Vital Discourse

Nasal obstruction is one of the most overlooked forces behind sleep apnea. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how nasal resistance, negative pressure, childhood mouth breathing, turbinates, and the nasal valve all influence airway collapse at night. Listeners learn how to recognize hidden nasal issues, why dry mouth signals nocturnal obstruction, and how...

Obesity and sleep apnea create a loop that reshapes metabolism, hormones, and airway function long before most patients notice the signs. In this episode of Vital Discourse, Dr. Ben Cilento and Dr. Lee Mandel explain how fragmented REM sleep disrupts growth hormone, leptin, and ghrelin, lowers metabolic rate, and drives weight gain that feels impossible to reverse. They break down how fat in the t...

Snoring and sleep apnea remain among the most misunderstood health problems in modern medicine. They are not harmless habits but airway disorders linked to cardiovascular risk, cognitive decline, and chronic fatigue. In this first episode of Vital Discourse , Dr. Ben Cilento and Dr. Lee Mandel explain how modern medicine approaches snoring, why anatomy matters more than gadgets, and how real treat...

Vital Discourse is a new weekly podcast that provides deep dives into important health-related topics. On Vital Discourse, two surgeons and friends—Dr. Ben Cilento, M.D. and Dr. Lee Mandel, M.D., J.D., F.A.C.S., F.A.R.S.—help listeners start making sense of their health. Tune in each week to get the inside scoop on issues concerning health, policy, and law, with advice, interviews, debates, and st...