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Thu, Jan. 23

Ignoring insomnia can lead to more serious problems

Dear Dr. Rosenberg:

My husband has trouble falling and staying asleep. He is becoming more irritable and fatigued. He will not discuss this with his primary care provider. Is this common? I have urged him repeatedly to do so.

A: Great question. It points out the problem of patients under-reporting their insomnia. In fact, in a recent study, only 5 percent of patients sought out their healthcare provider for help with their insomnia. The problem is that not only is it treatable, but untreated, the incidence of depression, anxiety and alcohol and drug abuse skyrocket.

Dear Dr. Rosenberg:

Is it true that alcohol can adversely affect sleep? My husband drinks a lot before bed and feels fatigued all day.

A: Yes. Recent studies show the specifics of how alcohol can ruin sleep. Normally, when we are asleep, the parasympathetic nervous system predominates. This is the quiet or peaceful part of our nervous system. After alcohol consumption in large amounts, this changes. Instead, the sympathetic or "fight-or-flight" part of our nervous system predominates

during the second half of sleep. This can stress the body and ruin quality of sleep.

Dear Dr. Rosenberg:

Five months ago, my son was in a car accident. He was unconscious for several hours. There was no evidence of brain injury. However, he has had trouble staying awake ever since the accident. His doctors can find nothing wrong. We are at our wits' end. Do you have any ideas?

A: The incidence of somnolence (sleepiness) post TBI (traumatic brain injury) is anywhere from 30 to 50 percent. There are several reasons. First, there may be damage to areas of the brain that produce wake-promoting hormones. Secondly, the incidence of sleep apnea may be as high as 30 percent after head injury. Finally, the incidence of insomnia resulting in daytime sleepiness is very high. I would suggest that if this continues you have him evaluated by someone who specializes in sleep disorders.

Dear Dr. Rosenberg:

I have had restless legs syndrome (RLS) with my last two pregnancies. I am now pregnant again. I do not want to take medications. Do you have any advice for me?

A: First of all, make sure you are taking iron supplements during your pregnancy. Low iron levels can be a significant cause of RLS during pregnancy. Other non-pharmacologic treatments include stretching before sleep and wearing elastic support hose. Also, curtail your caffeine intake.

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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