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10:52 AM Tue, Sept. 25th

Treating sleep apnea vital for kidney disease patients

Dear Dr. Rosenberg:

I have heard that people with kidney disease have a high incidence of sleep apnea. Is that true? My father sees a kidney specialist and he snores loudly at night. Should I mention this to him?

A: Yes. In a recent study published in the journal Chest, the authors found the incidence of sleep apnea in chronic and end-stage renal disease to be more than 50 percent. The authors felt that the high incidence was due to a combination of fluid overload and damage to neural pathways that control breathing. They urge timely diagnosis and treatment because of the already high incidence of stroke and heart attack in these patients. If untreated, sleep apnea can only accelerate this.

Dear Dr. Rosenberg:

I have been on temazepam for sleep for several years. It has been very effective. Recently I was placed on theophylline for my asthma. Now the temazepam seems to be ineffective. Could the theophylline be the reason?

A: Yes. Although a good drug for asthma, theophylline works in much the same way as caffeine. It blocks the action of a chemical called adenosine. Adenosine builds up during the day and helps to put us to sleep at night. If you took a morning dose but avoided an evening dose, that might eliminate the problem. I would discuss this with your prescribing healthcare provider.

Dear Dr. Rosenberg:

I am a 52-year-old man with epilepsy. Despite being on three drugs, I still experience at least one seizure per week. I snore at night and my neurologist insists I get a sleep study. If I do have sleep apnea, will treating it really help?

A: In severe refractory epilepsy in patients with sleep apnea, the average decrease in seizure frequency is more than 50 percent when treated.

Dear Dr. Rosenberg:

My husband has age-related macular degeneration. He has been receiving treatment but is responding poorly. He snores and stops breathing in his sleep. Can there be any relationship to his eye condition?

A: Yes, a recent study showed that those with untreated sleep apnea were more likely to be refractory to treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF).

The authors feel that the elevated blood pressure and low oxygen levels experienced by these patients may be the cause. They urged early diagnosis and treatment of sleep apnea, if present, in those with macular degeneration.

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.