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Mon, Oct. 21

Snoring not related to apnea can still lead to health problems

Dear Dr. Rosenberg: My wife is a very loud snorer. She had a sleep study done and, much to my surprise, she did not have sleep apnea. Is there any danger from just snoring?

A: Actually, there may be. Previously it was thought that snoring alone was a benign condition that was a problem for the bed partner.

However, several recent studies have shown that snoring may contribute to disease of the carotid arteries. These are the arteries that carry much of the blood flow to the brain.

It looks like the vibrations from the snoring damage the lining of the vessels and can contribute to strokes.

Dear Dr. Rosenberg:

My 7-year-old son complains of headaches every morning. I took him to see our pediatrician who asked me if he snores. I told him once in a while my husband and I notice that he does. Now he thinks he should have a sleep study. During his exam, he remarked that our son has enlarged tonsils.

Why the sleep study for a headache?

A: Your pediatrician is very astute. Many children with sleep apnea complain of headaches upon awakening. We think this is due to low oxygen and high carbon dioxide levels during the airway obstructions. The large tonsils may be the cause. If a sleep study is positive, your pediatrician will probably recommend an adenotonsillectomy for your son. There is a very high probability that will cure the sleep apnea and alleviate the headaches.

Dear Dr. Rosenberg:

A year ago, my husband had an overnight oxygen test and it was negative for sleep apnea. Recently, because of his fatigue and sleepiness, our new doctor ordered a sleep study. It was positive and he is going to be placed on CPAP. My question is, how could the first test miss the problem?

A: Overnight oximetry is a screening tool for sleep apnea. It can miss up to 20 percent of patients with sleep apnea. This is because not all patients with sleep apnea have significant drops in their oxygen levels with stopping breathing. That is why a thorough history may trump a screening test such as oximetry.

Dear Dr. Rosenberg:

I have sleep apnea. I am going abroad for five weeks. I would prefer not to take my CPAP machine. My healthcare provider advised me to take it. I do not see the harm in being off CPAP for five weeks. What do you think?

A: I think your healthcare provider is correct. Recent studies have shown a return of high blood pressure, vascular inflammation, insulin resistance and sleepiness within two weeks of going off CPAP. So my advice would be to take it with you. Why expose yourself unnecessarily to these potentially dangerous changes?

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