Apnea can affect growth hormone

Dear Dr. Rosenberg,

A friend told me that untreated sleep apnea could affect growth hormone. Is that true?

A: Yes, a study published recently demonstrated that people with sleep apnea had on average lower levels of growth hormone than those who were normal. In fact, after treatment with CPAP, their growth hormone levels increased significantly. We know that growth hormone is involved in many things, including tissue repair. I find this study very exciting as it may help to explain some of the negative changes we see in patients with untreated sleep apnea.

Dear Dr. Rosenberg,

After a heart attack, my dad, who lives alone, developed congestive heart failure. His new cardiologist wants him to have a sleep study for sleep apnea. My dad is skeptical and does not want to sleep in a foreign environment. I am wondering why the need for testing.

A: The fact is that 76 percent of patients with congestive heart failure have sleep apnea. It is estimated that 36 percent suffer from obstructive sleep apnea where the airway closes down while asleep, and 40 percent from central sleep apnea, where the person makes no effort to breathe. Both are associated with progressive and rapid decline in the heart’s ability to pump. The good news is that when treated, there can be a substantial improvement in cardiac function.

Dear Dr. Rosenberg,

My daughter has several children ranging in age from about 3 to 13. They all go to sleep and awaken at the same time. Two of them are irritable and have a hard time focusing in school. They are all averaging about 7 to 8 hours of sleep. I don’t think that is enough. I do not want to say anything unless I have some facts. Can you help?

A: Yes. Actually, the duration of sleep required very much depends on age. Here are some examples of what different age groups require: 1-to-3 years, 12 to 14 hours per day, 3-to-5 years, 11 to 13 hours per day, 5-to-10 years, 10 to 11 hours per day, and 10-to-17 years require 8.5 to 9.5 hours. Getting significantly less than this can cause problems with cognition, ability to pay attention, as well as behavioral issues such as impulse control and hyperactivity.

Dear Dr. Rosenberg,

My father suffers from severe depression. He also has sleep apnea but refuses to treat it. Is there a relationship between sleep apnea and depression?

A: Yes there is. In fact, several studies have demonstrated depression to be twice as likely in those with mild sleep apnea and three times more likely in moderate and severe sleep apnea. Several areas of the brain that are responsible for depression show damage from sleep apnea. On a positive note, a recent study showed improvement in depression when sleep apnea was addressed.

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