Hello Dr. Schubiner,
I want to thank you again for your graciousness and service to so many. There are scores of physicians out there whose ambition is clearly to make as much money as possible off of those who are suffering, whereas you are the true embodiment of a physician and the Hippocratic oath so many flaunt.
I am writing to ask you about sleep apnea and UARS (upper airway resistance syndrome). While I for the most part have been following Dr. Sarno's advice to "think psychologically, not physically", I am seeing a sleep specialist right now who points out that unhealthy practices such as orthodontics, lack of breast-feeding, mouth-breathing, and poor diet in the West have led to severe anatomical changes in people's upper respiratory apparatus (ie., severe dental crowding, small mouth/chin in relation to oversized tongue which collapses into the airway during sleep, general obesity etc.). I recently had a procedure to correct a severely deviated septum (I can now breath through my left nostril for the first time in years), trim my nasal turbinates, stiffen my nostrils, and - not least - had a sleep endoscopy performed. The endoscopy revealed severe blockages through tongue collapse, soft pallet collapse, and uvula collapse. I was able to view some of this later on camera, and noticed a very small airway behind the tongue. Basically what seems to be happening in my case is that when I start to go into deeper stages of sleep, my body is tired but my brain goes into "high alert" and I awaken 8-10-12-15 times over a 7-8 hr period, never getting restorative sleep.
The sum total of this problem (labeled UARS) is that I am unable to enter into stage 3 sleep and have not for about 4 years. The recommended solutions in order are CPAP, a custom fitted oral appliance designed to move the jaw forward (thus opening the airway), or - most seriously - maxo-mandibular surgery, wherein the upper and lower jaws are moved forward (the estimated success rate for that is very high). The doctor does NOT perform that surgery himself such that I have reason to believe he is not simply offering a surgical option to benefit himself.
My question to you is whether you would consider certain cases of sleep disturbance like this to be anatomical and not inherently a form of TMS/MBS, and whether you have had patients, friends or colleagues overcome sleep disturbances of this nature.
Unfortunately, my former sleep doctor was largely clueless about UARS (only looking for "sleep apnea" which is detected differently) and prescribed 1mg of Klonopin and 30 mg of Remeron to help me sleep. I have been on these for almost 3 years, and yet all the while, it would seem this was not strictly speaking a "brain" problem, but an upper airway blockage problem.
It is very hard to press on toward healing when one is presented with 2-3-4 different diagnoses, as I have been. Thank you for any insight you might have here, and thank you again for all that you do for patients.