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Fri, Dec. 06

Healthy sleep habits help control restless legs

Dear Dr. Rosenberg:

I have restless leg syndrome, and do not like taking medications. Is there anything I can do that does not include oral medications?

A: Yes. Although not as successful as medication, non-pharmacological treatments are available. These include improving sleep hygiene with a regular sleep/wake time; avoiding caffeine, alcohol and nicotine use; and, lastly, performing moderate daily exercise. Some patients report that acupuncture and massage are helpful, but these modalities have not yet been scientifically studied.


Dear Dr. Rosenberg:

I feel sleepy and fatigued during the day. I snore; however my wife says I do not stop breathing. My primary care doctor wants me to get a sleep study. If I don't stop breathing, what is the point?

A: Understand there are different forms of what is called sleep apnea. In fact, that is why I prefer the term sleep disordered breathing. In addition to apneas, where there is a complete cessation of breathing, we have what are called hypopneas, characterized by shallow breathing resulting in a drop of oxygen levels. We also see episodes called RERAS (Respiratory Effort Related Arousals). With RERAS, we see an increased effort against a partially closed airway, which leads to arousals from sleep. In our sleep lab, we frequently encounter patients with hypopneas and RERAS, but no true apneas. What is important to know is that these patients' bed partners may never see actual breath-holding. However, the consequences of these events - fragmented sleep and repetitive drops in oxygen levels - can be just as damaging as sleep apnea. The good news is that CPAP is effective for all of these conditions.

Dear Dr. Rosenberg:

I have sleep apnea and wear a CPAP mask. A friend of mine told me he is on a drug called Provigil for sleep apnea. Does this mean I could take Provigil and not have to wear the mask?

A: No. The medication Provigil is used to treat only one symptom of sleep apnea, and that is daytime sleepiness. About 10 to 15 percent of patients with treated sleep apnea will continue to be sleepy. This is probably related to damage in areas of the brain, caused from years of not being treated for sleep apnea. If you were to stop the CPAP and just take Provigil, you would continue to expose your body to the risk of stroke, high blood pressure, and heart attack associated with untreated sleep apnea. In effect, you would be treating a symptom and not the cause.


Dear Dr. Rosenberg:

I have heard that there is a relationship between sleep apnea and erectile dysfunction. I have ED and my wife says that I am a loud snorer. Is there any truth to this connection?

A: Yes. Men with sleep apnea do have an increased incidence of erectile dysfunction. We have found men with the disorder to have lower testosterone levels. Although not proven, we think there is a probable link. Additionally, the treatment of sleep apnea has been shown to increase testosterone and to decrease ED in 26 percent of patients studied.

Dr. Rosenberg will answer individual reader questions by incorporating them in future columns. Contact him at or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Dr., Prescott Valley, AZ 86314.

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