Kim Vopni (00:01.56)
Hi Dr. Mock, thank you so much for joining me. I am looking forward to this conversation. I know it's a topic that comes up a lot in my community with regards to waking at night to pee. However, not everybody knows the link between that and sleep apnea and that is something that we're gonna talk about today. But before we do, can you let us know who you are, what you do and what brought you to this world of telling people about sleep apnea?
Dr. Charles Mok (00:26.77)
Yeah, thanks, Kim. So I'm Charles Moak. I'm a doctor in Michigan. We have practices in a few different states. And I started my career in hospital-based medicine, and then the last 20-some years I've been doing an aesthetic practice. And part of that started focusing on helping people look better on the inside as well as the outside, and that got me into sleep. And if we look at the pillars of health, you we can look at our diet and exercise, and sleep is maybe underrated. In fact, when I was younger, it was a badge of honor not to sleep very much.
the algo, you know, doing all nighter and these are things that made us proud. We know that we actually have a shorter lifespan if we don't get sufficient sleep. And some of the technology that we use was we were using it for things such as vaginal tightening and some other skin issues, but they invented a way to use this technology to treat snoring. And we modified it to use sleep apnea. We've patented that. So we do a laser treatment to tighten up the airway to reduce sleep apnea. And this led me to get more and more interested into the
disease of sleep to be able to maybe explain to our patients better and then really realize the impact of not having sleep apnea. So sleep apnea is defined as under breathing or not breathing for a 10 second interval during the night more than five times an hour. And the oxygen drops down by three percentage points. you've heard of a, yeah, Paul Sox would be working on your finger reading or the doctor's office.
Normally is 96%. So let's say it drops down to 93 % and you're sucking in air or may stop breathing for 10 seconds. We count that as one point. And if it happens more than five times, it's considered a disease state. And we actually score people on a scale of zero to infinite infinity. But typically some of the severe sleep apnea has like 30 episodes an hour and somebody a mile might have five episodes an hour. And in our practice, we mostly deal with the severe ones.
And there are treatments available, but if we go into the history of sleep apnea a little bit, back in the 80s, we knew it existed, but we didn't really know what it meant. So the National Institutes of Health went to the University of Wisconsin-Madison to try to study the incidence of sleep apnea in that population. And the population was people, 30 to 60 men and women that were working in the private sector.
Dr. Charles Mok (02:51.134)
and see what the incidence was. Now if we go back to 1980, we actually were a thinner society and there's a link between weight and apnea. But this was where we had more like a 20 or 30 % obesity rate versus this 60, 70 % now. And what they found was that about 25 % of men and about 10 % of women had obstructive sleep apnea. And they measured them and they put the study to bed for 20 years. So they published it in 1988.
and then again in 2008. They went back and looked at the death records. And again, these were people that started the study at 30 to 60, so now they're 50 to 80. And what they found were people that had sleep apnea with a score over 30 were three times as likely to be dead. Even when they adjusted for other factors such as smoking and obesity and hypertension, three times more likely to be dead. And those deaths were pretty much exclusively cardiovascular disease.
And this led to the thought about treating sleep apnea into a lower cardiovascular disease. And if we fast forward another 10 or 20 years, again, 2008, 2018, not 2025, these people are getting older and older. And we're finding that people that have sleep apnea not only have way more cardiovascular events and death, they get Alzheimer's on average 10 years sooner. They're two thirds more likely to get Alzheimer's in the first place. So then what is this? What are our options?
Kim Vopni (04:07.0)
Wow.
Dr. Charles Mok (04:14.558)
Getting back to this history of 25 % of men and 10 % of women, that was back in 1988. More recent studies done in Europe with populations similar to American, there's one done in Switzerland and one done in Germany. It's more like about 33 % of women and 50 % of men have sleep apnea based on our current size. And the factors associated with sleep apnea, clearly age, male sex, obesity. Those are the three clear ones and it's kind of unusual for young
in women to have sleep apnea and it'd be almost 100 % for an obese older male. But if you take women, we treat a lot of menopause, women of menopausal age, the most common complaint in menopause is weight gain. And the sleep apnea instance is greater than 30 % in that population. And a big disservice to health in general is the fact that the U.S. Preventative Health Care Task Force recommends against screening for sleep apnea.
means doctors can't disorder sleep apnea test, there's gotta be some medical reason for it. So it's not routinely tested for and as a result, only about 5 % of people with sleep apnea are actually treated for it. 95 % either don't know they have it or if they have it, they're not treated for it. And the treatments are a little bit maybe not that great. There's these dental appliances you can wear. There's something called a CPAP machine. There's a surgery, they put like a pacemaker in your chest and it gives a little electrical signal to your airway. We do this procedure called nightlays.
They all work pretty well and sometimes the patient's gotta figure out what works for them. But the way I approach this is that you should at least get tested so you can make your own decision going forward because if something has a 300 % increase in death rate, premature death rate, Alzheimer's 10 years sooner, almost double the incidence of Alzheimer's, you really should have the choice to do something about it. So how do we measure sleep apnea?
Kim Vopni (06:06.926)
Yeah, yeah.
Dr. Charles Mok (06:10.478)
The classic way would be going to the hospital sleep lab and they wire you up and somebody's watching you sleep all night. really, that was being done commonly before COVID, but technologies emerged about 2015 or so where you actually wear something that looks like an Apple watch. It goes on your wrist, got a little sensor in your chest, a little sensor in your finger. They work just as good as the hospital based and they cost like a hundred bucks. And you do it in own home and it hooks up to your watch. Your doctor gets a report the next morning.
Kim Vopni (06:36.334)
So that's different from like the Whoop Band or the Apple Watch, right?
Dr. Charles Mok (06:40.25)
Yeah, so the Whoop Band and Apple Watch cannot give you a sleep score. The FDA would not allow it to do a medical diagnosis. Now I've got the Oro Ring on and it does give me little strikes at night when I have apneic episode, but it can't give a score or anything. So you could get some scoring out of, even my bed, I've got the SleepAid bed, it tells me if I snored. So we have all these, you know, maybe signals. If you don't snore at all, good chance you don't have sleep apnea. If snore at all, you probably have some apnea. There's a good link.
Kim Vopni (06:48.579)
Yep.
Dr. Charles Mok (07:08.798)
Not 100 % because it's a good link. But really this is called a WATCHPAT, W-A-T-C-H, WATCHP-A-T. It stands for Pulse Amplitude Technology. And they cost us $100. As a doctor, I buy them. And we just sell them at our cost. But you really can go online and get a telehealth visit and maybe $200 for the doctor visit and everything. So I suggest everybody just does that on their own because insurance companies, they don't want to pay for it.
Because if you have it, then they gotta pay for the treatment that makes you live longer. Maybe that's not the primary goal of American health is to keep you healthy. It's to pay for disease. So I recommend everybody just gets tested and you can guess it from the Woot band or the Apple watch or the O-Ring, but it's 100 bucks, 200 bucks tops. And we should just know. And that technology is actually getting cheaper and cheaper. So.
Kim Vopni (07:57.295)
Do have to wear it so you put it on and is it, can you tell it just by one night or do you have to have it on for series of nights?
Dr. Charles Mok (08:03.742)
That's a question. So one night is sufficient. There's occasional times where you'll get a bad reading and you gotta do it again, but it's unusual for somebody to have apnea one night and not the next. Now the example would be you're out and you drink heavy and you're super tired, you'll have worse apnea score. So typically you're doing this on a usual night in your own home. Now when you go to the hospital lab to get it done, they're just doing one night tests and you're sleeping in an environment that's very, people are watching you.
Kim Vopni (08:07.054)
Well.
Kim Vopni (08:30.424)
Totally.
Dr. Charles Mok (08:33.186)
You're hooked up to tubes. So that's the inaccuracy. And unless you have major medical diseases such as atrial fibrillation or heart failure, the watch works just as good as the in-hospital lab, which the hospital testing is about two grand. So I think just paying for it and checking in. If you have it, then you can go after treatment. And really the first place to get treatment is through a dentist. A lot of dentists specialize in sleep. And they do the technology we do, which is the laser treatment. In many cases, probably in every city.
Kim Vopni (08:45.496)
Very cool. Wow.
Kim Vopni (08:51.363)
Yeah.
Dr. Charles Mok (09:02.002)
And they also have these dental appliances that kind of pull your jaw forward or adjust your tongue. And they work quite well. In most cases, you'll go from mild to moderate down to, I'm sorry, moderate to severe down to mild or from moderate down to none. And you can test again.
Kim Vopni (09:06.158)
Mm-hmm.
Kim Vopni (09:17.902)
That's fascinating. I want to come back to when you were highlighting the white obese male is more likely, but then you mentioned menopause and you mentioned that there's an increase in that specific phase of our life. So what is it about this menopause transition that would increase our risk of apnea?
Dr. Charles Mok (09:37.214)
So probably principally weight. So if we look at what occurred, I if I look at, we treat menopause and the most common complaint is the weight gain, know, fat gets stuck on like cement, can't get it off. Right now we're seeing even with these GLP-1 agonists such as semilutide and trisepidide, they actually reduce apnea scores because the weight is going down. So it is the weight gain associated with menopause and age and you know for...
Kim Vopni (09:58.744)
Interesting.
Dr. Charles Mok (10:05.404)
women, there's that of that almost that cliff that occurs when all of a sudden your estrogen, testosterone, progesterone kind of dry up. The weight gain comes, here's what I find really fascinating is prior to 2000, 26 % of women who were in menopause were on menopause drugs, estrogen and progesterone. And we can argue we weren't using the right things, we're using Premarin and maybe that's fine.
But it was 26%. And prior to that, we knew that women in menopause on HRT lived longer. There was something called the PEPI trial. Then the biggest disservice to women's health in this century was the Women's Health Initiative trial, which was totally misread by doctors. And I remember I was in San Francisco reading USA Today said, Premarin causes breast cancer. Well, actually, the women in Premarin had less breast cancer. It was just totally misread. Kind like a political hot potato like COVID was.
And the incidence of prescription menopause drugs for women in menopause now, 1.7%. Now what's happened? We started treating menopause like a mental illness with SSRIs and antidepressants. Now the SSRIs and antidepressants accommodate 27 % of women in menopause, whereas 3 % prior to 2000. So what's happened is the SSRIs have gone up from 3 % to 27%. And menopause drugs, the ones that resolve menopause and make you live longer, went from
Kim Vopni (11:17.838)
It's crazy, wow.
Dr. Charles Mok (11:28.606)
25, 26, 27 % down to 1.7%. And the lifespan implications are enormous. So in Europe, they never stopped treating women in menopause like we did in the United States. We have big cohorts from Finland and Poland and Denmark showing the reduction in strokes and cardiovascular events are really massive in women treated with hormone replacement therapy. The longer they're on it, the more longevity they get.
Kim Vopni (11:54.818)
Right.
Dr. Charles Mok (11:55.11)
It's estimated as roughly three years of healthy lifespan are added on by treating menopause by something other than a mental illness. So I get a different tangent, that fashion project of mine. the, but it is that weight gain is part of it. And the SSRIs do not help reduce weight gain. They actually aid in weight. Yeah, makes it makes you heavier and makes you not care about it anymore, perhaps, but you get heavier. Whereas women on
Kim Vopni (12:04.686)
That's okay.
Kim Vopni (12:15.406)
That was another question I was gonna have is is that a side effect of SSRIs is waking? Yep
Yeah.
Dr. Charles Mok (12:24.958)
estrogen will gain less weight than women on nothing. Women on estrogen and testosterone typically will favor weight maintenance over weight gain. And again, something we don't do. So if a woman does have mild menopause symptoms, mild obesity, mild sleep apnea, you might just figure about it. Let's work on your hormones first versus wear that dental appliance or something. You're retesting, getting that weight down, maybe adding a GLP-1 drug. But the real message would be test for it because this is something that, you know, if you look at
Right now there's a big interest in say longevity and anti-aging. There's that Brian Johnson that famously spends three or four million a year on his age. But what can you write a check for that can cut your risk of death in the next 20 years by 70 %? Well, sleep study. If you don't have it, you're fine. But if you do have it you don't treat it, you're more likely to die. You're more likely to get cardiovascular disease, heart attack, stroke, Alzheimer's. No link to cancer, but to the big...
two big killers, disease, cardiovascular disease, and neurocognitive decline, and there's a huge link to sleep. And really, that's not crystal clear why, but the speculation is, because what we see in people that have sleep apnea, they usually feel like they're sleeping pretty well, because they're exhausted when they go to bed, just, out as soon as they hit the pillow. And when they wake up, they feel a little tired, but they're okay. But we look at their sleep, and the watch can tell you this, the whoop can tell you this.
Their deep sleep is pretty much minimal. They might have 15 or 20 minutes of deep sleep. And once we treat the sleep apnea, the deep sleep goes to normal, hour roughly of time. And it's during the deep sleep that there's something called a glymphatic system. It's kind of like our lymphatic system in our legs. And the glymphatic drains out some of the toxins from your brain. Now the cardiovascular issue, not super clear. It looks to be related to decreased nitric oxide production, which is something that helps your vessels dilate.
But it is during sleep, we repair ourselves. During sleep and fasting is when we do autophagy where the body's cells that are like the cleanup cells, the garbage crew cells that clean up sick senescent cells in your body. And without deep sleep, this process does not occur as well.
Kim Vopni (14:39.886)
So specific for my community, they're often struggling with incontinence issues and waking up at night to pee is a big problem. Sometimes that can be overcome when they recognize that they have trained, that they actually don't wake up because of their bladder, they're just waking up and going pee and training their bladder to go. So when we can intervene with interventions to help that...
that can often go away, but then there are other people who may have blood sugar dysregulation or sleep apnea, which could be making the bladder, like what is the connection there between sleep apnea and getting people waking up to go to the bathroom more frequently?
Dr. Charles Mok (15:15.358)
Yeah.
It's a great question. And when you look at sleep apnea, you do have more wakeful periods during the night because the choking does wake you up. And if you're waking up at three in the morning and you have a mild sense of urgency, you're probably going to go to the bathroom because you don't wake up at five. You're probably going to go. But if you're asleep, your body tolerates that one third, two thirds bladder fullness just fine. So it really is the waking up. So if you look at, there's a
There's a correlation between waking up during the night and going to the bathroom. There's many, many other factors as well, but specific with sleep apnea, they're waking up pretty regularly. They go through these periods where they get into deep sleep and they're snoring really deeply and they're having these apnic episodes and eventually they choke themselves awake. They realize, I kind of have to go, probably should just get this over with right now. So they don't have probably fuller bladders, but they, you you start sensing your bladder full, probably about.
50, 60 % capacity. Like I think myself, when I get in an elevator, I got this paranoia of the elevator breaking down. So I just check, 40%, probably should drain this baby out. I don't want to get stuck in that elevator. And at night, same thing, if I wake up and I have a little bit of energy to go, I'm gonna get up and go. So it's probably not the apnea causing the urgency, it's probably the apnea waking you up and making you aware that the urgency's not so bad, but I'll go anyway.
Kim Vopni (16:27.502)
He
Kim Vopni (16:44.748)
And when you have, so it's like, in my interpretation, there's a sympathetic nervous response that's happening with that jolting you awake, your body is alarmed. It's an alarm response really where the snoring, your breath is stopped, the body is waking you up. So that also is going to be triggering this, sensation, the anxiety, the panic that can make you feel like you need to go to the bathroom as well.
Dr. Charles Mok (17:08.956)
Very likely it's multifactorial like you're pointing out. And the thing is when we look at these sleep, when we do the watches, like a Whoop watch or an Oral Ring Apple watch, it gives you pretty good information. When we do the watch pad, there's actually a movement sensor on, there's a lot more sensors on it. We get really detailed on the waking periods and they do fully wake up at night. They wake up and become alert, but they actually fall back asleep pretty easily because they're so exhausted.
Kim Vopni (17:12.205)
Yep.
Dr. Charles Mok (17:37.95)
So something like a normal insomnia might be where you wake up and you can't fall back to sleep. But the patients with sleep apnea, they usually have such a sleep deprivation that they wake up, kind of have go to bathroom, then they spit the pillow and back out.
Kim Vopni (17:37.987)
Right.
Kim Vopni (17:52.365)
Yeah. I want to highlight, if you will, some of the repercussions. You've mentioned a few of them, but, heart disease is a big one, like more likely to die. But what are some of the other negative impacts of not getting good sleep to our health?
Dr. Charles Mok (18:09.938)
Okay, so there's a women's health initiative study. We have a little information there. have the nurses study from the 60s, 70s, 80s. We have the Framingham study. And they weren't measuring sleep apnea back then. They were measuring sleep duration. And sleep duration had a significant contributor to obesity. So we talked about obesity causing sleep apnea. It was actually bidirectional. So women who were
obese, I'm sorry, women who are obese prior to measuring sleep apnea, if they had less than five hours of solid sleep at night, they were three times more likely to be obese. And if they were over, if they were between five and six hours, or like 50 % more likely, if they got six hours or more, they had more of a normal weight distribution. Now, that being said, that it's not that you treat your sleep apnea and the weight starts falling off.
does not work that way, but studies have been done showing that somebody who has sleep apnea has what we call treatment resistant weight maintenance. They can hang on to their weight, but if they treat their sleep apnea, they actually don't have more calorie burn in a day, but they're much more compliant with an exercise regimen and with dietary modifications for sleep apnea. But then if we look back at just the sleep and health concerns,
We look at these million women studies and find that women with shorter sleep patterns, was mostly the obesity they were looking at back then. And again, now we know it's much more linked to cardiovascular disease and neurochondriacline. There is no link to cancer. There's also links to things such as vehicle accidents, depression, vehicle accident depression, osteopenia, like osteoporosis. So there's links to pretty much every disease and short sleep.
Regardless of the cause because again based on these studies done earlier We weren't measuring sleep after you're measuring how long were you sleeping and the good marker for that is if you have sleep apnea generally gets shorter sleep Because they're waking
Kim Vopni (20:13.293)
And that's total time, sleep, you know, going to bed and so the time between you go to bed and when you wake up and start your day would be a shorter period of time. But then there's also the intervals of sleep within there. You mentioned deep sleep and that is, should be, said, I think around an hour. But if you have changes to those intervals, that could also potentially be shorting the overall duration as well.
Dr. Charles Mok (20:37.266)
Well, if you get, if you have like your whoop or your aura ring or Apple watch, you'll say you were in bed eight hours, you slept seven hours. And so what they tried to do is get sleep diaries, how much were you awake during the night? So you go to bed at nine, get up at five, but I know I was awake an hour during the night, that means you had seven hours of sleep. So it's that not bedtime, but it's sleep duration, which is not equivalent to bed. I mean, if you measure yours, my sleep duration is always roughly 30 minutes less than my time in bed. I've got a
like a little latency to fall asleep, about 10 minutes. I usually wake up at night. I don't remember it, but you wake up. So that's something they probably couldn't measure back then, because it was more self-reported. But the short sleep was because of the choking and waking up, we presume now. We didn't measure it back then, but now we know there's a correlation between poor sleep and sleep apneas. very, what's interesting, I belong to the sleep medicine group, and I go to their national meeting, and they used...
uppers to wake people up and downers to put them to sleep at night approved for sleep apnea. So instead of solving the problem, we're going to give you a drug to knock you out at night and another drug to stimulate you, kind of putting you on like amphetamines to wake you up. And they're actually FDA approved for sleep apnea. It's kind of sickening. the tree and the big farmer has been getting big tentacles into our healthcare system.
But the relationship, and so now we have a condition that's shortening your lifespan, so do we do? We give people drugs so they're just not aware of the fact they're getting such crappy sleep.
Kim Vopni (22:09.935)
Yeah, with the sleep cycles that we go through, would be, so anybody who does have a wearable, what would be an ideal pattern? Should our deep sleep all happen at one time? Should our REM sleep always happen at one time? Or should we be moving in and out of cycles throughout the night?
Dr. Charles Mok (22:32.06)
Yeah, so typically you go through cycles and maybe most of your deep sleep occur early in the night or later in the night. But typically you go through cycles where you go into a non REM sleep, REM sleep, deep sleep, slight back and or light sleep, REM sleep, deep sleep. And you might go through that two or three times a night. As we get older, we go through less of those cycles. Now, to be clear, I was talking about using the drugs. If you use the drugs, you will be asleep longer.
but you'll get the same amount of crappy deep sleep and REM sleep. So they'll be knocked out and we can measure that on a sleep study. So they're actually asleep longer, but the sleep that counts is the REM sleep and the deep sleep. The light sleep is not really helpful for us. And if you're on sleep drugs, it's possible that these at home sleep devices aren't as accurate. might consider, let's say you did a study at home and it's like, well, my sleep shows pretty good that I don't feel it's happening.
Kim Vopni (23:05.551)
interesting.
Dr. Charles Mok (23:29.8)
But now if you're taking sleeping pills, it's probably reasonable to go to a sleep lab, but they can get more accurate on measuring the brain activity. Because what the watches and stuff doesn't measure is your actual brain activity. They're estimating it through your breathing patterns and your pulse. The PAT says pulse amplitude technology. So the measurement changes in the pulse amplitude. We've all heard of HRV. There's other things you can measure besides that.
Kim Vopni (23:53.114)
Yeah, Yeah, so I want to come into the treatments you said. we talked, you know, there's the dental appliances, there's the CPAP machines, and then you talked about this laser. I want to know a little bit more about how that works from a treatment perspective. And do you say they all work pretty well, but is there, why would you use that over a dental appliance? You know, how do you differentiate between what's going to be the best option?
Dr. Charles Mok (24:21.234)
Okay, great question. So there's really four non-drug versions. So one is a call that inspires, it's like a pacemaker. Not widely accepted by insurance yet. It's got a major complication rate. It's pretty expensive. So we're not going to talk about that. That's actually growing. Then there's the dental appliances, the CPAP machine, and then the laser treatment. There's a handful of different laser treatments. The number one is called night laser. It's technology that's widely available in the United States. So what...
How would you pick one or the other? The go-to by your family doctor is gonna be what's called a CPAP. And that's kind like a Darth Vader mask that works quite well and pushes air in your lungs. The issues are, a lot of people hate them. The compliance rate is less than 30%, meaning 30 % of people know they have sleep apnea and I prescribed it. 30 % use it, 60, 70 % do not use it. Hard to travel with. But if you can tolerate that and you like it, that's fantastic. It works great. It reduces your score by 70%.
The laser reduces your score by 70 % and you do it once every few years. So with the laser procedure, we use two different laser technologies, don't get into that, but basically we shrink the tissues in the airway so the tongue now, the back of tongue is little smaller, pulls the tongue forward in the mouth and opens up the airway. So when you lay back down, the tongue doesn't occlude the airway.
Kim Vopni (25:38.787)
how's that performed? is it, do you actually go into the mouth or is it via the neck? How do you do that?
Dr. Charles Mok (25:44.222)
Yeah, no, we great go through the mouth. It's not painless, but it's not painful. It feels hot So sometimes we use a little anesthetic spray takes about 20 minutes or so technician does it and it just feels hot I've done it myself. did in 15 Sleep apnea gone 22 still had no sleep apnea started snoring again. So I did it just one treatment Nothing since and if somebody's weight stays the same, again, I said I did myself my weights never changed If somebody's weight stays the same pilot's, know three to seven years
the way it's going up, might need do it every couple of years. And a lot of dentists have this technology. We're not dental, but we have this technology as well. But it's common for dentists offices that have the nightlays. So if you Google nightlays, you'll find somebody, usually in your community, that does this for sleep apnea. And then the dentist that's doing that also can see how you might work with a dental appliance too, which kind of pulls the jaw forward. And I would say that, test it. If you have an issue, find a dentist in your community that loves to treat sleep.
And they're really going, they're trying to figure out what's the best for people. I think your family doctor, they're not really motivated to treat this. the American, they started the U.S. Preventive Healthcare Task Force recommends against screening for sleep apnea. And because it's a chronic disease and your doctor knows you won't be compliant, they don't even want to write it on a chart because it kind of dings them for having a chronic disease they're not dealing with. So it's almost like they want to stick their head in the sand and not acknowledge it. So would say go through a dentist, pay cash for it.
Kim Vopni (26:53.252)
Mm-hmm, mm-hmm.
Kim Vopni (27:07.268)
Maybe a biological dentist would probably be more, like they talk a lot about airway stuff.
Dr. Charles Mok (27:12.446)
I don't know that. go to a lot of meetings with dentists and sleep doctors and the dentists that do this, they say, I got sleep practice. So they call it a sleep practice dentistry. And usually it's like 30 % of practice is sleep. And to be clear, this occurs in children as well. So it occurs at any age. I mean, that's my whole family. These kids are pretty cheap.
Kim Vopni (27:33.871)
Yep. Yep. And then from a, you know, so obviously there's the connection between the weight. losing weight, if the person has excess body weight or excess body fat, maybe you could say is something that they could do. Like I'm just thinking about these procedures could help, but we also want to look at the lifestyle. So how else can people optimize their health, their day to set them up for
better sleep. Let's say we've addressed the weight issue where this person is a normal weight and if they have sleep apnea then that's one thing but if just in general somebody who's wanting to optimize their sleep what else could they do?
Dr. Charles Mok (28:12.4)
Okay, so we have the sleep apnea component, which is really partially genetic. It'll mend much more often than women. Age, can't control that. Weight, we do have to control over that. So those are the biggies. Then we have like sleep hygiene things. And we are not a primary sleep clinic. So we just treat obstructive sleep apnea. But we know that there is sleep hygiene techniques to help you sleep good. So, you know, not.
drinking before bed a couple of hours beforehand, getting rid of screen time, people wearing those orange glasses and stuff to kind of reduce a certain amount of light reflex, not eating too much before dinner, reading rather than say getting on your screen, these all help. But I'd say my expertise is not in that, so I don't want to talk about stuff I only have a personal understanding about. We just treat the obstructive sleep apnea. And I'd say that when I even encourage patients that are
Kim Vopni (28:57.968)
Sure. Yeah.
Dr. Charles Mok (29:07.602)
they're questioning our technology versus other stuff. Like, I don't care what you do. They all kind of work about the same. Pick what works best for your lifestyle and for your budget. The other stuff's really cheap, but it does all work about the same. But for sleep hygiene, there's books on it. There's a lot of information to go get. But again, that's not my sweet spot, understanding that.
Kim Vopni (29:20.932)
Yep.
Kim Vopni (29:25.07)
Yep.
Yeah. Something you highlighted was the term obstructive sleep apnea. Is there, are there non obstructive? Are there different types of sleep apnea?
Dr. Charles Mok (29:36.922)
Yes, so there's something called central sleep apnea, which has to do with your brain wiring not being right. That'd be classic in like an Alzheimer's patient or something where you just forget to breathe at night. So it's a very small percentage of healthy ambulatory people. But a sleep study does pick that up what type it is. So obstructive sleep, to be clear, the obstructive sleep apnea means when you're trying to breathe in, the air can't make its way in. And the first thing that might happen, the person might start sleeping on their side and for a few years that might work.
Kim Vopni (29:53.859)
Okay.
Dr. Charles Mok (30:06.952)
They need to start sleeping on their stomach, kind of drops the airway forward and eventually they just start waking up because they're gonna be in a position where their airway obstructs. And there is a strong correlation between snoring and sleep apnea, but it's not 100%. However, if you have a loved one that's snoring at night, I'd encourage them to get a sleep study. If they're thin, healthy, young, not snoring, probably not worth the money to test for it. But in the other setting, I just would.
I would test an even woman over 50.
Kim Vopni (30:38.64)
All right, well, now I know what our Christmas presents to my husband and I are gonna be a sales watch. So if you bought the watch, could one person wear it and then another person wear it or do you have to buy it individual for each person?
Dr. Charles Mok (30:48.464)
you buy them individually. the wholesale cost is about $100. There's something called, okay, this is Watch Pat. I like that one, gives the best report. There's one called the Night Owl, way, way cheaper, not as much information, but it does answer the question. I know the Watch Pat can be had in Canada, where you're at, because I've sent them there before. But I know if you go online and there's telehealth companies that are national.
or the telehealth doctors certified in reading sleep tests. They can ship you the watch and go over the results with you for not a lot of money.
Kim Vopni (31:27.408)
Interesting, very cool. All right, well where can people learn more? I know you have a book. Where can people find that book and learn more and potentially even come and have a visit with you?
Dr. Charles Mok (31:36.862)
Yeah, sure. So it's Allure, A-L-L-U-R-E Medical. And you could just go to Google and type Allure Medical Books and our books are all free online. I've written 10 books on healthcare and I get my royalty checks realizing I'm not in the business of selling books. I'm in the business of running a medical practice. the books are all available online for free or you can buy them on Amazon. I prefer to just get the digital version.
Kim Vopni (32:02.818)
Mm-hmm, mm-hmm, amazing. Thank you so much.
Dr. Charles Mok (32:04.328)
So the book for the sleep is called The Sleep Apnea in 21st Century Epidemic. And for your audience, I've written another one that's our biggest seller book and it's called Testosterone Strong Enough for a Man, but Made for a Woman. And it's about why we should be using testosterone with estrogen, progesterone, and menopause.
Kim Vopni (32:19.088)
You
Kim Vopni (32:24.378)
Okay, well there I've just planted, or you've planted a seed for another podcast episode. All of the topic. Thank you so much. I appreciate your time and for joining us and I'll have the links in the show notes so people can find you.
Dr. Charles Mok (32:36.35)
Alright, thanks, Kim. Bye.
