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Permalink Reply by Mike on January 5, 2011 at 3:02pm

bumping up as reminder.

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Permalink Reply by Mike on January 7, 2011 at 10:17am

great review of what took place, j n k. the link to Dr. Park's UARS talk slides is now live on Manhattan AWAKE: http://manhattanawake.org/download/22

j n k said:

My book report on my field trip to that meeting:

After stressing that UARS affects both sexes, all ages, and all body types, Dr. Park talked about how human anatomy differs from animal anatomy, how human anatomy changes with age, and how there are many theories on why UARS is so prevalent today. He mentioned several surgical procedures that can, at times, aggravate OSA/UARS, including rhinoplasty, dental extractions, hysterectomy, breast implants, and any surgery that makes someone start sleeping on his or her back.

Common symptoms of UARS that he has noted are insomnia, fatigue, and cold, numb extremities. Common conditions that seem to be related are migraines, IBS, TMJ, firbromyalgia, and CFS.

Dr. Park's view is that bad sleep stresses the body to the point that the nervous system and immune system get inappropriately revved up, fostering constant inflammation. A person in that condition may also find that his or her senses and emotions tend to overreact and that his or her pain threshold is lowered to the point of feeling chronic pain.

Home tests are rarely able to pick up the subtle obstructions that ruin the sleep of UARS sufferers.

The most startling and thought-provoking statement, to me, was that he has found in his practice that from one quarter to one half of UARS sufferers he sees can be helped sufficiently with a conservative approach, and that one key part of that approach is that NOTHING BUT WATER SHOULD BE CONSUMED WITHIN FOUR HOURS OF GOING TO BED--no food, and especially no alcohol within four hours of bedtime. He acknowledged that this is not easy to do, since people with sleep-breathing issues tend to crave high-fat, high-sugar foods. But he maintains that it can be done and should be done and that it is part of a highly successful approach for improving how people with sleep-breathing issues feel over time.

Another important part of that conservative approach is what he calls "enhancing parasympathetic stimulation." Singing and swimming were used as examples of that. The idea is that a calm, non-stressed nervous system doesn't overreact as easily, and that activities that slow down the exhale part of our breathing tend to calm us. We all need to schedule relaxing, calming activities in our lives for the sake of our health, but this seems particularly important for people with UARS, since they particularly need to calm their nervous system.

Another thing Dr. Park discussed was the concept of "reflux arousals." They can disrupt sleep just as much as true respiratory-event arousals, but don't get counted in PSGs as anything other than spontaneous. That would tend to back up his nothing-but-water-within-four-hours-of-bed rule, if you think about it.

Dr. Park explained that many with heightened sensitivity from a revved-up nervous system may find that PAP therapy makes them feel worse, not better, even with no leak and very low AHI. If the conservative approach mentioned above does not help the UARS patient feel better, it becomes time to look at other options rather than forcing the PAP approach on the patient. Oral appliances may be considered at that point. If that doesn't do the trick, surgery should be considered, if, of course, the patient is a good candidate for that.

I was sitting toward the back for much of Dr. Park's presentation, so I may not have got all the details exactly right above. And I am not connected in any way with any medical field, so I may have misunderstood him in some important ways. But I pass this report along in case anyone here finds it helpful, as far as something to think about and to discuss with medical professionals.

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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on January 7, 2011 at 11:33am

Great Review JNK and thanks for posting the link Mike.  I'll look forward to viewing it this evening :)

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