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Wed, Oct. 16

Untreated nighttime heartburn can do a lot of damage

Dear Dr. Rosenberg:

My husband has severe heartburn. I am writing to you because it occurs mainly at night. He won't see a doctor about it and takes antacids at the bedside every night. He is also tired and cranky during the day. Is this a serious problem?

A: Yes, it is. Nighttime heartburn is more serious than daytime heartburn. The acid tends to stay in the esophagus for much longer periods of time. Therefore, the incidence of complications such as severe scarring and even esophageal cancer are higher. Additionally, it sounds like it is wrecking your husband's sleep, leaving him fatigued and moody. Taking antacids is definitely not the way to go. It sounds like he should see a healthcare provider.

Preventive measures and medications are needed.

Dear Dr. Rosenberg:

My husband is on CPAP for sleep apnea. He unwittingly takes his mask off in the middle of the night. He has a heart condition and knows he must wear it. Any ideas as to what would help?

A: This is very common amongst those with sleep apnea. One remedy is to set the low-pressure alarm. CPAP machines come with alarms that will go off if the pressure drops in the system because of either a large leak or removal of the mask. Another remedy is to put socks on one's hands at bedtime. It sounds silly, but this does lessen the chance that one will remove the mask in the middle of the night.

Dear Dr. Rosenberg:

My cardiologist sent me for a sleep study because he found some thickening of my heart on a test. He said since I didn't have high blood pressure or anything else to explain it, I might have sleep apnea. As it turns out, he was correct. Would treating my sleep apnea reverse the changes in my heart?

A: Yes, it can, and in fact, a study published in this month's journal Chest addressed just that point. Patients with cardiac abnormalities induced by sleep apnea were followed for a year. Studies showed improvement in as early as 12 weeks. Even more impressive, there was continued improvement at one year. So we can now definitely say that treating the sleep disorder can reverse many of the abnormal changes brought on by untreated sleep apnea.

Dear Dr. Rosenberg:

Every spring my wife and I go to our condo in Colorado. The house is at 9,000 feet in elevation. I have a headache, can't sleep, and am nauseated for the first week that I am there. I'm also very irritable. I think it's the poor quality of my sleep. Should I take a sleeping pill?

A: What you are describing is mild mountain sickness. It is due to low oxygen levels and pauses in breathing during sleep brought on by high altitudes. After a few days to a week our respiratory rates and depth of breathing increase while we sleep, alleviating the problem. There are several medications that are available that can be taken for the first few days to avoid these symptoms. I'd discuss this with your healthcare provider.

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 Dr., Prescott Valley, AZ 86314.

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