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Sun, Oct. 13

Apnea treatment can alleviate seizures

Dear Dr. Rosenberg:

My brother has epilepsy. He is 52 years old and on three medications and still has frequent seizures. According to his wife, he was diagnosed with sleep apnea but rarely wears his CPAP mask. Could the sleep apnea have anything to do with his seizures?

A: Yes, the incidence of sleep apnea in refractory epilepsy is 30 percent to 40 percent, shown in several studies. Treating the sleep apnea results in a 50 percent decrease in seizures in most and a reduction in the number of AED (anti-epileptic drugs) required.

Dear Dr. Rosenberg:

I really have trouble wearing my CPAP since I was diagnosed with sleep apnea. My question is one of motivation. Is this really a serious disease or not? I know if it were, I would be far more likely to put up with the hassle of wearing a mask to bed for the rest of my life.

A: Good question. The latest studies are rather straightforward. Basically, if you have sleep apnea that is severe, your chances of dying within the next five years is 10 percent higher if you choose to not treat the disease. The causes in the study varied from heart attacks to strokes and sudden death. The final results showed that one in 10 patients had died in the group that refused treatment versus those that were treated. I hope this helps.

Dear Dr. Rosenberg:

I am overweight and my wife says that I stop breathing during my sleep. I have also had swelling of my feet for several years. I have trouble getting my shoes on. I have had several tests and my doctors cannot find a cause. My new doctor says it could be my breathing. Does this make any sense?

A: Yes, that is a sharp and recently discovered observation. Recent studies have shown that sleep apnea may activate a system in the body called the Renin-Angiotensin System. When activated it leads to sodium and water retention. Thus we may have an explanation as to why so many obese patients with sleep apnea present with unexplained fluid retention.

Dear Dr. Rosenberg:

My husband was diagnosed with sleep apnea. He was told that he would be much more awake after treatment. He is very obese and was hoping treatment would allow him the energy to lose weight. However he is as sleepy as ever. Any ideas as to why he has not improved?

A: Yes, we are learning that obesity in and of itself can cause sleepiness. In a recent study up to 30 percent of obese individuals were found to be severely sleepy even in the absence of sleep apnea. It appears that the fat cells of the obese produce excessive amounts of substances called adipokines that can cause sleepiness. Following weight loss, the majority had a return of normal daytime alertness.

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

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