Dr. Rosenberg: Stroke victims need to worry about apnea

Dear Dr. Rosenberg,

My mom recently had a small stroke. She has hypertension and my dad says she snores, but it is not loud. Her neurologist wants her tested for sleep apnea. Is this necessary?

A: Actually, it is a good idea. Many studies have shown that the incidence of sleep apnea in stroke patients is close to 60 percent. Treating sleep apnea not only helps to prevent future strokes, but also increases the rate of recovery from a stroke.

Dear Dr. Rosenberg,

If I take a nap around 2 to 3 in the afternoon, I find I have a hard time recovering and have been avoiding them. The naps are usually 1 to 1½ hours. My wife says that is too long. What do you think?

A: Your wife is one smart woman. Several studies have shown that power naps, which are short naps, can improve our alertness for up to 135 minutes. The key is not to nap so long that you get into deeper stages of sleep. When that happens, it is hard to recover. Most studies have shown naps of 10 to 15 minutes to be the best.

Dear Dr. Rosenberg,

I have pulmonary hypertension. Recently, my specialist placed an oxygen meter on my finger overnight. After reviewing it, he noted that not only do I have low oxygen while sleeping, but also I might have sleep apnea. He wants me to be tested. How can an oxygen meter tell I have sleep apnea?

A: Although not always accurate, oximeters can detect sleep apnea. They show two things — the first is numerous drops in oxygen during the night with frequent returns to normal. Second, they reveal what we call a saw tooth pattern on a simultaneous tracing. Taken together this is highly suggestive of sleep apnea. In addition, sleep apnea can cause or exacerbate pulmonary hypertension when not addressed.

Dear Dr. Rosenberg,

My husband has fallen asleep behind the wheel for very brief periods on two occasions this year. He snores and makes choking sounds. I have urged him to get this checked out but he refuses, thinking that his driver’s license will be revoked. What do you think?

A: What you are describing are called micro sleeps. These are brief periods lasting from a fraction of a second to 30 seconds, indicated on an EEG when the individual actually enters sleep. Sleep apnea is a leading cause, along with insufficient sleep. Sleep apnea increases the incidence of motor vehicle accidents fivefold. Your husband needs to be tested and treated ASAP. He will not lose his license in the meantime. Some studies have shown a return to normal alertness after two days of therapy.

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.