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1:42 AM Wed, July 18th

Treating sleep apnea can help control seizures

Dear Dr. Rosenberg:

I have epilepsy. Currently, I am on three drugs for my seizures, but I'm still having them. My neurologist wants me to have a sleep study. I snore at times, but my wife has never seen me stop breathing. Do you think this test is necessary?

A: Yes, I do. Your neurologist is correct in ordering a sleep study. Recently, we have become aware of the relationship between sleep apnea and seizures. This is most pronounced in people with refractory seizure disorders such as yours. The incidence of underlying sleep apnea is as high as 30 percent in this group. It is felt that the loss of total sleep and the fragmentation of sleep due to the apneic events could be the cause. The good news is that with treatment, many have been able to get control of their seizures.

Dear Dr. Rosenberg:

Please explain how CPAP works in preventing sleep apnea.

A: The application of CPAP prevents the upper airway from collapsing. The pressure counteracts the collapsing forces found in the airway of patients with sleep apnea. It basically acts as a pneumatic splint, keeping the airway open during sleep. When patients are studied in the sleep lab, the technician applies increasing levels of pressure until we determine the correct pressure for the individual patient.

Dear Dr. Rosenberg:

My husband started sleepwalking about a year ago. He does this about two times a week. It was at about the same time that he started drinking heavily. He says he drinks to help him fall asleep. Could there be a connection?

A: Yes, most definitely. Alcohol is a known precipitator of sleepwalking.

Using alcohol is a very poor method to fall asleep. I would recommend a visit to your health care professional to work with his insomnia.

Dear Dr. Rosenberg:

I had a sleep study performed four years ago. I was placed on CPAP and since have done remarkably well. Recently, I was seen by my doctor, who suggested, that I be restudied, since it has been four years. I am wondering why, because I feel great.

A: Actually, it is not necessary. There is no reason for routinely restudying someone who is doing well. Many of the machines have smart cards that can be downloaded and reviewed. If there are significant breakthrough apneas, they will be detected on the smart card. The best reasons for restudying someone is if they have a return of symptoms such as sleepiness, fatigue or inability to concentrate while faithfully wearing their CPAP.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Dr., Prescott Valley, AZ 86314.