Category Archives: Neurology

Straight, No Chaser: Dementia – When Brain Health Goes Bad

dementia-brain eraser

In case you didn’t pick up on it, the posts regarding brain health served two purposes. The first is to ensure you give yourself the best opportunity to live a healthy, happy mental life. The second is to stave off the point in your life when you develop dementia. In this and the next post on brain health, we focus on dementia, which occurs when the brain becomes a certain type of unhealthy. Alzheimer’s disease is the most common cause of dementia, accounting for approximately 60-80% of cases.

Look at the below chart for a stunning illustration of the scope of dementia.

Dementia facts

As opposed to being a single disease, dementia describes a range of symptoms associated with a decline in memory or other mental skills. As such, it’s more helpful to describe functions lost instead of symptoms you may experience. Dementia is associated with a reduced ability to perform routine activities of daily living. It can be associated with significant impairment of other mental functions, including the following:

  • Memory
  • Communication and language.
  • Ability to focus and pay attention
  • Reasoning and judgment
  • Visual perception

Practically this could range from problems with remembering appointments or names, engaging in unnecessarily dangerous activities for no reason, or keeping track of items.

demenetia brain map

Dementia is caused by damage to brain cells. It’s the type of damage that could occur from a poor diet, age-related or other causes of poor blood circulation to the brain (e.g. a stroke). Depending on the involved area of the brain, various levels of loss of function may be seen. Based on the most common patterns and sites of brain damage, the mental deficits described above are those most likely to be seen. It is of note that the center of memory and learning (the hippocampus) is often the first area damaged, which corresponds to those deficits that define early dementia/Alzheimer’s.

My messages to you regarding dementia are pretty simple.

  • You don’t want it. Dementia is the end of the beginning and the beginning of the end. It is progressive. The symptoms will be more and more pronounced with time.
  • You need to address it. If you haven’t been forward thinking enough to engage in brain health, know the early signs, and get checked out as soon as possible. The good news is all dementia isn’t Alzheimer’s and could represent a treatable cause. Even when it doesn’t, steps to temporarily improve symptoms can be instituted.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.

This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.

Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.

Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.

Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.

If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.

http://www.aarp.org/health/brain-health/

www.luminosity.com

Whatever you choose to do, do something!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Brain Health – Foods and Brain Healthy Habits

brainfood

I only get asked about this everyday, so let’s review keeping your brain healthy. Unfortunately too often some of you only ask at the point when early dementia or Alzheimer’s disease has begun to develop, but this is another example of an ounce of prevention being worth a pound of cure. Also, these requests often seem to be related to some internet promise of health based on some fad or miracle cure. Remember the Straight, No Chaser dictum: your health won’t be found in a bottle.

In a previous post about how your brain works, we pointed out that your brain consumes a tremendous proportion of the body’s oxygen supply. So to begin the conversation, just remember that a diet promoting good blood flow throughout the body promotes good blood flow to the brain. I wish I could convince you that a baseline level of brain health is just this simple: consume a diet low in fat and cholesterol. If you’re not clogging the arteries in the rest of your body, you won’t be clogging arteries in your brain. The same things you’re doing to avoid diabetes and hypertension will help you here.

As such let’s provide an overview to five basic principles to keep your brain healthy. If you adhere to these, you can save the money you’re spending on ginkgo biloba.

brain health protect

Reduce your fat and cholesterol intake

It’s as simple as already discussed. High intake of these foods promotes a higher risk of Alzheimer’s disease later in life. Try these specific tips.

  • Use olive oil instead of other saturated fats.
  • Bake or grill your food instead of frying it.

brain health foods

Eat foods shown to protect and promote brain health

I want to make this simple. If you’re eating dark-skinned fruits and/or vegetables, you’re being good to your brain. These foods tend to have the highest levels of antioxidants fighting off damage to your brain cells. Here are some specific examples of brain healthy foods. Try working them into your diet.

  • Fruits – blackberries, blueberries, cherries, oranges, plums, prunes, raisins, raspberries, red grapes and strawberries
  • Vegetables – alfalfa and Brussels sprouts, beets, broccoli, corn, eggplant, kale, onion, red bell pepper and spinach
  • Nuts – almonds, pecans and walnuts are a good source of vitamin E, another powerful antioxidant
  • Fish – halibut, mackerel, salmon, trout and tuna (all contain omega-3 fatty acids, which are brain healthy)

Vitamins

The best way to obtain brain-healthy vitamins is through a brain-healthy diet. Foods strong in vitamins E, C, B12 and folate appear to be important in lowering your risk of developing Alzheimer’s. It should come as no surprise that the foods listed above meet that criteria. You may not know that obtaining vitamins through your food appears to deliver what you need better than taking pills.

brain health activities

Exercise

If you’re keeping your heart strong and pumping blood efficiently throughout your body, your brain is getting its needed supply of oxygen and nutrients. Check this Straight, No Chaser on basic exercise tips.

Be social, Be a lifelong learner

Exercise your brain through social interactions with others, especially those that “stimulate your brain.” The diversity of experience keeps different parts of your brain active, alert, functioning and healthy. Learn a new skill or language. It’s almost as good as starting over!

Another Straight, No Chaser will focus on additional ways for you to engage your brain to keep it working and working well.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Brain Health – How Your Brain Works

brain health fitness

Everyone at Straight, No Chaser and www.sterlingmedicaladvice.com is into brainpower. This is the first of a series of posts on brain health and brainpower. The purpose of these posts is to give you enough information to optimize, maximize and extend your brain health. Hopefully you’ve learned all this before (no pun intended), and we’re just reorganizing it for you.

The brain really is a fascinating organ; indeed it’s the body’s most powerful (with apologies to the heart; don’t be broken by the news). Despite jokes to the contrary, it only weighs about three pounds in the average person (I’d imagine many of you are inserting your own jokes about your favorite friends here…).

Brain Health

The brain has three major components:

  • The cerebrum is the area taking up most of the area in your skull. It controls thinking, problem solving, remembering, feeling and movement.
  • The cerebellum controls coordination and balance from its position in the back of the head, below the cerebrum.
  • The brain stem is also beneath the cerebrum but is in front of the cerebellum. The brain stem connects the brain to the spinal cord. It controls breathing, blood pressure, digestion and heart – functions you normally don’t have to “think” about (automatic functions).

You may be surprised to know about a quarter of your total blood supply nourishes your brain with each heartbeat. Your network of brain cells consists of billions of cells, and they extract approximately 20% of the oxygen and nutrients being carried by the blood. This amount can increase up to 50% depending on the brain’s level of activity. This is an immediate illustration of why brain health is so vital.

 CerebralCortex

Have you ever wondered why the brain has that wrinkled outer appearance? That area is called the cortex. The cortex roughly resembles a map corresponding to various functions. This area interprets sensations from within your body, and sights, sounds and smells from the outside world. It also helps you form and store memories, generate thoughts, make plans and solve problems. The cortex also controls voluntary movements.

left-right-brain-content 

Another common question about the brain relates to the differences between the left and right sides and what that has to do with people who are left-handed or right-handed. Here’s what is clear about the different halves of the brain.

  • The left half controls movement of the right side of the body, and the right half controls the left side of the body. Thus if you’re right-handed, you’re likely left-brain dominant.
  • In most people, the language area is mainly on the left.

 brain health neurons

All things considered, the adult brain has approximately 100 billion nerve cells, called neurons. Neurons are where the real work of your brain occurs. Via various branches, there are more than 100 trillion connections. This amazing and powerful network is called the neuron forest. This network of neurons is how we know to generate thoughts, feelings and memories. The individual “way stations” where chemicals (neurotransmitters) sent by neurons via electrical charges connect are called synapses. There are dozens of different types of neurotransmitters facilitating different levels of communication within the brain.

 brain health unhealthy brain

Functionally, this level of specificity is important to know at a general level because it sets the table for these additional considerations to be discussed in additional posts:

  • Good brain health keeps your brain working optimally.
  • Certain diseases (e.g. Alzheimer’s) destroy neurons and otherwise disrupt both the way electrical charges travel within cells and the activity of neurotransmitters.

This is a simplistic representation of how your brain organizes all the thoughts, activities, memories, skills and knowledge of self we have. Make the commitment to protect your brain. After all, it’s who you are.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Insomnia – You Are Not Getting Sleepy

Insomnia-picture

This is part of a Straight, No Chaser series on sleep disorders. 

So the pendulum swings from hypersomnia to insomnia. Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.

Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle.

insomnia

Unfortunately, there are many mental factors that can disrupt your ability to sleep. Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

insomnia comps

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.

As Edward R. Murrow used to say (well before I was born): good night and good luck.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?

Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, narcolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.

Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.

Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: Sleep Apnea

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.

The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.

Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.

Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.

Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.

Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.

We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.

Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!

http://www.youtube.com/watch?v=Wm-TZ-dO_rQ

This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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