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Tue, July 23

Several medicines may trigger sleep-eating

Dear Dr. Rosenberg,

I am sure I have been eating in my sleep. I have no memory of doing this. I find food in my bed and food missing from the refrigerator upon awakening. I have heard this can be caused by Ambien but I am not taking this medication. Do you have any ideas?

A: Although Ambien (Zolpidem) has gotten the most publicity, there are other medications and sleep disorders that can be the cause of eating at night. Examples include most other sleep medications and the anti-psychotic medications such as Olanzapine (Zyprexa) and Resperidone (Resperidol). Additionally, underlying sleep apnea and restless legs syndrome have been implicated. I would urge you to discuss this with your healthcare provider. If not caused by one of the aforementioned medications or sleep disorders, there are several medications available to treat this disorder.

Dear Dr. Rosenberg,

Is it true that sleep apnea can cause cancer? A friend of mine has it and refuses treatment.

A: Yes, there were two studies published in the past year that showed a definite link between severe sleep apnea and cancer. In one, the chance of dying of cancer was five times more likely in a group of patients followed over 20 years with untreated sleep apnea. In the second, the overall incidence of cancers of all types was 68 percent higher in those with severe sleep apnea followed over seven years. It is believed that low oxygen levels caused by intermittent closure of the airway may be the common denominator.

Dear Dr. Rosenberg,

I have no trouble falling asleep. However, I wake up three to four times a night. Frequently, I am unable to fall back to sleep. I don't know what awakens me. I am tired and irritable the next day after these episodes. My doctor sent me to a sleep specialist who said I should get a sleep study. I live alone so I don't know if I snore but he said sleep apnea could cause this. What do you think? Does this make sense?

A: Actually, it does. I frequently order sleep studies for patients who can fall asleep but have trouble staying asleep. We often find that people with this type of insomnia stop breathing in their sleep and that precipitates the awakenings. I was glad to see a study published in the December issue of the Journal Sleep that verified our findings. In this study of over 20 patients at low risk for sleep apnea, when screened by experienced clinicians, with this type of insomnia, over 90 percent had closure of their airway (apneas) demonstrated on sleep studies causing their awakenings. The authors themselves were surprised by these findings. It probably indicates that even in asymptomatic patients, the inability to stay asleep may be due to sleep apnea.

Dear Dr. Rosenberg,

I recently went to the emergency room with heart palpitations. I was diagnosed with an irregular heartbeat called atrial fibrillation. This woke me out of a deep sleep. My wife says my snoring has gotten louder over the last few years and I have gained a lot of weight. The ER doctor suggested I might have sleep apnea and that could cause my fibrillation. Is this true?

A: Yes, it is. In fact, the incidence of atrial fibrillation is higher in obesity and sleep apnea. A recent review on the subject indicated that the chances of developing this arrhythmia were four times greater in those with sleep apnea. Just as important is the fact that if you go back into a normal rhythm you are twice as likely to revert back into atrial fibrillation if sleep apnea is untreated. If I were you I would definitely get this checked out.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him through the form at www.answersforsleep.com or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Drive, Prescott Valley, AZ 86314.

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