Dr. Steven Park for the Airway and Facial Development Spreecast.

1. Sleep & Breathing:
The 2 Keys to Optimal Health
Steven Y. Park, MD
Otorhinolaryngology & Sleep Medicine
Assistant Professor
Albert Einstein College of Medicine
Department of Otorhinolaryngology
Montefiore Medical Center
Bronx, NY

2. Disclosures

9. Klinorynchy

10. Anterior Migration of
Foramen Magnum

11. Laryngeal Descent

12. Laryngeal
Descent

13. 3 Dental Concepts

14. `

17. Corruccini

18. Weston Price

19. Weston Price

20. Weston Price

21. Weston Price

23. Attractive?

24. Attractive?

25. ?

26. ?

28. Cover Comp 9 4/2/08
SleepInterrupted.com
Endorsed by New York Times
best-selling authors:
Dr. Christiane Northrup
Dr. Dean Ornish
Dr. Mark Liponis
Mary Shomon

32. Obstructive Sleep
Apnea Syndrome

33. Obstructive Sleep
Apnea Syndrome

34. Apnea Hypopnea Index
(AHI) > 5

35. Apnea:
> 90% obstruction
> 10 seconds

36. Hypopnea:
> 30% obstruction
+ 4% desaturation
or arousal

37. Respiratory Event
Related Arousal
(RERA)

38. Respiratory Disturbance Index
(RDI)
(Apneas + Hypopneas + RERAs)
/ hour

39. Inspiratory Flow Limitation
(IFL)

40. Upper Airway
Resistance Syndrome
(UARS)

41. Upper Airway
Resistance
Syndrome
(UARS)

44. Unexplained Illnesses” by Martin L. Pall, 2007

46. UARS & OSAS
OSAS UARS “Normal”

48. Why Are Things
Getting Worse?

51. Myers, G. S. (1971). Effect of sodium fluoride and sodium pyruvate on palatal development in vitro. Anatomical Record. Part
a: Discoveries in Molecular, Cellular, and Evolutionary Biology, 171(1), 39–52. doi:10.1002/ar.1091710104

56. Laryngeal Descent

58. SIDS

59. Prematurity and OSA
risk
X

61. Awaken
HR
Variability
Obst.
Events
Arousals
Sleep
Duration
NREM
Sleep
Sleep
Efficiency
+25%
Preterm Prone
Preterm Supine
3 mo Prone
+6%-40%

65. Multi-hit Theory

70. Tonsils

77. http://www.atsjournals.org/doi/full/10.1164/rccm.200201-050OC#.VEVHykvjlVL

80. Harper, R. M., Kumar, R., Ogren, J. A., & Macey, P. M. (2013). Sleep-disordered breathing: effects on brain structure
and function. Respiratory Physiology & Neurobiology, 188(3), 383–391. doi:10.1016/j.resp.2013.04.021

82. 7 Procedures That
Can Cause OSA

83. Nasal Surgery

92. Any Surgery that
Forces Supine Sleep

93. Sleep Hygiene

95. iPad

96. Circadian Rhythm

98. Age Hours Of Sleep Needed
Newborns (1-2 mo) 14-18 hours
Infants (3-11 mo) 13-16 hours
Toddlers (1-3 yrs) 12-14 hours
Preschool (3-5 yrs) 11-13 hours
Children (5-12 yrs) 10-11 hours
Teens (13-17 yrs) 9-10 hours
Adults (18 and up) 7-9 hours

99. Eating in bed

100. Eating in bed

101. 7 Procedures That
Can Cause OSA

102. 7 Procedures That
Can Cause OSA

104. Migraine
Genes
Red Wine
Weather
Chocolate
Genes
Red Wine
Chocolate

106. “Success”
Tonsillectomy
Nasal Surgery
Orofacial Myo
Dental
Tonsillectomy
Tonsillectomy
Dental
Dental

108. Basic Principles
All humans are susceptible
Redefine aging
New health paradigm

109. Practical Tips
Don’t eat within 3-4 hours of bedtime
Don’t drink alcohol within 3-4 hours of bedtime
Optimize nasal breathing
Sleep position
Head position
Migraine triggers
Relaxation / breathing techniques
Enlarge the airway

110. Practical Tips
Treat the patient, not the numbers
Practice evidence-based medicine, but always treat
the patient first

111. Practical Tips
It’s all in the patient’s history — listen to their stories

113. Practical Tips
Practice what you preach

114. Questions?
doctorstevenpark.com