Your Lifestyle Is Your Medicine
“Your Life Style Is Your Medicine” is a podcast that focuses on how a person's lifestyle can be the key to health and happiness. Routed in the principles of lifestyle medicine, Ed Paget, osteopath, and exercise scientist, interviews area-specific experts on how lifestyle impacts well-being, focusing on purpose, physical activity, nutrition, sleep, and stress, which could lead to a longer, happier life. Edward now runs immersive lifestyle medicine retreats, with the purpose of helping others take back control of their lives to live longer and healthier.
Your Lifestyle Is Your Medicine
Your Nighttime Breathing Pattern Could Be Silently Killing You with Dr. Dylan Petkus
Dr. Dylan Petkus shares his revolutionary approach to overcoming sleep apnea naturally through breathing pattern correction, myofunctional exercises, and lifestyle changes. He explains how his personal struggle with sleep apnea led him to develop a science-backed method that addresses the root causes rather than relying on CPAP machines or surgery.
• Sleep apnea affects approximately 10% of the population and can reduce lifespan by 10-25 years
• Contrary to common belief, sleep apnea affects many people who aren't overweight
• Only 30% of people prescribed CPAP machines continue using them long-term
• Sleep apnea often begins with hyperventilation, which creates negative pressure that collapses the airway
• Simple breathing exercises focusing on slow exhalation can significantly improve sleep quality
• The "relaxed pause" breath-holding test can help identify and track improvement in sleep apnea
• Myofunctional exercises (tongue and oral muscle training) comprise about 20% of the solution
• Improving mitochondrial health through nutrition and lifestyle accounts for the remaining 40%
• Mouth taping addresses a symptom rather than the root cause of breathing dysfunction
• Free resources for sleep apnea sufferers are available at apneareset.com
Check out Dr. Petkus' website at apneareset.com for free resources, breathing exercises, and information about his coaching programs.
Welcome to the your Lifestyle is your Medicine podcast with me, your host, ed Paget. Today's guest is Dr Dylan Pekkes. He is a peer-reviewed published researcher. He's featured in Time, forbes and Healthline and he's also a best-selling author in sleep medicine. He has a book called the Sleep Apnea Solution. He's got over 7 million views, over 70,000 followers across his social media and is a trusted expert in natural sleep apnea solutions.
Speaker 1:His personal story is that he struggled with sleep apnea himself. He spent years developing a science-backed, non-invasive approach to restore his natural breathing. So no CPAPs, mouthguards or surgery. He was once exhausted and foggy and he's now clear-minded and free. So in this podcast, dr Pekas is going to tell us all about this discovery that he came up with, how he implements it with his clients and patients, and some simple tests that you can do to find out whether or not you have sleep apnea, and also some solutions that you can simply just do at home for free to see if they help. His website is apnearesetcom and there's tons of free resources on there as well. He also does accept one-on-one clients. If you listen to this podcast and you think you need some extra help, please reach out to him.
Speaker 1:But today we actually got into this story of his, why he was a young man not particularly overweight, so he says and how he ended up getting diagnosed as having sleep apnea, which is a bit of a shock. But also what I didn't realize was how pervasive sleep apnea is in our culture and how lethal it can be. And so doing these simple exercises that he suggests, some simple nutritional changes, some simple throat exercises as well, some breathing exercises, we can actually reduce our chances of suddenly dying in bed, which is one of the stats we talk about. So enjoy this episode. There's a really positive note, apart from my slightly pessimistic intro just then.
Speaker 1:But this is going to be great and enjoy my interview with Dr Dylan Beckers. So, dylan, welcome to the show, thanks for having me, thanks for having me, and this is going to be fun because in lifestyle medicine there's different tenets and sleep it's one of those tenets, but I think it's the underlying core principle that allows everything else to work. And I'm so glad that you've agreed to come on the show and talk to us about sleep and sleep apnea and none invasive solutions. But just to set the scene for our listeners, can you tell us how you went from being a medical doctor, which I know you still are medical doctor, researcher, master's degrees and this and that to what you do now do you ever stop being a doctor?
Speaker 2:is this I guess I can just stop telling people. And then, once a doctor, always a doctor, it's a, it's a blessing and a curse. So, yeah, how I came about this? So, um, I think, as we know, research is really research. It's not like someone just starts studying lyme disease because they live in lyme connecticut. Um, I mean, they did, but usually they have, you know, connection to the problem.
Speaker 2:So, same thing for me, right where, long ago, many moons ago, the, my sleep started to like absolutely like deteriorate. And this was when, like bulletproof coffee was like a big thing. I'm not sure if it still is now, but it was just like, just push through the day, three cups of coffee, go, go, go. Don't think about your health, just biohack your way out of it. And, uh, it just reached such a point where, like, every night was like an absolute, like nightmare, waking up like 90, uh, every 90 minutes, that is. And then, uh, the mornings were just like I just felt like I haven't slept. And the days were just like, you know, type on my computer, try not to fall asleep at a meeting, um, and then, just like, go home later on like wasn't much of existence, uh, let alone a life. And that's when, um, you know anyone, anyone with like any degree of knowledge around health, uh becomes, I feel you become more hesitant to actually see a doctor in the office. Someone should study that, the the knowledge someone has and their likelihood to actually go see someone. And when I went there they were like, oh, you should get a sleep study. I was like, okay, great, and not sure if you ever had the pleasure, but it's like the most paradoxical thing of like, well, we need to see how you sleep, naturally. So we thought it'd be best for you to sleep somewhere else and hook you up to a bunch of electrodes and have, you know, someone come in every two hours and check on you. But other than that, it's pretty easy.
Speaker 2:So did that and uh came back with moderate sleep apnea on the report, which was very surprising for me, because when you know we get taught about sleep apnea in medical school, it's always I don't know why, but a lot of times people just go back to like in charles dickens and pick wickian syndrome for reason. It's one of the diseases that we decided to start off in 1900s. You know literature about, but nonetheless, the idea is it's sleep apnea. You can only have it if you're like 120 pounds overweight and you like all this stuff here. That wasn't me, by any stretch of imagination, pretty fit, you know not. I mean not like you know an Ironman, crossfit or whatever, but you know not. I mean not like you know an iron man crossfit or whatever, but you know not out of shape.
Speaker 2:And it was very surprising that like, oh, I have like that disease and pretty bad. And then they're like, well, you can try out the c-pap. Yeah, no, that's not the most attractive option. It's like, hey, you want to. It's almost. It's. It's hard to position something worse than the sleep study. Ask from the doctor, but then they really follow up very well with sleep with this machine for the rest of your life. Like, wow, we've already gone through that one. Let's just, let's just keep going down the middle.
Speaker 1:You just describe what that is, just for people who don't, who aren't familiar with it oh, a c-pap.
Speaker 2:So it's a mat, like, just imagine if you have, like a plastic leaf blower, uh, strapped to your face, um, well, that's that's how you feel about if you don't like it. Some people love it, that's cool, that's great. That's like the 30 to 40 percent of people who love it. Uh, the other majority, uh, do not, and would resonate with a leaf blower on your face and very uncomfortable, very, even just like anxiety provoking, just like strapped to your face, um, you know, very attractive to bedmates, definitely, um, unless they're into like, like star wars, but that's few and far between, at that level at least. And so it's. It's, in all seriousness, it's a continuous positive airway pressure. That's what cpap stands for, in which it's providing air into your airway to help keep it open all right it was.
Speaker 2:It was invented, um, in the late 70s, early 80s as a, as a stopgap measure. All right, because, um, you know, it's one of those, I guess conventional medicine, things like what's the most brute force well, I guess allopathic would be a better way to describe it what's the brute? What's the most brute force? Way in which we can keep the airways open and cpap again, a little bit better than the previous option, which was just cut a hole here for anyone, I'm pointing to your throat, just like, if you uh smoke cigarettes all your life and had throat cancer, now you got to breathe through a hole in your throat. That was actually option one, so, all things considered, cpaps a little bit of a step up, but that's what was given to me, um, and only took a couple of nights of that to say, okay, no way, no way.
Speaker 1:We're doing that, which which a lot of people do resonate with, uh, because did you have stats on how many people have a cpap machine under the bed that they never use?
Speaker 2:under the bed.
Speaker 2:Specifically, I don't have that data but the no, I do, I do know that out of. So they do these CPAP compliance studies because you know a lot of the research questions are the wrong ones. In allopathic medicine it's like well, let's not try to find better solutions, let's try to find more ways to coerce people into these solutions and with the CPAP, they'll look at compliance. So if you give 100 people a CPAP, like you're the Oprah CPAP, you get a CPAP. You get a CPAP, you get a CPAP. Everyone gets a CPAP.
Speaker 2:After a year, if you ask those 100 people, how's it going? How are you dealing with that thing? 30 of those people so 30%, will give you a thumbs up. Just up, okay, this was not like, did this completely change everything? Like I've benefited from this thumbs up, so 30 of. So, to answer your question, it could be as high as 70 percent have under their bed in the closet in the attic. Uh, but it's um, the, the people who can't get a CPAP to work. They're in the majority, the silent majority, if you will, and they kind of get gaslit by the medical stuff. But anyway, that's a separate story.
Speaker 1:But yeah, most people you know, enjoy it. Okay, so let's go back to you. So you were given the CPAP machine for sleep apnea, which we still don't have a definition of yet, or from you anyway.
Speaker 2:So sleep apnea is going to be breathing very poorly at night. That's like the headline of it. Now there'll be two main ways to determine this. The American Academy of Sleep Medicine will say more than five events per hour. An event will be defined as you stop breathing in a way that leads to your oxygen levels in your blood going down. All right, that happens five times or more per hour.
Speaker 2:Now, cms, which is like the in the States, like the, basically the Center of Medicare Services, et cetera, they use 15 as their metric 15 events or more. Now the reason there's a discrepancy is because they used to go with the 15 events per more, because between 5 to 15, you're mild and just like how in the. What was that? Late 1990s or early 2000s they changed the cholesterol guidelines and everyone had hypercholesterolemia. Crazy how that happens. Similar story. Similar story Because most people with mild sleep apnea they're very well functioning, they're not symptomatic.
Speaker 2:It's done in the spirit of maybe we can catch these people early or maybe we can have more CPAPs on the market. Either way, we'll let history decide that one. But yeah, sleep apnea you stop breathing multiple times per night, essentially effectively suffocating your body at a time when you should be resting, and it prevents you from resting, your body can't restore itself. And it prevents you from resting, your body can't restore itself, and then you have a lot of damage to your cardiovascular system, your brain, um, and just makes your, your days miserable, because instead of not resting, you're causing damage. It's like almost like a double whammy you have the rest that's taken away and now, instead of being restful, now it's just completely damaging to your system, um, so that's the, it's the easy way to understand sleep apnea there.
Speaker 1:So with you. So this is going back to your personal story. You were diagnosed with the sleep apnea. You had the symptoms of trying to function at a high level, being a medical researcher and so on, but that was tough. You tried the CPAP machine a couple of days of that, and so what happened next?
Speaker 2:Yeah. So at that point I gave it the good old, screw this, throw my hands up at this and decided, all right, what is like fundamentally going on with sleep apnea? Because a lot of times in research or just how I view things in life, is if we didn't have like any, any external input of this, like how we view this problem, like what's the the simplest way we could sort of figure this out. Kind of like, all roads lead to one. So so in looking over the research, one of the things I found because I don't know about you guys, but like Friday night going on PubMed, that's where all the literature is and then you can like sort by date and you can just go all the way back. Okay, really great times if you run out of things to talk about with your partner. Yeah, new hobby that's what you do that's what you do or not?
Speaker 2:but uh, they're. So they're studying 1953, in what? And this is some of the original research on sleep apnea, because, despite characterizing it, in the early 1900s there really wasn't that much actual research on it. It was just that much actual research on it. It was just these people are overweight, they snore, they don't sleep well, they lose weight, they feel better. Case closed everyone. But then you know the other 50% of people who have sleep apnea without being overweight. What about that? So what they found was that if you take a bunch of college students, which is the primary bed of research in America if you take a bunch of college students and you artificially using a ventilator somewhat of a ventilator if you cause them to hyperventilate at night, this will actually induce sleep apnea, which doesn't really make sense, because I just told you, like 12 minutes ago perhaps, or even sooner, this was about not breathing at night.
Speaker 2:So now I'm telling you about over breathing. Yeah, what the heck. Because when they, when they first looked at sleep apnea, how they did, it was actually even worse than today's sleep studies. They would have the doctor or the nurse just watching you in your bedroom. So if you think sleep studies are bad, you know they were worse and in some of that literature they even describe sleep apnea almost as nocturnal asthma.
Speaker 2:Okay, and if anyone's ever had asthma or seen really really bad asthma, like I'm talking, terrible asthma, not not just wheezing, but like you're like wheezing and then wheezing, and then people go through periods where they stop breathing, which is really scary. We're talking about like emergency room levels of asthma and they saw, they knew that. And then they saw sleep apnea, where it's you're breathing and then you stop breathing, and then the period afterwards you hyperventilate, right, and then you kind of get stuck in this cycle. But the thing is, the cycle is actually kicked up by these increases in breathing. So they have some studies in and this was way later, but, um, I think this was about I forget what year, but mid 2000,. Like 2010 ish. They looked at what is the tidal volume. This is how much air in and out someone is breathing at night People with sleep apnea, people without sleep apnea two separate groups and what they found is that people with sleep apnea, they'll breathe more and more and more and more, and then they'll stop breathing and they'll breathe faster.
Speaker 2:As a result, afterwards They'll breathe more and more and more, stop breathing, and it's this cycle of hyper-breathing stop breathing, hyper-breathing stop breathing, et cetera. So that's kind of the main thing that I found. I was like well, that's different yeah.
Speaker 1:I was just, isn't it?
Speaker 2:Yeah, I was just told I, you know, have a narrow airway and uh, yeah, that's. Uh, that seems like a big missing piece.
Speaker 2:But interestingly and this is a bit facetious of me, but when you describe that it sounds a little bit like the wim hof method you're hyperventilating and then holding your breath, hyperventilating, holding your breath. Well, the yeah, um, definitely your consciousness is doing that, as opposed to uh, I. This is the big part of it which is good to point out is that the as you're breathing, like that, the breathing, and it's not as extreme as when off of, where the ventilation rate's getting pretty high, but, as a result, this negative pressure that gets generated in your airway which I know like we always like to talk about negative pressure at that's lunchtime, that's a lunchtime discussion. Think of like a think of like a vacuum, or even how I describe it to people is there's a reason. If you have, like it's tax season right now I feel it's always tax season anyway and if you had those documents and you were going to go drive in your car, if you put those documents in the driver's seat, are you going to open that window on the passenger side? No, you're not, unless you want to get into some trouble down the road. And the reason is, when you drive really fast with an open window, there is a negative pressure outside that would then suck your tax returns out the window and then cause some problems. So same thing when you breathe really fast, it causes this negative, negative pressure and it's going to pull things, your tongue, uh, kind of the rear wall of your throat here. It'll pull that together and block the airway off. That's the fundamental mechanism.
Speaker 2:So back when I was saying what's the fundamental problem here? That is the fundamental problem. Even, like I know, I mentioned the tongue in the back of the throat and people might be thinking but I've been told it's my deviated septum. I've been told it's my adenoids. I've been told you know it's, it's something else. But the thing is, no matter what of like the 30 different things that can narrow your airway, they all functionally lead to a more narrow airway right. And then, as if I was to breathe through a straw like this, like if you challenged me to breathe through a straw for this entire interview, I would have to breathe faster and faster and faster to get the same amount of air or pass out. So I'll pick option one and as you breathe faster, then we're back to pulling things in. So it's a function of anatomy. And then also this bad breathing pattern has these two issues.
Speaker 2:Now for issue one. With the anatomy, you have to ask yourself. Okay, do I want to go down the road of surgery? Most people will say no, okay, and we can talk about that later. But then the other option is are you just going to like jam air down there, like jam plastic in your mouth, et cetera? Okay, because you know there's the anatomy issue. But then you can also just deal with the breathing issue.
Speaker 2:Because when you know study done by dent dentists, when they just looked at people's airway anatomy and said how many of these people will classify as having a narrow airway because of some thing you know, a small jaw or big tongue, adenovirus, etc. It's about 60 percent in the general population. Okay, okay, sleep apnea is about 10%, by more conservative estimates. So there's a mismatch here. So it's really the breathing pattern. That's really the bigger thing. And also, if we just think about, like, which of these is easier to tackle? Okay, like, do we want to do like a let's remove your uvula back of your tongue or let's do like 10 minutes breathing exercises? You?
Speaker 1:know, breathing exercises every time you would.
Speaker 2:You would hope yeah, the answer there. So when I was learning that back to that was like, oh okay, well, let me do these breathing exercises. And honestly, I know I've laid it out where it seems maybe perhaps semi-logical at this point I hope I've done that correctly. Uh, but when I discovered I was like, all right, this, this seems like the dumbest thing. Okay, maybe you're just, maybe your brain is just deteriorating, dylan.
Speaker 2:And so the first night that I learned about this, all right, I'm just going to do some breathing exercises, nothing fancy, and all I did was I did like a like a slow inhale for like half. So like a, so half inhale and then just breathe out as slowly as I could. So like half in like. So imagine if you just take half normal inhale, still at a slow rate, and then just breathe out through your nose as slowly as you can. No timing it, nothing, just like literally as slowly as you can. No timing it, nothing, just like literally as slowly as you can. And I basically just did that until I fell asleep, just laying there, breathing, etc.
Speaker 2:And then I woke up the next morning. I thought someone drugged me because you just like, see, like the little morning glow light on the window, which, if you're someone who's used to like getting up and seeing the clock at like 12, 1, 2, 3, 4, like you're used to that and then you see, like are those birds chirping? What the hell's going on here? Uh, it was very surprising, very surprising. So, um, that that was really the beginning of of that like okay, proof of concept and building on it more. Uh, it obviously wasn't fixed in one night that'd be great but that was the beginning of like okay, let's focus on the breathing here okay, and just to put this into perspective of people we've had some symptoms of sleep apnea that you had.
Speaker 1:We also have now the medical solution and then potentially the breathing is another solution. But some of the stats that you share actually in your book are quite shocking, with people over the age of 40 who have sleep apnea can die between 10 and 25 years earlier, and so people listen to this. This is not just something where you know you wake up feeling tired and you guess life's a little bit harder, but you know you can get on with it. I think this is a life, a life threatening condition. Is that how you view it as well?
Speaker 2:Yeah, I mean, it absolutely is, and in that it's immediately threatening and it's also a gateway disease. So there is a very strong reason that I have more truck drivers than I ever thought I would ever have in all my social media comments.
Speaker 2:And for the right reasons, for the right reasons, for the right reasons, because when you are a I believe it's like a cdl license in the states I think you have to, as described to me by by people on the internet you have to um, undergo, or like get evaluations about your sleep. If you're reporting that you're tired and they go get a sleep study, and then now you're placed in a situation that your truck driver having to travel and, by the way, let's make it harder here's a c-pad. And then, if you're placed in a situation that your truck driver had to travel and, by the way, let's make it harder here's a CPAP. And then if you're not using it, like 70% of people, if you're not using it, then you're out of the job.
Speaker 1:Yeah, so a little, a little micro population there, and as I understand sorry, as I understand they can monitor the usage of your CPAP right, insurance companies and people that can monitor it.
Speaker 2:They're watching every night.
Speaker 1:Yes, how do they do that?
Speaker 2:So they have the CPAP eyes, as we call it, because it collects your data every night, like how many hours were you using this and how effective was it, and different insurances at different thresholds, like you need to use it four nights out of seven, you need to use four hours every day, or guess night, rather different metrics. We don't hit those metrics, then, um, first year failure. Don't forget that, that's what they'll tell you. You're not, it's not your fault. Second, your insurance will oftentimes increase your premium, drop you entirely, and then the third one that I've seen a few times is life insurance will drop you. So it becomes this very like and that's in the States, like in, I think it's in. I'm not sure if it's australia or canada, but it can go into your license and if you're not compliant, that's going to cause some issues there.
Speaker 1:So it does become this very, very questionable gray area of privacy, health and public health well, and let's let's sort of give them a little bit of credit, these insurance companies things. It's because they know that sleep apnea is this gateway problem to all these other things. You know they take it seriously. Or maybe they just want to put up, put up premiums, but I think they take it seriously because they they have the data to show that okay, if you don't do this, you might end up with your diabetes or strokes or heart attacks or all the other things that come from sleep apnea yeah, yeah, absolutely.
Speaker 2:Because you're, you're. You're never going to win the game against an actuary in a cubicle, so that's the person running all the cool calculations that lets you know that you're not worth the investment if you don't wear your c-pap. Because, yeah, because they know immediately whether it is a car accident, whether it's a heart attack or a stroke. There's gonna be things that are gonna kill people more immediately. Um, those rates are like massively higher, or you're also good, I guess. The fourth one would be like your risk of hospitalization, like, let's just say, the flu here. Okay, your risk of being hospitalized from the flu goes up five times, not of getting the flu, but being hospitalized, because in the book when I mentioned I forget the exact statistic, but it's somewhere between like five and ten people suffocate overnight and die from sleep apnea.
Speaker 1:It's 36 out of 105 are found in.
Speaker 2:They're dead in bed yeah, so the majority of that's in hospitals, okay, because people are being hospitalized etc. There. The suffocations that is now some of those are still at home, obviously, but, um, it's just because every single function in your body is not going to work well if you're not sleeping Because this is again different than poor sleep, because, like insomnia is you don't sleep, okay great, you don't get that recovery Is your body having accelerated damage at night A little bit. But is it like burning on fire, like sleep apnea? No, so it's like really both sides are getting hammered dramatically there.
Speaker 1:Okay, like sleep apnea. No, so it's like, really, both sides are getting hammered dramatically there, so, okay. So if people listen to this, uh, if they're anything like me, they're like okay, this is a problem. Uh, I don't want to wear a c-pad machine. Um, I can get tested by my doctor. Is there a quick test people can do to know if they have sleep apnea?
Speaker 2:Yeah, so there's a little survey questionnaire here we can go through a quick questions. Okay, we'll do that. So it's called. It's called the stop bang for users at home who want to go look it up later. It's it's a screen device because sleep studies are expensive and also rather cumbersome, so your doctor should be doing this If they're not to make that decision. I've heard times they just look in the back of your throat like, yeah, you should get a sleep study. I'm like, okay, so eight questions. Number one and this is also things you know or things your bed partner has told you.
Speaker 1:I'm going to answer them, let's go?
Speaker 2:Yes, all right. So do you snore loudly, which is defined as someone can be complaining about it or hear you're snoring through closed doors, yes or no? No, no. Do you often feel tired, fatigued or sleepy?
Speaker 1:during the daytime. Yes or no?
Speaker 2:Yeah, yes, okay. Has anyone observed you stop breathing during sleep? Yes or no? Not that I know of. No, okay, do you have or are you being treated for high blood pressure? So, do you have high blood pressure or you're on blood pressure meds?
Speaker 1:No.
Speaker 2:No, all right, is your? I'll say the actual BMI, then I'll give you the shorthand. Is your BMI greater than 35? Probably or are you more than 30 pounds overweight? No than 35. Or are you more than 30 pounds overweight? No, okay, are you more than 50 years old? No this next one's also fun. Is your neck circumference greater than 40 centimeters?
Speaker 1:uh, we can go in inches as well. What's that?
Speaker 2:that's the way you'll be oh, no one knows that conversion, that science is not settled yet.
Speaker 1:I thought you would have it in inches.
Speaker 2:Even if it's in inches. I don't think most people know. So what I usually do is can you wrap your hands around your neck, yes or no? If you can, then you're fine. If you can't, then probably not. If you can, then you're fine. If you can't then probably not.
Speaker 1:So most people are less than that. If you buy quality shirts, you should know your color size in inches. Mine's 15 and a half, just that, maybe because I'm a Brit.
Speaker 2:Yeah, we just we don't do shirts down here in the States. Here it would be 15.7 inches, yeah, okay. And the last one is female or male, so male there. So, based on your answers, you would have a two Okay, which would be very low risk. Yeah, now, if you have a three or more, now you're getting to moderate risk, which means there's going to be a greater probability that a sleep study would be able to demonstrate sleep apnea.
Speaker 2:So that in an ideal world where people are using screening tools appropriately, let's say you got, uh, let's just say you got a five, because some people will say, yeah, I'm snoring tired. My wife says I'm doing this, yeah, I'm on a blood pressure med, you're at like. So five and above here, you're high. If you get, if you got a five or above, in that you're, you get a sleep study. There is a 90% chance that sleep study will tell you you have sleep apnea, okay. And then, if you don't, if it's this is the funniest part if it's negative I think it's like 50 or 60% of the time they'll send you for another one Until you get it. Until you get it, I'm a little questionable about that one, but and then they'll pick up another 5% of positives from that. So yeah, that's how that pans out there.
Speaker 1:OK, so we've gone through. We've gone through a screening test. We're now thinking, well, maybe someone's listening to this got sleep apnea. They've heard about the CPAP, or they know if someone has got it, or their doctor's even talked about it before and they're not interested. You brought up the subject of breathing. So tell us how you developed that initial or that initial spark, that initial, like you said. You woke up, feel like you've been drugged because you slept through the whole night. What happened after that? That?
Speaker 2:yeah. So after that I I thought I just completely, you know, solved the world's biggest problem and I was the, you know, smartest person of all time. So I kept doing the same thing and then started to have diminished returns on it, still doing like way better, but it would be kind of touch and go some nights, um. So I was like all right there, there's more to this. So it's humbler than that sense, because I know a lot of times the temptation is like it's just this one thing, have this one. If you drink a tablespoon of this you'll burn all your bit, like you know that that sort of stuff, the so then when I started to learn more, I was like, okay, how did? How did that breathing exercise even lead to the slower breathing at night? Like, how did this happen? Because I just read like okay, breathing fast, bad, maybe if I breathe slow before it'd be good. Okay, that's like the caveman thought at that time. But I didn't know how it worked. And so learning about like how our body responds to different gases, primarily CO2, carbon dioxide, which is a byproduct of your body, just like an engine burns fuel and then produces gas, just like the tailpipe from your car, and that one of the main gases is carbon dioxide, co2. That is your body's primary trigger to breathe. There's other ones, but CO2 is the most important signal.
Speaker 2:So when you have sleep apnea and yes, when I say this I mean obstructive sleep apnea, because I know people, when we talk about sleep apnea people will say well, do you mean obstructive or central? Central is 5%. I'm talking about the 95%, but it still applies to both. There is a chemical abnormality to sense carbon dioxide in your brain. That's like the sole problem of central sleep apnea. I don't want to say sole, but it's the primary problem. It's also a huge problem of obstructive sleep apnea. I would say, if not still the biggest. So there's a huge overlap on that. Because when I mentioned CO2, people were like but I thought obstructive wasn't a neurological thing, it is. Your brain is still off in a reasonable way. Okay, I think all of our brains are a little off.
Speaker 2:Nonetheless, co2, you need to be able to rewire how your body responds to CO2. Because remember when I was talking about the whole nighttime asthma thing and you stop breathing and then you kind of start breathing again. That is known. I'm going to throw a whole bunch of research word soup out. High loop gain ventilatory like threshold would be the name of that. High loop gain ventilatory threshold Fancy way to say.
Speaker 2:When you do something, you breathe way faster than you should. You go to the top of the stairs and you feel like you. You go to the top of the stairs and you feel like you just went to the top of mount everest. You went like you chased it through the dog or whatever, and then you're like oh, I'm breathing really fast. It's because that is the dominant pattern for like six to eight hours every single night and then it starts to bleed into the daytime.
Speaker 2:So and this also will address an issue that some smart cookies are thinking of how the heck does you know you breathe during the daytime and then it affects your breathing and you're like I can't control that. You're right, you can't. But you also really don't consciously control your breathing during the daytime. Your brain is telling your body constantly like hey, you know, breathe like this based on the signals it's getting. So when I learned that like okay, so CO2 is affecting how I breathe, all right.
Speaker 2:And then there's this brain breath connection with neurons and all that and these connections. And is there any way I can rewire this and how I do that. Like, yeah, so if you expose yourself to more CO2, which probably isn't the best word, that probably just evoked a vision of like breathing in CO2 gas If you increase your body's own natural levels of CO2 there it sounds more friendly by doing these breathing exercises that have longer exhales and longer pauses than the inhale portion, then that will start to accomplish the job of improving your body's response to co2. So you're breathing a little bit slower and then you don't have as much strong pull inside your airway at night to pull in your tongue and pull in the tonsils and all that, and then things start to correct in a way. So that's like the big thing. Okay, well, I need to, like you know, do breathing like this and then like progress it and so on and so forth, so that it's able to have a more profound effect at night.
Speaker 1:Okay, so would measuring someone's respiratory rates when they're resting be indicative of sleep apnea or all this problem?
Speaker 2:the it can be. It's a little hard because it's not going to be as sensitive as a measure, because a respiratory rate of like 10 versus 12 doesn't really sound that different, but it is kind of big difference on a kind of a big time scale, like eight versus 12. But the a better test, if you will, because, remember, this is all again about how your body responds to CO2. So there is a test. You want to do the test? The pause here? Me, yes, yes, no, the other person here, yeah. So, and we can do this together with the users at home. Let me get the stopwatch here. So the idea is so this is known. This, this has many terms. This is like. I think there's like eight different names for this.
Speaker 2:So this is known in the literature as a basal breath hold test. This has been something that they do have been doing since the 80s, once they learned about the, the high loop gain parts. It's also known as a controlled pause from. I'm going to butcher the name of this, but buteyko breathing buteyko, oh yeah, I've never said yeah. Other people, other adaptations will call it a I I think like an oxygen score, like a Bolt score. I call it the relaxed pause for a very specific reason because it should be a relaxed measurement. Sometimes people are like I'm a performance athlete, pedal to the metal, you want to. This should be like a very easy thing. So that's my differentiation.
Speaker 2:Or spin on it nonetheless, all those different ways to say it is how long can you hold your breath comfortably, comfortably, after a normal exhale? So this, this is not like you're eight years old and your friends like how long can you hold your breath at the bottom of the pool? It's not that it is inhale, exhale, hold. And then here's the difficult part is you want to then start breathing again at the first sign of air hunger. So if you're familiar with wim hof, you probably know what that feeling is like.
Speaker 2:Okay, if you've done, if you've done breath, you know that like for the uninitiated person you may not. So let me describe is that oftentimes people will describe it as like a warm sensation in their chest or like some discomfort, or maybe like a little, perhaps like a tug in, like their chest muscles or chest walls. That's what we'll feel like there. The other way to think about it is after we do the pause you should not have to take like rescue breaths, like you shouldn't be like did I do it right? No, that's not relaxed. There's a reason we call it relaxed, all right. So, all that being said, I guess we'll have a competition.
Speaker 2:But, we'll do it Inhale.
Speaker 1:Hang on. Hang on Just just before we start. So I have done a lot of wim hof and so I'm familiar with that. But also just before we got on, I just finished a 10k run. So what I've noticed in wim hof when I do that is that if you're uh, you're um, you're doing a lot of exercise, your body goes into I forget there's a technical word for it but you need more oxygen afterwards and I find it's really hard to actually hold my breath after oh epoch yeah, yeah, epoch yeah, yeah, so I don't think I'm in epoch right now, but just just in case people are watching, they go hey, don't you want to be fit?
Speaker 1:no, okay, all right, I got all my excuses out yeah, epoch for people at home is oxygen debt.
Speaker 2:After you do exercise, that your body kind of catches up and maybe breathes a little bit more deeply afterwards. So all right. So we're going to, on the count of three, everyone at home, unless you're operating major machinery. All right, do this later. And then I have the timer here so I hold all the power. So, on the count of three, we're going to inhale, so three, two, one, inhale through your nose and then exhale through your nose and then we're going to pause and then we're just going to sit here. So we're at five seconds and seven now, and that's where I was originally. And again, it's the slightest touch of air hunger. So there you're at 16. And then we'll let it go to 20. So most people will be under 20.
Speaker 2:I assume if you didn't just run a 10K, it's where people in the States is a long distance. No one knows what that means in miles. It's 64 miles. It's has that what the science has agreed on? I think. I think they figured out pi before the conversion. I'm just joking. I, I, I trust your metric conversion, the. You would probably probably 25, 30, etc. Here. So most people when they do this, if they. They do this correctly. That's the big thing. If they do it correctly, they will be less than 15 if you have sleep apnea. So it is.
Speaker 2:It's a more sensitive than just ventilatory rate. Is it super specific? I would say it's specific enough for sleep apnea. There's other conditions you may have, like say you have CO. Have like say you have copd, say you have asthma, say you have other inflammatory conditions. Your relaxed pause will be low.
Speaker 2:Doesn't always mean you have sleep apnea, though, but if you have sleep apnea and you want to use this metric, it's probably one of the best ways to track. How is my breathing pattern at night? And then the beauty of it is you can use this metric to track your progress, which people have loved more than I ever thought possible, like people obsess about this number, and usually what I'll see is as people get to 30, I would say 75% of symptoms have resolved. As people get to 45 seconds which I know may sound really far off if you're like we're at 10, but it's possible If you're at 45 seconds, that's like a 95% reduction. Now you know everyone's unique and individual. Your mileage may vary because there's all these other factors that'll influence your breathing too, but that's one of the primary metrics for someone to track there.
Speaker 1:Okay, so a person starts doing intervention of the breathing exercises. They're tracking their respiratory sorry, their relaxed breath hold. No, what do you call it Relaxed?
Speaker 2:relaxed breath pause I call it the relaxed pause. You can you can just continue the trend of throwing more words around. You can call the, you can call it the controlled basal breath hold relaxed, oh the basal relax pause.
Speaker 1:I like that. Um, okay, and so your, your method of helping people sleep. Apnea is not just breathing exercises there. There's way more to it. So can you just give us a high level overview of maybe some more exercises. And I know you go into nutrition, I know you go into hormones, I know you go into all sorts of different areas. But I'm interested in sort of getting a an understanding of what you do, but not necessarily all the details, because obviously that's you know that's, you'll be here for like four hours.
Speaker 2:Yeah, exactly so, yeah, yeah, so let me, let me tell kind of my my personal context of so did the breathing exercises and overall, probably like a month went by where I felt like, okay, I strongly feel like I 40% better is what I would say at that time. And then, as I learned, I was like, okay, well, it's like just kind of going from that main idea of like, okay, my airway, let's focus on this. I don't know why it took me this long, but I was like, well, what if I also just have my like, the muscles in my airway are also like just less prone because it's a two way street, because if you have a strong inhale, yeah, it's going to pull muscles back. It's going to pull floppy muscles back even more. So if those are stronger, in a better posture position, then you're good. So next thing I led to you was it's called myofunctional therapy, which is fanciest way of like lip and tongue exercises etc. Stick your tongue out, that sort of stuff, which there has to be some. I have functional therapists listening to this right now. It was just like rolling around in agony that I just described it like that, but that's like the general gist of it. So doing those, I would say, is another, perhaps 20% of the equation, and this is generally some people may find like breathing exercises good, do some tongue protrusion? Oh my god, this is the most amazing thing of all time and you know everyone's mileage will vary. So there are 20% to my functional. Then we have this other part of the pie, so we're at 60%. We still got 40% left, all right. Well, what the heck is it? So we're going to go on the magic school bus everyone. So I apologize in advance.
Speaker 2:So we talked about CO2 being the common thing. Remember, the more we can boil things down to the fundamental problem easier to fix. We talked about like actual breathing, mechanical side of it, but also CO2. If we don't think about like what is producing it, we're just dealing with this constantly, almost like on the back half of it. So back to the engine. Fuel goes into your engine, produces CO2. Well, if we ignore the engine forever, we're missing a lot of opportunity. So that engine is your mitochondria and you should have a few neurons in your brain saying like powerhouse of the cell, yada, yada. That's like usually the reaction. That's what's going to fundamentally take foods, turn them into biochemical energy and also CO2. Just like an engine If you ever had a bad engine it's going to blow more smoke out the tailpipe and probably other orifices.
Speaker 2:So the more we can improve your mitochondrial function. Then CO2 on the production side, because right now breathing and all that like, that's just like how you're compensating for it. But if we also address the production side, then that makes everything work together a lot better. So that's why I said that you know there's not like a golden line of like. If everyone gets the 47 seconds on the relaxed pause, 100% of people will be better. Because people may still have other issues in their physiology that are harming their mitochondria, that are causing a CO2 problem on the production side. So that really opens things up Because we can go from a like a stance point.
Speaker 2:Let's say, on nutrition, you can eat generally well and healthy, right, but like, are you eating in a way that's very good for your mitochondria, yes or no?
Speaker 2:Most people are like I don't know. So you want to be able to do that. Or something also very important is going to be your circadian rhythm, because if you have like bad circadian rhythm, you aren't producing enough melatonin, then your mitochondria are going to be really bad as well, or also like your nervous system stressors. That's going to impact your mitochondria. Your environment is going to impact your mitochondria. So it's a lot of different factors. I would just put it into a big old bag of holistic lifestyle changes that are, like targeted at your mitochondria because then that'll help on the co2 production side. So that's really like the, the, I guess like a lot of the missing piece, because a lot of times people will just focus on the breathing, because it's that very like just this one thing and I wish it was, and it still kind of is, if we think about it. But the breathing exercises only do one aspect of it. You want to be able to also target it metabolically as well.
Speaker 1:We're talking. One thing Some people have said to me can't you just put the tape over your mouth, like in? There's a recent book came out called Breathe, the Lost Art of Science. In uh, there's a recent book came came out called breathe the lost the lost art of a science. I butchered that but I'll get it in the edit. But uh, there's a recent book that came out on breathing, nesta. That's it, nesters, yeah, yeah. And he recommended, um, putting tape on the mouth. Is that something that helps us sleep out? No, or is it just sort of now? Now I understand it better from what you've told me.
Speaker 2:I don't think it's going to do anything, but you tell me Well, so I have a dog and I have three actually and when I take their tails and I wag them, it doesn't actually make them happy. So the reason I bring this up is because that's how mouth tape is. Yeah, because your mouth opening at night is another consequence of poor breathing patterns. You don't breathe poorly because your mouth is open. Your mouth is open because you breathe poorly. Very different because when you have that fast, inhale your body. This isn't how it works. It's it works a little bit differently. But we'll keep it really simple. If you have to breathe more volume, your body has to make a choice am I going to go through those two small holes or this one big one? And it will choose the bigger one because there's a bigger volume of air. Now how it works in physics is again back to negative pressure and all that. You're more likely to open up your mouth than to continue to go through the nasal passageways when you have more volume of air. But that's how it works. So that's why Now I'm not saying mouth tape is worthless, but fundamentally, if you correct the breathing problem, then the mouth will stay closed Now at times when working with people. Then the mouth will say close now, at times when working with people, mouth tape can be a good bridge because you can kind of force the issue a little bit more, and the research would also reflect that. So I think they're.
Speaker 2:So, out of the two studies that have been done specifically on mouth tape, only been done in people with mild sleep apnea and at most it drops your sleep apnea severity by about four points, which isn't a whole lot Because in the grand scale, like five to 15 is mild, yeah, 15 to 30 is moderate, 30 plus is severe. So dropping at five points, you know, not a whole lot there. So it can be beneficial if, like, maybe you're trying to like optimize, but if you're someone who's like severe etc. That's like I don't know. It's like someone they're bleeding out, they their aorta and we're like, oh, you know, maybe let's check their vitamin k2 levels. Is the other clot? Like no, we need to, right, I mean to stitch that thing up. Um, so yeah, I know, I know mouth tape is trying to. It may be appropriate for, like a, a normal healthy audience, but sleep apnea audience it's it's not going to be the optimal first step okay, interesting.
Speaker 1:yeah, I always wonder when you hear about someone who has great success with one thing and they may have just been that person who found that one thing that worked for them. And I heard the analogy of if you go to the optician and you say I'm not, you know, I'm not seeing so good, maybe I check me out, get some glasses. And the optician says, hey, no need for that. Look, these glasses really helped me. Just try these on. And you know it's like, yeah, they work for him or her, but it might not work for you. And I think that's sometimes what happens with these more like on-trend things with mouth tape and so on. They may have worked for one person amazingly, but they're not going to work for the population.
Speaker 2:Yeah, yeah, like there's so many of those things. Like what did someone say recently? It was someone who, breathing into a balloon for some amount of minutes per day, like it, fixed my sleep apnea right right now it's the same thing, because that person likely just had a deficit in the muscles that help them breathe out right, and that may have been their only deficit, because there's, like you know, 15 different factors like your, the muscles help you breathe in, muscles breathe out. How slowly. Like there's all these different factors and that was just that person's one thing, so that that I might steal your analogy with the glasses. So can you hear me on a different podcast? And I'm not gonna credit you, I'm just not but I stole it from someone else, okay as long as we're both stealing, I think it's acceptable.
Speaker 2:They're like an artist, they say, but it's the same thing there.
Speaker 1:Okay. So if someone's been listening to this and now they're, now they're interested. They think they or their spouse or bed partner has a sleep apnea problem. Where can they find out more about you?
Speaker 2:about you, yeah, so I think the the best place to start. We have um like a free guide. It's on our website, so it's apnea resetcom and it just goes over a lot of the. I mean really just like took all like the best starting tips. It's like 50 pages, um, have them in there of like different exercises you can do, watch people through the tests we talked about as well, and just some other you know, lifestyle tips like nutrition, et cetera, to start making progress, because a lot of the times like yes, always bring up your problems to your doctor.
Speaker 2:Now there's some countries where, like people email me and like so I have sleep problems. Then I can see, um, you know, I call my doctor and my next appointment's in two years, so everyone can guess what country that is. But the the idea that you have to wait until then to do something about it, where you can just be doing like some of the breathing exercises that are in there, yeah, for like 10 minutes a day, it's crazy. So, like, whether it's breathing exercise lifestyle, you can still do something on the way to doing that. You don't? You shouldn't wait two years just for someone to say you should go to sleep study, like yeah, no kidding. So that's a great start because it walks you through um, different things you can do and also tracking different things, like, uh, tracking like or like. I point you to the direction of like hey, maybe use this app for your snoring or if you want to get an overnight full socks, et cetera. Just kind of it's a good starting point for people in that sense.
Speaker 1:Talking about apps, I did want to ask you about the O-ring or the Whoop. Do those things actually give you information that talks to you about sleep apnea or not?
Speaker 2:So I wouldn't say it's the best. I would say that's still in that category of if you're more mild, it's good for optimizing, because the auction data on these things as of this moment in early 2025, I would never hang my hat on saying, oh, this gave us a really good picture of your auction levels overnight, really good picture of your oxygen levels overnight. They don't sample enough, whereas like an overnight pulse ox is, you know, registering a number every like 510 seconds. So that's gonna be way better than just knowing like way fewer data points. So I wouldn't say those are the best. Now, if you're, if you've made vast improvements and we just want to focus on sleep quality, I think they're sufficient. Sufficient.
Speaker 2:But before then, we really want to know how are your blood oxygen levels? Are they doing well? What's the average? How many events are you having? What's your heart rate during these events? Those devices don't have that capacity yet. Maybe they will in the future, but for right now, those things where you got to like actually have something on your finger or your thumb and it's on a wristband, uh, until something better is developed, that's what people should use. Uh, if they are going to monitor their own auction levels by themselves, yeah, okay, so we've got your website.
Speaker 1:we've got a free resource. Um, some people like to listen to this and then try and work with the person who is on the podcast. Is that possible with you or not?
Speaker 2:it is possible. Yeah, you just gotta say my name three times from your bathroom mirror then I appear. So, yeah, so if you uh, I mean I'm all over social media, you can find me there or on the website. I'm like% confidence interval that our email is on. There you can always reach out and we can take from there, because we have different ways in which we work with people, whether it's like educational consults or health coaching program. We have those available for people who are interested at that higher level of service. But I always tell people pick your own adventure the pace you want to go at.
Speaker 1:Okay and related, but uh, slightly off topic. I heard that you don't use a cell phone for text or social media or anything like that, but you're actually pretty savvy on social media. How do you do that?
Speaker 2:I know right, so contradictory. How did you know that? So, yeah, I really, I, um, I'm trying to remember the last time. Well, let me just paint like this. So, when I was in med school, my, um, if people want to contact me specifically for something like a classmate, they knew it would be better to text my uh girlfriend at the time, who's my wife now. They would reach out to her first. So I just like and I know it's right here um, I just, I just don't use it.
Speaker 2:I, I don't like texting, I don't like speaking to people, despite me speaking literally right now. Uh, just not something I I enjoy doing. So, yeah, I just don't. I just I don't enjoy it, I don't like it. I think a lot of times it just uses up time. But yes, I do also post like 90,000 times per day on social media and comment back quite a bit to people. So I'm a bit of an anomaly in that way. Do I still scroll on TikTok to look at dog videos? Yeah, I do, and for research, of course, what would be a good video? But I do need to at least watch three Great Pyrenees videos before then. But yeah, I just don't use a phone very frequently.
Speaker 1:Okay, wow, Well I was impressed when I heard that it was on another podcast. I was thinking that one of the big problems around sleep is, you know, blue light and sort of dopamine hits before you go to sleep and I try and limit this with my kids as much as I can. And then for myself, I self justify and I say yeah, but you know, my work is based online. Therefore, I need to look at Instagram and I'm like no, I don't, and I just try and put the whole thing down before about seven o'clock, but it's hard, it's, it's really is a struggle with the addiction for everybody yeah, it's um, yeah, like when we onboard, um, I guess, as part of our, our coaching program, we do have like a, an online facebook community, and a lot of times I'll be like, hey, do you use facebook?
Speaker 2:and they're like, no, not of times I'll be like, hey, do you use facebook? And they're like, no, not really. And I'll be like, all right, let's start, let's not start this habit. Then, yeah, let's avoid that. For because it's funny, because people go through our program and then they're oftentimes using their phones way less and way less, and people are like wait why aren't like people more active? Like well, we literally tell you to not use social media, yeah, yeah and as part of this as so there's that all right, dr dylan.
Speaker 1:Thank you very much for coming on the show. It was a lot of fun and very informative.
Speaker 2:Appreciate that of course, of course. Thanks for having me, and I had a blast, so thanks for having me on I hope you enjoyed listening to and learning from Dr Dylan.
Speaker 1:I certainly picked up some things from that and I'm going to be looking out for these things in my patients going forward as well. But hey look, I don't actually make these podcasts to get this to be the most popular health podcast in the health section of Apple Podcasts or whatever. I actually make them so I can refer my friends, family and my clients to an episode. So, for example, if I pick up that someone might be having problems sleeping with sleep apnea, I'm going to refer them to this episode, and that's what I would like you guys to do as well. So sure, give me a rating if you can Go to Apple Podcasts, go to Spotify, wherever you go, put down a five-star. Those all help get the podcast out there. But more importantly, you can help by sending this podcast to someone who you think might benefit from listening to the information. Really appreciate that. Your support means a lot to me and stay tuned for the next one.