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Sleep, Vitamins and Family Practice Dr. Stasha Gominak ETMC Neurologic Institute, 700 Olympic Plaza, 912 Tyler, TX (903) 596-3808 www.drgominak.com 2/19/2011
Why don’t we doctors know much about Sleep?  ,[object Object],[object Object],[object Object],[object Object]
Sleep and Headache ,[object Object],[object Object],[object Object],[object Object],[object Object]
6 years of sleep studies: 9/10 daily headache sufferers have abnormal sleep ,[object Object],[object Object],[object Object],[object Object]
Normal Sleep is a highly organized process ,[object Object]
What is Light Sleep? ,[object Object],[object Object],[object Object]
Deep Sleep: Slow Wave Sleep ,[object Object],[object Object],[object Object],[object Object]
Growth Hormone in Slow Wave Sleep may help us heal ,[object Object],[object Object],[object Object],[object Object]
Deep Sleep: REM Sleep ,[object Object],[object Object],[object Object]
9/10 daily headache sufferers in my practice have abnormal sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Migraine “Brainstem Generator”  is in the same area of the brainstem where we do timing and paralysis of sleep
Posterior brainstem Periaquiductal Gray plays a large role in sleep and sleep paralysis ,[object Object],[object Object],[object Object],[object Object]
Features of my patients’ sleep disorders: (They don’t have fat necks!) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Wobbly Paralysis Switch ,[object Object],[object Object],[object Object],[object Object],[object Object],Too   Paralyzed Not Paralyzed   Enough
Simplifying abnormal sleep studies : 2 common features: ,[object Object],[object Object],[object Object]
If headache improves how about other pain? ,[object Object],[object Object],[object Object],[object Object]
Why does everyone and his brother seem to have Sleep Apnea? Did we make it up? Has it always been there or is it new? What’s causing it? Why is it more in “developed countries”?
All over the world 9/10 sleep studies are abnormal. With sleep apnea comes: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
I thought Sleep Apnea only happened to fat people
Does obesity cause sleep apnea or does sleep apnea cause obesity?
Obesity and Sleep Apnea ,[object Object],[object Object],[object Object],[object Object]
Why is the CPAP experience important? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What’s happening here that’s goofing up my patients’ sleep? Periaquiductal gray
Why don’t we fix the sleep instead of blowing air up the nose? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamins and Sleep ,[object Object],[object Object],[object Object],[object Object]
Vitamin D and Sleep ,[object Object],[object Object],[object Object],[object Object]
Vitamin D receptors concentrate in 3 brain areas;  periaquiductal grey, lateral ventricles and pituitary/hypothalamus
What is Vitamin D anyway? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
In the 1970’s- 80’s Dr. Walter Stumpf “explained” what D hormone does
Dr. Walter Stumpf and D hormone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why would we have a hormone made by UVB that bosses the pituitary and hypothalamus? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Where are the D Receptors?  (Where they are may suggest what they do.) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summer: High D message (70-80) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Winter: Lower D message (50-60) ,[object Object],[object Object],[object Object],[object Object]
D Hormone and Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
D Hormone not Vitamin D ,[object Object],[object Object],[object Object],[object Object]
Epidemiologically related to D deficiency- (same list as sleep apnea) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Disorders of GI tract epidemiologically related to D deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cholesterol and D Hormone ,[object Object],[object Object],[object Object],[object Object],7   dehydrocholesterol Pre vitamin D
Cholesterol and D Hormone ,[object Object],[object Object],[object Object],[object Object]
Vitamin D inflammatory connection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Autoimmune Diseases Epidemiologically linked to D deficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why did they call it a vitamin if it’s not one?   Why the “D2” and “D3” numbers ? ,[object Object],[object Object],[object Object],[object Object]
D2 is NOT the same as D3 ,[object Object],[object Object],[object Object]
What does this D have to do with my patients? Where’s the evidenced based medicine?
Vitamin D and Cardiovascular Dz ,[object Object],[object Object],[object Object]
Vitamin D and Cardiovascular Dz ,[object Object],[object Object],[object Object]
Vitamin D and Cardiovascular Dz ,[object Object],[object Object]
Vitamin D and Atrial Naturetic Factor ,[object Object]
Epidemiology is fine. What about treatment trials? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Restorative sleep is the cure for cardiovascular disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How to replace the D to fix the sleep and why all the controversy about dosing? ,[object Object],[object Object],[object Object],[object Object]
What is the right level ? ,[object Object],[object Object],[object Object],[object Object]
What’s the right dose? ,[object Object],[object Object],[object Object],[object Object],[object Object]
The right  dose  is different for each person. But the right  level  is the same for all humans (just like thyroid or estrogen) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D Toxicity and why the FDA’s not crazy ,[object Object],[object Object],[object Object],[object Object]
Why the FDA’s not crazy ,[object Object],[object Object],[object Object],[object Object],[object Object]
The  FDA  recommended dose has absolutely nothing to do with the blood level that should be achieved in a clinical trial to produce normal sleep and cure disease. It also has nothing to do with the dose you want for your sleep to be normal so you don’t have to take those pills.
My Observations on Particular Patient Groups
Hypertension ,[object Object],[object Object],[object Object],[object Object]
My Observations on Particular Patient Groups ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bone Health ,[object Object],[object Object],[object Object],[object Object]
Arthritis ,[object Object],[object Object],[object Object],[object Object]
Unexplained or Chronic Pain ,[object Object],[object Object],[object Object]
Depression and “Bipolar” ,[object Object],[object Object],[object Object],[object Object],[object Object]
Why do women get fat after babies? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Babies and Children ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Babies and Children ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Our healthy vitamin D future

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Sleep painvitfampract

  • 1. Sleep, Vitamins and Family Practice Dr. Stasha Gominak ETMC Neurologic Institute, 700 Olympic Plaza, 912 Tyler, TX (903) 596-3808 www.drgominak.com 2/19/2011
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. The Migraine “Brainstem Generator” is in the same area of the brainstem where we do timing and paralysis of sleep
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. Why does everyone and his brother seem to have Sleep Apnea? Did we make it up? Has it always been there or is it new? What’s causing it? Why is it more in “developed countries”?
  • 18.
  • 19. I thought Sleep Apnea only happened to fat people
  • 20. Does obesity cause sleep apnea or does sleep apnea cause obesity?
  • 21.
  • 22.
  • 23. What’s happening here that’s goofing up my patients’ sleep? Periaquiductal gray
  • 24.
  • 25.
  • 26.
  • 27. Vitamin D receptors concentrate in 3 brain areas; periaquiductal grey, lateral ventricles and pituitary/hypothalamus
  • 28.
  • 29. In the 1970’s- 80’s Dr. Walter Stumpf “explained” what D hormone does
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45. What does this D have to do with my patients? Where’s the evidenced based medicine?
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58. The FDA recommended dose has absolutely nothing to do with the blood level that should be achieved in a clinical trial to produce normal sleep and cure disease. It also has nothing to do with the dose you want for your sleep to be normal so you don’t have to take those pills.
  • 59. My Observations on Particular Patient Groups
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.
  • 69.
  • 70.
  • 71.