Medical Articles by Dr. Ray

Nov

2022

Lack of Sleep Harms the Immune System and Causes Inflammation

By Ray Schilling | Cardiovascular disease, depression, Diabetes, Heart Disease, Inflammation, Insomnia, sleep, Sleep apnea

A research group from Boston, MA and New York, NY found that a lack of sleep harms the immune system and causes inflammation. This was summarized in this CNN article.

Specifically, they first conducted experiments with a mouse model. They studied the effects of sleep disruption and sleep deprivation and could later confirm identical changes in man. The observation was that a lack of sleep caused the hematopoietic cells in the bone marrow to proliferate, but the cell diversity was less than in people with normal sleep patterns. The same pattern of bone marrow proliferation was present in mice. This research was published Sept. 21, 2022 in the Journal of Experimental Medicine.

Chronic sleep deficit

A chronic sleep deficit caused chronic inflammation and eventually autoimmune diseases. Again, this was a pattern present in both the mouse model and in humans. Next the researchers observed what happened with sleep recovery. In the past it was assumed that with sleep recovery all of the physical changes from sleep deprivation would disappear. However, the opposite was true: both in mice and in humans the bone marrow stimulation and the lack of cell diversity persisted.

In the mouse model the researchers could show that there were permanent epigenetic changes, which were caused by sleep deprivation. The same is true with humans, but this is more difficult to show than in the mouse model. The researchers came to the conclusion that sleep deprivation stimulates bone marrow maturation, but restricts the clonal differentiation. In doing so the body initiates inflammation, which becomes chronic even with sleep restoration.

Human sleep studies

There were 14 volunteers that were the test subjects. One group was the normal sleep control. The other group underwent chronic sleep deprivation. Each group did this for 6 weeks. There was a 4-to-6-week washout period. Following this the previous normal sleep group started a 6-week sleep deprivation program. On the other hand, the prior sleep-deprived group switched to 6 weeks of normal sleep. All of the participants had daily late afternoon blood tests.

There are many sleep disruptions, which cause a sleep deficit

In modern life sleep gets disrupted in many ways. There can be sleep fragmentation, sleep restriction, jet lag, obstructive sleep apnea (OSA), and insomnia.

People with these conditions often oscillate between these various types. They may have a few days of normal sleep, but then have sleep deprivation again for a few days. Every time they have sleep deprivation the bone marrow enhances hematopoietic activity. Normally there is a high leukocyte number in the blood at the end of the day and in the morning a lower leukocyte count. But with sleep deprivation there is a high monocyte count in the blood that stays high even when subjects switch back to a normal sleep pattern.

Epigenetic effect of sleep deprivation on bone marrow cells

The authors found that sleep deprivation affects the genetic control of hematopoietic cells in the bone marrow. They called this the epigenetic effect of sleep deprivation. This is responsible for the evening leukocyte response, the monocytosis and the tendency for autoimmune diseases. They summed this up by saying: “Our findings support the hypothesis that periods of poor sleep, even if followed by sleep recovery, have sustained consequences on immunological health.”

Lack of sleep harms the immune system and causes inflammation says the literature

There is ample evidence that a lack of sleep causes cardiovascular disease, diabetes, depression and more frequent infections. Healthy sleep is important when you want to age well without complications. But enough sleep is also necessary to prevent obesity, diabetes and cardiovascular disease. Experts consider getting enough high-quality sleep as essential as a balanced diet and regular exercise.

Lack of Sleep Harms Immune System and Causes Inflammation

Conclusion

So far, most researchers believed that when you miss some sleep for a few nights that a afternoon nap or a few nights of longer sleep would compensate for the sleep deficit with no sequelae. Think again, because new research from a group in Boston, MA and New York, NY found that lack of sleep harms the immune system and causes inflammation permanently. Sleep deprivation stimulates the bone marrow cells to multiply and causing proliferation of monocytes, called monocytosis as well. Despite afternoon naps and recovery sleep this condition remains and can lead to autoimmune diseases. All this was unknown up to now. Our bone marrow cells need regular sleep hours to stay diversified and to optimally fight infections in the body. This prevents autoimmune diseases and keeps our defenses against viral diseases strong.

Nov

2022

Poetry Helps Anxiety and Depression

By Ray Schilling | Anxiety, depression, Pain

Recently CNN published an article that stated that poetry helps anxiety and depression. Notably, poetry helps to cope with loss, fear, a marital break-up and helps during loneliness like a quarantine for Covid-19. Certainly, it is because of this that two authors, David Haosen Xiang and Alisha Moon Yi wrote this 2020 review about poetry’s healing power throughout the pandemic. It is important to realize that they conducted poetry classes at Harvard Medical School and Harvard College. In doing this they observed various health benefits from writing, reading and listening to poetry. Indeed, they saw that poetry combatted stress and depression and reduced postsurgical pain. In addition, poetry improved mood, work performance and memory.

Poetry helped hospitalized children

Another key point, a 2021 study involving 44 hospitalized children measured the effects of poetry on fear, sadness, anger, worry and fatigue. By all means, all of these parameters were reduced when the children were reading, writing or listening to poetry. However, one exception was pain in this group of children, which was unaffected by poetry.

Details of the statistical results

To clarify, here are the results of this study in more detail. A statistically significant reduction of symptoms requires a p value of 5% or less. The 44 hospitalized children had a fear reduction with a p value of 2.1%. Exposure to poetry reduced sadness with a p value of 0.4%, anger with 3.9%, worry with 4.1%, and fatigue with 0.1%. As indicated already the only exception was pain reduction, which had a p value of 9.1% meaning that it was not statistically significant. Poetry has the ability to provide comfort and boost your mood when you are exposed to stress, trauma and grief.

Emotional responses elicited by hearing poetry

Poetry can also elicit peak emotional responses. In a study from 2017, researchers examined psychophysiological responses of 27 people. They measured how many people experienced chills or goosebumps when they listened to poetry read aloud. The researchers concluded that physical responses are connect to the rewards-sensing area of the brain.

Pleasure inducing activities can stimulate the reward areas of the brain

The pleasure center consists of the nucleus accumbens, the amygdala and the hippocampus. Together they contain dopamine neurons that communicate with the grey matter nerve cells in the prefrontal cortex. I have discussed this elsewhere in more detail. A pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can all cause dopamine release that the person perceives as pleasure. But so can drugs, smoking cigarettes, drinking alcohol and taking street drugs.

Dr. Amen’s SPECT scans

Dr. Amen is a psychiatrist who specializes in SPECT scan technology. SPECT stands for Single Photon Emission Computerized Tomography. This is summarized in this review. Briefly, a SPECT scan shows where most of the blood flow occurs in the brain. People who abuse drugs or nicotine develop areas that have a lack of perfusion. It looks like holes in the brain as depicted under point 5 of the above link, which can create abnormal thinking patterns. Fortunately, with drug rehabilitation the brain pattern can normalize again.

Discussion of why poetry helps anxiety and depression

It is the excitement of the pleasure centers in the brain that relieves anxiety and depression. It seems to not matter whether we listen to poetry read aloud, read it or create it. But a pleasurable meal, sex, winning a video game, listening to music, earning money and reading a funny cartoon can also release dopamine in the pleasure centres of our brain. Repeated stimulation of the pleasure centers from exposure to poetry seems to be what gives us relief from anxiety and depression.

Xiang and Yi who observed students writing, reading and listening to poetry at Harvard Medical School and Harvard College said: “Whether it is coping with pain, dealing with stressful situations, or coming to terms with uncertainty, poetry can benefit a patient’s well-being, confidence, emotional stability, and quality of life.”

Poetry Helps Anxiety and Depression

Conclusion

Newer research showed that poetry helps anxiety and depression. This is true in university and college students as well as in hospitalized children. One study concluded that poetry seems to activate the rewards-sensing area of the brain. Other studies showed that it is the nucleus accumbens, the amygdala and the hippocampus, which form the pleasure centers in the brain. The psychiatrist Dr. Daniel Amen did detailed studies with SPECT scans where brain changes are made visible. Brain SPECT scans have a similar appearance in people exposed to writing, reading and listening to poetry as people who had a pleasurable meal, sex, were winning a video game, listening to music, earning money or reading a funny cartoon. The common denominator is the release of dopamine from the pleasure centres of the brain.

Oct

2022

Overcoming Grief after a Loss

By Ray Schilling | Anxiety, depression, Mental Health, stress

This article is about overcoming grief after a loss. During the Covid epidemic many people died, which caused a lot of grief among their loved ones. Unresolved grief can cause anxiety and depression. Whenever you have lost a loved one, counseling can help you to continue the grieving process.

Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She published the book “Anxiety-the missing stage of grief” (Hachette Books, 2018). In it she explores the stages of grief and notices that anxiety is very much part of the grieving process. However, this point is often overlooked by mainstream psychologists. Claire Bidwell Smith offers strategies to deal with the loss of a loved one and overcome the anxieties that people often feel as well. Here is a write-up from CNN where Claire Bidwell Smith was interviewed.

Anxiety is a powerful emotion

Anxiety can be very powerful, but it is often mistaken for a physical problem. As a result, people present at the emergency room of a hospital for various symptoms of pain and a myriad of other complaints. After expensive tests the doctor finds no physical abnormality and the diagnosis is anxiety or panic attack. Smith said that 70% of her referrals went to the hospital first and were diagnosed as panic attacks. Patients have a hard time to understand that their anxiety is a direct result of their grieving process.

Relationship between grief and anxiety

CNN asked Smith how grief and anxiety are related. She answered that a sudden death from an infection like Covid makes you realize that we are not safe and are not in control. Everything in your life changes and emotional upheaval is much bigger than ever imagined. Grief, which consists of emotions that accompany a loss of life can force you to kneel down emotionally speaking. This process feeds anxiety. People who grieve the loss of a loved one get anxious about their own health and about the safety of other loved ones. They may not even realize that what they are experiencing is anxiety or that this is related to the grieving process.

Anxiety

Anxiety is a condition that presents with fears and worries. This can present with many different body symptoms. The patient may experience chest pains and think it is a heart attack. But tests are normal and the physician calls it anxiety. Similarly, anxiety can present as stomach aches, headaches or insomnia.

What coping strategies are available?

There are many support groups to help people with anxiety; in addition, grief therapists can help with individual counseling. It may be difficult to motivate the patient to make use of these services. Since Covid you can have access to virtual anxiety support services. It is important that people seek counseling support, as otherwise they get stuck in their anger or guilt. Unfortunately, many people give up and end up in substance abuse. They develop relationship problems and get into trouble at work or in school. So, not seeking support only backfires. Get yourself on a waiting list for a counselor! Work through your grief and you will feel better.

What is your advice to people who resist a formal mental health treatment?

Smith mentioned that there are a lot of self-guided online courses. Also, reading books and articles about grieving are useful, because you get on with your grieving process. Social media is another source for information about the grieving process. It helps you to understand what other people with the same problem experienced and how they overcame it. Having said this, people can develop a full-blown anxiety disorder or clinical depression. In this case they require an assessment by a psychiatrist.

What is the role of meditation and mindfulness in healing anxiety?

Smith pointed out that when we grieve and when we are anxious, we spend time in the past or we worry about the future. Meditation and mindfulness bring our awareness to the present moment. Meditation helps us to focus on our own thoughts. It helps us also to detach from negative thoughts or irrational fears.

Imagination as another powerful tool

Smith explained as an example that she was not there when her mother died in the hospital. When she is overcome by negative emotions regarding this memory, she envisions herself crawling into the hospital bed with her dying mother, holding her and saying good bye to her. Smith admitted that it took her about 5 years before she was ready to do these imagination experiments. By using this imagining tool your present focus is on the now away from negative emotions of the past or fears what the future may hold.

Stories help to reduce grief

How we handled a painful story from the past determines how it influences our daily thinking. Often people do not know how to handle such a story and they tend to suppress it. But psychologists found that it is much healthier to deal with these stories and reframe them. When people find a way how to explore their story, they can reframe it and remove the negative feelings that had an association with it in the past. Healing comes from therapy, from counseling, online grief forums and support groups. There are also grief writing classes where you can rewrite your story experiencing how the past memories become less powerful and the future is brighter.

Stay connected with your lost loved one

It used to be taught that the best therapy would be to “letting go and moving on”. But now psychologists think it is better to move forward with the person you have lost. Specifically, what this means is that it is OK to have an inner talk with the person you lost. Smith added: “For example, pondering: What advice would my dad give me about this job offer? What would my mom think of my new boyfriend?”

The crux of grief work is making meaning out of loss

CNN asked Claire Bidwell Smith whether she quoted Hope Edelman who authored the book “The After Grief”. Hope Edelman said in this book that the “crux of grief work is making meaning out of loss”. Smith’s reply was that this stage develops naturally. But she cautioned that guilt, regret and anger are standing in the way of our ability to make meaning. They have to be dealt with first. This is why counseling, grief work and overcoming guilt and anger are so important.

Overcoming Grief after a Loss

Conclusion

When we lose a loved one or lose our job, we experience a grief reaction. There are powerful negative feelings like anger, guilt and other feelings that make it difficult to overcome our grief. Claire Bidwell Smith is an author of several books and has a master’s degree of clinical psychology from Antioch University in Los Angeles. She was interviewed by CNN regarding her work and her latest book “Anxiety-the missing stage of grief” (Hachette Books, 2018).

Anxiety is an important aspect of grieving

In the interview she explained that anxiety is an important aspect of grieving. But many people go to the emergency room of a hospital, because they think the symptoms, they feel are physical. It is the emergency physician who tells them after several tests that they have anxiety and they need to seek a counselor. After a few months of counseling grieving persons usually feel a lot better. They are now accepting what happened in the past and hope for a better future.

Oct

2022

Plant-Based Meat Alternatives are Healthier

By Ray Schilling | Cancer, Cardiovascular disease, diet, food, Health, Nutrition, Obesity, Weight loss

A recent study showed that plant-based meat alternatives are healthier than the original meat dishes. This spread into various health websites on the Internet. One example is this one.

Some statistics about plant-based meat alternatives

Plant-based meat alternatives came to the market in the 1960’s. At that time, they consisted mainly of soy. Later textured vegetable protein joined soy products. Today they consist of pea protein, soy, potato, oils, various binders and flavorings to mimic the texture and flavor of meat.

The global plant-based meat market was about 5 billion USD last year. It is projected to increase by 19% from 2022 to 2030. The plant-based dairy alternatives market totaled 11 billion in 2020. The estimate is that this will grow to 32 billion in 2031.

How healthy are plant-based substitutes?

In the center of this discussion is the publication of Christopher J. Bryant from the Bath University in England. This publication reviewed 43 studies regarding plant-based substitutes regarding healthiness and environmental sustainability. In the following I am discussing the findings, particularly about health benefit of plant-based foods versus meat-based foods.

Problems with our current food consumption

There are several problems with human diseases that are transmitted from wildlife. HIV arouse from hunting of non-human primates. Rabies was transmitted in South America by vampire bats from cattle to humans. Early cases of severe acute respiratory syndrome (SARS) came from contact with wild life. Finally, bats transmitted the SARS coronavirus-like virus from wild animals and live animal markets to humans. Subsequently human to human transmission caused the spread of Covid all around the world as a pandemic.

Use of antibiotics in feedlots

In order to control diseases in closely kept animal feedlots farmers feed the livestock antibiotics. This helps to contain infections, but it also poses a grave problem to humans as antibiotics become more and more resistant. Superbugs developed this way. 18% of meat imported from China was contaminated with Salmonella. 88% of those exposed to contaminated meat were resistant to at least one antibiotic. But 58% were resistant to multiple antibiotics.

A Harvard study from Boston showed in 2020 that red meat and processed red meat consumption caused 15% more heart attacks compared to those who substituted the protein source with plant-based foods. The same study also noted that the heart attack rates were about 15% less for subjects who substituted meat with plant products in comparison to meat eaters.

Other results of the study

Several of the reviewed studies compared the nutritional profile of plant-based meat with the animal-based counterparts. Plant-based meat was significantly lower in saturated fat, and protein. However, they were significantly higher in fibre and salt. 40% of meat products were classified as ‘less healthy’. In comparison to that investigators assessed that only 14% of plant-based meat was ‘less healthy’. When saturated fat, sodium, sugar, and overall calorie content were tabulated, plant-based meat products compared favorably to meat. But salt content was often too high in plant-derived foods.

Plant-based burgers were much healthier than conventional beef-burgers, as they contained no cholesterol, less trans-fatty acids and less saturated fat. Vegetable-based food that contains pea protein is particularly valuable with regard to a high protein content.

Criticism of plant-based meat alternatives

At the present time many plant-based meat products have too much sugar and salt in it, but lack iron and vitamin B12. Various authors suggested that the food industry should add iron and vitamin B12 to their products and reduce the sugar and salt content.

Muscle synthesis

Mycoprotein is the active biochemical that builds up the protein of the muscle mass in man. Non-animal-derived dietary protein contains ample amounts of mycoprotein according to this publication. These authors investigated the ingestion of mycoprotein in a dose-response manner. They also measured insulin levels for 4 hours after ingestion of plant-derived mycoprotein. Insulin levels remain higher than normal for a sustained period.

Weight loss

A 2017 study showed that 40 grams of mycoprotein, which is the equivalent of 18 grams of protein was sufficient to lead to a robust muscle synthetic response. 60 g of mycoprotein (27 g protein) provided an optimal response regarding muscle synthesis. Gram for gram milk protein and mycoprotein were equivalent in amino acid bioavailability. Several studies examined weight loss following mycoprotein meals. One study found in overweight patients that chicken protein consumption was higher in comparison to consumption of plant mycoprotein. The mycoprotein consuming group chose to eat 10% less calories than the chicken control group.

Greenhouse gas emissions and other factors

The publication cited above also included a lot of findings regarding how plant-derived food saves greenhouse gas emissions and other facts. For instance, the pork supply chain requires 3.3-times more fertilizer and 1.6-times more pesticides than the production of plant-derived food. What this means is that plant-derived foods are more environmentally sustainable than animal products.

Plant-Based Meat Alternatives are Healthier

Conclusion

Plant-derived foods have improved in the past few decades. Pea-derived plant products are now equivalent in terms of protein content to milk and meat. By eating more plant-derived food people consume less meat, which helps the environment, but also benefits the person who eats it. We know that with the consumption of a certain amount of plant-derived food less people develop cardiovascular disease, diabetes and cancer. 40 grams of mycoprotein, which is the equivalent of 18 grams of protein was sufficient to lead to a robust muscle synthetic response.

Consumer beware

It is important to realize that not all is well with the list of “fake meat” and other highly processed plant-based products. Consumers must read the list of ingredients. If a product contains a laundry list of ingredients that not even an adult can pronounce and understand, it is very likely a highly processed food product that only pretends to be good for you. Should the sodium content be too high, steer away from it. High sugar content means that you put it back in the shelf. All in all, eating more plant-derived foods makes you healthier and improves the environment at the same time. But it is up to us to be discriminating colourful advertising from a nutritionally sound product.

Sep

2022

When is Someone at Risk for Suicide?

By Ray Schilling | Anxiety, depression, Drugs, Mental Health, suicide

We are asking ourselves: When is someone at risk for suicide? This year’s National Suicide Week was from Sept. 4 through 10, 2022. Every day of each year it is important to be aware of signs and symptoms of impending suicide. However, the purpose of the yearly National Suicide Week is to really bring it to everyone’s attention how common deaths by suicides are. We all can contribute to improve the situation by increasing our awareness.

Some suicide statistics

In the US alone nearly 46,000 persons died by suicide in 2020. This means that there is one death by suicide every 11 minutes. In 2020 nearly 800,000 died by suicide worldwide. About 1.2 million attempted it. The hope is that the public will learn through education to recognize the signs of an impending suicide. This way the suicidal person can get counselling and hopefully not commit suicide.

Abnormal behaviors to watch out for

People who are getting suicidal may practice with guns, overdosing with pills or handle potentially lethal items. Other behavioral red flags could be giving away cherished items. The suicidal person may sleep too much or not enough. Isolation or withdrawal may be another pointer in a previously sociable person that he or she is becoming suicidal. Revenge thinking, reckless driving, agitation can all be pointers as well that the person is preparing for suicide. Justin Baker is the clinical director of The Suicide and Trauma Reduction Initiative for Veterans at The Ohio State University Wexner Medical Center. He said: ”A lot of times people need to kind of work up to that actual making an attempt because it’s a biologic thing you have to go against, your own survival”.

Watch what people say

When people become suicidal their words often indicate what they want to do. It is a warning sign, if someone is talking about wanting to die, by suicide or otherwise. Some people state that they feel like they have no reason to live. This is an alarm signal that they may be suicidal. Some people say that they feel like they are a burden for the people living around them. Other problematic statements are: “You don’t need me for this anymore” or “I feel like it’d be better if I just wasn’t here.” Someone uttering statements like these should get counseling. This allows them to vent their feelings and to reassess their situation.

Suicide risk factors

Hopelessness: People may express that they feel the future won’t be any better. Or they do not see a way out of the pain that they are in.

Obsession with death and dying: Some people ruminate about dying and they develop a plan what they may want to do to themselves.

Extreme mood swings: When somebody who usually is depressed and stressed behaves calm or cheery, this is an alarm sign that the person may be suicidal. They may have struggled with their decision to kill themselves, but when they accepted that this is what they want to do it calms their mind.

Past trauma: Abuse, trauma and neglect in the past are risk factors for suicide in the future.

Drug abuse: substance abuse predisposes a person towards being suicidal later on in life.

More suicide risk factors

Severe chronic illness with chronic pain: when a person has a chronic illness, and it is difficult to treat, people lose hope and they feel trapped. At this point suicide appears to be an option.

Mental disorders: people with schizophrenia, anxiety, depression or personality disorders are at a higher risk to turn suicidal. This is particularly so when they did not receive treatment and their mental condition deteriorates.

Family history, other factors and teen suicides

Family history of suicide: when there is a family history of suicide or a personal history of failed attempt of suicides the risk of suicide is much bigger than in the general population.

Other factors: There are many more factors that all can have a bearing on the risk for suicide. Financial loss and loss of a job are examples, but also prolonged stress from bullying or harassment. Divorce, breakup of a relationship, insufficient social support and many other negative emotions can contribute to a risk for suicide as well. A lot depends on the emotional make-up and the resilience of a person.

Teens: Teens are particularly vulnerable to commit suicide. It is important to listen to the teen in trouble and to arrange for counseling and support. More on teen suicide here.

What to do when faced with a person who contemplates suicide?

There are several crisis phones that are important to remember. In 2019 congress in the US has proposed to establish crisis lines with a simple 3-digit number: 988. But not all states have this number activated yet. The national crisis line in the US is: 1-800-273-TALK (1-800-273-8255).

In Canada the crisis hotline is: 1-833-456-4566.

There are counselors who have experience in listening to people in distress and talk to them.

When a person wants to commit suicide call 911. Sometimes a person in mental distress needs to be hospitalized and treated by a psychiatrist. Some people may benefit from electroconvulsive therapy, others from antidepressants. Cognitive therapy and behavioral therapy have a place as well in treating depressed patients. Close follow-up is important to prevent a relapse.

When is Someone at Risk for Suicide?

Conclusion

This year’s National Suicide Week was from Sept. 4 through 10, 2022. In the US alone nearly 46,000 persons died by suicide in 2020, nearly 800,000 died by suicide worldwide. It is important to recognize the signs of impending suicide. There are several high-risk factors that point to impending suicide, such as hopelessness, obsession with death and dying and extreme mood swings. There are certain constellations that are associated with a high risk for suicide: a history of a mental disorder, a break-up of a relationship, a severe illness with chronic pain and others. It is important to get the person at risk to a counselor or psychiatrist.

Treatment intervention for suicidal person

By talking it out, the pain of suffering gets eased. If there is an underlying depression it can be treated with various treatment modalities. Cognitive behavior therapy may help to change the negative thought patterns. It is important to intervene early. Close follow-up to prevent a relapse is also important.

Aug

2022

Ultra-Processed Food and Dementia

By Ray Schilling | Alzheimer’s disease, Dementia, diet, exercise, Fitness, food, Nutrition, sugar

Researchers are more and more concerned about an association between ultra-processed food and dementia. A new study found that when you consume more than 20% of you daily food intake as processed food, you can start developing cognitive decline. Eating just 2 cookies per day, which have about 100 calories, will lead to cognitive decline.

What is processed food?

Foods such as instant noodles, hot dogs and ice cream are not healthy. There is too much salt, sugar and unhealthy fat in them that undermine your health. If you consider breakfast granola as “healthy”, you’d better take a look at the ingredients: sugar is one of them! Frozen meals, sugary drinks, take-out pizzas, deep-fried chicken and French fries also belong to unhealthy foods. Unless you buy fresh ingredients and make your own Mediterranean-style meals, you will struggle staying healthy. Processed foods lead to weight gain, which is difficult to shed unless you give up processed food.

Processed food often contains flavorings, colorings or other additives. White bread and bakery products, fried snacks, crackers, cookies, ice cream, candy, cream cheese and processed cheese, soda and frozen meals fall into this category.

Conference in San Diego

At the 2022 Alzheimer’s Association International Conference in San Diego researchers revealed the results of a Brazilian study. 10,000 Brazilians were followed with dietary habits and intermittent cognitive tests for up to 10 years. In the beginning none of the participants had a cognitive deficit. The average age at the time of the beginning of the study was 51 years. When you eat more than 20 % ultra-processed food of your total calorie intake every day, cognitive decline is showing up on the cognitive tests. Specifically, patients who consumed more than 20% calories from ultra-processed food developed 28% faster decline in cognitive tests. They also developed 25% faster decline in executive functioning.

Comment from a co author

Co Author Dr. Claudia Suemoto, an assistant professor in the division of geriatrics at the University of São Paulo Medical School stated: “In Brazil, ultra-processed foods make up 25% to 30% of total calorie intake. We have McDonald’s, Burger King and we eat a lot of chocolate and white bread. It’s not very different, unfortunately, from many other Western countries”. She went on to say: “58% of the calories consumed by United States citizens, 56.8% of the calories consumed by British citizens, and 48% of the calories consumed by Canadians come from ultra-processed foods”. She expressed her concern that these statistics show that many more seniors than now will develop Alzheimer’s disease. In the Brazilian study researchers followed their subjects for up to 10 years. After decades of exposure to ultra-processed food the numbers of people with cognitive deficits and Alzheimer’s disease will be much higher.

Other means to prevent cognitive decline

A study showed that regular aerobic exercises (running, treadmill, walking) or stretching, balancing and range of motion exercises both prevented cognitive decline. The best is to build some form of exercise into your daily routine. This is particularly important for people who have desk jobs.

What are healthy foods to eat?

We need to eat more vegetables, fruit and cut out sugar, omit too many starchy foods, salt and unhealthy fats. So, how does that work? In the following I am giving examples of a healthy breakfast, lunch and dinner.

Breakfast

Start the day with fresh fruit, a bowl of rolled oats with milk or a milk alternative. Add a few almonds or chopped nuts or ground flaxseed. You could add raspberries, blackberries, strawberries or blueberries.

If you want a breakfast with egg, try an omelet with eggs or egg white with mushrooms, onions and chopped greens! No, it does not always have to be kale! Enjoy arugula or spinach. Add some salsa on the side.

For those who hate to prepare breakfast, take it easy: put 1/2 a banana, a cup of berries, 1 tablespoon almond butter and 3/4 cup of low-fat yoghurt into the blender. Blend at high speed. This takes less than 2 minutes. Enjoy! It does not get much easier than that.

Lunch

Assemble some mixed salad greens, 1 sliced tomato, 1 cup of sliced cucumber, half a sliced avocado and 1/2 shredded carrot on a plate or in a bowl. Add 2 slices of cheese or 2 tablespoons of crumbled feta cheese. Add one boiled and sliced egg or alternatively 4 slices of chicken breast. Make a dressing of 2 tablespoons of olive oil and 1 tablespoon of balsamic vinegar. You can prepare this easy lunch the evening before and take it to work.

If you want a warm lunch, cook a simple Italian-style vegetable soup. Sprinkle it with a tablespoon of grated parmigiano cheese and serve it with a slice of whole-grain bread. A vegetable chili is a good choice for a colder day. Have some fresh fruit for dessert.

Dinner

Make vegetables the main event. Do not have a huge steak with an afterthought of vegetables, but build a tasty meal around vegetables with a protein of your choice: lean meats, such as chicken breast, enjoy fish or other seafood or experiment with other protein sources, such as tofu. The latter works well in an Asian-style vegetable stir-fry. And otherwise: breaded and deep-fried chicken or battered fish are not healthy choices, even if you prepare the meal at home! Forget the breading and dip the meat into a tasty marinade instead! If you want to have a quick dessert, make a colorful fruit salad with a dollop of yoghurt on top. For all those who drool over a decadent dessert in a restaurant, go ahead and order that Tiramisu and share it with others of your party. But it should be an exception rather than a regular treat.

Ultra-Processed Food and Dementia

Conclusion

Researchers are more and more concerned about an association between ultra-processed food and dementia. A new study found that when you consume more than 20% of you daily food intake as processed food, you start developing cognitive decline. Eating just 2 cookies per day, which have about 100 calories, will lead to cognitive decline. It is fairly easy to cut out junk foods from your diet and to adopt healthy eating ha its.

Meal suggestions

Start the day with fresh fruit, a bowl of rolled oats with milk or milk alternative. Add a few almonds or chopped nuts or ground flaxseed. You could add raspberries, blackberries, strawberries blueberries. I sweeten everything with stevia extract and avoid sugar completely. For lunch you could have mixed salad greens with 2 slices of cheese or 2 tablespoons of crumbled feta cheese. Add one boiled and sliced egg or alternatively 4 slices of chicken breast. For dinner make vegetables the main event. Do not have a huge steak with an afterthought of vegetables, but build a tasty meal around vegetables with a protein of your choice: lean meats, such as chicken breast, enjoy fish or other seafood or experiment with other protein sources, such as tofu.

Final remark

You see, it is fairly easy to avoid ultra-processed foods that lead to cognitive decline. It involves a critical look at your current eating habits and very likely some cleaning-out of less than desirable foods from your pantry.

Aug

2022

New Immunotherapy Approach against Cancer

By Ray Schilling | Cancer, immune system

A recent publication reported about a new immunotherapy approach against cancer. The model it dealt with was a very vicious brain cancer with the name glioblastoma. The results of this research were subsequently transferred to another vicious cancer, osteosarcoma, which is a form of bone cancer with a very poor prognosis. Researchers have to do further clinical experiments to establish this new immunotherapy in osteosarcoma patients. Physicians completed the following experiments and clinical studies.

Oncolytic virus Delta-24-RGD can lead to remission in glioblastoma patients

Researchers at the University of Navarra, Pamplona, Spain together with The University of Texas MD Anderson Cancer Center in the US investigated glioblastoma patients. They found that treatment of glioblastoma patients with oncolytic viruses Delta-24-RGD led to a greater than 3-year remission in 20% of cases. Normally, patients with a glioblastoma survive only 9 months on average. 12% had a greater than 95% reduction in the size of the tumor. This was a phase 1 clinical study with 37 patients who had recurrent malignant glioblastoma. The authors said: “Oncolytic adenoviruses are attractive therapeutic agents because they can kill tumor stem cells and induce cell death by several mechanisms, including direct lysis, expression of toxic proteins, induction of cytokines, and T-cell–mediated immunity.” The particular oncogenic virus that the researchers used was an adenovirus Delta-24-RGD.

Transferring glioblastoma results to a cure for osteosarcoma

The same researchers wanted to see whether the cure rates of treating patients with glioblastoma was transferable to other cancer patients. In particular they were interested in patients with osteosarcoma, which is a similarly vicious cancer. Advanced osteosarcoma has a survival rate of 27% after 5 years. The researchers first did experiments with a human osteosarcoma cell line in tissue culture and at the same time a murine osteosarcoma cell line. Later they tested the action of oncolytic viruses Delta-24-RGD in a mouse model.

Experiments with osteosarcoma cells in tissue culture

The advantage of such experiments is that you can control all the parameters easily in a Petri dish. But critics say that this is far removed from osteosarcoma behavior in humans. Researchers found that the oncolytic virus Delta-24-RGD killed many osteosarcoma cells in vitro. They also were able to insert a new gene into the oncolytic virus, which was equally effective in killing osteosarcoma cells. They called this virus Delta-24-ACT.

Curing osteosarcoma in a mouse model

Next the researchers tested effectiveness of the oncolytic viruses, Delta-24-ACT and Delta-24-RDG in mice. They injected osteosarcoma cells from tissue culture into the tibia of mice. Tumor growth was subsequently measured. The experimental groups were given two oncolytic virus infections, the control group did not. On day 10 and 18 the researchers could see that controls had faster growing tumors compared to the experimental groups. The experimental groups had less tumor side effects. And the experimental mice survived longer than the controls. Further research showed that the oncolytic viruses produced a 4-1BBL protein, which stimulated the animals’ immune system to fight the osteosarcoma.

New immunotherapy approach against cancer: Effector T cells

Researchers could prove that in mice treated with oncolytic viruses it was the special protein (4-1BBL) that stimulated T lymphocytes to become killer T cells. They in turn attacked the osteosarcoma cells.

New immunotherapy approach against cancer: The need for human research

Doing research in humans is more complicated than in a mouse model. But in order to improve survival rates in patients with osteosarcoma human research is absolutely essential. However, research is complex and the effects of oncolytic viruses is only in the 20% range with regard to increasing survival. This requires more research. It may be that instead of oncolytic viruses a stimulatory protein would arm T cells to become killer T cells that fight the cancer.

New Immunotherapy Approach against Cancer

Conclusion

Glioblastoma patients had a better survival after treatment with oncolytic viruses Delta-24-RGD. Researchers translated this type of research to another cancer, osteosarcoma. This also has a poor prognosis, Researchers did experiments in tissue culture and in a mouse model. They were able to show that oncolytic viruses produced a 4-1BBL protein, which stimulated the animals’ immune system to fight the osteosarcoma. Specifically, the protein armed T lymphocytes and turned them into killer T lymphocytes. These destroyed osteosarcoma cells in tissue culture or in the mouse model. It is encouraging to see positive results in a laboratory setting of a tissue culture. The step further in an animal experiment is also a positive achievement. More research will improve the cure rates of osteosarcoma. The effective treatment of osteosarcoma in humans is still far away! The next step is human research that shows improvements in patients’ survival rates.

Jul

2022

What Electronic Cigarettes Do to You

By Ray Schilling | e-cigarettes, heart attack, Lung Disease, Prevention

A review paper of Canadian researchers showed what electronic cigarettes do to you. They can be an effective smoking cessation aid for motivated smokers who eventually want to quit. But when people continue to inhale electronic cigarettes, their use can cause heart attacks, strokes, high blood pressure and increased heart rates. With regard to the lungs electronic cigarettes can cause vaping-associated lung disease, obstructive pulmonary disease, asthma and chronic cough. A literature review showed that e-cigarettes are less harmful to the heart and the lungs than smoking combustible cigarettes.

Increased use of e-cigarettes in younger people

In Canada the 2017 Canadian Tobacco, Alcohol, and Drugs Survey, which included all ages, found that 15.4% tried e-cigarettes. But among adolescents between 15 to 19 years old 22.8% were using e-cigarettes. For young adults aged 20 to 24 the figure of e-cigarette users was 29.3%. In addition, there was a significant increase of Canadian adolescents aged 16 to 19 from 29.3% in 2017 to 37.0% in 2018. Data from the US shows similar trends. E-cigarette use among US high school students increased from 11.7% in 2017 to 27.5% in 2019.

Some facts about e-cigarettes, cigarette smoking and smoking cessation

First, researchers noted that the smoking of e-cigarettes has a 3.62-fold risk of leading to subsequent cigarette smoking.
Second, a UK study found that when people used e-cigarettes for smoking cessation, 80% of the e-cigarette group were still smoking e-cigarettes after 1 year. In contrast, only 9% of those who used traditional nicotine replacement therapy (Nicorette etc.) to quit smoking were still using nicotine replacement after 1 year.
One study compared heart attack rates in a group of regular cigarette smokers and compared this to e-cigarette smokers. Cigarette smokers had a 2.72-fold higher heart attack rate than non-smokers, while e-cigarette smokers had a 1.79-fold heart attack rate compared to non-smokers.

Effect of e-cigarette use on heart and lung disease

Several studies looked at the relationship between e-cigarette use, heart attacks and strokes. There was a 1.4-fold higher incidence of coronary artery disease in e-cigarette smokers in comparison to non-smokers. The e-smokers had a 1.71-fold higher stroke incidence and 1.59-fold higher heart attack rates. In a large metaanalysis done with e-cigarette smokers, researchers noted the following facts: Electronic cigarette smokers were compared to non-smokers. Researchers noted a 2.27-fold increase of the heart attack rates in e-cigarette smokers. There was a 2-fold elevation of the systolic and diastolic blood pressure in e-cigarette smokers.

Switching from cigarette smoking to e-cigarettes

Patients who switched from tobacco smoking to chronic electronic cigarette use had a 7-fold reduction of their systolic blood pressure and a 3.65-fold reduction of their diastolic blood pressure. The researchers concluded that switching from cigarette smoking to e-cigarettes had some merit in terms of risk reduction for cardiovascular disease. But the final judgment on this is still pending. Certainly, quitting entirely from cigarette smoking is the best choice. I reported previously that e-cigarette smokers find it difficult to quit completely and if they smoke conventional cigarettes to stop that.

Effect of e-cigarettes on lungs

In addition to cardiovascular effects there is a direct effect from e-cigarette smoking on the bronchial tubes and the lungs. The vaped substances from e-cigarettes contain a lot of noxious gases that irritate the lining of the respiratory tract. This syndrome is called EVALI (electronic vaping associated lung illness). In 2019 and 2020 there was a rush of EVALI cases in the US with 2807 hospitalizations and 68 deaths. In Canada there were 19 cases of EVALI, 15 hospital admissions, and no deaths. Patients with EVALI have problems breathing, they cough and they have chest pain. Researchers suspect that vitamin E acetate and tetrahydrocannabinol are the major culprits that cause EVALI. But at this time there is no definite proof for that.

Poor quality of vaping fluid from the black market

These substances are not present in commercial e-cigarettes, but when you buy vaping fluid on the black market, it is often mixed in. Prolonged use of e-cigarettes can cause changes on spirometry, such as chronic obstructive pulmonary disease (COPD). Chronic use of e-cigarettes may cause premature onset of COPD.

What Electronic Cigarettes Do to You

Conclusion

E-cigarette use is increasing at an alarming rate among youths and persons who never smoked. The emerging evidence from researchers showed that there is a risk when you expose yourself to the smoke of e-cigarettes. There is an association of both heart disease and respiratory disease to e-cigarette smoking, but the risk is less than with exposure to regular cigarette smoke. Some researchers think that a switch from cigarette smoking to e-cigarettes could provide a viable harm reduction strategy for some smokers. But unfortunately, many continue to smoke e-cigarettes instead of quitting altogether. And in this case the risks for heart disease and lung disease remain!

Jul

2022

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

By Ray Schilling | Arthritis, back pain, chronic pain, osteoarthritis, Pain, regenerative medicine, stem cells

Traditional treatment for osteoarthritis is not very successful, but stem cell therapy is a new way to treat osteoarthritis.

Traditional treatment of osteoarthritis

Osteoarthritis is a common degenerative type of arthritis. Wear and tear are diminishing the hyaline cartilage that coats joint bones. The lubrication of synovial fluid is diminishing as well. The end result is that the patient suffers pain from bone rubbing on bone in affected joints with swelling of the synovial membranes. The physician usually prescribes diclofenac topical solution for the affected joints and also gives anti-inflammatory drugs by mouth (diclofenac or ibuprofen). Unfortunately, the patient may develop side effects of the anti-inflammatory medication, such as kidney damage and gastritis. The end result after years of suffering is that the joints turn stiff and the joint pain becomes unbearable.

Joint replacement surgery

This is when the doctor refers the patient to an orthopedic surgeon, and an artificial hip or a knee joint replacement is the next suggestion. These surgical procedures are not without dangers. Postsurgically blood clots can develop and cause pulmonary emboli. Infection and sepsis can also develop. Often the surgery does not solve all of the problems and leaves the patient with a permanent limp.

Stem cell therapy to treat osteoarthritis

Regenerative medicine has developed an alternative to the conventional treatment of osteoarthritis. I described this new approach to osteoarthritis before here.

Stem cells are harvested from fatty tissue of the patient and injected into the affected joint. Stem cell stimulators like platelet rich plasma and low-dose laser therapy activate the stem cells that were lying dormant in the fatty tissue. These type of stem cells are mesenchymal in origin, so they go by the name of mesenchymal stem cells. When injected into a joint with osteoarthritis they can transform into any tissue that is needed to repair the damage of the joint. A defect of the hyaline cartilage is covered by stem cells transforming into cartilage cells and fixing the hyaline cartilage defect.

What stem cells do

Stem cells fix any meniscal degeneration in the knee joint by mending what is degenerated. They can form new tissue that over-bridged mini tears in the meniscus. If the synovial membranes that produce joint lubrication are damaged, the stem cells rejuvenate the old tissue and joint lubrication normalizes. The end result following stem cell treatment is that the osteoarthritic joint becomes regenerated with normal function. Stem cell treatment normalizes the osteoarthritic process in the joint, and down the road no joint replacements are necessary. This is a huge advantage in comparison to the conventional treatment of osteoarthritis.

My own experience with stem cell therapy for osteoarthritis of my left knee

I have experienced mild left knee arthritis for 5 years. It was not severe enough to treat with anti-inflammatory pills. I used higher amounts of fish oil capsules, which helped somewhat. I heard that Dr. Michael Weber from Lauenförde, Germany treats osteoarthritis with stem cell therapy.

He had treated my back successfully on several occasions in the past. I had previous stem cell treatment 4 years earlier as summarized here. Part of this was stem cell therapy for my left knee. During the Covid time I could not go to the gym for a period of time. Instead, I went for long walks on a nature trail that was bumpy and had many roots. This flared up my previous problem with my left knee. But in early June 2022 I made my way back to Dr. Weber’s clinic for more stem cell therapy.

The following summarizes how he treated my left knee with stem cells.

Liposuction to harvest stem cells for treatment

The doctor used a local anesthetic to freeze the skin and subcutaneous tissue on the right flank. Subsequently a solution of normal saline that contained adrenaline and bicarbonate was injected. This allowed Dr. Weber to withdraw fatty tissue easier 20 minutes after the normal saline injection. The generous portion of fatty tissue harvested was brought to a cell separator, which separated stem cells, fat cells and connective tissue. The stem cells were counted by a technician. They were found to be 100% viable and there was a total of 980 million stem cells.

Intravenous stem cells

Dr. Weber administered one portion of the total stem cell harvest intravenously. I was told that this ensured that stem cells would be delivered to tissues that needed renewal through stem cell therapy. There are several methods to stimulate stem cells. One of these methods is to give oxygen intravenously with a device with the name Oxyven (from Swiss Medica) . This procedure took 20 minutes. A second method to stimulate stem cells is with low-dose laser therapy. Dr. Weber used intravenous red, green, blue and yellow lasers, for 20 minutes each.

The laboratory kept the rest of the stem cells overnight at room temperature. Dr. Weber told me that it would have been a mistake to keep the stem cells in the refrigerator overnight as the cold temperature kills all of the stem cells!

Targeted stem cell therapy

The following day I received treatments with my stem cells harvested the day before. The doctor drew blood up first, which underwent centrifugation. The interface between the red blood cell portion and the plasma contains PRP (platelet rich plasma). Dr. Weber mixed PRP in with the stem cells. PRP is a powerful stimulator of stem cells.

Dr. Weber inserted a needle into my left knee and injected stem cells (and PRP) into the left knee. Following this he inserted a thin sterile fiberglass applicator. This served to introduce four laser lights into the knee, namely red, green, blue and yellow low-dose laser beams. Dr. Weber connected each for 20 minutes. He explained that the laser light activates the stem cells, similar to PRP and to oxygen (Oxyven, Swiss Media).

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

I get monthly chiropractic manipulations to my spine to stabilize it. My chiropractor told me that it would help to have stem cell therapy in the C4 to T4 area of the upper spine and in the L4 to S1 region in the lower spine. Dr. Weber concentrated his treatments on exactly these levels of my spine. He placed interstitial needles over the facet joints bilaterally in the lower cervical spine, upper thoracic spine and lower lumbar spine. Subsequently he injected the stem cell/PRP mix and followed this up with the four laser lights for 20 minutes each.

Follow up after the stem cell treatments

There was a lot of swelling in my left knee during the first two days after the stem cell treatment. I also experienced pain with walking. But on the third day the swelling disappeared completely. After 1 week the previous mild left knee pain improved significantly. After 1 month the left knee no longer ached with stairs or uneven ground. Presently I am still completely pain-free. My back pain also disappeared within 2 to 3 weeks.

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Conclusion

When it comes to the treatment for osteoarthritis, conventional medicine offers topical and oral anti-inflammatory medicine. Usually, the physician also recommends active exercises and heat applications by a physiotherapist. When anti-inflammatories no longer work and bone rubs on bone in a hip or knee joint, total hip or total knee replacement by an orthopedic surgeon is usually the next step. Unfortunately, these surgical procedures have a certain complication rate. They often do not lead to perfect end results with residual pain and possibly a limp

Stem cell therapy is usually not what a family practitioner recommends. But when the physician does stem cell therapy at an early stage, the success rate is good and as in my case you can always do another stem cell therapy to improve the knee or hip joint further. There are three procedures that help to stimulate stem cells: platelet rich plasma (PRP), intravenous oxygen (Oxyven, Swiss Media) and low-dose laser activation. In my case Dr. Weber applied all of these methods together with stem cell therapy. Improvement in my case was very rapid, and it was a delight to witness the result of stem cell therapy as a patient.

Jul

2022

Can Surgery Help with Snoring?

By Ray Schilling | Insomnia, sleep, Sleep apnea

Snoring is a common problem in people, and so the question is: can surgery help with snoring? About 25% of adults snore regularly, 45% snore occasionally. You are more likely to snore when you are overweight. Other factors are being a middle-aged or older male or a postmenopausal woman. Over the last decades various surgical procedures were in development in an attempt to cure snoring.

Obstructive sleep apnea

A person with obstructive sleep apnea has a problem of a relaxed rooftop in the mouth, where the uvula drops down. At the same time the tongue is falling backwards and together with the relaxed rooftop this leads to intermittent obstruction of the airway. The end result is loud snoring, which can lead to intermittent cessation of breathing. A positive pressure device is a common remedy for this condition, which keeps the airway open during your sleep. It is called continuous positive airway pressure (CPAP). However, this system is somewhat noisy, and about 50% of patients find it disturbing and cannot tolerate it. Many patients prefer a surgical, permanent solution.

Classification of snoring

Most snorers have primary snoring. Among these patients there is a minority who stop breathing periodically, which lowers the blood oxygen content. The patient awakes from this and tightens the muscles in the palatine-pharyngeal area and then breathes normally again for a while. These patients have obstructive sleep apnea (OSA). However, when deeper sleep is reached in OSA patients the cycle repeats itself. A clinical test how to distinguish between primary snoring and OAS is a polysomnography study, which also goes by the name of a sleep study.

Uvulopalatopharyngoplasty

This sounds like a tongue twister! In lay terms it is a surgical procedure which removes the uvula and the adjacent tissues of the palate and throat walls. There are side effects like swallowing problems, throat changes and the permanent feeling of a foreign body in the throat. Since the original design several modifications were introduced, which reduce the side effects of this procedure, but do not entirely eliminate them.

Somnoplasty or radiofrequency ablation

For patients with primary snoring, who do not have OSA a new procedure utilizes low levels of radiofrequency heat energy to create finely controlled localized burns in the lining of the soft tissues of the palate. This tightens the palate tissue and avoids the vibrations that cause snoring. The procedure can be done in the office setting under local anesthetic. It takes only about 30 minutes. When researchers compared pre-treatment scores with scores after three years following two ablation radiofrequency treatments there was a significant reduction of the snoring activity. Somnoplasty is another name for the FDA approved ablation radiofrequency treatment. This treatment works well for patients with primary snoring, but is not so successful for patients with OSA.

Maxillomandibular advancement (MMA)

The physician orders this fairly invasive surgery for patients with OSA who cannot tolerate continuous positive airway pressure. The goal of the surgery is to remove the two obstruction points where the patient chokes at night. This occurs most often behind the palate and behind the tongue. MMA was introduced more than 35 years ago. On the plus side, the success rate is about 90%. The minus side is the fact that it is major invasive surgery where the surgeon moves both the upper and lower jaws forward opening up the two choke points in the back. The surgery lasts about 6 hours and it takes approximately 6 weeks for it to heal.

Hypoglossal nerve stimulation

An alternative for patients with moderate to severe OSA is the use of hypoglossal nerve stimulation. Patients with OSA have a weakness in the muscle tone of the muscles that push the tongue forward. When they fall asleep the tongue tends to fall backwards obstructing the airways. This can be remedied with the use of hypoglossal nerve stimulation that stimulates the muscles that push the tongue forward.

Results with hypoglossal nerve stimulation devices were encouraging, as more than 80% of patients with OAS who had this device inserted had a successful treatment outcome. 4 years later, in the same patients there was still effectiveness of the hypoglossal nerve stimulator and the improvement in quality of life remained the same.

Can Surgery Help with Snoring?

Conclusion

There are several procedures that can help patients with primary snoring or patients with an obstructive sleep apnea (OSA). For patients with primary snoring, who do not have OSA a new procedure utilizes low levels of radiofrequency heat energy to create finely controlled localized burns in the lining of the soft tissues of the palate. This tightens the palate tissue and avoids the vibrations that cause snoring. In patients with obstructive sleep apnea a continuous positive airway pressure device (CPAP) is a common remedy for this condition, which keeps the airway open during their sleep. But only about 50% of patients tolerate this procedure.

More surgical procedures

The uvulopalatopharyngoplasty can help a certain number of patients. Here the ear/nose/throat surgeon removes the uvula and the adjacent tissues of the palate and throat walls. The surgeon does this under general anaesthesia, and patients will take about two weeks to fully recover. Another more invasive procedure is the maxillomandibular advancement (MMA). The goal of the surgery is to remove the two obstruction points where the patient chokes at night. This occurs most often behind the palate and behind the tongue. The surgical procedure is in use for more than 35 years and the success rate is about 90%. However the surgery will take several hours, and recovery of the patient will take about 6 weeks.