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Exclusive Interview with International Brain Injury Expert Dr. Richard Downs

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Exclusive Interview with International Brain Injury Expert Dr. Richard Downs

March 08
21:15 2021
March is Brain Injury Month. We’ve invited Dr. Richard Downs to tell us how brain injury and sleep apnea affects the health of millions of Americans.
Exclusive Interview with International Brain Injury Expert Dr. Richard Downs
 
Dr. Downs, We’d like to thank you for joining us during Brain Injury Awareness Month.  Most people don’t realize that brain injury and sleep apnea are related.  How serious is this issue?
 
Approximately 50-70 million people have it in the US and it is increasing due to obesity and aging.  Most of them are undiagnosed and that is very serious because it can cause or worsen heart disease stroke, high blood pressure and contribute to the development of diabetes and obesity.  All these ailments are worsening, and the obesity issue is a vicious cycle causing more sleep airway obstruction.  Worse yet, those with obstructive sleep apnea have worse outcomes if they get Covid 19.  
 
It is estimated that over 38,000 die in the US each year from cardiac disease related to sleep apnea according to the American Sleep Apnea Association. Celebrities with the disease include Shaquille-O’Neal, Regie White, Brett Favre, Jamarcus Russell, Rosie O’Donnell, Roseanne Bar, the late Regis Philbin, and Randy Jackson.  Carrie Fisher died from the ailment and it’s likely that Chief  Justice Anthony Scalia died from it also.
 
Major disasters such as the Exxon Valdez and the Three Mile Island accident are sleep apnea related.  

We hear alot about brain injury in players and other athletes, why isn’t brain injury in the average American often discussed?

It is great that these stories are making us more aware, however the specialty of sleep medicine was not established until 1975.  It is a relatively late development.  Some of this is due to the fact that the earlier studies on it were done by researchers outside of mainland medicine.  It is also true that the recent epidemic of brain injury from brain suffocation is related to modern poor diets and the continuing airway reduction in size due to many modern trends.  We also have 20% less sleep time than a century ago, smaller lower faces and very little education about it in our medical and dental schools.  Even now most are not being tested to see if they have it when signs are obvious. 

Athletes get a lot of attention but snoring is laughed at and considered just annoying by adults and considered cute in children. It is nothing but cute.  Mouth breathing and snoring in children is a serious problem that will lead to permanent facial structural changes that leave us vulnerable to a lifetime of airway suffering.  

We are also a culture of pill takers to solve everything.  This can have serious consequences when the root cause of stroke or heart disease is not found and treated before surgery and multiple medications are given.  
 
Everyone knows we’re in the middle of a pandemic.  Is Covid-19 and brain injury related in any way?
 
Recent studies show that the pandemic has caused an increase in insomnia.  When this happens people are more tired and then eat worse diets, gain weight and generally get less sleep.  As you some might know, weight gain increases airway obstruction leading to obstructive sleep apnea.  It is a vicious cycle of increasing airway obstruction which in itself produces more ghrelin hormone and less leptin hormone, these then increase weight gain because appetite is increased.  We feel more hungry more of the time.  Loss of sleep increases the opportunity to eat more.  
 
Loss of sleep also trains our brains to focus on worse types of food; especially those that cause weight gain and heartburn. All of them then interfere with sleep cycles and total sleep time. Fear of Covid 19 can then lead to more disturbing dreams and restless sleep.  And, as I mentioned before, once you have gained weight and tipped over the threshold from pre diabetic to diabetic, your outcomes from getting Covid 19 become worse.  
 
You’re such an inspiration to us all and your story is quite impressive.  Please share a bit of your journey with us. 
 
As some might know, I am a dentist.  As I got older my snoring became so loud that my wife continued to punch me to turn over every night until finally having to leave the room to get some sleep.  I did not know it was a serious sign of sleep brain injury through sleep apnea.  I just thought it was normal for some people.  I had no clue and I was never asked any questions about it by any of my primary care physicians for dentists.  
 
One day I saw an article that dentists were helping those with sleep apnea with oral appliances.  I was curious and went to a continuing education program for it.  I was shocked to find out the seriousness of this disease and had myself tested. I found that I had a moderately severe obstructive sleep apnea.  I treated myself first before I treated any patients and I had immediate cessation of snoring.  My wife was amazed and so was I.  Subsequent testing showed I was able to bring my sleep apnea under control. I also began to lose weight because it was easier than before I was treated.  
 
Since that time of discovery I have pursued education in this field with enthusiasm.  I have learned so much and continue to do so.  It’s my responsibility to ensure that my friends and colleagues also  know how to treat this on themselves and their patients.  
 
What’s next for you? How can everyone contact you?
   
I am actively working to bring the allied health professionals into the realm of finding and treating this disease.  I am involving those groups that have not been traditionally involved because the specialty of sleep medicine is overwhelmed with patients.  There are fewer sleep specialists in this area of care too than there used to be.  We must help these, our health care colleagues, to manage this disease the CDC has labeled an unmet and unrecognized epidemic.
 
I am also working with the DOT physicians to bring sleep apnea education and testing to our truck drivers, airline pilots and ship captains so that our transportation highways, shipping lanes and airways are safer.  
 
I’ve created a web site for the lay public who wants to find an FDA approved sleep apnea testing service they can get on  their own.   Technology is progressing so quickly that it’s possible to finally find those 50 million undiagnosed cases and get them to the appropriate care. This could be the single most important change to our nation’s health ever embarked upon.  Everyone needs sleep and without sleep, the brain suffers.  
 
Those wanting to contact me can do so through the public web site www.onlinehomesleepstudy.com DOT drivers can also privately use this site.  
 
Dr. Richard Downs, DDS, FAGD, FICOI, D-GMDIA  
Past Editor of the Iowa AGD Newsletter and past President of the Iowa Academy of General Dentistry
Co Founder of Dentist Select, LLC maker of Oracare Products
Board Member and Stock Holder in Toppen Dental Infection Control Products
Published in Dental Journals and Lecturer in oral wound healing.

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