Category: Heart Health

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Heart Health

The Glucose Goddess Method of Blood Sugar Control

Here at Heart Health, we view the body as a whole, all systems working in harmony for the purpose of our wellbeing. To feel well, the body has to function properly, and there is nothing more vital for this purpose than our metabolic system – in charge of metabolizing blood sugar. A topic that the Glucose Goddess Method explains very well.

Don’t worry, no CGM or glucose monitor needed, or HOMA-IR formulas. Let’s dive in.

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Blood Sugar Control

In 2023, food abundance and food processing are the leading health risks to those in the West. With a solid public health infrastructure, we have less infectious disease to worry about. It’s metabolic diseases that pose the biggest health risk.

A few centuries ago, it was too much lead in the food that posed the biggest risk. Later, it was viruses and, even later still, bacteria. Now, we have too much glucose floating around in the body, which causes excess fat deposition, cell destruction, aging, hunger, inflammation, and fatigue.

Blood sugar control is not just a topic for diabetics. If you wait to address blood sugar once you’ve been diagnosed with prediabetes or type 2 diabetes, it’s a bit too late.

The goal isn’t perfect blood sugar numbers – that kind of obsession bursts at the seams somewhere else. But we need to mind our glucose numbers, and it requires a concerted effort by all body parts to keep serum glucose numbers in check.

The Glucose Goddess Method

We like the Glucose Goddess Method because it’s evidence-based and you can follow it easily. She does a fantastic job of explaining and teaching the important points of blood sugar control. Easy to follow and with good results.

Some think she’s all about using a CGM or checking your blood sugar numbers with a glucometer, but really, she’s done that for you already. All that you have to do is follow the style of eating and movement she talks about.

We recommend her 4-week guide as a great place to start – you’ll get all of her hacks in one short 4-week program. Later, you can go back and read her Glucose Revolution book for more background and maybe to solidify your efforts in controlling your blood sugar.

Blood Sugar And Heart Heart

Cardiovascular health and blood sugar are closely linked because we know that excess glucose in the blood causes damage to cells, increases inflammation, increases atherosclerosis, and leads to unstable plaque, which can cause heart attacks or strokes.

The main things we are concerned with here at HH are:

Plaque buildup, or atherosclerosis, by itself, isn’t the worst thing. For those who are sedentary, it can lead to angina, yes. We worry most about the buildup of unstable plaque – the kind that breaks off and causes a strong inflammation cascade, which leads to complete blockage of the vessel – leading to the death of the heart muscle.

Excess serum glucose damages the sensitive electrical system of the heart, leading to arrhythmias, which can make the heart stop or lead to heart failure.

Key Factors of Glucose Control

1. Prevent Glucose Spikes

Prevention is better than treatment. The best way to prevent an initial glucose spike is to eat the kind of foods that don’t raise your serum glucose. It’s what you eat, when you eat it, and how you eat it, that can control those spikes.

  • Eat foods that your body can’t easily convert to glucose.
  • Eat slowly and chew well.
  • Don’t eat late at night.
  • Know in which order to eat your food.

2. Lower Glucose Spikes

It’s inevitable that your blood sugar will shoot up, often due to stress, being sedentary, or having eaten something your system didn’t like.

Lower serum glucose by controlling your metabolism.

  • Start breathing exercises, meditation, and exercise.
  • Hydrate slowly and consistently throughout the day.
  • Consider supplements – though these are not often effective.

3. Improve Glucose Metabolism

A more longterm strategy is to make our bodies into glucose metabolism factories – the kind of intestinal tract, liver cells, and muscle tissue that can immediately get the excess glucose out of the blood vessels and safely store it away.

  • Know your visceral fat content.
  • Decrease inflammation using inflammatory signals and serum markers.
  • Build more muscle or more effective muscle.
  • Maintain or improve your gut flora.
Categories
Heart Attacks Heart Health

You Had a Heart Attack, Now What?

After a heart attack, it’s normal for many to fall into major depression. They will recognize their frailty for the first time. And the church of meds and doctor visits only adds to feeling overwhelmed.

Fortunately, for many of us, a myocardial infarction is a call to our health. A signal that something major happened, but we’re still getting another chance.

Not to downplay the emotional toll a heart attack has on us; not at all. Sitting with those helpless feelings and talking it through with an expert is quite valuable. But we won’t dive too much into that here today.

Surviving a Heart Attack

Sadly, only 1/2 of us will survive a heart attack. In fact, the way many find out they have arterial plaque in their coronary arteries is on autopsy.

Those who survive have an opportunity to live their healthiest lives ever. We’ve had patients who had an attack in their early 50s and changed things around to now live healthily into their 80s.

To survive a heart attack means that your myocardium suffered some damage but not enough to make it stop. It also means that your tactical approach from this point on can change your Heart Health drastically.

Book a consult with Coach Mo to review your Heart Health Plan after a heart attack.

After a Heart Attack

Step 1, address the emotional side of it. Even if you don’t believe in ‘mental health,’ your attitude towards your cardiovascular health is one of the key driving forces to healing your heart and living a long and healthy life.

1. Exercise

Early activity. Cardiologists are reluctant to recommend early activity, but with the right experts in the mix, almost everyone will benefit from movement after a heart attack to help improve their peripheral vascular response and cardiac output.

How much activity do I need and how much can I tolerate? How can I tell if I’m overdoing it or if I can keep pushing it.

Cardiac rehabilitation. Similar to exercise, this is a bit more involved, and the goal is gradually improving the person’s exercise capacity. Most insurance-based cardiac rehab programs aren’t up to snuff, but plenty of private rehab experts are great at their art.

Where can I find private cardiac rehab experts who will guide me through my heart attack recovery?

2. Medical Interventions

Medical intervention. Medications are an important part of the Heart Health recovery after a heart attack. It also depends on whether you had to have any stenting or other procedures done.

What medications do I need and for how long? What’s the purpose of each one and why is my doctor choosing them?

Blood glucose control. Blood sugar control isn’t just for diabetics. Glucose spikes will cause damage to vessels and circulation. It will impede recovery. You don’t need a fancy CGM, but you need to know how your blood glucose responds to foods & stress.

What is my blood sugar first thing in the morning and 2 hours after a meal? What is my blood sugar after certain foods, alcohol, stress, and exercise?

Address inflammation. Inflammation may be a factor in why we develop heart attacks. Atherosclerosis by itself isn’t too dangerous – it’s the instability of the plaque that matters more.

3. Lifestyle Changes

Dietary changes. Whether genetics or lifestyle habits lead to your attack, recovering from one requires fine-tuning your diet. A diet program should be tailored to you, not a cookie-cutter plan.

Am I getting enough whole foods in my diet? Is there anything processed I can cut out? Am I getting enough calories for my activity levels?

Sleep optimization. Heart muscle needs healing, arteries need to flow well again, and circulation has to go back to normal. This tissue healing can only happen with restful sleep. It doesn’t need to be perfect, but you can’t skip over it.

Did I have a restful sleep? Do I need to cut out the caffeine or alcohol? Do I need to go to bed earlier?

Stress management. Stress that you can cope with and manage is okay; it’s the excess stress that tends to make a heart attack recovery difficult.

Am I stressed? What 3 steps can I take right now to help reduce this stress level a little.

4. Empowerment

Education. Understand why the heart attack happened will help you prevent future heart attacks. The human body may be complicated but the basics of how it works and how it malfunctions is fairly easy to understand.

Categories
Heart Attacks Heart Health Hypertension

Clever Ways of Reducing Salt Intake

We loved a recent video by Nutrition Made Simple where the author points out the risks of excess salt in the diet. And he also discusses clever ways of reducing salt intake. See the link above to watch the entire video.

High Salt Intake

Most of us consume too much salt because we get it in canned food, pastries, bread, packaged foods, pasta, tofu, and even sweets. It’s tough to avoid.

It’s a habit – which is the toughest thing to overcome. Over several decades, our taste buds have gotten used to a strong salty flavor, making it hard to start using less salt suddenly.

Like heavy foods, such as fried foods, it’s often a flavor profile we are accustomed to. Over time, it’s possible to break the habit, but it takes many months, often a couple of years.

Salt & Heart Disease

Studies show that heart disease is linked to higher salt intake. Lowering our overall salt intake or ensuring we get enough healthy grains and fruits into our system decreases the risk of heart disease and doesn’t just lower blood pressure alone.

Replacing Sodium with Potassium

The suggested alternative is to use a salt that isn’t made of sodium chloride (NaCl) but instead of potassium chloride (KCl), which is safer, as the studies demonstrate.

Lowering the total sodium intake and replacing it with potassium decreases the risk of death and strokes. That’s a powerful intervention, and the food’s taste isn’t sacrificed because KCl is still quite salty.

Heart Health Coaching clients also know that eating more fruits and vegetables adds potassium to their diet. Remember, adding potassium, not just the sodium replacement, is a driver of better Heart Health.

Salt Substitutes

There are lots of salt substitutes out there, and your favorite health food store should have seasoning options with no salt at all, with some potassium, or some combination of the two.

The key is to experiment and see if it tastes different. And of course, just adding less salt to your food will reset your taste buds and is a good way to crave less.

Categories
Heart Attacks Heart Health Hyperlipidemia

How To Lower ApoB Levels

We discussed the importance of measuring apoB levels to understand someone’s Heart Disease risk. Now, let’s talk about what we can do to lower apoB and by how much.

Diet: 5-10%

For most of us, reducing saturated fat intake and excess processed carbs could have an additive effect on lowering apoB levels.

Increasing fiber intake and switching to more whole plant-based foods with the occasional healthier oil options will further lower apoB levels.

Some clients believe that saturated fat can be good and cite research that it may not be as harmful as some claim. Our Heart Health Coaching Program settles this debate through lab tests by monitoring not only apoB levels but also inflammatory markers.

Exercise: 7%

Some studies show that exercising 30 minutes 5 times weekly can lower apoB levels. Most of these studies focus on aerobic exercise and less on resistance training.

At HHC, we believe that resistance training can be incredibly potent when done properly and long enough.

Insulin Resistance: 10-15%

The factors that improve insulin sensitivity and, therefore, lower insulin resistance are often the same things as above – dietary change and exercise.

However, there are independent factors that make insulin more sensitive in the body that involve VLDL production. Or perhaps it’s all related and difficult to tease out in studies.

Weight Loss: 10-20%

Some individuals have apoB production/clearance pathways incredibly sensitive to weight. Losing weight helps improve apoB by as much as 20%.

Stress Reduction: 5%

Stress is part of everyday life. It’s the type we cannot cope with that is the most damaging. There are plenty of proven coping strategies out there, as well as medication techniques.

8 weeks of meditation could lower apoB levels by up to 5%.

Sleep Improvement: 10%

When it comes to sleep, we care about restful sleep. Any number like “7-8” hours is often too vague. Some of our patients need 9-10, while others can go a few days with 6-7, and they can recover with more sleep later.

It’s rare to see someone who does well when consistently getting too little sleep. When their sleep is improved, we see apoB lowering by 10%.

Want to Lower Your ApoB?

Work with Coach Mo – he’s caring, competent, and curious. Come up with a strategy to lower your apoB and improve your Heart Health.

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Categories
Blood Sugar Heart Health Metabolic

How To Use The HOMA-IR Formula

HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. It’s a formula used to estimate insulin resistance in the body. Insulin resistance is a condition where the body’s cells don’t respond effectively to insulin, a hormone that regulates blood sugar (glucose) levels. This can lead to higher blood glucose levels – a characteristic feature of conditions like type 2 diabetes.

HOMA-IR Formula

The HOMA-IR formula typically involves measuring fasting blood glucose and fasting insulin levels and then plugging these values into the equation below.

HOMA-IR = (Fasting Insulin (μU/mL) × Fasting Glucose (mmol/L)) / 22.5

This calculation gives an estimate of how well the body responds to insulin – how efficient the body is at utilizing insulin and blood sugar values. A higher HOMA-IR value indicates greater insulin resistance.

Using the Formula With Clients

First, we’ll say that it’s rarely necessary to use this formula since many other signs and symptoms can be used to estimate someone’s insulin resistance.

However, when we use it, we obtain a fasting insulin level and fasting serum glucose (not a finger stick) and track someone’s progress over time.

It doesn’t matter much what the actual value is; more important is how well we can manipulate the value to improve someone’s longterm cardiovascular outcome.

High Insulin Resistance

Someone with a high HOMA-IR value will have more insulin resistance, which increases their risk of Type 2 Diabetes and cardiovascular disease – specifically, the atherosclerosis associated with heart attacks and stroke.

Fortunately, insulin resistance is something easily manipulated by lifestyle factors. Well, we say easy, but habits are among the most immovable objects in the world.

Alternatives to HOMA-IR Calculation

Many of our clients don’t have access to this test, so here are some alternative methods to estimate if someone is insulin resistant:

1. Fasting Blood Glucose

Whether by a fingerstick test or a blood test, elevated values are suspicious for insulin resistance and metabolic dysregulation.

2. Elevated A1C

The glycosylated hemoglobin value, the A1C, when elevated, often indicates someone is insulin resistant.

3. Glucose Tolerance Test

Often, this is done by having the person eat a sugary drink that has an exact measurement, and multiple blood tests are done to see how the person responds to this glucose challenge test.

4. CGM Measurements

A Continuous Glucose Monitor, often worn on the arm, estimates the serum blood glucose, and high spikes often indicate insulin resistance.

5. Increased Waist Circumference

There are various cutoffs used, such as 35″ for women and 40″ for men. These elevated numbers indicate visceral adiposity, which is associated with insulin resistance.

6. History of Gestational Diabetes

Those with prediabetes, gestational diabetes, or a strong family history of diabetes may be insulin resistant. But of course, this should be confirmed since it’s just a risk factor for this condition.

7. Acanthosis Nigricans

This rather common skin condition is often associated with insulin resistance. It can happen in many parts of the body, not just the neck.

Reverse Your Insulin Resistance!

Are you tired of feeling trapped by insulin resistance? Ready to take control of your health and regain your vitality? Our coaching service promises a brighter, healthier future.

Why Us?

Experts: Our Heart Health experts understand the complexities of insulin resistance. We provide personalized strategies tailored to your unique needs.

Proven: We’ve helped countless individuals reverse insulin resistance, leading to improved energy levels, weight management, and reduced risk of diabetes.

Holistic: We believe in addressing the root causes of insulin resistance, not just its symptoms. Our comprehensive approach includes addressing all lifestyle factors and the habits needed to see positive results.

Book Your Consultation Today:

Invest in your health and future happiness. Act now to reverse insulin resistance and unlock a brighter, more energetic you. Contact us today to schedule your consultation.

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Categories
Heart Health Hypertension Prevention

Isometric Exercise to Lower Blood Pressure

A prescription medication like benazepril can lower the systolic blood pressure of someone with hypertension by 5-10 points (mmHg) and the diastolic number by 3-5. But what about exercise to lower blood pressure? And which exercise is best?

Longterm Effects of High Blood Pressure

When a person takes a blood pressure lowering medication such as an antihypertensive, the goal is to lower the blood pressure to decrease the longterm effects of hypertension.

Longterm effects of hypertension include:

  • increased risk of stroke
  • kidney damage
  • heart disease
  • erectile dysfunction
  • dementia
  • peripheral vascular disease
  • atrial fibrillation

Fortunately, a lot of the damage can be reversed by lowering these elevated pressures. The sooner, the better, which is why it makes sense to screen individuals for hypertension.

Measuring the number in the doctor’s office, however, is the least effective method of screening for elevated blood pressure; it should ideally be done at home or using an ambulatory blood pressure reading.

Exercise to Lower Blood Pressure

We hear the mantra frequently that exercise lowers blood pressure, which is true. But which type of exercise is most effective?

Fortunately, a recent, well-designed research study answered this exact question. And, as we have predicted before, cardio is the least effective among the various exercise options.

Types of exercises tested in this study:

  • aerobic training (cardio)
  • dynamic resistance training
  • combined training
  • high-intensity interval training (HIIT)
  • isometric exercise training

The advantage of using exercise to lower blood pressure instead of just medications is that exercise has the added advantage of improving blood sugars, increasing bone density, decreasing the risk of injuries from falls, and improving mood and sleep.

At Heart Health Coach, we prioritize comprehensive approaches to improving heart health rather than singular methods.

Which Exercise to Choose

This study found that isometric exercises came far ahead in lower systolic and diastolic blood pressure numbers. So, which exercise should you do?

The best exercise to choose is the one you can stick with and enjoy. If you despise exercise then the best one to choose is the one that will have the most result with the least effort.

Don’t change what you’re doing because of this study. Instead, measure your blood pressure using proper techniques (not just a blood pressure cuff) and see if you are at goal.

If you’re at goal, exercise based on what you enjoy. If not at goal then add in some isometrics (handgrip, leg extension, wall squats).

Isometric Exercises for High Blood Pressure

We are fans of the exercises mentioned in the video above since they are a range of different isometric exercises anyone can perform at home.

The data points to holding the contraction for 30-180 seconds with 1-2 minutes of rest between the next set, for a total of 3-6 sets. Why so vague? Because chances are you’ll have great results just by doing these and doing a little more might lower that blood pressure a little more.

Categories
Diet Heart Health

The Low-Fat Diet Myth

Fortunately, this particular myth has been addressed enough that many of our clients know that the type of fat or oil they consume is more important than the quantity. The low-fat diet myth perhaps originated from good outcomes when people cut out the most unhealthy and, at the time, most ubiquitous fats.

Healthy Fats

We won’t get into what is healthy fat and what isn’t because such information is readily available online and reliable. The AHA has good information on the topic of healthy vs unhealthy fats.

What we want to address here is that fat is quite important and rarely the cause of atherosclerosis or obesity, even though these two conditions are often associated with fat intake.

It plays an important role in satiety and vitamin absorption. Without healthy fats, the body will have a harder time absorbing and holding on to nutrients.

Low-Fat Diets

There is a difference between low-fat and non-fat diets or what some might call a very fat-restrictive diet. The low-fat diet myth claims that with lower fat intake, you have a lower risk of heart disease and lose weight. In fact, the opposite is true.

A dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors.

WHI Study

However, there are instances when a low-fat diet makes sense. And, of course, for anyone who benefits from a better calorie balance, it might make sense to cut out the most calorie-rich foods, such as oils and fats.

Our colleagues over at Mastering Diabetes are major proponents of a low-fat diet, and it makes perfect sense in their program. This isn’t to say that everyone with normal A1Cs should consume a low-fat diet.

The Source of Fat

Fats and oils end up being used interchangeably in our common vernacular. Arguments over whether seed oils, olive oil, or butter are good or bad are common. They often end in stalemates, and opinions tend to trump science.

At Heart Health Coach, we don’t believe there is any fat that is necessary for good health. Meaning you don’t need olive oil to be healthy or that coconut oil is a must for anyone who wants to prevent dementia.

However, if our clients are going to consume butter, we want them to obtain it from a good source. The same is true for any oil or fat.

Within species (like cows), the diet of the animal can impact the nutritional profile of the butter. Grass-fed cow’s butter, for example, often has a higher omega-3 fatty acid and vitamin K2 content than grain-fed cow’s butter.

When cattle are finished on pasture, the resultant meat and dairy products are higher in omega-3 fatty acids and have an improved omega-6:omega-3 ratio. Grass-based diets have also been shown to enhance total conjugated linoleic acid (CLA) isomers, trans vaccenic acid (a precursor to CLA), and antioxidants in beef.

BMC Nutrition Journal

Low-Fat Diet Myth

The low-fat diet myth has led to egg white omelets, non-fat milk, and fat-free cookies. These dietary modifications are not only ultra-processed, but they also provide the person with a dietary intake profile that skews nutrient absorption.

When we meet with clients, we spend quite a lot of time on gathering a proper nutrient profile. We develop a diet risk score to help us make further dietary suggestions.

The PURE trial found that contrary to prevailing dietary guidelines, higher fat intake was linked to a reduced risk of mortality, while high carbohydrate intake was linked to an increased risk.

This isn’t to say that this trial is the end-all-be-all on this topic. It has plenty of limitations, but it’s safe to say that historically people have done well eating a well-balanced, nutrient-dense diet that included fats. It’s the quality of fat that might be in question in the low-fat diet myth.

Categories
Afib Heart Health Prevention

Proven Ways to Prevent Afib

It’s not on most people’s radar, but there are proven ways to prevent Afib – Atrial Fibrillation – a cardiovascular condition that increases the risk of strokes and heart failure.

Lifetime Risk of Afib

The lifetime risk of Afib is 1 in 4. A good 25% of us will have Afib when we get older. Over the age of 65, it can be as high as 1 in 3.

We work with our Heat Health Coaching clients to identify their risks and adopt a way of life to help decrease that overall risk.

Healthy aging is a major program for us here at Heart Health Coach, and we address all such risk factors.

Proven Ways to Prevent Afib

Here at HHC, we take evidence-based medicine seriously. We don’t just look at the latest and greatest research published without considering its biases. Instead, we focus on data that has been proven time and time again and work our way towards the factors less based on strong science.

1. Age

There are modifiable risk factors and nonmodifiable risk factors. We mention age because as Afib risk increases with age, it’s even more important to modify the factors that can help decrease our lifetime risk of developing this condition.

2. Family History

Also not a modifiable risk factor, but nevertheless among the strongest drivers of Afib, having other family members with Afib increases our risk of developing Afib at some point in our lives.

3. Hypertension

From causing left atrial enlargement to increased sympathetic activity, elevated blood pressure is a major driver of Atrial Fibrillation.

It’s a modifiable risk factor. Those who manage their blood pressure even with medications will see a 26% decrease in the lifetime risk of developing Afib.

4. Excessive Exercise

Younger athletes who train quite hard may be at increased risk of Afib. Fortunately, their cardiac arrhythmia may not necessarily increase their risk of stroke – the main side effect of having this condition.

Nevertheless, if family history is present and if any other abnormal rhythms are present, it’s worthwhile to investigate the potential for paroxysmal Afib further.

5. Sleep Apnea

Decreased blood oxygenation, elevated pressure on the heart, and increased risk of PACs may all contribute to developing Afib if Sleep Apnea remains poorly controlled.

A study over a 5-year period showed that controlling Sleep Apnea with a CPAP device may decrease the risk of developing Afib by 40%.

6. Endocrine Problems

Obesity, blood sugar dysregulation, and thyroid problems can contribute to Afib.

Don’t Fear Afib

Fortunately, we have medications to treat Afib, and this is important to mention because this article isn’t meant to be fear-inducing.

Some will even develop transient Afib brought on by stress, sleep, or dietary changes which might resolve on its own.

From medication to ablation to lifestyle changes, there are ways of treating Afib, which we’ll discuss in future articles. One of our clients cut out alcohol and with it, her Afib disappeared.

Categories
Diet Heart Health

Diet Risk Score

Here at Heart Health Coach, we generate an overall risk score for our clients to help them decide which areas to focus on first. The diet risk score is a portion of the overall score, and here is how we calculate it. We don’t ask what you eat like other traditional dietary intake forms.

Mainstream Dietary Assessment

So, let’s ask our medical director, Dr. Mo, what his diet was today. He’ll likely list what he ate and what time he ate them. The ingredients might be simple if he made everything from scratch, but that’s not the reality.

Our clients who tell us they never eat sugar or processed foods might have mayo, dates, and the occasional chips. It’s so infrequent for them that they use the term “never.”

Observational or questionnaires on food intake are notoriously inaccurate. Instead, we use an alternative diet assessment questionnaire.

Diet Questionnaire

  • Where do you shop for groceries?
  • Who does the grocery shopping?
  • What’s in your fridge and cabinets?
  • What was the last thing you put into your mouth?

These are high-yield diet-related questions that are more telling than asking someone about their diet directly.

News and media have made food and diet a bit of a complex topic; too complex and subjective for traditional diet questionnaires to be accurate.

Diet Risk Score

Based on the answers above and a few other questions, we calculate the diet risk score of the client.

Buying at mainstream grocery stores often will result in less nutritious food with a higher chance of eating processed meals.

If the person is quite particular about doing their own grocery shopping, it indicates that they have a specific dietary goal they are trying to achieve.

The contents of our fridge and pantry can say a lot about what ends up in our stomachs. Perhaps the box of Wheaties won’t be eaten, maybe it’s for the significant other or the kids, but it’s in the house, and it’s processed.

The last thing that went into someone’s mouth could be a bite of a donut because a coworker offered them one, or it could have been an energy bar because they missed their lunch.

Absolute Risk Score Value

At HHC, we don’t worry too much about the actual score – the number itself is irrelevant. What matters is how this number changes over time.

For some, diet will be the biggest factor in their overall Heart Health risk, and by making some changes based on this dietary risk score, their overall cardiovascular risk should improve.

Using trends, our clients don’t get into the habit of comparing themselves to others. Instead, they can focus on how their risk scores change over time using their own N=1.

Categories
Heart Health Metabolic Treatment

Uncovering Sleep Apnea

Sleep apnea is one of the factors we use for a Heart Health Risk Score and address to decrease the risks from such a condition.

Briefly, this is a condition in which the body doesn’t get enough oxygen which can lead to brain and tissue injury.

Sleep Apnea Testing

Traditionally, patients have quite a journey when trying to have their sleep-disordered breathing diagnosed. In fact, quite a few primary care physicians can’t get easy insurance approval for sleep studies.

The idea of in-lab sleep testing, where you spend 1-2 nights in a sleep laboratory, is daunting. While an alternative to this is in-home testing, it’s not that much easier.

Is a sleep test necessary?

Current Clinical Guidelines

Clinical guidelines are useful concepts in Western Medicine that allow clinicians to follow similar algorithms for patients.

However, no two patients are alike, and guidelines, when they must be followed or when they become the standard of care, leave many patients and clinicians on the sidelines.

The AASM linked above recommends that, ideally, an in-lab polysomnography be done in a sleep laboratory for a proper sleep apnea diagnosis. Alternatively, an in-home sleep test can be done but with many limitations.

The AASM recommends against the use of clinical questionnaires for the diagnosis of sleep apnea.

STOP-BANG Questionnaire

The STOP-BANG questionnaire screens for the potential of obstructive sleep apnea (OSA), a subtype of sleep apnea. In fact, OSA is the most common type of sleep apnea by a landslide.

This validated questionnaire is more than enough to establish a very high suspicion of an OSA diagnosis.

Of course, whenever possible, we like to make sure. As in, clients are advised to obtain formal in-lab polysomnography (PSG) or, at the very least, an in-home sleep test.

As health coaches, we cannot advise individuals what to do or not do. But our philosophy is that guidelines should be followed unless immediate harm is possible from having untreated sleep apnea.

For our clients, we recommend that they speak to their physicians to decide if an auto-titrating positive airway pressure (APAP) is appropriate for them even before any testing can be performed.

Once treatment has begun, it’s still possible to undergo testing.

Highest Risk Patients

In our experience, individuals at the highest risk for sleep apnea or complications from sleep apnea are those with:

  • heart failure
  • hypertension
  • obesity
  • dementia
  • older age
  • kidney disease
  • COPD
  • heavy snorers
  • daytime fatigue
  • insomnia

If you’re looking for a hassle-free way to get treatment for OSA and want to take a home sleep test, there are companies like Empower Sleep that make the process easier.

For less than $200 you can purchase your own home testing device to diagnose OSA.

Sleep Apnea & Heart Health

There are plenty of articles linking sleep apnea and heart health; no need to dive too deep into that topic again here.

We approach the topic of sleep apnea and cardiovascular health by educating and empowering our clients. These two conditions have a bidirectional relationship; sleep apnea increases inflammation in the body and elevates blood sugars, and cardiovascular disease can make it harder to oxygenate the body.

Is OSA permanent? Not necessarily; certain underlying conditions can be treated to help reverse sleep apnea.

Can OSA treatment improve heart health? It seems that those who have their sleep apnea managed properly with a CPAP machine drastically improve their cardiovascular health.

The Magic of Masks

A properly fitted mask makes all the difference. Too often, people give up on their machines because they have difficulty tolerating their masks.

Finding a mask with the proper fit makes all the difference. Not only are they more comfortable, but they are also more effective.

We recommend working with a good sleep apnea technician or a great salesperson to help you find the full-face or nasal mask that fits you best.

Making the Habit Stick

Our clients fall into 2 categories:

  • those who stick it out with their machines
  • those who give up after 2 weeks

Any new habit takes time to cultivate. There will be setbacks before the habit becomes part of your routine. With tiny, whisper-quiet devices these days, you can travel with them with ease and help the habit stick.

Commuting to work, exercising, brushing before bedtime – none of these were intuitive habits until you did them enough for them to stick.

The goal is to work with the setbacks and ask:

  1. What went wrong?
  2. What can I do differently next time to improve?

Sleep Apnea Health Coaching

Our role as health coaches is to support clients in achieving their ideal health goals by helping them overcome doubts, fears, and hurdles related to changing habits. We leave clinical decision-making to the clinicians.

The goal as always is to prevent major health consequences from cardiovascular disease. We achieve this by focusing on:

  1. managing sleep apnea successfully and consistently
  2. measuring potential outcomes changes based on treatment
  3. adjusting other relevant risk factors to decrease cardiovascular morbidity risk
  4. empowering individuals with knowledge and self-confidence