Do you know if you, your spouse, or your loved ones snore when they are sleeping? If you do, you're going to want to listen to this podcast on critical next steps! Dr. Gene Sambataro has been practicing dentistry for over 40 years and he strives to educate his patients on dental treatments to avoid due to toxins and how the mouth can be an indicator of breathing problems, which results in snoring. Snoring could be an indication of airway obstruction in sleep apnea, and depending on its severity, one can be one breath away from a heart attack. Listen to Mollie and Dr. Sambataro’s conversation on the relationship between mouth, jaw, breathing, and sleep conditions, followed by options and tips to address these issues!
BIO:
Dr. Gene Sambataro has been practicing dentistry for over 40 years with special interests in orthodontics, dental orthopedics, temporomandibular joint disorder, sleep-disordered breathing, and implantology. He graduated from the University of Maryland School of Dentistry in 1980 and soon after started incorporating a more holistic approach to his practice.
Dr. Sambataro strives to educate his patients on how they can make healthier decisions in their lives, as well as sharing his knowledge around toxic-free dentistry, which avoids mercury amalgam fillings, fluoride, and toxic root canals. Nearly 80% of all illnesses can be connected to infections, toxicities, and imbalances in the mouth, which is one of the reasons he is so passionate about practicing Biological (or Holistic) Dentistry.
A few of his affiliations include the Academy of General Dentistry, the American Academy of Dental Sleep Medicine, the International Academy of Biological Dentistry and Medicine, the Holistic Dental Association, and the International Dental Implant Association. He is also a Board Member for the Maryland Society of Integrative Medicine and the author of “Stop the Snore, Dental Solutions to Healthy Sleep.”
EPISODE LINKS:
drsam@julianctr.com
IG: Biohackingbiologicaldentist
Twitter: DrSambataro
Facebook: blkbeltx4@aol.com
LinkedIn: drsam@julianctr.com
SHOW NOTES:
🦷Gene’s Introduction: From Dentistry to Sleep Biohacking
🦷Healthy Start Program: Teaching People How to Sleep Properly and Treating Two-Year-Olds
🦷What Does Dentistry Have To Do with Sleep Apnea?
🦷Snoring and Sleep Apnea Stigma and Denials
🦷The Correlation of Jaw Structure and Airway Obstruction
🦷How To Find Out if You Snore when You Live Alone?
🦷Sleep Apnea and Heart Attack
🦷Four Things To Look At When Doing At-Home Sleep Test
🦷How To Reach Out to Your Dentist To Treat Sleep Issues
🦷C-PAP Machine is the Gold Standard
🦷Four Options to Improve Your Airway
🦷Why We Did Not Get Proper Growth and Development?
🦷Jaw Expansion Can Be Done in Adults
🦷Lifelong Correction Vs Lifelong Commitment
🦷Gene’s Sleep Supplements and Devices: Russia Machine, Healey, and Others
🦷How Does Your Body Releases Peptide to Stimulate the Kidney When You Are Not Breathing Properly
🦷Gene’s Sleep ‘Aha’ Moment: Sleep Environment and Body Temperature
🦷How To Reach Out For More Information: drsam@julianctr.com
QUOTES:
“There's no excuse for that because we have so much knowledge now it's not worth the risk. Somebody might say, well, okay, well-developed diabetes. I'll deal with that. When I get it, when you may not get a second chance, this might be the only chance you have. So that's why I'm so adamant about it.”
Hi, welcome to the sleep is a skill podcast. I am just ecstatic to get into this conversation today. I had the opportunity, to kind of go back and forth with Jean beforehand. And there is just so much that we've got to get into and I have a personal connection because he is actually the father of a good friend of mine. Renee Bell's a, one of the biohacker babes, so I just cannot wait for this conversation. I've been looking forward to this. Calendar. So thank you so much for taking the time. Oh, thanks for the invite. I think this is a great opportunity to share with your audience. So, and I've been listening to your podcast. I'm becoming a fan. You're doing a great job for this, um, little area that's been not touched on for really a long period of time. And I think it really needs to be emphasized. So thank you for taking a step forward in creating such a great podcast and information. Thank you so much for saying that. And, as I shared with you, I, you know, I still have some cringe factor of some of my early podcasts as I'm starting to, you know, get more and more comfortable in this arena, but you gotta do what you gotta do to get the, this information out. And I really appreciate the shared enthusiasm on this topic. It's changed my life and, the lives of so many of my clients. So I'm excited to hear more, uh, because I know you have a passion for this and that you have been a trailblazer. We were just speaking beforehand. You were, you were playing with HRV back in the early. The nineties before so many people even knew and it's still so many people don't really know what some of these metrics are, but you were doing this way back when, so I would like to turn the spotlight on to you and just have you share a little bit about your story, um, and how you became to be known as the, um, biological dentist and the biohacking dentist. so let us know kind of your origin story. Sure. So that's been a recent blend because biohacking has become such a common term now that more and more people are finding out about it. In fact, wait a minute, I've been biohacking for 30 years. I didn't have a name that we called it. So, and, and I don't know if relay ever related this story to you when they were her and her sister were young. They walked into the kitchen one night. I don't know where they were coming back from dance class or something. And I was at the kitchen table with an ear candle in the side of my head and my wife was lighting it on fire. That was like in a. Early nineties, late eighties, early nineties. So, you know, I had a, we had a solid, I had a pulse electromagnetic frequency. I had a red light therapy, you know, I was using photo where we call it a low level laser therapy then instead of photobiomodulation same thing now. So I was using all those things late eighties, early nineties. I didn't know it was biohack. And I just thought, well, anything that's going to help you become more healthy I'm into it. And so I'm also kind of, I love gadgets and toys. So there wasn't any. I wouldn't try. So that was a nice blend with where I had already started my journey. Well, it's, I'll take a step back. I graduated from dental school, 1980 that I did my residency at university hospital in Baltimore, then went into private practice. So for the first five years, I was practiced traditional dentistry, just like when we would talk place mercury amalgams do root canals, you know, all the standard stuff in 1986, 87, very close friend of mine from high school, actually my best friend from high school. Diagnosed with a stage four melanoma. They gave him three to six months to live. By the way he is alive still today, he went the alternative route. but the interesting thing is he came back from his journey and said the first thing that they asked me at this clinic, which is in San Diego, I think it was Livingston Wheeler clinic. It's not, I don't think it's there anymore, but, you got to get all that metal out of your mouth and I'm like, what does that have to do with your melanoma cancer or anything? So I immediately kind of jumped on it. I was always thinking. Kind of inquisitive. So I reached out and I was able to find, and it wasn't so easy in those days, no internet. So I found this guy, how Huggins in Colorado Springs, who was kind of the pioneer. so that was the journey. So I called him up. I read his book, it's called it's all in your head. I still remember sitting on the plane with my wife and my wife. Renee's mom is a dental hygienist. We've worked together for all these years. And I said, kind of we're poisoning our patients. We've got to stop doing this. So that was the beginning. So prior to that, we were all, we were looking at nutrition, but it wasn't a really big part of the practice. So that was kind of really a change. So then it started, you know, no more mercury than later with no more root canals, introducing nutrition into the practice. And of course, once Renee became an adult, she became an integral part of that and actually wrote a chapter in my book. so, but then in the early nineties, I started looking at mostly snoring, uh, because dentistry is now getting into this, these snore appliances. Right. Not sleep apnea pie, but basically snore pies. But if we felt like they had more than storing, we would then refer them to a sleep center. so in the early in the night there weren't many sleep centers and there wasn't really a very close relationship. So if you referred them out, you never saw them again. And they never came back. So it was an ongoing issue. My dad, uh, was a heavy snore, uh, you know, separates, slept in different rooms from my mom. Uh, by the way 35% of married couples do live separately because of snoring that led me down the journey. Then, uh, in 2001, my father died of sudden heart attack, which not too long before that he had a stress test that he was perfect, said he didn't have sleep apnea. I don't believe that I believe that's what killed him. So that was really the impetus for this particular journey. So this is blending and so kind of sleep disorder, breathing. Sleep apnea, biological dentistry, biohacking. It all kind of fits into one panacea. So that was the drive to then write the book. So I became heavily invested in sleep disorder, breathing, sleep apnea, and all the related things like snoring, upper airway resistance. and so that's been my, you know, my real commitment because I believe this is at the main pillar of health. So we talk about nutrition. We talk about exercise. So I think that's the two pillars. The third pillar is sleep. I really think sleep is the foundation because obviously you do, you wouldn't have a patch. Yes, absolutely. Yes, no. I thought, geez. I mean, we're, we talk kids even now in schools about nutrition, which wasn't taught when I was a kid, but, uh, exercising on there. They're getting less of that because they're. Intimacy time, but yeah know, so, but there's still a lot. I mean, in every corner there is a, a new gym opening up with pre COVID. There was also physical exercise, nutrition, emphasize nobody's talking about sleep. Why aren't we introducing this to our children? How to sleep properly, how to breathe, how to breathe. So letting kids stay up late, not really investing the right things into their sleeping patterns. So I started to initially. It's sleep apnea in adults. And then I thought, wait a minute, what kind of treating down the road? Let's go upstream and say, what can we do for children? So they don't grow up to be adult sleep APNIC patients, but that's when we started getting to this program called the healthy start program, which we're now doing. So we're actually, we can treat children as young as the age of two. Wow. Really? That was a long journey, but that's kind of where I am and it's ongoing. And I love what you said about your podcasts. The early ones were, you know, you were still working on it. I'm still working on, it's a forever process. Yeah. It's a great journey. You learn new things all the time. How can you help? And basically it's all about helping your patients. That's all, you know, whatever, whatever emphasis I put in my education or new toys or new hacks, and it's all about making a better experience for the patient and helping them on their journey. So, but we start with, Hey, are you sleeping? How are you sleeping? music to my ears will. Number one, thank you for sharing, kind of, the background and also, your, the personal connection there for you, with your father. And, you know, I'm so sorry that that went in that way, and it really certainly underscores your commitment to this area of seeing that and being, having a part of that as your personal story and so I'm grateful that part of that has seemingly fueled, your inquisitive nature. Around certainly health and wellbeing, but some of these areas that are just not getting a lot of the airtime, that could be available to make a difference. So I'm glad, uh, that you are on the forefront of that. And, and also not just having that be honed into a particular group. but even having that across the board, even beginning at two years old from the sounds of it. So that's amazing. Yeah. And yeah, my, I wasn't going to let my dad's death be the end of it. I wanted to make sure that there was some ongoing. Legacy. So we actually changed the name of my office. It's now called the joint center for comprehensive dentistry, but we're one part of is also the joint center for, um, uh, effortless sleep. So that's one of our, one of our that's amazing. Okay. So, so fantastic. So we're, it's clear the commitment is there. And also that's part of the reason why I'm so excited to speak with you today too, because that excitement and that always learning, does keep you on the, the forefront. And there's no kind of dusty information that you've been collecting from 20 years ago. You're like on, you know, you've been on it and we were speaking beforehand and you were aware of all the latest and greatest, uh, tools and at home things that you can do and all kinds of stuff. So we're going to get into it. So if you could, kind of walk us through, because I think an important thing on this topic is the demystification of some of the action steps that we can take, how we know if we have a problem. Well, I'm in the area of snoring in the area of, sleep apnea and just kind of getting to the root problem. So if you could help us to one discern, when we need to start taking action, what that looks like, whether it's creating partnership with your doctor, how, how do we go about all of this? and how does that lend itself to dentistry as well? just kind of filling in all those gaps for people. Okay. Yeah. It's a great, uh, concern because that's a common question. Like what is the dentist? I have to do with sleep and sleep apnea and wait a minute. Don't they work on teeth and gums and orthodontics, but you know, this is, this is right in our realm and every single dentist should be on board for this and get trained with us. We are the first ones really take an in‑depth look in the mouth. Even the Ian tees, they look right past the tongue. They look right past the teeth. They're not looking at the palette. They're looking in the back of the throat. Typically looking for pathology. Yeah, we're looking at what is the underlying structure that might be contributing to narrow jaws, enlarged tongue scalloping of the tongue. What we call a Mallampati where you can't actually see the airway. You can't see the little uvula that's supposed to hang down and you're the little punching bag. So, so we're looking in the mouth all the time. So for a dentist to be looking in the mouth and not looking at that to me, it's just pure malpractice. It's unethical. Even if you don't treat it. You should definitely recognize it. And this is all, I'll say a process. So I treated, I started doing orthodontics in 1983. And part of that was extracting T putting on braces, not really looking at what was the under causing etiology. So orthodontics, in many cases, just treating symptoms, you know, you've got crooked teeth. You don't have enough room. We'll take some teeth out. Okay. That then progressing also on the sideline, treating things like that. Bruxism people that grind their teeth. We would make an appliance in an evidently within two years, they'd come back. The appliance was either broken or they wore a hole through it. So we did one thing. We protected our teeth, but we didn't address the underlying cause. So now with the, invention, especially in 3d cone beam technology, we can get, besides visually looking at the mouth. Now we have an x‑ray and by the way, it's all. Digital. So for people who are concerned about radiation, yes, it is. X‑ray, it is radiation. That's much less than probably an hour out in the sun or flying across the country. I just want to make that, cause I know that people are always concerned about that. Why you're such a biohacker that you even consider that because you know, so many people would, uh, breeze right past that. So thank you for answering that question. That's perfect. A bunch of remedies actually Renee helped me with, to counter like someone before they get the x‑rays. So we has some homeopathic remedies. And some other things that help block like vitamin E so things that really helped with, blueberry extract things and help with radiation. Um, but anyway, so it's opened up a whole nother aspect because now we can visually see the structural component of the airway. So we can look at starting with the nasal passage. We'll get into more about that. I know. Cause you're talking about nasal breathing, Maori what's happening here? Like are the turbinates blocked or is the septum DVD? We can look into the sinuses and the science is full of fluid. Then we can look into the back of the throat and something called the nasal pharynx. And then just below that, the oral pharynx and that's where you see the soft palate and the tongue. This is where the obstructions occur. So you're going to have an obstruction either from nasal passage congestion or from the tongue and soft palate. And this is what creates that obstruction, which could start out as snoring. So snoring definitely is a, an obstruction. It's a partial obstruct. So partial air is flowing through. That's what causes that fluttering or that ignoring that are our spouses are annoying snoring, but if you get a complete obstruction, what happens more often during REM sleep? Because what happens during REM we're paralyzed, right? Other than our brain is in hyperactivity, just like we're awake. We're in that beta state with the rest of our body's paralyzed, the tongue is a muscle. So it's collapses into the back of the throat. When you see the waking up, they don't even realize it it's the spouse. It's scared to death. Cause it looks like their significant others taking their last breath. Yeah. Farming. Then the one who's having the sleep APNIC event is in total denial. It happens all the time. I don't snore. I don't gasp rare. I feel fine. So you've got to really dig deep and a lot of times it's and I would say more. So the wife reporting about the husband and yeah. No, definitely. I am a male, obviously. I agree. But so many men are in denial. They just will not accept that. I don't know. There's some kind of stigma about that. Like, okay, if I buy snore or I have sleep apnea, I'm not as manly or, you know, whatever it may needs. It's a very weak excuse because when you look at all the different things that happen in sleep, so let's say you're not sleeping. You have insomnia, you can't fall asleep. Can't stay asleep, wake up, can't go back to sleep. All those things are going to affect you. Long‑term but sleep apnea can have an acute response. You could have a heart attack and it may be your only heart attack and maybe the end of your life. It can happen that quick. And there's certainly many, many reports of people, famous people, judge Scalia, football players who have died in their sleep or sleep apnea. So this is not something to really take lightly. now there are comorbidities that could lead to it. Alzheimer's diabetes cancer, which those are kind of long‑term chronic issues, but what about suddenly die in your sleep? I mean, there's no, there's no excuse for that because we have so much knowledge now it's not worth the risk. Somebody might say, well, okay, well developed diabetes. I'll deal with that. When I get it, when you may not get a second chance, this might be the only chance you have. So that's why I'm so adamant about it. And I think that's what happened to my father because when you see most heart attacks happen, And early in the morning, right? Yeah. So no oxygenation to the heart and brain overnight. Absolutely. Well, one, thank you for underscoring, the importance of this, because there can be a lot of lightness that goes, Oh, you know, storing, Oh, you know how the, you know, the wife is, the husband is the whatever, uh, and kind of belittling of this, or just, you know, but not necessarily from a place of malice or what have you, but just from, Lack of awareness of what this can do over time. And then particularly if beyond the snoring is, levels of, you know, mild, moderate or severe, apnea is happening, then this is something to really understand, has a big implication and impact, uh, in our health. So, so thank you for underscoring that, so, and you also spoke to some of the different tech that's available now, the 3d, the ability to add that. And when did that come out, by the way, 3d. It came out in the early 2000, initially, mostly being used by orthodontists. you're looking at jaw structures, but then we were like, wow, we can see the airway. Why, why aren't we addressing the airway? Amazing. I always tell my patients. I said, we see these signs. We look in your mouth, your teeth they're ground down. You get scalloping your tongue, large tongue narrow airway. We see it on the x‑ray, but I always make it clear. Anatomy does not dictate physiology. A high correlation. So if I see somebody with a small airway, I've got to ask them the right questions. So we have a whole series of questions to get down to it and the best way to determine it. And I always say, you know, test on guests, you got to do a sleep. You got to do a sleep study. I mean, it's this the bottom line because I don't know what I'm not sleeping next to you. I don't know what's going on. Hopefully your spouse's asleep. They don't really know what's going on. So let's test it. So then we have definitive objective data that we can make a decision. And going forward, what's going to be the best treatment for you in particular. And I want to make it personalized for you. So the gold standard is what a C‑PAP machine. Some people do great with it. I get a patient comes in, says, I love my C‑PAP machine. I don't try to talk them out of it. It's saving their life. They're not using either. When I say C‑PAP they make a face. Like I, I don't, I'm not wearing that. You know, I forget what community. The seat pap machine is a perfect birth control device. So true. That's not true, but it's lifesaving. So, so then, uh, we want to give them what all your other options. So, and we've talked a little bit about that. Yeah, absolutely. And even, um, on the point of, so if we've established that this, we might be kind of at risk and, so one, do you have steps that you suggest for people. Some clients that are single and they say, I don't even know if I snore, they don't even have that level of awareness. do you suggest certain products, you know, there's like the snore lab or different things. Do you have them, kind of investigate that topic further? Or do you, straight from the anatomy just say, listen, like let's just rule out and have you do a sleep lab? What is kind of, what are those steps there? Yeah, I mean, I individualize it, it depends on the kind of their one acceptance of it. What, what, you know, if there's any funny. Natural, blocks that might be occurring. Sometimes people want to go the simple way. Most of the time, if not always, I give them my book and I said, read the book. That'll give you plenty of information and then you can come back. But we do recommend some of the apps like snore lab. So we hadn't. In fact, it's interesting. You bring that up. We had one patient. He does. He, or he didn't know that he even stored. Cause he wasn't. He was, he lived by himself. He went on family vacation and. On his family vacation, they recorded him snoring. So when he came in and say, you know, you're a little bit overweight, you know, we probably should look at this. So the interesting thing about that is you just never know, um, how close this guy was to having a heart attack. So it, you know, they measured the sleep, uh, score by what they call AHI apnea, hypopnea index. So less than five is correct. Normal, but if you have a 4.9 and you tell them you're normal. So I don't go much by that. I go more by other facts. Five to 15 is mild 15 to 30 is moderate and above 30 is severe. His was 86. So every hour he stopped breathing for some period of time, 86 times an hour, sometimes as long as two minutes. So this guy was one breath away from a heart attack. Where, um, because I, I do have some clients that it just can occur as this big topic and a lot and off sleep lab. And I don't want to do that and, and all this stuff, but what you're speaking to can really be life‑changing and I've seen, and I'm sure you've, of course you've seen some of these crazy, uh, kind of before and afters, where then they get diagnosed as whatever, mild, moderate, or severe sleep apnea. Then they start taking some of these approaches. They lose weight. They're happier. They're rested. They're I mean, just it's a whole new. World so much happier. And then the smell is as much happier too. It's like a domino effect. So yeah, because they, it's interesting because the spouse sometimes has the worst effect from it because one, they're not sleeping now because they're so worried and hearing the snoring and, the, actual snoring, the decibels can be so high that they've never done a study showed it could have auditory damage to this. Um, but yeah, so, and you're right. People take it lightly, but one good thing is that now people can do a home sleep study, so they don't have to go to a sleep center. I'm sort of, I only recommend that if somebody I know has severe sleep apnea, but think about, you're going to a strange place in a strange bed, someone's recording you. How do you sleep and really get good information. So are at home, you can do it one or two nights, depending on how long, how many times you want to do it. Just to get more data. We look at four things. Are you snoring? To what degree are you grinding your teeth? I'm going to talk about the importance of that in a second, please. Are you grinding two or three? Do you stop breathing? How often do you stop breathing and how often, or how far down does your oxygen desaturation go? So you stop breathing your oxygen. These ad drops the seventies or eighties. I mean, that's a significant issue in terms of overall health. Just think about, I mean, just starting today. If someone came up and started to choke you. They're hand over your mouth and you stop breathing. You're gonna, you're gonna go immediately into that fight or flight that sympathetic drive. How are you going to sleep if you're in a sympathetic system all night long? Absolutely. Um, okay. This is fantastic. So you have that, kind of grouping of things that you're looking for. Uh, what about, and, and you mentioned that at home. So when we've discovered, all right, we need to, let's just get this tested and rule out certain things. Or get, clarity around the severity of this. Uh, so from that place, what are their options? So it's, uh, contacting their doctor and then going to a sleep lab. but what are some of the other possible at home or things that they want to be mindful of, of certain other, cause there's other, at home kind of gadgets that are popping up too, that are presumably available to help diagnose these areas, but are there things that we need to, maybe be aware of. No hacker, you probably would, you know, look at whoop or, or a ring. So, obviously, yeah, charging back here yet, that gives you, you know, some data, uh, but it doesn't tell you what your oxygen levels are. And I think that's extremely important because it, I mean, it does look at respiration, looks at HRV. It looks at your body temperature. It looks at heart rate. but what's happening to your oxygen levels. Cause that might well not might. That is affecting all those patients. So something like a pulse oximeter, which you can buy online, uh, fairly inexpensive. So just to look, to see what your oxygen level, and you can get them that actually have a recording on it. So you can record throughout the night to see if your oxygen is dropping. So before you even reach out to a practitioner next, if it is dropping at most would all know asleep position, but most people do have a dentist. That's where I would start, you know, just ask your dentist to treat sleep issues. Do you know, someone that treats it because there's a lot of dentists that specialize in it now, but that's a good place to start because they have a relationship probably with their dentist so they can have that conversation. so that's where I would start. And then they could, if they're not able to help you, they can lead you to the right person, to the right referral. Whether it's another dentist that, you know, is an expert in sleep apnea or sleep, we call it sleep disorder breathing. So that's a good place. So yeah, so they can use, um, at home things to kind of figure it out. But I think Paul sucks. Probably one of the most important thing. When you talk about sleep apnea, you know, the ordering is great for looking at your sleep and if you're getting enough Ram and getting enough deep sleep, you know, when you're waking up. So, um, and in what your HRV is and what my favorite thing is the readiness. But yeah, I find it somewhat not always accurate. I'll get to like high readiness number. I got, I don't really feel that correct. I'll get a load ready. I'm feeling I'm feeling really good. So I don't know. I don't put everything into that. And I don't think you should put anything in one thing. So that's just another tool. Absolutely. Okay. That's where I would start. I would reach out to the dentist because as a dentist, that's fantastic because I think, you know, some people might not, if they're having difficulty night after night, feeling tired, fatigued, you know, reaching out to their dentist might not be in the forefront of their mind. So I think that's important to call out and so then you, you take this. So you get the test, uh, you go through those kinds of, top five things that you're looking at. Uh, I know you mentioned too, underscoring a bit more of the grinding element of things, uh, because I do have some clients that, you know, they're anxious, they're stressed and they say, Oh, I don't have a problem with snoring or it's mild, but it's the grinding. And then they have headaches. Uh, so what do we need to be conscious about for grinding and sleep quality? Yeah. So very important to notice when they're grinding. Like if you're grinding. During the day, you're probably under an extreme amount of stress, no doubt, whatever that may be, whether it's work or family or finances COVID or whatever, you're whatever you're dealing with. If you're a grinding because of stress. And I say emotional stress at night, you've got a serious issue. You probably need to do some cognitive behavior therapy or something like that. Most of the time it's physiological stress. So what happens is when your oxygen levels drop, you go into that fight or flight sympathetic state. One of the ways to counter that the body's amazing ability, right? To intuitively figure out what to do unconsciously as we grind our teeth and then process of that ad helps to open the airway. So our body is saying grind or slide 24 or clenched out all that helps to open the airway and provide additional oxygen to the body. So it's all done intuitive. You're not thinking about. So when we see that. That you go, Oh yeah. I grind my teeth because I'm nervous. I'm stressed out or my dentist ground, my teeth. This is a clear way pattern. This wasn't done by your dentist. So you were trying to blame it. I said, look there, and then we will put that together with those other things we talked about. Do you have a narrow arch? Do you have a high palate? Do you have scalloping of the tongue, your Mallampati score, which is looking at the back of the throat, all those things. And then I let's take a, let's do 3d combing. Let's look to see what your airway. So it's always a process of using specific tools and questionnaires and really digging deep. And, you know, sometimes the patient, the sign said that it looks like they do have a problem. We'll do, what's called an Epworth scoring. So airport sleepiness. And if they have a low score on that, I mean, I don't care. What's going on. They're not tired. They're not fatigued. They're functioning product. Do we need to really intervene? I think only I would still do a sleep study just to verify. I think we need to verify because of what I said before that this could be your last breath. Do we really want to take that chance? I don't think you want to do that. So, absolutely. And one of the things that I've seen for, well for myself and also other clients is depending on where they're at with their sleep, they might, you know, that might be just something that they're swimming in as their regular life. They they're don't know of what else could be possible. I know certainly to use myself as the example for so many years, I didn't know that having consistent, great sleep. That would even feel like, uh, so I didn't have a frame of reference, so I was like, Oh, I'm fine. You know, it's okay. It's good. Uh, and so I wouldn't even know what else to compare things to as being possible. So, uh, you're making a great point that sometimes even if our own self‑assessments might not be reliable in all cases when it comes to sleep. so sometimes getting that external testing can be really important. okay. So we're looking for snoring grinding when we're stopping to breathe. Oxygen desaturation elements of things. And from that place, so you, you get your kind of, uh, scoring and you get the information and then what happens. So I know other clients have spoken of, Oh, this is going to be so expensive. This is going to be this trial and error thing. It's not going to work, blah, blah, blah. so if you can help run through some of the optionality for people, what is it? What are their options? Well, I think from a legal sense, Important and ethical salmon. We always have to mention the gold standard net as a C‑PAP machine. Sure. Um, so from, from a financial situation, almost all insurance will cover C‑PAP. So some of them will require them to wear the C‑PAP for a short period of time. If they decided, Oh, I don't want to do the C‑PAP. I want to do a dental appliance, which I'll talk about in a second. Okay. Or they still need this period. And now how do they know they're wearing now? They have it with Bluetooth. So they're actually, they can actually tell where you're wearing it or not. So you can't just say you used to be able to say, Oh, I hate to say, I'm not wearing, I can't wear it, whatever. Now they know whether you even tried to wear it. So they require that you wear it for a certain period of time. And I think that's fine because if you can tolerate the C‑PAP machine financially and it's going to save your life, there are some downsides to it. One, not just we've talked about, you know, The, um, the, the issue with, um, having had this massive thing on your face, you got to travel with it and you got to clean it, you know? So it's going to be a little bit of an inconvenience, but having this thing strapped to your face can actually push the whole maxilla and mandible into a backward position. I'm going to talk about that in a second, because this is what creates the airway issue. So someone who has already deficiency in their profile. So if we're looking at their profile sideways, Well, we can see that's another sign that we looked at. So we see this kind of dished in face. So having that pressure that C‑PAP on you and actually worse than it over the years. So, and as it worsens, you need to turn or titrate the airflow up higher and higher. And as you do that, as striking as the back of the throat, so it's to be quite uncomfortable, but I don't want to, I'm not going to bad mouth feedback because they are truly lifesaving. So that's the one. If the second choice is a dental appliance, That would be something that you would wear at nighttime impose your jaw forward, or I should say keeps your jaw from falling back when you're sleeping, especially on your back, keeps your tongue out of the airway. Very effective, not it's probably about 90% effective, not quite as effective as C‑PAP, but very effective and a lot more compliancy for some people. Some people will just, I'm not putting anything in my mouth. I don't like anything in my mouth while I'm sleeping. Okay. So what else can we do? You might have to go to a C‑PAP. I don't want to wear a C‑PAP. So we made it do some nasal cones and mouth taping teach you how to breathe, sleep properly. So you know, all those things. And then the third option, actually, there's four. I'm going to give you the fourth one too. The third option is to, actually get to the bottom line. Etiology. Why do you have an airway issue? It's because you didn't get the proper growth and development that should've occurred under normal instances because in our genomic pattern, We should all have these wide jaws just as our ancestors. And this was really done by Western price in the 1930s. You know, most people are familiar with his nutrition, uh, background and how he looked at these, you know, cultures around the world, perfectly straight teeth, wide, big smiles, no cavities. They didn't have any dentists, orthodontists, or, you know, they just ate off the land and within one generation at all change. So now what's happening. We're not breastfeeding. Long enough since it'd be minimum 18 months, uh, to we're starting kids off with soft gooey foods, they need to cheat for. They're not going to choke. Parents are so afraid that their children or infants are going to choke. They're not going to choke. Then we're born to chew food, to give them a raw broccoli and let them chew it because that chewing capacity, which actually stimulates muscle muscle development and growth of the jaw. So as muscles are strengthened the jaw to adapt to it just like you would for. Treating osteoporosis, right? You're doing, you know, when you're doing some kind of muscle activity, you know, weightlifting to strengthen the bone underlying bone. So you get bone to actually grow. This is the number one reason why kids end up with the need for orthodontics or extraction. So, so we're, we're addressing both things. One. Now we have a child we can treat that didn't get breastfeeding, who didn't chew hard foods. They have a narrow jaw. Parent brings them in their mouth breathing. They are. Bed wedding. They have, uh, emotional issues. They may even have ADHD. So all of these things that we're seeing in these children, because they're not sleeping. So what can we do? So we can start when we call our healthy start program, we can start at the age of two, start developing these arches. So that then one they're breathing better. They're sleeping better. They're doing better in school, they're socializing better. And we just prevented the need for braces and extractions and most likely an adult. Sleep APNIC patients. So, and all the other co‑morbidities that go with that? Absolutely. Whoa. Well, that's incredible getting at the root of it all. Yeah. And the third option is similar, but now we already have the adult with the narrow arches. So we missed this. We missed the chance, but we can still expand them with expansion appliances. And these appliances, the 3d expansion appliances have been used up to the age of 19. That's the oldest patient. That's had them done my patient, but it's been reported. We can sell. We were told in school, you can't pass a certain age. You can't expand the jaw. That's not true. You can absolutely expand the jaw. So why do you want to expand it? Because then you can teach the patient through myofunctional therapy, how to swallow proper lip posture, all the soft tissue that goes into this, this eating swallowing speaking pattern has to be corrected so that then we can expand the jaw. And the patient tongue can then go in its proper place when they swell up against the roof of the mouth in a forward position instead of the back of the throat. So that's an amazing, so in answer to your kind of question, like that sounds like a lot of work that sounds kind of expensive. Absolutely. We give patients options, right? Everyone should be informed of everything. That's possible. Let them make the option, let them make the choice of what option they want to choose. And then the fourth thing, I'll go over real quick. We do this laser laser treatment in the back of the throat. It's called night lays. It's a non ablative that doesn't burn it. Doesn't cut it. Doesn't remove tissue back to the throat, collagen soft tissue. If you heat it up, it tightens up. So this technology was actually taken from the medical field because they were using it for women to tighten up ladders and uterus, same technology. So when you tighten up that soft palate and the back of the throat, it opens. Use up the space again. So, so there are a lot of options. And then after all that, and they say, I don't want to do any of that. I said, well, what can we do for you to help you? Okay. So first thing I would say, let's figure out what's happening. When we look at the sleep study, you're on your side. You're not snoring. You're on your back. You're snoring. Okay. So we've got to get you off your back or, or, or we got to show you properly how to sleep on your back so you can sleep on your back. And the analogy I always give is if you've had CPR training, What's the first thing you do tilt the head jaw thrust, right? Open up the airway. So you have to be able to have something on. If you're on your back, you have something on your neck, that's keeping your airway open. Okay. Most people are just kind of buried in the pillow. And if you're on your back, usually your pillow raises your head too. Like this, the proverbial forward head posture. Yes, exactly. There's a lot of that. It's bad enough during the day, but now you're doing it while you're sleeping. You're not getting oxygen there. So, you know, and then we will talk about all the things that you talk on your podcast, all the different hacks you can do, you know, are you drinking alcohol late at night caffeine, you got to stop that, what your room looks like, you got to block it out. So I'm going to go into all that cause you do a great job informing your, your listener. So we will address that also. Um, and then Renee will address the nutrition part of it. the Hilton slate and course Kaddish. So many, so many things to look at now in terms of neurotropics and you know, Well, whether you're using melatonin, um, there's no shortage there. Uh, okay. So then, so first of all, so much excellent information that you just have, uh, given us and out of all those, you know, kind of top four steps that you can take, um, as it pertains to the apnea and snoring and, uh, you know, depending on, I know it's such a big topic cause it's bio‑individual and depends on the anatomy. So I know you can't possibly. kind of blanket statements and, and here I go to try to, um, get more blanket statements, uh, have you started to see yourself gravitating towards particular? Um, one more than the other out of those are particular groupings or there particular candidates that are really, benefit, you know, say laser treatment more than others. How do you think about the, the answer for each person of where, which direction they should go? I try to do it based on their individual with their interests are with their finances are what their commitment is. my favorite, if everyone, if none of those were issues with the patient, I would say do the 3d expansion because we're getting to the underlying etiology. So we're correcting what didn't happen. And that's a lifelong correction. So C‑PAP is a lifelong commitment. You gotta wear a C‑PAP forever because you haven't corrected the underlying. Topical structure a forward mandibular advancement appliance. Again, you're not, you're not correcting the underlying and there's also some issues with the mandibular advancement appliance. You can start to have TMJ issues and then the night lays is kind of, I almost say like a quick fix. I don't want you to do anything else, but I'm willing to do some laser treatment. so you'll get some improvement again. It's not permanent. So if someone wants to make the long‑term commitment and I find maybe because of the kind of practice I had being a. Holistic practice. People were coming in with that mindset. So they're not insurance‑based healthcare, you know, they're thinking about what's the long‑term etiology. What's, you know, what's going to help me in terms of longevity. And I don't want to have to wear something for the rest of my life. I'll make the commitment. So sometimes they have to say, well, the finances are an issue, but I'll make it, I'll make it happen. So I kind of encourage that, but I never push one over the other. I want to make them the choices, but it was my choice. It was my daughter, my wife, my, I would encourage the 3d expansion because it's really getting down to the underlying cause and etiology, how cool for this 3d expansion, like I'm looking at pictures and what have you, what does this look like for those of us that, you know, so like my experience with it, I know of clients that have gone through this or who are curious about it. I have certainly not done it myself. So. So, what does this look like? What's the timeline? What are some of the expectations? is there anyone that's not a candidate for that? What is it's very, very cool. step that could be taken that I think a lot of us don't know about and pretty much can, uh, fit to any individual, unless they've got a lot of teeth missing. If they're missing a lot of teeth, they can do Amanda or Basma appliance, but it's very difficult to expand because you really need those anchors to be able to do the expansion, uh, otherwise. Pretty much for any, any individual. the timeline is typically depending on the patient and we don't, we don't pressure anybody. Like this is a recommended number of hours. You should wear, want to wear it during the day. You want to wear it all night. You're well, I can't wear it at night. I can't sleep, but no, actually you can sleep better if you have it in there. So, you know, you deal with all those issues that patients come up with objections or whatever. we say, look, you go at your own. Pace the bottom line is it's not a race. We want to get you from here to here. If it takes six months, that would be ideal. And I've seen people do this in six months. I've seen people take 18 months. So at the end of that, they can continue to wear those appliances. Or this is another, I guess, important piece is that now that we've done this expansion, our teeth aren't coming together the same as they were before. There's a part two to that. And that is Invisalign, um, or. Or some kind of invisible aligners. So, clear aligners, it can be Invisalign or anything. We don't do a lot of braces anymore just because people don't want to wear braces and want to wear braces when you have something like clear aligner. So, so now we've done the expansion. Now we're going to bring all the teeth together so that you can chew properly. Got it. Wow. Okay. Well, I I'm clear that I could speak with you all day. So I'm going to try to be respectful of your time. so wanted to, just to, uh, hop into, since you are such a, um, Pro in this area of just the holistic approaches to, to help them wellbeing in general, but certainly with your area of expertise. Uh, I know you were sharing before that you even have people, I didn't even know that people were doing this, that you, uh, when your clients come in, you're giving them HRV readings. And you've been doing that for years and years. I know you've got lots of cool things that you, uh, are bringing into your daily life. So we want to know what are you doing for your sleep? So the first question for that is what does your nightly sleep. Look like right now. Well, it's changed. I know I ended up for certainly for someone like you, I'm sure this evolves all the time. Yeah. I have to say, I thought sleep was a waste of time. Uh, as probably many of those people were in the sleep arena, like, you know, I have too many things to do. you know, I need to stay up to one or two o'clock to get everything done. And I said, wait a minute, I can't be preaching about the importance of sleep. If I'm not doing that myself and it took a while to call and I still have those, it's just sometimes I get that racing mind. So, so I do use a series of, you know, supplements that help me sleep. I'd say, and I use some other devices. I love the, you know, the Russia. I don't know if you're familiar with the Russia machine. Yeah. So I think it has a great, piece there. I use, the Healey as another has. Some good frequencies on there and then the, there's a set in a number of things that help with sleep. I'd probably have a bunch of them on my night table that I've used in the past and not using now. but they all have, so I really believe in an energy frequency to help calm down the brain. I mean, basically we were talking about an electrical impulse that's occurring. When we talk about going from beta to alpha, to Delta Delta data, all those phases are, you know, there's EG. He frequencies, when we're looking at those, how do we get into those? And the best way to do that is by using these energy frequencies sound is obviously a very good way to do that. I do have the, what's called new tones, new, some new calm have that. so I have a lot of things on the side. So I'd say right now, uh, that Russia is my number one choice. I love the technology behind that because it's, we don't need to go into all. It's base 12 using base 12 mathematics, which almost everything else is based 10. So it took a couple of hours or you can go into all that. And I'm not the expert on that. those are the things, there's a couple of different products by design, for health that I love for sleep. so I did take that every night and then of course, all the regular hygiene, there's no TV in my room. We haven't had a TV in our room for over at least 10 years. If not more, my wife's still not happy about that, but. I have to say this. I hope she's not, she won't be offended. She is like the master sleep. Really? I come home, I put my blue blockers on. I turned the lights down. I have a special screen on my laptop. I do meditation. I do the rush. I do all these things in the wind down. She's in bed, reading on her computer. Doesn't think twice about it. I know my fiance is like that too. It's just. Wakes up with that, you know, an order ring score 95. So she's a, she's a master sleeper. I am not. So I've had to use these hacks to help me sleep. Now I did a sleep study. I do not have sleep apnea, uh, but I'll say this as myself in about 45% of the population will sleep on it or will snore on occasion. Okay. So it's pretty hot and wet. And most of that is on their back. I'd say it's probably even higher than that. About how many people sleep on her back? I do snore when I'm on my back, I got to stay off my back unless I have the proper positioning with the pillow. So I think during that sleep process, you've got to find the right position. So I have a special pillow. I have a pillow between my knees. I have a self that I'm hugging. So it was like, you take so long just to get ready to go to bed. I love it. Well, we can learn from that cause you know, a lot of the people. Listening, kind of veer on the side of you and what you're dealing with of it doesn't quite come so naturally. So that's fantastic, that we can learn from you. So then the second question would be, and you might've already kind of spoke to some of this, but what is on your nightstand? And it could be your proverbial, nightstand, like, you know, apps or, um, beyond gadgets, uh, anything. And I know you spoke to some, so, just anything we should, any, any other things you should be aware of? Well, I do have some different devices. That, you know, you can plug in your ears to listen to, uh, apps on your phone. Wholetones, that's what I was trying to think about for honesty. Yeah. That's a great device. So you can either use the headphones or not. you know, I'm a little weird about anything that has Bluetooth technology. I think it kind of defeats the purpose. so right now I go to my special room in my house and I do my Rasha. And then I come back. So at all, and I'll do whatever frequencies I'll do stress reduction. I'll do chakra balancing, uh, emotional tones and that'll do deep sleep and dream sleep or REM sleep. Uh, and that helps me just fall right to sleep. I, and so I had no problem falling asleep. My biggest issue is if I wake up and I want to talk, touch on that real quick for the call here is, um, difficulty getting back to sleep because I'm thinking about all the things I need to do. Okay. At the end of the day or the next morning. So one ritual. I do try to make sure that I do my to‑do list before I go to bed. I wake up and think, how am I forget these things, um, touch on the fact that many people wake up to go to the bathroom? I think for women it's bladder issues is prostate and those are some issues, but there's something called P atrial nature, erratic peptide. We released that to the kidneys. If we're not breathing properly, The body releases certain fluids, and it feels like the lungs are filling up and the heart's beating harder and it releases this peptide and it causes you to have to go to the bathroom. So you're going to release the fluid by stimulating the kidneys. So a lot of times that's, what's waking you up. Um, so I'm reason I bring that up is this is directly related to sleep apnea. So to no other reason, to even not get enough oxygen, the body senses that grinds your teeth. Yeah, maybe gas for air or wakens you to go to the bathroom and they thinking, Oh, I just have a prostate or bladder issue, which you might, but yeah. Well, thank you for saying that too, because, um, I think that can go into the, the multiple things that might be signs that we want to take those steps to get that sleep study or what have you, because, uh, those wake ups, I have so many clients that they literally come, um, just because they're getting so frustrated by those wake ups. Or they blame it on the bladder, the prostate, the whole thing. They go through the whole litany of things. They stopped drinking water, um, or liquids, you know, I've got one client that I'm working with that stops, drink water at 5:00 PM. Uh, it's just all of these practices that they're, if we're not being mindful of some of these other, um, things that you're pointing to, then we might be missing. What's really there. And, uh, falsely attributing it to something else like, Oh, I just need to go to the bathroom all the time. Um, and there might be something else there. No, if we're sleeping properly, our, our, our brain should be released in antidiuretic hormone. So it's kind of like going into hibernation. So, I mean, how does a bear go into hibernation for six months and not have to defecate or urinate? So we can't go six hours of that. I have to go to the bathroom. So, so again, I would start to look at it. Yeah. Is there some neurotransmitter issues? Uh, also we talked about GABA, which is the only inhibitory neurotransmitter. So you might be GABA deficient. Um, so know, I think there's. It's such a vast array of things you gotta, I mean, it's, it's almost daunting when you think about all the things you've got. So I want to say to your listeners don't feel bad. I mean, I'm sure you do too. Molly. We've all gone through all these things and we're constantly looking at new things. Um, so you know, it doesn't really end. Oh, I want to say, I do want to put 10 out to the amp coil Amcor is another really great device. Yeah. Yeah. Oh, that's perfect. Um, because of your podcast, I did order a hat B. Yeah, that's amazing. Um, so great actually, and you know, it's so funny. I still have to test it. I have it. I have a whole box. I should show you again. Um, you might be able to see, I have a hole. Can you see that? It's like tower, I have a whole tower of things I need to go through. I've been in Sedona and it around. So I'm actually behind on my gadget testing. Uh, so maybe we'll be testing around the same time. Okay. Well, we'll keep in touch about that. What sounds like a great device. I think I'm looking at it. Like for that time, when I wake up in the middle of the night, that might be a great time to do it during the day. I mean, I have a pretty stressful schedule. I do a lot of surgery. Uh, so I'm in, in sort of a sympathetic state. Most of that. You don't want to relax now. Yeah. So thank you for, thank you for being for us. Please stay on alert. I think that's going to be a great device. I think also for my sleep patients, because. And I find out quite often, I address the sleep apnea. Yeah. Now they address the sleep apnea. Wow. I'm sleeping through the night. They're not as tired now. They have insomnia. Now they have the energy for insomnia. Absolutely. Right now they're like wide awake. Fantastic. We'll have to connect more on our experiences with that. That's great. Um, and then that can, I would imagine, um, you, since you have, you've been so engaged in this topic. Last question would be, what would you say at all? All of these things has made the biggest difference for your kind of sleep game or your biggest sleep aha moment in your life, uh, that has really kind of change or move the needle for you in that area. Wow. That's a tough question because, and I, and I get this question a lot, like, did this thing really work or that thing really worked, I think because I do so many hacks, it's really difficult to push the needle, you know? So. Keep it simple for most people, I think, you know, looking at your body temperature. And so I love to take, uh, do the inference on and then jump into cold shower, go to bed. I think that's a great hack. Keep your room temperature down to do the things that are simple and free. Well, inference on is not free, but I guess you could hot shower or hot bath. So keep those things simple that makes sure that your environment's correct, you know, You're not going to bed mad and make sure that, uh, you know, you kind of released all the emotional stuff from the day that you can calm that brain down. Uh, and then if you, if you suspect sleep apnea for right now, stay off your back. Yes. And they get in touch with your dentist. If you have tie tennis balls to your back to keep you off the back, I wouldn't do that. Oh, I'll just say real quick. I do recommend mouth taping. When I do recommend a thorough evaluations, nasal passage. Just make sure people are breathing adequately through the nose before you are taping up the mouth. Does that make your only source of auctions? It's very important. Good call. Um, okay. So much information. So then, um, what's likely is, uh, people listening to this, want to know more about how they can follow you and are there options if they're not local? Um, do you have kind of telemedicine options or, um, things that people can do virtually? Absolutely. And I do that all the time. Just like we're doing right now. Um, I can't fix your teeth through telemedicine. I can't take your teeth out. I can't do this thing, but we can talk about sleep and we can talk about sleep apnea or I could be an adjunct to someone who's local to you. So more as a coach, like these are the questions you want to ask. So, uh, they can reach me, um, uh, Dr. Sam, Dr. Sam and Julian ctr.com where they can go to the sleep site, which is a Julian center for effortless sleep. Beautiful. I'm gonna to reach out to you. Hopefully I can make, maybe we can do some links to your podcast on yes. Oh, I would love that. Thank you so much. And, uh, yeah, I'm excited to be able to, um, be in partnership with you and share, um, you know, just to provide more and more resources for people that are at that crux of, um, you know, how they kind of need that Sherpa to guide them. And I know you're definitely that person and also be sure to follow, um, on instinct. Graham as well and different social media platforms. So we'll be putting all of those links into the show notes too. Um, because I know you've got lots of great information and of course, in partnership with your daughters who are just rocking and rolling on their health crusades as well. So it's a whole family affair. Yeah. And you know, it's great, uh, to link up with you and, um, people of like‑mindedness and, and passion towards this sleep issue. Uh, especially now with this. Call this a, I hate to say, even use the word COVID, um, just say this, this state of fear that people are in, um, and that's affecting their sleep. And then, you know, we know for sure if you're not sleeping, uh, a couple of things that happen for sure is our lymphocyte levels go down. So our immune system is much more prone to infection. So if you're exposed to, you know, it's not just COVID, it's everything. So just saying, I want to own a closing. What really got me interested about sleep. What changed me more than anything when I saw that 40% reduction in your testosterone levels, I'm like, take it home. Exactly like that can't happen. I know because, and so many men end up getting testosterone replacement therapy as they age. And what have you. Um, and so you're speaking to such an important point that I think so many people don't realize that that's such a fantastic and important and root place to start. Um, if you get back those readings that your testosterone levels are. Low or concerned about that begin here. So let's start with the easiest thing before we start doing testosterone injections or pellets or whatever. Yes. So great to add that because I forgot that was a major influence. No, that's huge. And yeah. Cause exactly half of this is about the motivation to take all of these steps, to implement all of these things. Because if we don't have the strong, why people are not going to do all of, you know, the frequencies and the setting, you know, the blue blockers and all. All these things and what you tell them about testosterone. Uh, they're committed they're in. So yes. Thank you for adding that. Well, I really appreciate you taking the time. Um, I know you're in between, you know, surgeries and all this stuff that you're doing to really make a difference for people. So thank you. Thank you. And looking forward to more in the future, hopefully, and in the future, we'll be able to, you know, paleo effects and all of those different conferences that I know you guys frequent. So looking forward to it. Get back on a normal schedule. Huh? I'm ready to out travel anywhere. It doesn't bother me. We're in it to win it. Absolutely. Well more to come. This has been great. I enjoyed speaking to you. Thank you for all that you're doing your audience should be very grateful that you are making such a passionate commitment to this because it's so, so important. Oh, well, thank you. All right. Well, enjoy the rest of your day. Appreciate it.