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It’s Not Your Mattress, It’s You

Having a comfortable mattress is important to most people. What a comfortable mattress won't do is fix your breathing issues. Dr. Madan Kandula and Dr. Ethan Handler discuss the topic on this week's episode of ADVENTing.



Dr. Kandula: Alright. So I think... So I've seen lots of ads and messaging these days on mattresses, and pillows, and this, that and the other thing. Which is on one hand's good. I guess there's awareness about sleeping, impact on quality sleep. On the other hand, it's a... I think for most of our patients, that could benefit from a nice mattress, or benefit from a proper airway, it's airway. I think people don't understand the fact that a mattress that's good and comfortable is nice, but if you can't breathe properly too, you can't sleep properly. I think that message sometimes gets lost in the mattress. It's easy to go out and buy a new mattress and spend a lot of money on a mattress. It's harder to look in the mirror and say, "Maybe my poor sleep is more about me than my mattress."

Dr. Handler: Well it's also easy, I think, to target patients from a marketing standpoint, if you're a mattress company or something else. And now with Fitbits and Apple watches and everything else to track your sleep, and understand some more about your sleep quality is correlating those things, and saying, "Hey, this is your problem or your solution." You know? And so that's why all these bed in a boxes have popped up. And you can go online and do your profile, and what heat do you want, and uprightness, but like, but is that going to fix a problem that's starting here? Absolutely not.

Dr. Kandula: Correct. Yeah, anybody, like snoring for instance. Like snoring by definition is basically your body letting the world know that you've got a compromised airway. That annoying sound that you make when you're sleeping at night when you snore, it's your airway trying to shut down.

Dr. Handler: And what do some of these mattresses do? They try to propel people up. Pretty soon you're gonna be hanging from the ceiling sleeping, right? Like, you know, that is trying to put a band-aid on a solution that obviously is a problem. That's a nose and throat issue.

Dr. Kandula: Correct.

Dr. Kandula: Yeah, although if you're the guy or gal who's snoring, and you elevate your head a little bit, it's better than laying flat, probably. It's not getting to the root of the problem.

Dr. Handler: No, and it seems uncomfortable, I mean I don't know. I've never slept that upright, but I don't know.

Dr. Kandula: Yeah, I mean it's a thing. I guess if that's the tool you have to address this issue, fine. But basically, it's fundamental in my mind, is from a sleep standpoint. And sleep is important. Sleep is vital. It's crucial. You need sleep. You need good quality of sleep. To guarantee the best quality of sleep, you've gotta be able to breathe properly, period, end of sentence, that way. And to compromise your sleep, you compromise your airway sort of thing. And millions of people walk around this country and this world with airways that are compromised. And they get one night sleep where they're elevated a little bit, or whatever the gimmick is that they're using that's a little bit better than the thousands of nights they've had before that. You know, I guess theoretically it's better than nothing, but it's still not getting to the root of what's going on.

Dr. Handler: And it's not an inexpensive way not to address an issue, right. You can go out and get a mattress. Maybe it's more comfortable, but your sleep quality isn't gonna change. And it's not inexpensive to do all that.

Dr. Kandula: Yeah, no I hear you. And I think part of the challenge is, and this is our fault too. It is our fault as far as, I think it is our fault being in medicine, being the gatekeepers for sleep, which is what ENTs are. Our specialty is the specialty that is responsible for folks that have snoring and sleep apnea. Both as far as treating them properly, and as far as getting the messages out. And we've done a poor job of messaging. 'Cause people don't know what to do. People have been snoring. People snore. They might have sleep apnea. I think, unfortunately, they don't know who to turn to, or what to do, which is a problem.

Dr. Handler: Yeah, and I think part of it, as physicians, and maybe it's part of just the dogma and the mantra is not to go say, "I can help people," and go out and try to find those people that you can help because you have this way of helping them. It's more of letting them get to you. But if you sit on the sidelines, and you just wait for people to come to you, you're leaving all these people out there that aren't aware or understand that they have an issue that's going on. That it's something that as head and neck surgeons, we can address as far as nose and airway goes. And so, and it's kind of just... So it's a balance between physicians being trained to kind of again, take kind of a more hands-off approach versus like, "Hey, I have this ability and a skill set. "And I understand that you have this problem going on. "I can help you."

Dr. Kandula: Yeah, which is, I'm thinking about what you're just saying there. 'Cause it's, that's how we're trained as physicians. Is as destructive and hateful as you possibly get, right? Like how--

Dr. Handler: Explain that. Explain that.

Dr. Kandula: Meaning, that's basically like slapping somebody in the face of saying, "Hey, I'm high and mighty. "I'm gonna sit here and I'm gonna wait for you "to figure out that you got a problem "that I might be able to help you out with "because I'm all-knowing and all-powerful." Versus saying, "Hey buddy, you're not sleeping great. "I get you here. "You're not sleeping great. "You're snoring, that's annoying for you. "It's annoying for everybody. "There are things you can do about that. "And there's not one thing you can do about that." "There's probably a dozen things "we could think towards doing, "that we can think to do about that, "and none of those things involve your mattress. "All of those things involve trying to actually figure out what's going on and treat that properly." But, flip that around. The standard of care, the standard of care in sleep is just flip opposite. It's insane to me that that's how it is. And that's how it is. And it's even worse than that. It's even, to me, the neutral ground of, "I'm really important, and you're not. "Go figure it out, and whenever you figure it out, "I may be here, I may not. "We'll see," kind of thing. It's different than the next level of hate is, hey you're gonna come in, I'm gonna see you. I'm not gonna listen to a word you say, and I don't care what you want. Hey you snore, here's this machine. I'm gonna shove in your face and say, "Hey, use this thing and get out of my office "because I've got other people "that are lining up to see me." Like that's... Whatever the next step beyond hate is, I say that's hateful. And go figure why that's repelling to people. Go figure why people don't want to go and seek treatment for their snoring or maybe sleep apnea. Because, like what insane person would knowingly walk into that lair.

Dr. Handler: Right.

Dr. Kandula: Like, why would you do that? But that's, unfortunately, that's how is, man. That's how the world is around us.

Dr. Handler: But that's why we're having these conversations, to try and raise the level of awareness that there's something that we can do about it. Imagine if a mattress company, or all the mattress companies were like, "Hey, we have these soft things that you can sleep on, but good luck trying to find us." You know, like how are they gonna reach people, right? And so like, there's no problem with them advertising and everything else. And it's not that we're advertising. It's just that people just aren't aware. You know, people struggle and have these problems, and it's on us to get out there and say, "Hey look, this could be your issue. "Let us evaluate it. "If it's not, great. "If it is, we can help you."

Dr. Kandula: Yeah, I agree. And it's nothing wrong with mattresses. And I don't have any, you know--

Dr. Handler: No mattresses? You sleep on one.

Dr. Kandula: I guess I don't hate mattresses as much as I hate the status quo in medicine, as you can tell. I hate that.

Dr. Handler: Yes, I gather that, yes.

Dr. Kandula: I think that thing needs to die a painful death because the time has come for it to happen. I sleep on a mattress, and I sleep on a pillow. And I think my mattress and my pillow are fine, and you know--

Dr. Handler: I love my mattress.

Dr. Kandula: Which is great, like--

Dr. Handler: I can breath.

Dr. Kandula: I don't want you to have a bad mattress. But I'm just saying, that a lot of those things are, to me those are all sort of signs and symptoms of a more fundamental, underlying problem which is that sleep in this country is sub-optimal for most folks. Most folks don't get the kind of sleep that they're looking for.

Dr. Handler: You can say this world, I mean to be honest.

Dr. Kandula: This world, absolutely. The reason I say this country, this country, there are the reasons in this country to take care of these issues. Back, our ancestors, not that long ago, were sleeping on the ground. And that's... So you don't need a mattress to sleep. Think of it this way, you don't need a mattress to sleep. You could sleep on the ground. You could sleep on wherever. You need an airway to sleep. You need airway to sleep, if you don't have an airway you're not sleeping, right. But you can sleep on any sort of a thing that you come up with. And I think in this day and age, it's a shame that the mattress is the winning message versus the airway, which nobody ever really talks about, you know, kind of thing, which is a shame. It's a shame that nobody ever really calls it out, so we're calling it out. I think game on, you know. Mattress companies, I'm not coming after you, but I am coming after the status quo. And we're coming after the reality that so many people who could be living a better life than what they're currently living. And the first step in that process is really understanding the fact that that's the way it is, so yeah.

Dr. Handler: Yeah.

Dr. Kandula: That's the story, man.


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