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Fri, Dec. 13

Medication, therapy can help PTSD sufferers get much-needed sleep

Dear Dr. Rosenberg:

My brother lives with us. He came back from Iraq with PTSD (post-traumatic stress disorder). He having trouble falling and staying asleep, which is making him increasingly irritable. I am trying to get him to seek help. Do you think it would make a difference?

A: The answer is yes. Insomnia is an integral problem associated with PTSD. If untreated, it interferes with emotional adaptation and further contributes to the increased irritability associated with PTSD. The good news is that there are now many treatment options, both behavioral and pharmacological, to help with the sleep disorders associated with PTSD. I would urge your brother to seek help from Veterans Administration or your family physician.

Dear Dr. Rosenberg:

I have had insomnia for at least seven years now. I have taken numerous sleep aids. Initially, they seem to work, but after a while they do not. My doctor wants me to have a sleep study. Does this make sense to you?

A: Yes, indeed it does make sense. Many people with chronic insomnia have an underlying sleep disorder that wakes them up. It is something most folks are completely unaware of while they sleep. In a recent study, 70 percent of patients with chronic insomnia that was refractory to medications had an underlying sleep disorder contributing to the problem.

Dear Dr. Rosenberg:

My husband has lost interest in sex. He has gained more than 50 pounds since we got married and he is a loud snorer. I have read that these issues can be medically related. I cannot convince him to see a doctor. He says he is just stressed and he will get over it. What do you think?

A: I think you are on to something. Recent studies have shown that sleep apnea can cause a decrease in testosterone levels. This is because of sleep fragmentation and low oxygen levels. Additionally, obesity alone can be the cause. This is because obese men produce more estradiol, the female sex hormone, which suppresses testosterone production. I would encourage you to convince your husband that his loss of libido may not be because of stress, but to other potentially reversible causes.

Dear Dr. Rosenberg:

I was diagnosed 10 years ago with fibromyalgia. My legs hurt at night and I get some relief by rubbing or moving them. I was told at a support group this was part of my fibromyalgia. However, I have seen on the Internet that this could be a sign of restless leg syndrome. What do you think?

A: I think you are correct. We know that restless leg syndrome (RLS) is very common in people with fibromyalgia. In fact, in a recent study published in the Journal of Clinical Sleep Medicine, RLS was 10 times more common in those with fibromyalgia. In addition, you state that the symptoms occur predominantly at night. That is a key characteristic of RLS. I recommend that you discuss with your primary care provider treatment of your RLS.

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 Drive, Prescott Valley, AZ 86314.

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