Vital Discourse

Dr. Ben Cilento and Dr. Lee Mandel
  • 5.0 (2)
  • ALTERNATIVE HEALTH
  • SERIES

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 you stop guessing and start making sense of your health. Tune in every week for the inside scoop on health, policy, and law, for advice, interviews, debates, and straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise and bring you the guidance you need. In each episode, they help listeners navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in.

Episodes

  1. EPISODE 1

    Snoring, Sleep Apnea, and the Truth About Quick Fixes

    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 treatment plans are built through clinical data and patient-specific design. Listeners will gain clarity on nasal airflow, home sleep testing, CPAP therapy, oral appliances, and hypoglossal nerve stimulation while learning how to protect their own sleep and overall health.  Chapters:  00:00 Intro – Why Vital Discourse Exists 08:14 Dr Lee’s Journey Through Medicine and Law 17:02 The Medical and Legal Disclaimer – Framing the Conversation 20:01 What ENTs Actually Do and Why the Airway Matters 35:21 Why “Quick Fix” Culture Misleads Patients 55:33 Launching Episode 1 – Why Start with Snoring and Sleep Apnea 58:41 Understanding the Three Levels of the Airway 1:01:57 What Sleep Apnea Really Is and Why It Matters 1:03:39 Home Sleep Tests vs Lab Studies – Measuring Real Sleep 1:11:55 From CPAP to Surgery – Matching Treatment to Anatomy 1:18:14 The Power of Nasal Airflow and Why It Shapes Every Outcome 1:24:57 Inspire and Genio Implants – The Future of Sleep-Apnea Therapy 1:39:15 Inside an ENT Evaluation – What Patients Can Expect 1:45:16 The Hidden Costs of Ignoring Sleep Apnea 1:56:19 Final Takeaways – Clear Steps Toward Better Breathing and Sleep If you enjoyed this episode, make sure to subscribe, rate, and review it on Apple Podcasts, Spotify, and YouTube Podcasts. Instructions on how to do this are here.

    42 min

  2. EPISODE 2

    Obesity, Hormones, and the Vicious Cycle of Sleep Apnea

    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 tongue, neck, and belly changes airway physics, how inflammation and insulin resistance add strain, and how GLP-1 medications, testosterone, CPAP, surgery, and weight programs fit into a coordinated plan designed to restore both breathing and metabolic health. Chapters: 00:00 - Introduction 00:00 - Welcome & Episode Overview 00:36 - Understanding Sleep Apnea 00:36 - What is Sleep Apnea? 01:14 - The Paper Straw Analogy 02:23 - Recognizing Sleep Apnea Symptoms 03:14 - Snoring vs. Obstruction 04:30 - Sleep Study Diagnostics & Severity Levels 05:57 - The Sleep Apnea-Obesity Connection 05:57 - Common Medical Advice About Weight Loss 06:39 - The Truth About Correlation 07:24 - Why Weight Gain Comes First 07:48 - How Sleep Apnea Prevents Weight Loss 07:48 - Sleep Disruption & REM Sleep 08:11 - Understanding REM Sleep & Muscle Relaxation 09:30 - Growth Hormone & Metabolic Changes 10:29 - Leptin & Ghrelin: The Hunger Hormones 11:49 - The Vicious Cycle Explained 12:20 - How Obesity Worsens Sleep Apnea 12:20 - Anatomical & Mechanical Effects 12:43 - Fat Deposits in the Tongue & Throat Muscles 13:32 - Critical Closing Pressure & Airway Physics 14:40 - Impact on Lung Function & Oxygen Saturation 16:27 - Heart Health Complications 16:52 - Neuromuscular & Inflammatory Effects 16:52 - Fat's Impact on Muscle Control 18:04 - Inflammation & Sleep Apnea 19:23 - Why Weight Makes Treatment Harder 19:51 - Treatment Approaches 19:51 - The Multi-Pronged Approach to Weight Loss 21:03 - GLP-1s: Benefits & Risks 22:00 - The Testosterone Trap 24:06 - Comprehensive Treatment Strategy 25:26 - Key Takeaways 25:26 - Vital Point: Weight Doesn't Define Sleep Apnea Risk 26:32 - Importance of Professional Help 27:33 - Closing Thoughts & Call to Action

    29 min

  3. 10/12/2025

    Vital Discourse is Coming Soon!

    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 straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise to bring you the guidance you need. In every episode, they help their audience navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in. The first episode is coming soon.

    1 min

Trailer

5
out of 5
2 Ratings

About

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 you stop guessing and start making sense of your health. Tune in every week for the inside scoop on health, policy, and law, for advice, interviews, debates, and straight talk you won’t find anywhere else. With backgrounds in military and law, Dr. Ben and Dr. Lee cut through the noise and bring you the guidance you need. In each episode, they help listeners navigate the healthcare system, find answers to their most pressing questions, and take steps to start feeling great, with lots of laughs along the way. No appointment necessary—the doctors are in.

Information

  • Creator
    Dr. Ben Cilento and Dr. Lee Mandel
  • Years Active
    2K
  • Episodes
    3
  • Rating
    Clean
  • Copyright
    © Copyright 2025 Dr. Ben Cilento and Dr. Lee Mandel
  • Show Website
    Vital Discourse