Why Your Dentist Might Save Your Life Before Your Doctor Does

I've spent decades telling people sleep apnea is a snoring problem. It's not. It's a heart problem. It's a brain problem. It's a marriage problem. And in the United States, 87% of the people who have it don't even know they do.

In this conversation, I sit down with a dentist who specializes in something almost nobody talks about — the connection between your mouth, your jaw, your tongue, and the quality of every breath you take while you sleep. We talk about why CPAP isn't your only option, the modern habits quietly reshaping our airways from childhood, the hidden reason your tired, slim, healthy-looking friend might be the next sudden cardiac event, and the simple change you can make tonight that costs nothing.

If you snore, sleep restless, wake up tired, or love someone who does — this episode could literally save a life. Listen all the way through. There's also a special gift from today's guest at the end.

In this episode, you'll learn:

• The body part responsible for the majority of sleep apnea collapses — and it isn't your weight
• Why one of the most common bedtime habits in modern life is silently raising your blood pressure, anxiety, and risk of sudden cardiac death
• The simple at-home assessment most doctors never offer that can reveal what your sleep is actually doing to your body

Connect with Dr. Maria Sokolina:

Website: https://drmariasokolina.com/

Other links: https://linktr.ee/mariasokolina

Chapters:

01:00 – The Trip To The Dentist That Saves Your Life
 03:12 – Why A Dentist Cannot Diagnose Sleep Apnea
 04:09 – What Sleep Apnea Actually Is
 06:37 – Beyond The Middle-Aged Male Stereotype
 08:30 – The Cardiac, Brain, And Intimacy Connection
 11:21 – CPAP Is Not Your Only Option
 13:53 – Why One Treatment Doesn't Fit Every Life
 16:37 – The Braces Epidemic Is A Breathing Story
 17:44 – What Breastfeeding Has To Do With This
 19:12 – Why Half Of CPAP Users Quit
 19:42 – Nose For Breathing. Mouth For Eating.
 22:39 – Why Mouth Breathing Triggers Fight-Or-Flight
 24:07 – Don't Stick Your Tongue Out Was Bad Advice
 25:03 – Why A Dentist Becomes A Sleep Specialist
 29:02 – Inside The Oral Appliance
 32:36 – Is This Treatment Forever?
 34:33 – Why The Tongue Stores Fat First
 37:13 – Why The Book Was Written
 40:18 – The Friend Who Almost Died
 41:50 – The Friend Who Wasn't As Lucky
 43:43 – The Kids Nobody Is Checking
 46:41 – Closing Thoughts And A Gift

Transcript

SPEAKER_00 0:00

Very few people know this, but a trip to your dentist can save your life and your marriage. Imagine it's a Thursday afternoon, and Don Draper goes to a midtown Manhattan dentist. He sits in the chair, falls off to sleep, and the dentist comes in and she looks at him, notice he's sleeping with his mouth open. Then she does the exam. Then she finds out he has very dry teeth. She could tell he's been grinding his teeth, a very narrow palate. And she asks him, Have you been trouble having trouble with snoring? He said, Well, not really, but my wife sleeps in another room. And she goes, Okay, orders a sleep study, then the results come back. He has moderate sleep apnea. The great news is he went to the right dentist, Dr. Maria Solina, I'm sorry, Sokalina, who is an expert in sleep apnea. And she's able to get a unique plan for his specific needs. And this is our great guest today. So I'm very excited to have her. And I will say that this podcast is for informational purposes only, not medical or dental advice, and always seek the advice of a professional for all your needs. Maria, thank you so much for being on today.

SPEAKER_01 1:13

I'm so honored to be here. Thank you very much. And thank you very much in general for making this program possible. But people can get real medical information, not filtered, but from experts. And you make you bringing experts to the world, and people from all over the world can access the information, you know, in English, unless they transcribe now, that's also possible. So, you know, like a whole world can have this unique lens of you know, certain specialty was you're bringing, and thank you very much for bringing dental sleep medicine. But not to be so intrusive, I want to change a little bit your introduction. It was very generous, it's a very common picture, but some of it doesn't happen exactly like that. Sure. As a dentist, I'm not allowed by law diagnose abstractive sleep apnea. That's true. Dentist is so close to all the symptoms, but I'm a traditional doctor, I have a license, and according to my license, we have a certain rules and how we practice. So dentists are not allowed to diagnose sleep apnea. What I do, I can raise the awareness in my patients and I can refer them to sleep doctors. What they get is a sleep study and discuss the sleep study with the medical, and then discuss the sleep study with me. Because what I learned over the last 15 years of practicing dental sleep medicine, we see this disease from totally different views. And that's what I reflect in my you know newcoming book, Breathless, what I'm gonna give as a gift to your audience today.

SPEAKER_00 2:57

That's fantastic. And could you please describe to us what happens with obstructive sleep apnea, what causes it, what are the signs and symptoms? Because there's a lot of people who really don't know much about it.

SPEAKER_01 3:09

So this is, you know, I'm gonna put scientific view and then you know mix it a little bit with my own clinical experience. I consider this as a disease of evolution. We advance in a lot of areas, we become so close to the space, we have artificial intelligence, but as everything progresses, it's always duality of a situation. So the duality of situation in a bro brush strokes, white brush strokes, I can say abstractive sleep apnea. Now we can be a little bit more focused on the disease. That's a disease when the person experiences collapse of the airway during the sleep. I usually show them that toy, you know, this is the nose, this is the mouth, and this is the airway. When you sleep very often on the back, but not always, uh, your airway collapses. And we it's a multifactorial disease. When I start start learning about abstractive sleep apnea, everybody talked about abyss, middle-aged male. But the truth is that disease, which was researched many years ago, uh, had a certain group of veterans where this particular disease was studied. They take, you know, they took the veterans who were middle-age, overweight, male. And that's how they did the research and they did the symptoms, you know, snoring, high blood pressure is one of the indications, um, you know, extra weight, um diabetes, you know, some some you know, some disease would come as a bouquet, but what happened? The airway collapsed, sometimes it collapsed fully, so airway close, or sometimes it collapsed partially. We consider it like 30% of narrowing of the airway, and cumulative numbers of those collapses in an hour, it helps us to make a diagnosis. We use that number called AHI. Now it might change also. There are you know some development in that field, but I'm gonna give you like a general terms for people who you know suspect they can learn and without being overwhelmed with information. But the truth is, this disease can affect everyone. Females, very slim and sportive, they have abstractive sleep apnea, and kids, they have abstractive sleep apnea as well. But just the under the disguise, like under the picture of sleep apnea, it can be totally different symptoms, the clinical picture as well, which can have an underlying reason, abstractive sleep apnea, because we breathe that many times a day, and we're supposed to sleep eight hours a day. And then if the sleep gets interrupted with constant collapses, that's not a quality sleep. So now we're talking about symptoms, being tight, falling asleep behind the wheel, or not necessarily, uh falling asleep everywhere. Um, and we I'm from New Jersey, and we had uh several fatal train accidents, and sleep apnea was the underlying cause. So um snoring, very common. Uh, and very often, 70% of males they come to learn about abstractive sleep apnea because they want to improve the intimate life. So there is a very direct connection between, you know, I don't want to go into that's not my area of expertise, but intimacy details, direction, uh, and connection with uh sleep apnea. So they start exploring that area, and usually urologists or primary care physicians send them for sleep study and they learn what they have abstractive sleep apnea. Uh, but um, I um recently met with uh ophthalmologist, and he had a certain disease which also correlates with the presence of abstractive sleep apnea. So, this disease, when collapse happened at night, whole body response, heart response, and rhythm can change, and blood pressure can rise, and uh hormonal level because uh interrupted sleep affects certain stage of sleep. We call it you know deep wave sleep, so important for hormonal balance, and of course it affects REM sleep. That's why a lot of people complain on a brain fog or fact what they can remember anything or cannot learn. I gave you the symptoms what I would say I hear a lot in my practice, also very important dry mouth, and complain of the spouse, snoring as well.

SPEAKER_00 8:27

And you save marriages by by alleviating this. The interesting thing is, and it's a sad thing, a good friend of mine lost her husband through sleep apnea. And you know, he had a sudden cardiac arrest. And we all know that sudden cardiac arrest, especially when it occurs at home, if it's unwitnessed, you know, it really pretty much you're not going to survive it. It has to be witnessed for you to have any chance of survival. You know, so I don't think people are really understanding, think about the snoring, but they don't think about the cardiovascular effects of sleep apnea. Like you said, the arrhythmias increase the risk of heart attack, stroke, metabolic issues, increase type 2 diabetes. You you talked about the erectile dysfunction, but it affects so many parts of our lives. And then just like you said, you know, people are perceived as being depressed, low energy, and all these other issues. And I I think that this is uh something that really isn't screened for effectively. And I hardly ever speak ill against my fellow physicians, but I think that most physicians, and I would even say you know, a number of dentists probably need to do a better job of screening for it because it's out there and I don't think the public's really aware of it. So I I think this is I love what you're doing with this. And the other thing that really is interesting to me is everybody thinks of obstetric sleep, uh obstructive sleep apnea, and they think of CPAP, they think of these big masks. So they say, okay, I have that. This is my only option. I have to wear this big face mask, I have to try to sleep. And it is the gold standard, and I know for severe obstructive sleep apnea, you have to do that first. But could you please explain if someone comes to you and they say, Boy, I can't do the obstructive sleep apnea, what can you offer them?

SPEAKER_01 10:21

Yeah, this is a very, I would say, philosophical question of our time. Yes, it's a golden standard, but I'm gonna, I'm a student of science. So according to American Academy of Sleep Medicine, the white paper, you know, we do according to the guidelines, they said what mild and moderate sleep apnea don't need CPU intolerance fact. So if somebody has mild sleep apnea, and I know people said to the doctor, I trust you, you make a decision for me, but it's not a bad idea to look at the sleep study. And on the sleep study, there is that number, AHI. Maybe it's not a perfect number, but so far it's a standard. So if your number is from 5 to 15, you have mild apnea. And you're eligible to start your therapy with this very delicate oral appliance. You know, I have several choices here, but this appliance moves your jaw forward and open the airway so the air can pass through. Um, if you have moderate apnea from 15 to 30, you also can have the oral appliance, not a CPAP mask, uh, without CPAP intolerance. And only if you have a severe apnea, then you need to try CPAP first. But I want your audience to understand me right. As a dentist, I'm not allowed to diagnose sleep apnea and prescribe the treatment for sleep apnea. So I work always, the captain of my team is a medical doctor. So I work very closely with the medical doctors. And as a physician who does this treatment for many years, I understand and I love the effect what CPAP machine brought to the world. I'm not against CPAP machine under no circumstances. That's how I look at that picture. Life is long, we go through different stages of life, and to have being a modern person, to have just one treatment modality, which is a CPAP, I understand you can play with a mask, but it's not enough. Some people live in the marriages, some people are dating, some people are traveling. You know, there are so many varieties of the lifestyles, and we're not the cookie cutters, not one size fits all. We have to have a different option, but also what I find kind of lacking in that picture, uh, airway is not only here, it's actually inside. So it's a nose and a mouth. And how whole collapse happened, usually people don't have I might not have a full picture, it's a very multifactorial disease. I know for a fact what tongue is responsible for 70% of collapse. That's why moving the lower jaw forward, doing it conservatively, because the jaw joint will respond if you become very generous with the movement forward. That's one part of the story. But another part of the story is a nose, and nose knows knows a lot of things, so the resistance in a nose creates that turbulence. What we observe as snoring. And if something starts turbulating like this, a lot of tissues that are hanging here also start turbulating, and at certain point, this particular hurricane creates closure, and that's the collapse. But of course, I start talking about the disease of evolution, modern age. We live, comparing to our ancestors, comfortable lifestyle. We have a stone of you know, most of us, I don't know, a lot of people who have to chew the raw meat. Uh, also, you know, that's one advantage and duality of it of industrial revolution. Another thing, now woman role is not just um you know, housekeeper. You know, you don't have to be housewife, you can have a life. So breastfeeding becomes you know a question of choice. But all of that really affects the development of that area. You know, mushed food, you know, I love soft food, it's melting in my mouth, but at the same time, I don't have to use my teeth to stimulate the bone and a bone shrink. And then we wonder how come we have a braces epidemic? So that's like a stage of life. Everybody has to have braces. Why teeth are crowded? Why Joe don't have uh space to feed all 32 teeth? Then, you know, when I just start doing dental sleep medicine, they said the modern human have a brain development. That's why Joe suffering. In philosophical terms, we can say that way because you know we invent a lot of blenders and bottles not to do the breastfeeding. That's true, it's a brain development, but I believe combination of nutrition, proper stimulation, you know, education about breastfeeding. And I know you're you know you related to that area.

SPEAKER_00 16:16

Absolutely. And most people, it's hard to get people to start breastfeeding, and it's hard for them to continue it.

SPEAKER_01 16:22

You know, it's that I don't understand.

SPEAKER_00 16:24

You know, I encouraged everybody to try breastfeeding. We have great lactation consultants. I shout out to all of them, they do a wonderful job. But you're 100% right when people say, Well, I'm I'm going back to work at six or ten or twelve weeks, then it's gonna be hard to breastfeed. And most workplaces try to make accommodations as best as they can, and obviously some are easier than others. You know, an office is easier than a factory floor, but you're 100% right. You know, there's less women that are gonna breastfeed at three or six months or even a year. Where, you know, when I was a youngster, that was much more common that people would breastfeed until the child was ready to eat regular food. Solid food. Solid food. And that certainly is had, and it's funny because I had that discussion with my wife recently. I said, you know what, it's so funny because every child now has to go see the orthodontist. When I was growing up in the 60s, very few children did. I can think of everybody in my neighborhood growing up who saw an orthodontist and had races. Now everybody magically has to have races. So I mean there definitely has been changes with that. The other thing I really love that your work talks about is nasal breathing, the importance of that. And I I'm gonna say something with the CPAP is when people are given to CPAP units, about 50% of them fail. And I think part of why they fail is they're not prepared correctly. They don't say, listen, you need to change. You've been breathing through your mouth for 58 years. We have to change to here now. That's not gonna happen in a second. And you need specific techniques to do. No one talks about that. They just said, here's the machine, good luck, call us if you have a problem, or don't. But you know, there's much more into that. So could you please tell us about the nasal breathing, how you help people do that, and the importance of that?

SPEAKER_01 18:13

That's you know, that's also I find the nasal briefing or mouth briefing, it's also a very philosophical question. And I want your audience, uh, you know, if I know we talk a lot, but if they remember one thing about Dr. Maria Sokolina, you know, your guest today, about importance of nasal briefing. Nose is for briefing and mouth is for eating. We don't eat in a bathroom, we don't uh sleep in a kitchen, we usually deserve certain areas for certain activities. So this is for breathing and this is for eating. The truth is, we live in a modern world. Modern air and environment have a lot of things that might not be so agreeable with us, and food choices as well. They might not be the best for you specifically, and your body might react, and you might find what getting the air through your mouth is so much less energy consuming rather than going through nasal resistance. But I'm gonna go back to the Indian tribes, and I'm a student not only the nature science, but also history. So, a lot of, you know, I travel a lot. I want to learn from forgotten habits what he brought to modern life, and we can use it and benefit from that. So I'm gonna talk about American Indian tradition, when mom feed the baby, breastfeed the baby, then she would put her fingers on her on his lips, on baby's lips, and close them to stimulate the nasal briefing. And there is a book written by the lawyer 200 years ago, Shut Your Mouth and Save Your Life. So that's very important. Number two, uh, if you want to breathe through your nose, it has to be conscientious efforts. It's not only simply the nose. When somebody starts breathing through the mouth, they use totally different muscles. They use muscles of chest, and it's actually, by the way, it's a sympathetic nervous system. So they stimulate themselves all day long and all night long. How come they can sleep if they in a fight or flight response? That's very challenging. So that particular habit affects neck health, shoulder health. So, how come um people would tell you your head is five miles in front of your body, forward head posture, your uh neck constantly bothering you, you have to live in a massage uh you know office because it's constantly hurt that due to the specific briefing technique. Yes, there are a lot of coaches who would be so happy to explain you how to brief right and do that coaching, you know, brief briefing coaching programs. In our office, we offer myofunctional therapy to help our sleep patients, you're right, who brief for 50 years in a wrong way, to change that habit. Yes, it's difficult, but it's possible. Also, we recommend to decrease the resistance with different types of you know, exp let's say expansion, dilatators, and certain cream to make the swelling of the turbinates less. And I have on my program, I have a podcast, Sleep Apnea Briefing Snoring Hell. I talk about different devices, what people can use to decrease the swelling. In that area, so it's all possible if you put your heart into that. So, yes, nasal briefing, or that a contributing factor to sleep apnea, and you mentioned, thank you very much for mentioning what the doctors don't bring the patient's attention to that. I'll give you the facts. According to St. National Health Institute, 87% of sleep apnea cases in the United States are undiagnosed. Now the numbers: 24% males and 17% of females in the United States have sleep apnea. But how come numbers in Germany, in Japan, and I think Poland, they estimate their sleep apnea rate as 50%. We are so good, we just, you know, between 24 and 17. But they're 50. What's so wrong with them? And we why we are so low in um, I would say revealing the disease.

SPEAKER_00 23:07

Yeah, we're hiding from it. They're obviously dealing with that 100%. The other thing, when I was reading your work with the myofunctional, I was thinking back to childhood, and everybody said to the children, don't stick your tongue out. And then I was thinking, I was like, we shouldn't have been sticking our tongue out. We told them the wrong thing. We should they should have been doing their tongue exercises.

SPEAKER_01 23:28

Tongue exercises.

SPEAKER_00 23:30

Absolutely. So no, I I love that you're going through the whole system, getting back to where we have to change everything. Because it's a big change for people. And how did you now you have a great dental practice? I was looking on your website. You do almost everything. You have restorative, you know, you you've got cosmetic, you do implants, you do orthodoxy, you do almost everything. How did you 12 years ago say, you know what, this isn't enough for me. I want to do sleep medicine. What made you do that?

SPEAKER_01 24:03

Uh uh the fear. I was scared that people are gonna break my work. Because this traumatic, you know, we, our sole mission on this planet is to breathe. If we can't breathe, we can leave. So when people cannot breathe due to the collapse, they're gonna break everything what I'm so meticulously gonna put in the mouth. And it's applied to restorative work, you mentioned right, it applied to implants, what's so dear to my heart, because even now I still do that work. I have a sweat in some cases. I've been doing it since 2002, but still, you know, it's an exciting procedure. And absolutely, I don't want it to fail. I also move the teeth. I'm trying to create bigger arches, more space for the tongue. I do a lot of comprehensive cases, like um collaborative cases. I don't do it all. I have a lot of wonderful partners, but I design the cases. I design the cases, I want it to work according to my design, how I see it can work in the long run. So it was originally my dream. I'm gonna build this beautiful system, and it's gonna work for many, many years. Of course, you know, I absolutely understand that, you know, emergency can happen, but I want to make sure the system, system, what I create, the teeth stand straight, the load is vertical, the bite is correct. You know, we have a certain rules how you know it should function. The front teeth is gonna protect back teeth, they're not gonna break in half, uh, the gum's gonna be healthy, they're not gonna be bleeding, what bacteria cannot get into the system and cause cardiac disease. So there are in my field, you know, people have a very negative perception of dentistry, and I'm trying to change it with my book. What if you not gonna look at the dentist as a middle-age kind of you know, monster with torture chambers, but look at the scientific portion, how this is a beginning of everything. We use our mouth for so many wonderful activities, the I would say for most pleasurable activities if you put it together. So it's a very special thing, and not a lot of people know what we use our mouth for balance. For balance, if we have a problem with vision and we can orient ourselves in space, this is the area how we control our posture, because it's a very challenging thing to stand on two feet and actually move in space and have eyes on the level of the horizon. And what we can change? This we can squeeze, we can, you know, do a lot of activities, what can ruin the work. So, of course, I can control everything, and I don't want to control everything, but I want to explain to my patients if we do this, that's gonna happen. If we don't do this, this is gonna happen, and that's your choice. And um, how I start doing sleep from that. I want to offer my patients the way to protect the teeth, way to protect the investment. Yes, it's true. People don't like the dentist because that's investment, but a lot of things go into that investment. And health, number one. Health, that's priceless. So uh I want to protect the investment. I want to explain to them what those tremendous forces are gonna ruin any investment they're gonna put, and I can protect it. And of course, I don't do it only for my patients. Most of my patients are referral from medical doctors, and I only do the protection. But I also work with the dentist who want to protect, you know, other dentists, they protect the work, and then I refer patients back, you know, for dentistry.

SPEAKER_00 28:02

Now, these appliances look like they're mouthpieces that you would, you know, get over the counter, but they're not. And how do they push the jaw? Because the whole thing, it sounds like you're advancing the mandible forward, and that gives more room for the tongue.

SPEAKER_01 28:17

For the tongue.

SPEAKER_00 28:18

And how do you do that? How do you actually move it forward? Is there a way with the with the device, with screws that you can do that? And how do you determine how much you need to move it forward? And how is that tolerated by the patient?

SPEAKER_01 28:31

There are 120 designs on the market. Wow. There are two types of appliances, some of them tongue-retaining appliances, but that's not my type of tea. Not my cup of coffee, whatever. That's not my type. Sure. I do mostly mandibular advancement device, the device would move the jaw forward, and second thing, hold the jaw close. I try to keep the jaw close because in that position, tongue stay forward. This particular device, I like it because it's so small and it has like a little puzzle, and those puzzles do not let jaw to move back.

SPEAKER_00 29:12

Gotcha.

SPEAKER_01 29:13

So that's uh that's the you know beauty of that particular appliance. But there are other appliances with a different mechanism, they can have, let's call it the wings, and that's how it calls hold the joy. And there are some metal bars. I do many types. I do, you know, I look at the mouth, and then you know, we decide the design based on whatever I see in the mouth, and sometimes based on the insurance recommendations as well. Sure. Medicare have a certain criteria, and I follow the criteria. Uh so it move the jaw forward, and then I put a little, let's say, metal structures, what people can put elastic rubber bands to keep the mouth closed. Okay. I, you know, I want to stimulate that. So um, you know, we choose the design. We don't in my office, we don't use the impressions, but you know, maybe 10 years ago we did. Uh, we get custom exact um impression or scan of the mouth, and then lab fabricate something most minimalistic design, what can fit in the mouth and keep the jaw in a forward position and keep the mouth closed. But also, not a lot of dentists do that, but we do that uh if patient has a lot of crowding. You mentioned everybody needs orthodon. But very often people had orthodontic treatment, and even they have four or eight teeth removed. And within a lifetime, because they keep the same mouth breathing, the same swallowing habit, which was never corrected when they had orthodontic treatment, even they had so many teeth removed and tongue space restricted that much, they still teeth still crowded back. So for people like that, or for people who want to correct crowding, because of course appliance can be much smaller if your teeth are straight, uh, we can do orthodontic treatment in the same time as we do oral appliance therapy. Sometimes orthodontic treatment takes a year, or maybe even a year and a half. You know, we do it with the clear aligners. Uh, I can do uh oral appliance on top of it.

SPEAKER_00 31:35

And how long do you use the oral appliance for? Is this something that's a permanent type of thing, or is there a time period where you can take that out and not use it?

SPEAKER_01 31:44

Oh, that's a wonderful question. Of course, you use oral appliance only at night.

SPEAKER_00 31:49

Yes.

SPEAKER_01 31:49

But sleep apnea is a progressive disease. Truth is, and in my book, I talk about options. What can be done, what can lead to cure. And we're talking about orthogonic surgery, we're talking about surgical expansion of the upper jaw, we're talking about myofunctional therapy. You know, there are some ways to correct it. But otherwise, it's a lifelong disease, and this is just one of the ways to control the disease. You know, these, you know, oral appliance can eliminate the snoring, you know, especially if you combine it with the nasal treatment. Uh uh also, you know, sometimes I use help of ET because some people, you know, whatever I talk about is not enough. And I want professional, you know, help to drain the sciences, you know, different things. What I want to create less resistance in that area. But sometimes we use oral appliance in combination with a CPAP machine. But for a lot of people, also the cure would be GLP1 medication. If they lose weight, sleep apnea either will be fully eliminated, especially if they address the nose, or you know, to the different level from severe to mild. That's also, I see a lot of powerful results, combination between GLP1 treatment and oral appliance therapy. So that's also another way to cure. Last thing I want to tell to your patients what visceral fat, what people get it in the stomach, first place, it gets stored in the tongue.

SPEAKER_00 33:32

Uh, if you get the fatty tongue and it takes up the room and obstructs our airway, that that's not no, that that's very, very important. Now, one thing I was wondering about, because I was thinking there are people who have normal BMI who have terrible sleep apnea. And I was thinking, I wonder if that then goes back to issues with the sinuses, with the nose, allergies, asthma, things like that. And then we're looking at them and we're saying, well, you can't have sleep apnea because you don't fit our profile of that. But maybe it's up in the nose and it's hidden from the casual observer, not from you, but from the casual observer. But do you think that's part of that for the thin?

SPEAKER_01 34:14

That's absolutely part of that. I was very surprised many years ago, but now I'm I'm not that surprised. I don't have that much fascination because everybody comes like that. They come with a bouquet. They have high blood pressure, history of asthma, nasal allergies, sinus infections, you know, the dry mouth, yeah, anxiety, and depression. So it's a very common bouquet what they have in addition to sleep apnea diagnosis. And how I connect these symptoms, I connect them through the tongue. Because when people have asthma and they have that fear of not able to take a breath, they keep the tongue low. Because if you keep it low, you can always open the mouth and take a breath. But that tongue, what you keep it low, abstract the airway at night. And knows, funny organ knows if you don't use it, you lose it. The turbine that gets swollen. There are so many underlying mechanisms, but I don't want to sound so complicated because if you cannot keep it like kiss, keep it simple, stupid, then people lose their attention or interest. So when people suffer with nasal allergies, also you know, have a soft nose or congestion. And some people don't even put it in a medical history, but then you know, I start asking them, and we get to that point. You said, Yeah, yeah, yeah. They retrain the tongue, they keep the tongue low. And when they keep the tongue low, it doesn't have that suction with the palate, and that's all collapsed. This is very specific physical, you know, phenomena. The tongue, if it stays suction to the roof of the mouth, other organs have negative charge sort of things, and chances for collapse are less.

SPEAKER_00 36:13

Oh, that's perfect. And please tell me about your book. I'm so excited, and it's an unbelievable undertaking. And I was thinking this morning, you remind me a little bit of Joseph Conrad, who wrote Heart of Darkness. He's uh a Polish gentleman, and it is one of the best written books I've ever read. And interestingly, that you know, English was the second or third or fourth language, but it's a phenomenal book. So it's always great to be the people come. English isn't their first language, and yet sometimes they're way better at it than as native speakers. So it's very interesting. But please tell me what made you write the book and how that works.

SPEAKER_01 36:52

Um, what made me write the book? Even when I was very little, I loved stories. I and now, you know, as a student of history, I learned what stories actually made us who we are. Because we share the oral stories in the shape of myths, in the shape of fairy tales, and later on in the shape of Bible, new testimony, old testimony. Those are the stories would keep us, you know, excite us and move forward. Uh so stories, you know, fascination with the stories was, you know, first. Then when I learned how to read, I told myself a story before I learned how to read, but then I learned how to read, and I'm from St. Petersburg, Russia. So we have a lot of writers. Oh, I never thought I'm gonna become one of the authors, but I love to read. I can eat books for breakfast, lunch, and dinner. So that was, you know, in the summertime we have that reading assignment, and I really love that time. I was so looking forward to that. And then a lot of writers, a lot of Russian writers also have a medical background. So, in our field, and I always tell my colleagues or people who I uh you know offer my mentorship, what um we have a fascinating field, what people bring us the story and they you know pay us for it. You know, that's and we have to use the benefit of that. That's you know amazing, and then you have observant eyes, so you can connect a lot of not even uh details what was not shared and understand the story even brighter. So those stories, and you know, and uh because of that, I also like to travel and collect the stories on the road. Uh, but most important thing and I reflected in a book. I had a dental assistant and with friends, and um one morning she went to the kitchen and her husband was collapsed. And it was just like a story you described earlier in this interview. And luckily, we have a mandatory CPR training every two years, dental office have to fit, you know, have to follow those guidelines. So we had it a week prior, and you know, she called 911 and she started doing CPR with a 911 operator, and husband, who was my patient, who I suspect, abstractive sleep apnea, but he did not follow my advice. He had uh ventricular fibrillation, and just like you mentioned, you know, we can call it cardiac arrest, or if we go deeper, it's ventricular fibrillation, chances of survival outside of the hospital only 3%. And for my book, I interview several cardiologists, and they always talk about the connection between sudden cardiac death and history of abstractive sleep apnea. So I thought not I witnessed, like directly witness, but indirectly, I witnessed that story. And I was thinking, you know, how come I was, you know, it sounds strange, fortunate to witness such a story and not to let other people know to prevent that accident from happening from happening. But then I also had another friend who was not as lucky, and he was very young, and he had a sleep apnea, he was very famous with snoring, and you know, he occupied very special space in my heart. I was so sad to lose him in a young age, 47, and I see how his life unfolds right now. You know, he has a grandkids, he has beautiful, his daughter got a beautiful family, and they're having so much fun, so many loved moments, and he's gone. And every time I think about that, and I really want to commemorate him. So, you know, I talk about those two stories in additional to hold, you know, the I can't wait to read this book.

SPEAKER_00 41:13

This is so exciting, and and I'll put down all the information in the show notes because you've got a great website. Your link tree's got lots of great information. So I want everybody to go look at the link tree, and then your website's phenomenal for your dental office. Anyone in the Clifton, New Jersey area, I want you to switch dentists, go over to see Dr. Maria Sokalina, and if you're in midtown Manhattan by Carnegie Hall, get over there as well, right by the Russian tea room, get over there. And no, I think you're doing phenomenal work, and I love that your background you went to medical school in Russia, so you have a medical background, and then you went to NYU here, and you did dental school, you did residencies, you have a very eclectic background, and you bring knowledge from throughout history and the world together to help your patients. I love that.

SPEAKER_01 42:04

Thank you. That was such a kind word. Thank you very much, and I really hope your audience is gonna enjoy the book. It's gonna be for very limited time. I don't know when you're gonna release the podcast, but you know, use the benefit book as now 99 cents, and maybe in a subtle way you can give somebody a message because I'm not only talking about adults. Another thing would touch my heart very deeply kids. Because kids are such a unique creature. I have two of my own. So I'm have a live experience what it means to raise the human being, and how very often school or preschool trying to put those unique human beings into the box of a certain standards, and you have to do that, but a lot of those kids might have interrupted sleep and you know, secondary bed weighting, huge tonsils and other noids can contribute to that, uh, small jaws, just like adults, and they might not have a restorative time when they stay in bed, and then they express the tiredness as being hyperactive, not listening to directions as being just simply tired, you know. And I, you know, illustrate that in my book with the story. I have a hero and I have parents who are very frustrated, and the school, they don't, yeah, I can't say they don't care, they don't go into those intricacy of the home life of this child. As a parent, we do have um luxury of seeing more.

SPEAKER_00 43:46

Absolutely.

SPEAKER_01 43:47

We could see that the whole thing advocate for the child to understand this situation. Yes, it all can be changed, and not with medications.

SPEAKER_00 43:59

No, I agree. Love that approach. I have to ask you one last question, and I'm so thankful for all your time. What do you miss the most about St. Petersburg?

SPEAKER_01 44:09

About St. Petersburg, it's a very, I would say, controversial question. Right now, especially. Yes, I'm a product of St. Petersburg. I really like aesthetic, great architecture, beauty. We have a wonderful theatrical life and musical life, and just in general, historical life with a lot of um a lot of famous people, the people who I follow, they were from St. Petersburg. That's number one. Number two, I did not lose the connections with my friends. That's a significant part of my soul. And yes, I put a lot of Russian moments in my book. You know, I'm a hero of my book as well, but I put it for me and for my other heroes. I put those moments, what I maybe miss, or I think about them, or I'm trying to move my memories, because um, as you're getting older, that foundation starts playing more and more significant role. But important part, I don't agree with what's going on right now in St. Petersburg, Russia. And a lot of people who I share my childhood and my youth with, they have a totally different opinion. And that put very significant black spot on the memories.

SPEAKER_00 45:41

It's always a challenge, and you know, I would say that I love people a lot more than politicians throughout the world. That's you know, so I I would just, you know, say that. And but I think it's good to think back, and you're right, there's so much culture in St. Petersburg. It's legendary culture, uh, be it from ballet to music, arts, literature, it's unbelievable. So, and and that memory is still there, and that historical memory is still there.

SPEAKER_01 46:08

Yeah, it's a very interesting to live in the duality of that. It's a very like I have a double consciousness, and I live in a past, and I don't know, I want it or I don't, but I do. And I have people who are so dear to my heart, and I enjoy them so much, they are so special to me. I have a very strong tie. And from another standpoint, I can believe what I'm witnessing, what I'm witnessing right now. And what is your favorite part? It's a very, very deep.

SPEAKER_00 46:39

What is your favorite part about America? If you're talking to somebody from Russia, say, I really love this about America.

SPEAKER_01 46:44

Oh, I really love a lot of things about America. I really love the ability, what I can become, who I want to become. But nobody's gonna tell me you have to do this, this, and this to follow this particular pathway, what somebody else would design for me. So that luxury, I can't I wake up every morning and I'm so thankful. So that part, you know, besides interesting nature, what I love and uh a lot of expression, I live, you know, very close to New York City, so I enjoy that so much. Uh, there are so many things in the United States what I think I appreciate. Um, and a lot, and I find what a lot of people are very critical about that. Like they never stand in line for eight hours to get simple shoes.

SPEAKER_00 47:38

Yeah. No, we're we're very lucky. We're very lucky. And I'm just gonna close by saying you're an inspiration to all of us. Thank you. So we're better to have you here. You improve, and I really love your approach to medical care and how you look collaboratively, you work collaboratively with other physicians, and you look at all the features of a serious medical problem and you attack each one of them so your patients can have success. That's fantastic. And everybody, I want you to read that book because I can't wait to read it. I know it's gonna be fantastic, and thank you so much for being here.

SPEAKER_01 48:15

Thank you very much. I really appreciate that.

SPEAKER_00 48:18

Thank you, and please, everybody, like and follow for more. Let me know if you have any questions. We'll see you next week. And please, I can put everything in for Dr. Sokalinas. All her information is gonna be in the show notes. And definitely check out her book, check out her website, check out all her socials. She's got a lot of great podcasts and reels out there, which I've been gorging myself on this week and loving them. They're all fantastic. But thank you so much.