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Mon, June 24

Nocturnal nose whistle is not music to reader’s ears

DEAR DR. ROACH: Every night for the past several months, my sleep has been interrupted by a whistling sound when I exhale. I notice it only when I wake up in the early morning. It prevents me from going back to sleep. My husband tells me that it is constant during the night. If I concentrate, I can hear it during the day, but it doesn’t bother me. I am a 61-year-old female; I don’t smoke and am in good health, with no medications. This nighttime wheezing/whistling is very annoying. Is there a natural remedy you could recommend? – P.M.

ANSWER: A whistling sound happens with airways that are small enough to cause turbulent flow (which is why we purse our lips to whistle). In the nose, you could have a deviated septum, which leads to a smaller passage on the affected side. You also might have congestion in the nasal passages (in “congestion” the lining of the nasal airways is inflamed: swollen and with enlarged blood vessels); this can come from allergies or infection. There are several other less-common causes.

In order for me to suggest a “natural” remedy (I’m guessing you mean drug-free), I would need to know which of these is more likely. However, one possible treatment would be to try nasal strips. They use tape to open the nasal passages at a common site of blockage. This might stop the whistling and make it easier to breathe through your nose. Another possible solution would be to rinse the nasal passages with saline: There are several ways to do this, such as with a Neti pot or a suction device. Swimming often helps people with allergies, as the water washes away allergens in the nose. Finally, identifying any allergens you may be reacting to could allow you to avoid them. In this, an allergist may be helpful.

DR. ROACH WRITES: A recent column about a young man who fainted during an injection led to many comments on my Facebook page (facebook.com/keithroachmd). There were two common questions, the first of which was whether this event could have been a seizure. The answer is that a seizure is very unlikely given the time course (immediately with the injection) and the prior history of near-fainting episodes. The muscle movements described are more consistent with a faint than with a seizure. Many people were unaware that involuntary muscle movements are common in faints.

The second question is how to prevent further episodes. I had recommended lying down. It might not be 100 percent effective in preventing a faint, but it can at least prevent injury. Others recommended stress-reduction techniques such as breathing exercises or muscle contraction and relaxation before the injection (or a blood draw, if that is the issue). Distraction techniques can be helpful. One reader said her doctor told her to shout during the blood draw, and that technique worked (smiling or coughing during the procedure has helped some people, too).

A colleague of mine in anesthesia gives a surprisingly hard punch in the opposite arm, and the person barely notices the needle on the other side. One reader had success by using an ice pack on his head and a second on the back of his neck: He said he is so focused on his freezing neck and forehead that he can’t think about anything else.

Making sure you are well-hydrated ahead of time helps, too. Very occasionally, I have given a fast-acting sedative for people who can’t tolerate the procedure any other way.


Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

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