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Sun, Dec. 15

Column: Too little sleep impairs mood, concentration

Dear Dr. Rosenberg:

Due to the economy, my husband had to take a job that requires he be up at 5 a.m. His previous job allowed him to sleep until 7 a.m. He has become irritable and seems to not be paying attention when I talk to him. Do you think less sleep could be causing this? On weekends, he sleeps until noon, which is also something new for him.

A: What you are describing is called insufficient sleep and is the most common cause of sleepiness. We know that lowering sleep by as little as one hour a night can lead to sleepiness. Impaired mood can occur after only one night and loss of the ability to concentrate in as little as two nights. Even worse, the impairment in concentration becomes progressively worse over 60 days. My advice to you is to urge your husband to attempt to get to bed earlier so that he obtains at least seven hours of sleep.

Dear Dr. Rosenberg:

My husband is a loud snorer and he stops breathing while asleep. I can't get him to a doctor. Recently, he has had two minor traffic accidents. Could there be a correlation and should I be concerned?

A: The answer to both of your questions is yes. A recent study found that people with sleep apnea were six times more likely to be involved in road accidents. In another study using driving simulators, people with sleep apnea performed worse than subjects administered alcohol to just over the legal limit. You need to point these things out to your spouse before he or someone else is badly injured.

Dear Dr. Rosenberg:

I am wearing a CPAP mask for sleep apnea. No one has ever explained how it works. I know I feel better since I started wearing it, but I would appreciate having a better understanding of why.

A: Since 1981, CPAP has remained the best and most reliable treatment for sleep apnea. CPAP acts by raising the pressure in the upper airway to a high enough level to force the throat open during sleep and prevent it from being sucked close when you breathe in. That is basically it in a nutshell.

Dear Dr. Rosenberg:

I was recently diagnosed with sleep apnea. During the test, my doctor told me my oxygen levels were quite low. My question is why do I need to return to the lab for one of those CPAP contraptions? Why can't I just wear oxygen at night?

A: Excellent question and one that I am asked frequently. The low oxygen is basically a manifestation of the underlying problem, which is the collapse of your upper airway. When the airway collapses it results in what we call an arousal from sleep. This arousal causes the muscles of the upper airway to contract and allows you to breathe. The arousal causes your sleep to be fragmented and results in major elevations of blood pressure; thus, cardiovascular consequences such as high blood pressure develop. Secondly, your sleep is disrupted, which leads to the daytime consequences of sleepiness and difficulty thinking. Therefore, as I tell my patients, wearing oxygen alone is not going to solve the problem.

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.

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