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Thu, Nov. 21

Control sleep patterns with light

Dear Dr. Rosenberg:

I have had trouble falling asleep since I was 16 years old. I consider myself a night owl and don't get sleepy until 2 a.m. A friend told me about using light treatments to allow me to fall asleep. Does this work and when would I use it?

A: What you are describing is a circadian disorder called delayed sleep phase disorder. Basically, the clock genes in your brain are set to a different time to fall asleep. Light has the greatest influence on this part of our brain. Exposure in the morning can help you to fall asleep earlier the next night. There are several forms of light. This includes getting out in the natural sunlight, light boxes and light visors. The key is to use these within the first hour of awakening. Then every day or two set your alarm clock one-half to one hour earlier and expose yourself to the light source. Optimally, you should be able to get to sleep earlier until you reach your goal as to when you want to go to sleep.

Dear Dr. Rosenberg:

I have fibromyalgia. I told my doctor that I feel like I never get enough sleep. He says that it is a common complaint in people with fibromyalgia. He is now recommending I get a sleep study. I don't snore; so what is the point?

A: Your physician is aware of the common occurrence of sleep-related disorders and fibromyalgia. A well-known variant of sleep apnea is upper airway resistance syndrome. It is particularly common in women with fibromyalgia. We find 10 to 20 percent of people with this condition do not snore. However, it results in repeated arousals from sleep, resulting in daytime sleepiness, fatigue and lowers pain tolerance. Upper airway resistance syndrome is treatable and can make a big difference in fibromyalgia.

Dear Dr. Rosenberg:

I have had epilepsy for several years and have seizures weekly. My neurologist now wants me to get a sleep study. I don't have any symptoms of a sleep problem. What do you think?

A: I think your physician is aware of the new research relating seizures to sleep apnea. In a recent study, 50 percent of men and 20 percent of women with difficulty to control seizures had sleep apnea. Interestingly, a majority had no symptoms of a sleep disorder. It is felt that the low oxygen, fragmented sleep and decreases in cardiac output associated with sleep apnea may be contributing to the inability to control these seizures.

Dear Dr. Rosenberg:

I think I have sleep apnea. According to my wife I don't snore. For this reason, my health care provider says I couldn't have sleep apnea. But I'm always sleepy and fatigued. Do you agree that I can't have it?

A: Actually, not all patients' snoring is obvious to one's spouse. In fact, the majority of snoring may occur in REM (dream sleep). This tends to occur between 2 to 4 a.m. when your bed partner is far less likely to be awake. Additionally, some patients present with symptoms of gasping, choking, drooling or a dry mouth. So your bed partner not observing snoring does not eliminate the possibility of a sleep-related breathing disorder causing your symptoms.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' 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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