[COLUMN] OSA & elixir of life

MY wife, Farida, and I have just been on a river cruise on the Vikings to historic Rouen, Omaha Beach, Normandy, Amsterdam, Belgium, and Paris, where the Faculty of Medicine at the University in Paris-Cite conducted valuable research on the effects on the brain of snoring with Obstructive Sleep Apnea (OSA) (prolonged breath-holding while asleep), with the following findings:

  • “Those who snore can be aging their brains by years and hurting their brain health by depriving themselves of oxygen and getting deep sleep. Loud snoring and obstructed breathing, often caused by sleep apnea, can lead to higher chances of stroke, Alzheimer’s disease, or overall cognitive decline:
  • Deep sleep is one of the best indicators of sleep quality and the study found that for every 10% decrease in deep sleep, the white matter hyperintensities increased, equivalent to the brain aging 2.3 years.
  • The same 10% reduction of deep sleep was also associated with reducing the integrity of axons, and that decrease was similar to the effect of the brain appearing 3 years older.”

These findings were published in Neurology on May 10, 2023.

CPAP versus Inspire

The gold standard in the management of Obstructive Sleep Apnea is called CPAP (Continuous Positive Airway Pressure) therapy, using a CPAP machine to force air into the airway (inflating the throat area) to keep it open (unobstructed by a flimsy soft palate, uvula, and the tongue), allowing the person to breathe normally, getting enough oxygen into their lungs. The dangerous breath-holding could occur dozens, or even more than a hundred, each night. CPAP induces good restful sleep, reduces tiredness, accidents due to sleepiness, and lowers the risk for heart attack, stroke, dementia from insufficient oxygenation.

The principle of CPAP was introduced in 1912, using positive pressure during lung surgery. It only became popular in 1965, since Obstructive Sleep Apnea was first recognized as a disease entity. There are about 936 million adults in the world with OSA. It is now used by at least 33 million people in the USA, including President Biden, Supreme Court Justice Antonin Scalia, Shaquille O’Neal, William Shatner, Toni Robins, Randy Jackson, Regis Philbin, etc.

In 2014, The U.S.-FDA approved a surgically implanted device called Inspire. It works by electrically stimulating the hypoglossal nerve (tongue) to keep it from falling back and blocking the airway, which is also accomplished by CPAP with inflation using positive pressure air, without surgery.

Inspire is used only as an option for those who cannot tolerate CPAP because of the original full facemask used, but today there are comfortable nasal pillows and nasal masks that do not cover the whole face. CPAP is more consistent in its performance, compared to Inspire’s 70-80 percent success rate.

Beware of media Ads conveying half-truths. Always do due diligence. Dr. Google is on duty 24/7.

MedWalk and brain health

A healthy diet, in this case, the Mediterranean Diet, and active lifestyle, like walking daily, lowers the risk of dementia (7th leading cause of death) and cognitive impairment. A combined study, called “MedWalk,” that was just completed in 2023, revealed following a MedWalk program diligently could reduce Alzheimer’s dementia and decline in cognition.

These findings are so far as important to the whole world, where there are 55 million cases of Alzheimer’s, about 10 million a year, or one case every 3.2 seconds. The prevalence: Finland has the highest (54.56 cases per 100,000 population), United Kingdom (42.70), the U.S. (33.26, currently 6.7 million cases), and the Philippines (10.6 per 100,000, currently about 1 million cases).

The M-Diet

The diet based on the historic eating habits of people who live around the Mediterranean Sea, which the American Heart Association recommends for cardiovascular health, features the following: High intake of vegetables, fruits, whole grains, beans, and legumes, low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts; consume limited added sugars, stay away from sugary beverages (soft drinks), high sodium, highly processed deli foods, refined carbohydrates, saturated fats, and fatty or processed meats.

The Harvard School of Public Health emphasized the importance of healthy fats, like olive oil, nuts, avocados, and oily fish (anchovies, herring, sardines, mackerel, salmon, stripe bass, black cod, blue-fin tuna, cobia, for brain-healthy omega-3). It advises the public to eat red meat only occasionally, and get their protein from fish, seafood (at least two times a week), and small amounts of poultry, eggs, and dairy.

The main source of liquid should be water, and, as per the traditional Mediterranean Diet,

a small glass of red wine, with lunch and dinner is fine. All the above should be paired with daily physical exercises, like brisk walking as the basic, and an overall wholesome lifestyle and behavior; no smoking, no alcohol abuse, or use of illicit drugs.

The M-Diet has been associated with great benefits to cardiovascular and brain health. The 7-country study revealed that dietary patters in the M-Diet, and in Japan in the 1960s, these diet patterns were shown to lower the rates of coronary artery disease and all-cause mortality.

A meta-analysis of several independent studies posted in March 2023, with a pooled sample of more than 70,000 female volunteers, has found that, by adhering closely to a Mediterranean Diet, women reduced their risk of cardiovascular diseases by 24 percent and their risk of death from any cause by 23 percent. Women are more compliant with diet instructions than men, the reason the studies chose women as their subjects.

The fable that the Spanish explorer Ponce de Leon, who died at age 47 from an Indian poison arrow, was searching for the “elusive” Fountain of Youth for decades around the world in the mid-1500 has been debunked. Anyway, that “phantom rejuvenating spring,” the “elixir of life,” has always been here: Its called “a healthy lifestyle.”

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The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.

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The opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of the Asian Journal, its management, editorial board and staff.

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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, Health Advocate, newspaper columnist, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. He was a recipient of the Indiana Sagamore of the Wabash Award in 1995, conferred by then Indiana Governor, later Senator, and then presidential candidate, Evan Bayh. Other Sagamore past awardees include President Harry Truman, President George HW Bush, Muhammad Ali, and Astronaut Gus Grissom (Wikipedia). Websites: FUN8888.com, Today.SPSAtoday.com, and philipSchua.com; Email: [email protected].


Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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