to get to where I need to go.  But drop my in Dubai without a map or GPS and I’m pretty much screwed (especially since my Arabic is a little rusty…).

That’s a pretty good analogy to the human body and its complexity.  The most that any of us can hope for is a glimpse of insight into how it works and how we, as physicians, can help patients heal and live full lives.

This is one of the reasons why my passion has always been normal physiology and how the lifestyles we are SUPPOSED to be living impact that.  I figure it’s easier to match how we are designed to live then to figure out the details of that process.  Sort of like recommending more vegetables in your diet (because it’s the right thing to do) instead of understanding how glucosinolates in broccoli assist detoxification of environmental contaminants.

Just to complicate things even more, every system in the human body communicates and interacts with every other system.  The connections between the gut and the brain are particularly strong.  This is why treatment for any “brain disorder” should always include a look at the gut.

While this relationship may seem a little strange at first glance, the reality is that the gut is considered the body’s “second brain” since its production of neurotransmitters is as heavy as the brain.  As an example, 2/3 of the body’s serotonin is produced in the gut NOT the brain.

To further complicate matters, your DNA codes for about 25,000 different genes that make all kinds of different proteins to make sure your body is working the way it is supposed to.  Just in case that sounds a little overwhelming, the bacteria in your gut, collectively, have about 3 MILLION genes, all equally capable of making proteins that effect your health and risk of disease.

With this as a background, we can now look at just how absolutely jaw-dropping amazing this particular study is.  It brings together so many of these concepts that it is going to make your head spin.  In this small study, researchers looked at 19 children who had newly diagnosed celiac disease confirmed through an intestinal biopsy and followed them for 6 months while on a gluten free diet.

In these children with gluten sensitivity, there were some disturbing findings:

  • 37% of the children had headaches that affected daily activities.
  • 32% demonstrated symptoms of obstructive sleep apnea.
  • 48% of the children had abnormalities on EEG (a test using electrodes to check brain activity).

These findings clearly indicate that gluten (essentially a gastrointestinal condition) was having very definite negative effects on the brain.  And make no mistake–these are serious conditions to be found in children.

Luckily, the researchers then found some amazing things that were affected by 6 months of a gluten free diet:

  • The headaches disappeared in 72% of children.
  • EEG abnormalities disappeared in 78% of the children.
  • ALL children no longer had symptoms of obstructive sleep apnea.

As I mentioned, this is a small study.  However, it does link to and support other studies that have found an increase in migraine headache in those with gluten sensitivity, which gives it more weight.  While many have called the gluten free diet a “fad” I think these naysayers have managed to miss much of the medical literature linking gluten with a long list of health problems.

Even better, this is a DIETARY change with no real downside or side effects.  It is an approach that truly gets to the root of the problem rather than just glazing over the symptoms with dangerous medications with a long list of side effects.

Also, while this study only evaluated biopsy-confirmed celiac disease, which is at the far end of the spectrum, you can bet that lesser degrees of sensitivity will also link to neurological damage.  It will just be more subtle.

 

Sleep Apnea Compliance: Is Your Brain Worth It?

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sleep apnea and dementia
karuka/Dollar Photo Club

I recently wrote an article about the strong links between sleep apnea and dementia. But hey–you’re only 45 and dementia is way too far away to worry about.

But what if sleep apnea was causing brain damage RIGHT NOW??

Let’s backtrack a little here and cover what sleep apnea really is.  There are two basic types; central (caused by an inability to regulate breathing while asleep) and obstructive (caused by mechanical blockage in the back of the airway).  You are probably familiar with obstructive sleep apnea and associate it with snoring and obesity.  This is the type of sleep apnea that you can’t miss if you’re sleeping in the same room with someone who has obstructive sleep apnea.  And, in more severe cases, you just have to be in the same zip code…

Central sleep apnea, however, is not thought of as much but it has a much more sinister plot.  It is very closely associated with prediabetes.  To put in more clearly, the prediabetic process is dangerous enough to your body to cause it to stop breathing at night.  “But my doctor checked me for this and said I was fine,” is not going to cut it anymore.

The key to both of the sleep apneas is simple; manage the condition short-term with a CPAP or BiPAP but eliminate sleep apnea long-term through appropriate lifestyle changes that are going to lead to weight loss and pulling away from the diabetes development track.

For those of you out there who THINK you may have sleep apnea but you are afraid to find out (via a sleep study)–you are probably making the biggest health mistake of your life. Sleep apnea is devastating for your health.  It is an extreme stress on your body and brain that WILL shorten your life.  And the answer (CPAP), while a wee bit of a hassle, is non-drug, non-addicting and can have a major impact on your daily life.

On a side note, for those of you who snore but do NOT have sleep apnea, there have been concerns over the past few years on the relationship between snoring and later heart disease.  This means you are not off the hook for making the aforementioned lifestyle changes.

Back to this particular study.  In it, researchers looked at 8,059 Hispanics aged 45 to 74 years, to see if there were relationshiops between brain testing (specifically, neurocognitive scores were measured using Word Fluency Test, the Brief–Spanish English Verbal Learning Test, and Digit Symbol Substitution Test) and obstructive sleep apnea.  The sleep apnea was graded based on the Apnea-Hypopnea Index (AHI), or how many times the patient stopped breathing in an average hour of sleep.  Normal is consider none to 4 episodes per hour.  Here’s what they found:

  • The mean AHI was 9.0 (this means that, on average, everyone in the study had some degree of sleep apnea).
  • As the AHI number got higher, the female patients scored worse on all 4 of the brain-based tests.

The bottom line is that there are clear associations between sleep apnea and damage to the brain as demonstrated in these tests.  If you even remotely think that you may have sleep apnea, you need to have this fully evaluated at a sleep center or at home with a home sleep-study kit (not as good for other sleep disorders, but is pretty good for identifying sleep apnea).

And, if you have a CPAP machine collecting dust on the nightstand, it’s time to dust it off and start using it.  Your brain will thank you.

 

Critical Links Between Sleep Apnea, Deep Sleep and Dementia

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sleep apnea and dementia
karuka/Dollar Photo Club

Hundreds of millions of dollars are spent on dementia research annually. While many may not like my opinion, I think we’re throwing this money away.

To date, we have had very little in the way of a “cure.”  The research dollars continue to hit dead ends.

Here’s the problem.  By the time that someone is diagnosed with a neurodegenerative disorder, it is likely that he or she has already lost a large chunk of the dopaminergic cells of the substantia nigra (Parkinson’s) or the cells of the hippocampal region and the neocortex (Alzheimer’s dementia).  In these patients, the loss of brain cells has been going on for decades.  DECADES.

The process is a freight train going.

I do not think we will ever be able to stop this freight train.  Slow it down maybe:  studies on coenzyme Q10, magnesium, exercise and ginko biloba have demonstrated the ability to slow the progression of neurodegenerative disorders.

One thing, however, is very, very clear.

Prevention is possible.  We now have very clear cut risk factors for Alzheimer’s dementia.  And the vast majority of them are modifyable.  Very modifyable.  Smoker?  Quit.  Don’t exercise?  Start.  On your way to diabetes?  Change your diet and exercise.  Too much brainless TV?  Shut it off and challenge your mind.

This particular study adds yet another preventable risk factor to the list.

Sleep.  And lack of it.

And not just the take-a-pill-so-you-can-sleep sleep, but good quality, slow-wave sleep (SWS, non-REM stage N3).  Ironically, some drugs that you may take to help you sleep are actually interfering with your ability to hit the SWS stage of sleep.  Drugs like  fluoxetine (Prosac) and paroxetine (Paxil) have been shown to interfere with SWS sleep.

Researchers looked at a group of 167 Japanese American men in Honolulu, HI who were followed until their death and had their brains examined at autopsy.  Specifically, researchers were looking for signs of brain damage associated with cognitive loss and Alzheimer’s (Braak stage, neurofibrillary tangle and neuritic plaque counts, microinfarcts, generalized brain atrophy, lacunar infarcts, Lewy bodies, neuronal loss and gliosis in the locus ceruleus).

This brain damage was then compared to the results of a sleep study (polysomnography) done at the beginning of the study.  Here’s what they found: and died through 2010 (mean 6.4 years to death). Polysomnography measures included the apnea-hypopnea index, duration of apnea or hypopnea, duration of hypoxemia, minimum oxygen saturation (SpO2), duration of slow-wave sleep (SWS, non-REM stage N3), and arousals.

  • Sleep duration with oxygen saturation levels (SpO2) less than 95% was associated with a whopping 388% higher levels of microinfarcts (small strokes).
  • Greater SWS duration (in other words, better deep sleep) was associated with less 68% less atrophy in the brain.
  • Lewy bodies were 83% less common in those who had more sleep at 95% oxygen saturation or more.
  • Higher minimum oxygen saturation during REM sleep was associated with less gliosis and neuronal loss in the locus ceruleus (in English–less inflammatory cells and less dead brain cells were found in the region of the brain stem that deals with stress and our ability to respond to stress).
  • Cognitive scores declined less among men with greater SWS duration.

These are some pretty serious associations.  And it all fits into the picture of what we already know.  Prediabetes and diabetes are very closely associated with cognitive loss, dementia and Alzheimer’s.  Prediabetes and diabetes are also closely associated with sleep apnea.  So it just makes sense that sleep apnea and poor quality sleep would be linked to brain damage.

Brain damage.

That sounds serious.  AND, it sounds like it’s finally time to go get that sleep study done and find out if you need to be using a CPAP or BiPAP machine.  Your brain will thank you.

 

4 Hours Less Sleep = Prediabetes

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SLEEP RESTRICTION LEADS TO COMMON DISEASE.

OK…I have to say that I practice everything that I preach, but my only weakness is getting enough sleep.  Being an information junkie, it’s hard to shut the brain off and get to bed at a decent hour.  But looking at this article it really makes me reconsider an earlier bedtime.  One single night of sleep restriction (4 hours) induced prediabetic traits in the liver.  A single night!!  If this happens to be a pattern for you, we can see how much this greatly increases your risk for diabetes over the long run (and do NOT forget that prediabetes in itself is incredibly dangerous to our health).  Of course, sleep problems in general can also be a sign that someone is already on their way to diabetes from elevated cortical at night.  Sleep prescription medication, by the way, do NOTHING to fix the actual problem…

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Natural Remedies for Seizure Control: You Haven’t Heard This

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natural remedies for seizures
Photo courtesy of CPAP, sleep apnea, seizures, natural remedies for seizures, epilepsy

I’ve been reviewing research related to seizure control and brain health for many years now through the lens of natural medicine.

I still remember being in a consult with an epileptic patient with a very well-known neurologist to discuss natural methods to help control seizures.  Despite this particular neurologist’s association with one of the top healing physicians in the world, his did not feel that there was really much to be done for seizure control beyond medications.

I guess he could never really look beyond the deficiencies and brainwashing of his traditional medical, drug-oriented training to evaluate the power of natural approaches to seizures.

That was really sad for this particular patient.  And every other epileptic patient saddled to a neurologist (or epileptologist, for that matter) who believe antiepileptic drugs are the only answer.  They will spend their lives chasing one drug after another to find one that helps your seizures and has acceptable side effects.

But, if you’ve been lucky enough to partner up with someone who actually reads medical literature, you will find that there is a long list of approaches that have been documented in the medical literature that can help you better manage or even eliminate your seizures.

It is all about healing your brain.  If you experience seizures (or migraines or both) your brain is not functioning the way it is supposed to.  Messages are getting into cells that are not supposed to be.  Other messages that are supposed to be delivered to the cell don’t make it.  Your very brain cells are starved for energy so they can work the way it was intended.

Natural approaches to seizures take this into account.  I’ve covered many of them over the years, from vitamin D to exercise to fish oils.  Some are simple.  Others require an upheaval of your lifestyle.

But I have never covered the approach outlined in this particular study.

I guess, had I thought about it, sleep apea would have a strong association with seizures.  It’s a stress on the body and brain.  It’s linked to prediabetes (prediabetes leads to sleep apnea and sleep apnea worsens prediabetes) and prediabetes is really bad for the brain.  It starves brain cells of the oxygen it so desperately needs.  And, it occurs at night when the seizure threshold is lower.

Researchers looked at a group of 132 adults with epilepsy to evaluate them for sleep apnea to see whether the use of a CPAP had an effect on the number of seizures over the course of a year.  Here’s what they found:

  • Seventy-six (57.6%) of the group had obstructive sleep apnea (this is pretty darn high).
  • 73.9% of those in the PAP-treated group had more than a 50% seizure reduction in seizures (versus only 14.3% in the untreated sleep apnea patients—HUGE difference).
  • Overall, the PAP-treated group experienced a 58.5% reduction in seizures (versus 17.0% in the untreated sleep apnea group—again a HUGE difference).
  • 83.7% of those who had PAP-treated sleep apnea had a ≥ 50% seizure reduction or became seizure-free (versus 53.6% in those who did not have sleep apnea and 39.4% in those who had sleep apnea but did not use a PAP).
  • To put this in perspective, in those PAP-using sleep apnea adults, they were 9.9 times more likely to have a good outcome than those with untreated sleep apnea and 3.91 times those who did not have sleep apnea.
  • When measured in terms of seizure reduction, the group with PAP-treated sleep apnea were 32.3 times more likely to experience a ≥ 50% seizure reduction compared with the group with untreated sleep apnea and 6.13 times compared with the group with no sleep apnea.

These are some pretty serious numbers.  To flip everything around, it can be said that sleep apnea is very, very bad for the brain when left untreated.  If any of these fits you (whether or not you have seizures), it’s time you got checked out:

  • Chronic loud snoring
  • Witnessed apneic episodes or breathing pauses during sleep
  • Excessive daytime sleepiness
  • BMI > or equal to 28
  • Small jaw / small airway
  • Large neck size (at least 17” male, 15.5 female)
  • Family history of sleep apnea

In addition, your risk for sleep apnea is increased if you have high blood pressure, Type 2 diabetes or untreated hypothyroidism.

If any of the above fits you AND you are epileptic, given how much of a difference it made in this study, you need to get checked out for sleep apnea and get treatment (i.e. CPAP) if you have sleep apnea.

Sleep-disordered breathing, glucose metabolism in hypertensive men – (03-26-01)

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Sleep-disordered breathing, glucose metabolism in hypertensive men

I love seeing articles demonstrating the intricate ties between all systems of the body and many of today’s chronic diseases. This study suggests that obstructive sleep apnea may contribute to the risk of diabetes, independent of obesity. Try this…lack of sleep is a known stress to the human body. The stress hormone in the body is cortisol. Cortisol wreaks havoc on many systems in the body, including insulin sensitivity. Thus, it makes complete sense to link sleep apnea with diabetes.

Synergy : Journal of Internal Medicine 249 (2), 153-161

Read entire article here

Metabolic disturbances in obesity versus sleep apnea – (06-23-03)

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Metabolic disturbances in obesity versus sleep apnea: the importance of visceral obesity and insulin resistance

I must admit this is a very interesting concept. Basically, this article opens up the idea that sleep apnea may actually be a manifestation of underlying insulin resistance and obesity. We have always known that abdominal obesity was a risk factor for sleep apnea, but the association with insulin resistance would really change the approach to treatment. I am always in support of a CPAP machine because sleep apnea can have some pretty serious long term consequences, but now we should add aggressive lifestyle changes for insulin resistance as well.

Read entire article here

Adverse Effects of Modest Sleep Restriction – (06-01-04)

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Adverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines

I know I’m guilty here. We all know that sleep is very important and is a stress on the body, but to increase inflammation is definitely news to me. And considering that inflammation plays a role in just about every chronic disease we know of, getting a good night’s sleep becomes even more important. I would like to see if the use of drugs for sleep, such as Ambien, would avoid the increase in inflammatory markers since is does interfere with the deepest levels of sleep.

JCEM — Abstracts: Vgontzas et al. 89 (5): 2119 –

Read entire article here