FAQs

Frequently Asked Questions

 

Dear Dr. Rosenberg,

Question: My dad has Coronary Artery Disease. He has been stented several times, but still has chest pain; mainly at night. Our doctor wants him to have sleep study. He says they need to know if something is going on while he is sleeping. What will a sleep study show?

Answer: Basically, your father has what is called Nocturnal Angina. That is chest pain due to Coronary Artery Disease while asleep. Usually, when we sleep the heart is at rest and angina is far less likely to occur. However, in patients with Sleep Apnea the heart requires more oxygen during the apnea episodes. Because of airway occlusion there is less available. This is a leading cause of night time angina and should definitely be investigated.


Dear Dr. Rosenberg,

Question: My 22 year old son lives with us. To put it bluntly, his snoring is unbelievably loud. He was tested for Sleep Apnea last year and the test was negative. I was told that he would never have to worry about the disease; that he was just a loud snorer. So, is this the end of our concerns?

Answer: Probably, however several things can happen to change his status. First of all, if he gains a significant amount of weight he could develop Sleep Apnea. Secondly, certain types of medications called Benzodizapines, examples being Valium and Xanax; could turn snoring into Sleep Apnea. Heavy Alcohol intake at night can do the same thing. Finally, some recent studies have shown that the vibrations from snoring can damage the nerves that line the upper airway and eventually result in Sleep Apnea. My advice would be to let your son know, that if he develops symptoms of sleepiness, fatigue or inability to concentrate; he might need to be reevaluated for Sleep Apnea down the line.


Dear Dr. Rosenberg,

Question: I have suffered from tension headaches for years. They occur in the morning and usually are gone by noon. My girlfriend tells me I grind my teeth while sleeping. No one has ever pointed this out before. Nothing I have taken helps the headaches. Could my tooth grinding be related?

Answer: Yes, it may indeed be related. What you are describing might be Sleep Bruxism. Symptoms include waking with jaw muscle pain, fatigue, wearing down of dental surfaces and morning tension type headaches on the sides of the head called the Temporal area. I would recommend you bring this to the attention of your dentist. If you have Sleep Bruxism, there are several excellent treatments. However, for starters you should eliminate caffeine, nicotine and late night alcohol. All of these have been associated with Sleep Bruxism.


Dear Dr. Rosenberg,

Question: I have been diagnosed with mild obstructive sleep apnea (AHI 6.2) and Oxygen saturation of 87%. I had the sleep study, because I often do not feel rested when I get up in the morning. I am almost 78 years old with Coronary Artery Disease, but in reasonable health otherwise. I am not going to use CPAP, however I am considering the oral appliance. I have a friend who says he is getting good results with an apnea pillow. I checked online and found the Better Sleep pillow and the Sona pillow. Are these pillows effective for apnea symptoms and if so; do you have a recommended brand? If not, do you agree that the oral appliance would be an effective treatment? My dentist does not do the fitting, do you have someone you recommend?

Answer: Excellent questions! The first answer is based on whether your Apneas were predominantly position related. That means that at least 50% or more of your Apneas occurred with you lying on your back. In your sleep study, it will be referred to as the supine position. If that were the case; in Sleep Apnea as mild as yours, the pillow might work. However, I would definitely have my overnight oxygen levels rechecked if you decide to go that route. As for dentists in your area. The American Academy of Dental Sleep Medicine would be an excellent resource.


Dear Dr. Rosenberg,

Question: I have a child with Attention Deficit Hyperactivity Disorder. He has problems with sitting still and going to sleep. At bedtime, he walks around his bedroom. Now, that he is eight years old; he tells me that his legs bother him all the time. I have been reading about ADHD and Restless Legs Syndrome being related. What are your thoughts?

Answer: I think there is a very strong possibility that your child has Restless Leg Syndrome (RLS). Several recent studies have linked the two disorders. There may actually be a common denominator in the form of low brain dopamine levels in both Attention Deficit Hyperactivity Disorder and Restless Leg Syndrome. It is important to get your child evaluated for and possibly treated if he has Restless Leg Syndrome. At the very least his ADHD should improve and in some cases has even resolved. Remember, we used to call these “growing pains”; but they are not.


Dear Dr. Rosenberg,

Question: How many hours do you need to wear a CPAP to get real benefit?

Answer: My initial answer is as long as you are asleep. However, there are several studies that have been more specific. In 2009, a study measured markers of inflammation in patients with Sleep Apnea. We think many of the complications of Sleep Apnea are due to inflammation. The study found that a minimum of four hours a night was needed to bring these levels back to normal.


Dear Dr. Rosenberg,

Question: I have been drinking five to six cups of coffee, a day for many years. I am having increasing trouble falling asleep and my doctor wants me to stop drinking it. I have heard that there can be an associated withdrawal. Is this true and what can I do about it?

Answer: Yes, it is true. People consuming five to six cups a day are ingesting about 6 to 700 mg of caffeine. The withdrawal syndrome usually occurs 18 to 24 hours later; which consists of severe fatigue, irritability, mood swings, headache and flu like symptoms. This can be avoided by a gradual taper. I would suggest you decrease your consumption by one cup every two days, until off of coffee drinks all together.


Dear Dr. Rosenberg,

Question: My husband was diagnosed with Sleep Apnea two years ago. He never returned to the lab for treatment. He says he feels fine and does not want to be treated. I have been reading about the associated risks; if untreated. He is 35 years old and we have two young children. Any ideas on how to motivate him?

Answer: Yes, you could start out by telling him the incidence of heart attack and stroke is about two to three times normal when Sleep Apnea is left untreated. Diabetes is also markedly increased in untreated Sleep Apnea. Most impressive though is a recent study that showed that untreated men live to an average age of 58 years old verses normal men who are live an average of 78 years. So, if he wants to see his children grow up and possibly grand children; his chances are much better if he gets treatment for his Sleep Apnea.


Dear Dr. Rosenberg,

Question: I have a child with Attention Deficit Hyperactivity Disorder. He has problems with sitting still and going to sleep. At bedtime, he walks around his bedroom. Now, that he is eight years old; he tells me that his legs bother him all the time. I have been reading about ADHD and Restless Legs Syndrome being related. What are your thoughts?

Answer: I think there is a very strong possibility that your child has Restless Leg Syndrome (RLS). Several recent studies have linked the two disorders. There may actually be a common denominator in the form of low brain dopamine levels in both Attention Deficit Hyperactivity Disorder and Restless Leg Syndrome. It is important to get your child evaluated for and possibly treated if he has Restless Leg Syndrome. At the very least his ADHD should improve and in some cases has even resolved. Remember, we used to call these “growing pains”; but they are not.