Los Angeles, CA | Dennis Prager Sleep Apnea Radio Interview | Dr. Avi Ishaaya Centers

The Dennis Prager interview with Dr. Avi Ishaaya, discussing the dangers of sleep apnea and how to get tested and treated for this condition.


Dennis Prager: Dennis Prager, here. This is Sponsor Spotlight. My guest is Dr. Avi of I Am Sleep and let me tell you something... You, my listeners. You need to know this. I asked to do this. And that's pretty rare because I have enough work in life. I have to say that. But I have such gratitude to this doctor that I asked to introduce him and to interview him. And I'm going to tell you, if you take this seriously it will change your life. It did change my life overnight and that's literally true. Overnight, my... It's a good motto for I Am Sleep, though. Change your life overnight. That's exactly what happened to me.

Dennis Prager: My friends, everyone who snores might be disturbing whomever they're sleeping next to, of course. But the issue of snoring can be far, far more serious than just making noise. You're probably not getting enough oxygen because you are gasping and grasping for oxygen, for air. I found that this was true and I'll tell you how I knew I needed to see somebody. And that is, I was actually starting to fall asleep while driving. Thank God I never fully fell asleep but I was catching myself and it is scary. So, I went for a test at an institute and they found that I had sleep apnea, which was this gasping for breath constantly during... 70 times an hour. And they gave me a CPAP machine, which would push air into my nose and therefore enable me to breathe through my nose.

Dennis Prager: The thing is, I thought I was being waterboarded. I actually left this place where I had the test at four in the morning and went home. And I told my wife, "I can't handle this. I'd rather have sleep apnea than be waterboarded." But I got to do something. I even considered surgery. Happily, I found out about this I Am Sleep and Dr. Avi and what they have done there. I took the test that I had taken at this other place. I didn't have to leave my home. In my own bed overnight. Totally painless. Unbelievably easy. They diagnosed me by computer. I think the man's a genius for inventing this and I mean it sincerely. And then they gave me their machine, which I adapted to in two seconds.

Dennis Prager: I owe this man a lot of my health. I have not yawned... I'm not kidding... Since that day. So, Dr. Avi of I Am Sleep, welcome.

Dr. Avi Ishaaya: Thank you for having me, Dennis.

Dennis Prager: I want you to explain to people, because this is your area of expertise, why this is so important. Because a lot of people think snoring is just nuisance, but it's not.

Dr. Avi Ishaaya: Yeah, absolutely, Dennis. The issue about sleep apnea is that it has what we call short-term and long-term consequences. In the short-term, you actually described a little bit, is... One of the hallmarks is daytime sleepiness where you fall asleep driving, reading, watching TV. The other main short-terms are difficulty with concentrating, difficulty with memory. A lot of problems with irritability and even people will complain of having to wake up multiple times to go to the bathroom in the middle of the night.

Dr. Avi Ishaaya: But the long-term issues are really dire. Things like heart disease and heart attacks and strokes and now we even know that cancer is a big risk factor that occurs in patients with untreated sleep apnea. So, we really need to be very proactive about diagnosing and treating patients who have it, much like we did with you.

Dennis Prager: You certainly did. You remind me, here, on the symptoms... You had mentioned sleepiness and, happily, I was never irritable. But you did mention another symptom which I did feel and I'm telling you, it is... You see this all the time. You see people changed. I have to believe that you must get more love letters than Bill Clinton got. I mean, I'm not kidding. What you have done for people... Am I right? Am I exaggerating?

Dr. Avi Ishaaya: You're absolutely right, Dennis. The beauty of treating a patient with sleep apnea is that literally after one night, like you described, you start feeling better. Even after using the machine for a week, you feel unbelievable and the energy level you have and the alertness you have and being able to wake up and feel refreshed is overwhelming.

Dennis Prager: Yeah. I want you to tell people two things. One, how easy this test is. I told them but I'd like you because you developed it. And number two, and of course, the importance of you don't have to leave your home. Every other place, you have to go to some place, sleep in a public bed, as it were. We'll start with that.

Dr. Avi Ishaaya: Yeah. The test is really easy. The beauty of it is that we even can do the consultation by telemedicine. If a patient doesn't want to leave the home, they can just call us and we can do an interview by video and then we send them this device, which is a little bit bigger than an Iphone. It's as reliable as an in-lab sleep study. And we ship it to them, they it get overnighted, they wear it just like they would at night, they sleep, and they wake up in the morning and send it back to us. And we're able to then score it immediately and then call them with the results.

Dennis Prager: What percentage of people who snore have sleep apnea?

Dr. Avi Ishaaya: Well, we know that about 50% of the nation snores and about 20% of the nation has sleep apnea, so it's probably somewhere around 60% or so, we think.

Dennis Prager: And it's particularly, though not exclusively, if you're overweight. Correct?

Dr. Avi Ishaaya: Correct. About 70-75% of all patients with sleep apnea are overweight. And the other 25% are a potpourri; people with jaw abnormalities, young patients who have large tonsils. Effectively, we do see a much higher percentage with the Asian population, as an example, that are not overweight but have a very high incidence of sleep apnea.

Dennis Prager: But there's no such thing as sleep apnea without snoring. So, snoring is the general key to knowing you have it.

Dr. Avi Ishaaya: Most of the time. It really depends on how flopping your airways are. Most of the time, people snore very loudly and you get to a point where the bed partner sleeps in another room. That usually is a hallmark complaint.

Dennis Prager: I have told the story, and I'm not embarrassed to say it again, that the first night I wore your machine over my nose, my wife got up in the middle of the night... I think the dog barked or something... And she actually bent over to assure herself that I was living. That's how dramatic... Happily, she always slept through my snoring. But I was so quiet. I mean, utterly silent. And I'm still amazed by it, frankly. I don't know how many things bring you that many benefits at one fell swoop.

Dennis Prager: Why is your CPAP machine, that is the breathing part, different from others?

Dr. Avi Ishaaya: Well, our machines are automatic. They're called automatic positive airway pressure machines. They have a couple of things. One of them, they're very smart. They actually detect the exact pressure you need as opposed to-

Dennis Prager: Oh, I didn't know that.

Dr. Avi Ishaaya: Yeah.

Dennis Prager: I was wondering. Because it does seem that way. The regular CPAP machine just sends air into you, so it's like standing in front of a major wind blower and you can't stop it.

Dr. Avi Ishaaya: That's exactly right. That's exactly the complaint most of everyone says to me, where the automatic machines... They actually have what they call A-flex technology. It actually conforms to your breathing cycle a lot better so it breathes with you and-

Dennis Prager: Yeah.

Dr. Avi Ishaaya: The amount of pressure being blown is almost half.

Dennis Prager: I'm always... I'm so amazed by it. I try to outsmart it. Can I breathe... Can I inhale without letting it know? And it knows. It's eerie, actually. You're right. It'll only send air to the extent that you need it and when you need it.

Dr. Avi Ishaaya: Exactly.

Dennis Prager: We're very lucky. I want to philosophize for a second, Dr. Avi... And again... Let me give you the number here, folks, because I'm telling you, you will thank me. You hear that, but my credibility with you, my listeners, is very great because I only endorse what I believe in. And I asked to do this particular interview. First of all, it's 855-I-AM-SLEEP. Everybody can spell that. 855-I-AM-SLEEP. If you want digits, 855-426-7533. 426-7533. And it's just IAmSleep.com. It's very simple if you want to go and read about it, but order it. And I think it's important for people to know that insurance covers... What does it cover? It covers the machine, correct?

Dr. Avi Ishaaya: It covers both the testing and the-

Dennis Prager: Oh, really. It's both?

Dr. Avi Ishaaya: Therapy.

Dennis Prager: The testing as well?

Dr. Avi Ishaaya: Absolutely. Absolutely.

Dennis Prager: Well, then, folks. If you don't do it... This is one of those examples of I can't understand why someone wouldn't do it. It's so self-recommending and it's so good for you. It's good for your husband or wife. It's good for your dogs. I don't know. Maybe the dogs sleep better now. I don't know. One of my dog sleeps... He's a bull dog. They all snore.

Dennis Prager: Folks, this is an amazing thing, this I Am Sleep product. You developed this test, didn't you?

Dr. Avi Ishaaya: Well, we didn't develop the actual test. We developed the actual process; the whole bundling of being able to do a telemedical consultation, be able to send a-

Dennis Prager: Well, that's what I mean; that you could do it from remote.

Dr. Avi Ishaaya: Right.

Dennis Prager: You don't have to go into a...

Dr. Avi Ishaaya: Exactly.

Dennis Prager:
Some institution of some type.

Dr. Avi Ishaaya: Exactly. You can be a hillbilly in the mountains and still get the test.

Dennis Prager: Yes, that's right. And then also, you also have... Through a simple memory card, you can then tell me how I'm doing.

Dr. Avi Ishaaya: Right.

Dennis Prager: I remember going in and saying, "You know, on March 3rd at 3:00 AM, you got up." That was really great. The guy with the straight face. But that's terrific that you can see, folks, on a graph, your progress. This is how many times you gasped for breath before this and now how many times. I think it's like three times an hour from 70, which is nothing, essentially. It's nothing.

Dennis Prager: This is a very great thing. We're going to take a break, here. This is the Sponsor Spotlight and as I said, I asked to do this because frankly, I want to thank Dr. Avi. He has made, truly, this deep impact on the quality of my life. And because I want to help you. 855-I-AM-SLEEP. That's the simple number. Get yourself tested or go to IAmSleep.com. The phone number for I Am Sleep is exactly that. 855-I-AM-SLEEP or 855-426-7533. 855-I-AM-SLEEP. 855-426-7533. And on the internet, it is IAmSleep.com. This is Dennis Prager for Sponsor Spotlight.

Dennis Prager: Actually, I think this particular episode of Sponsor Spotlight ought to be renamed to Life Saver Spotlight. That's how much I endorse and am grateful. And that's the reason I'm doing this. I'm not paid to do this. I asked to do this because I am so grateful to this doctor, Dr. Avi, for developing this and for making this possible.

Dennis Prager: Folks, I call it QOL. That's quality of life. It's a term I use with my friends a lot and there are things that enhance your QOL. There are things that detract from it. One of the worst things that can detract from it, outside of monumental tragedy, is walking around tired. I have been... I'm being very open because I want to help everybody. And I have been blessed with inordinate amount of energy.

Dennis Prager: Many of you know, I fly virtually every week of the year. I cross the country about every other week then lecture then broadcast and write a column and write books. And I am blessed with energy. But it was starting... There was something starting to happen. And that was that during the day I was so... I would get episodes of such fatigue that even sometimes behind the wheel I felt sleep coming on, which induces terrible adrenaline rush in you. You jolt yourself. What? You're falling asleep while doing 65 on a freeway? And it didn't make any sense. It didn't matter how much sleep I got. It had nothing to do with the amount of sleep I got.

Dennis Prager: And then, sure enough, it turned out that I had sleep apnea. What do you... Dr. Avi, how many Americans have that?

Dr. Avi Ishaaya: About 20%.

Dennis Prager: So, 20... 1/5th. That's 60 million people.

Dr. Avi Ishaaya: Right. One out of five.

Dennis Prager: Yeah. 60 million Americans should be using your machine, sir!

Dr. Avi Ishaaya: Agreed.

Dennis Prager: That's my project. I am annoyed. No, it does. It annoys me when people can be helped and they don't know about it. I knew I had it because I had gone for a test a year before but I didn't help myself because I couldn't. The machine they gave me called CPAP made me feel, as I've told you, like I was waterboarded. Then I was told about you and my life changed literally overnight. 60 million Americans. I mean, that's like an epidemic.

Dr. Avi Ishaaya: Yeah. It is an epidemic and it's expected to rise because of the obesity epidemic.

Dennis Prager: Really? And you don't have to be obese. You shouldn't be listening and think, "Well, I'm not obese. It's not an issue." First of all, a quarter are thin and have it.

Dr. Avi Ishaaya: Right.

Dennis Prager: As you pointed out. Like in the Asian community you say it's particularly endemic or... Yeah, endemic. And also, children. Some children have it, apparently.

Dr. Avi Ishaaya: Yeah. And a lot of children are actually misdiagnosed with attention deficit disorder and they turn out to have sleep apnea.

Dennis Prager: Oh, how interesting.

Dr. Avi Ishaaya: Yeah.

Dennis Prager: What a sad thing in their case.

Dr. Avi Ishaaya: Yeah.

Dennis Prager: How would the parent know?

Dr. Avi Ishaaya: Well, you need to do a sleep study. And we can actually do home testing on children these days as well.

Dennis Prager: So, if your kid is walking around fairly regularly tired or attention wandering because they're tired, that would be something to diagnose here.

Dr. Avi Ishaaya: Actually, most of the kids are irritable. They can't sit still, they can't concentrate in in class. And teachers usually will complain to the parents and the parents will take them to be evaluated and they're diagnosed with attention deficit disorder where, in fact, they have sleep apnea.

Dennis Prager: I'm curious, does the average doctor... Let's say a guy goes to his doctor, says, "Doctor, I don't know what's going on here. I have a good life. It's not a psychological issue, so I'm not depressed. But I just find myself constantly fatigued." Does the doctor immediately say, "Well, maybe it's sleep apnea."?

Dr. Avi Ishaaya: Unfortunately, not. The awareness factor is really not there. About 85% of all people who have sleep apnea don't even know they have it and unfortunately, physicians are not in tune to asking the question as well.

Dennis Prager:
Yeah. I'll bet that that's the case. They might think chronic fatigue syndrome or whatever that's called where it's as simple as this. And my dear listener, please know when you do this, your helped that night. It's not gradual. One night is all you need and you realize you're different.

Dr. Avi Ishaaya: Right. It's an immediate... It's almost an immediate prescription of health.

Dennis Prager: If you're getting up... Here's an example. I'm speaking especially to men now. You get up like five times a night to go to the bathroom, all right? A lot of men will think, "Oh, I'm getting older. It's a prostate issue," right? It's just what happens. Maybe it isn't. Maybe it has nothing to do with that and it's just sleep apnea because you keep getting up because you're waking yourself up gasping for breath and you don't know that. By the way, that was true with me. I never, ever get up at night now. Never.

Dr. Avi Ishaaya: Yeah, that's a very common complaint, in fact. Waking up frequently to urinate.

Dennis Prager: How would you not? You keep getting up because you're not breathing right. It's amazing you sleep at all with sleep apnea.

Dr. Avi Ishaaya: Right.

Dennis Prager: It's a marvelous thing. There are many symptoms of this. It was a doctor who recommended my first sleep apnea test because I went to him for dizziness. And he said, "Have you ever had a sleep apnea test?" I said, "No." He said, "Well, do you have it?" And I didn't know. And by the way, I've not been dizzy since. I have no idea if it's connected. I don't want to make that claim. But I just want to say one doesn't even know. You know, Dr. Avi. But I don't think most people realize how much this affects... I asked you last time we spoke... I had a theory. If you're not getting enough oxygen, which is what's happening, correct?

Dr. Avi Ishaaya: Correct.

Dennis Prager: Well, why wouldn't that affect your brain?

Dr. Avi Ishaaya: It does. We've had several studies come out about early dementia and permanent memory loss that occurs as a result of untreated sleep apnea. So, yes. You're absolutely right. Everything that affects a low oxygen state will affect any part of your body. So, your heart, your brain. Everything.

Dennis Prager: All right. Let me make clear all that's involved. It's nothing for you. First of all, whatever it is that you would need is covered by insurance. I just want you, my listeners, to know that. Second, this is... Here's the way it works. They send you this little machine. You hook it up to yourself. I mean, hook up... I don't even want you to think you were hooking it. It's nothing. It's like putting on a ski mask or something. It's nothing. It's less than a ski mask. You just put it on. You attach it to this machine that you send. I mean, I followed the directions easily. It's a well done job.

Dennis Prager: You do it. It takes five minutes. You go to sleep. They get the results in your institute there at I Am Sleep. They get the results and they tell you. Last night, you were gasping for breath X number of times per hour. Is that correct?

Dr. Avi Ishaaya: Yeah. We tell you how many times. On your back, on your side, how long you stopped breathing, how low your oxygen dropped. We give you all the details you need to know as far as how bad your sleep apnea is.

Dennis Prager: Yes. Exactly. And by the way, I had 70, which sounds horrific. There are people over 100.

Dr. Avi Ishaaya: Right. Even 120.

Dennis Prager: I mean, can you imagine that? 120 times in every hour? Then, you get the results and then what do you do?

Dr. Avi Ishaaya: We call you with the results. We go over the detailed description of what we found while you slept and then we talk about the options. Obviously, our gold standard is the automatic positive airway pressure machine or the Auto PAP-

Dennis Prager: Which is also covered by insurance.

Dr. Avi Ishaaya: Which is also covered by most insurances, yes.

Dennis Prager: And by the way, there is a whole panoply of types of coverings over your nose. If you want it over your nose, it's fine. In your nose is fine. It's all rubber. It's totally comfortable. You want it over your nose and mouth. Anything that's comfortable for you. Different sizes. And I got to say, your people are wonderful.

Dr. Avi Ishaaya: Thank you.

Dennis Prager: No, really. You have a beautiful staff of people.

Dr. Avi Ishaaya: Thank you.

Dennis Prager: And they really seem to give a hoot if you are happy.

Dr. Avi Ishaaya: Yeah. We really want to handhold every patient and to get them to a point where, like you, they're using their machines each and every night and they're happy and their life has changed.

Dennis Prager: Yes, our lives are changed. You get the test, you take the test, they give you the result the next day. Then do they have to go in for the mask and the machine? What happens then?

Dr. Avi Ishaaya: No, we can do everything remotely. We're able to coach everyone by phone most of the time. Sometimes we'll do video chats to help with the fitting. And the nice thing about it is that we get all the messages from the machines each and every night so we can see if your mask is leaking, how many hours you've used it, how high your pressure was. So, we can call you and-

Dennis Prager: Right.

Dr. Avi Ishaaya: -Re-do.

Dennis Prager: Believe me, I can tell you. They don't abandon you once they get the machine. Your guy Anthony must have called me more often than his girlfriend, I'm telling you. He wanted to know I was doing okay. And it was terrific. It was effortless. I mean, I didn't really need much handholding after that. But it's important for people to know they don't have to go anywhere. Everything is doable at home. And those of you who have relatives or friends outside of the LA area, you got IAmSleep.... They can go to IAmSleep.com. They could live in Zimbabwe and do this. Is that right? All they need is a... What is it? A hook-up through the internet or what?

Dr. Avi Ishaaya: Right. They can actually sign up through the internet and we can work with them to get a prescription and if need be-

Dennis Prager: Right.

Dr. Avi Ishaaya: We can actually do a telemedicine interview depending on the situation.

Dennis Prager: Yeah.

Dr. Avi Ishaaya: But we make it very convenient so that patient's can really do it remotely from just about anywhere.

Dennis Prager: 855-I-AM-SLEEP. And I want you to send me a thank you letter. I want you to send him first. Or at least send him and send me a copy. Look, as I said, folks, I am not getting paid to do this. I asked to do this. I just want you to know that. This is from the bottom of my heart. This is life changing stuff. 855-I-AM-SLEEP. That's 855-426-7533 or IAmSleep.com. The test, the machine. You don't have to go anywhere. You can do it all at home. And let me tell you something. It works. Got a final word there, Dr. Avi?

Dr. Avi Ishaaya: Well, Dennis, I appreciate you helping me send the word out because I really think it's so critical for any patient who has sleep apnea to get themselves treated. It really is life-changing and makes a difference not only in their livelihood but also in their overall health.

Dennis Prager: Yeah, and your partner will thank you.

Dr. Avi Ishaaya: Absolutely.

Dennis Prager: But first, he or she will check if you're alive. Then they'll thank you. She was relieved, my wife. My husband is living. He's so quiet. Well, she's a great wife and you're a great doctor. 855-I-AM-SLEEP. 855-426-7533. IAmSleep.com. This is Sponsor Spotlight and I am Dennis Prager.