Your Sleep Questions Answered, Part 1

Allen Blaivas, M.D. Health Pro
  • The original mandate of this blog was to help readers with answers to some of their sleep related questions. Since we have been covering many topics in detail, I have not really had the opportunity to answer your questions, so now is my chance. I greatly appreciate your interest and questions and will try to answer at least some of them. In the interest of space, I will attempt to paraphrase some of the longer questions. Also, and most importantly- while I will attempt to give you information and an overview of things to look out for, please realize that this blog can not take the place of speaking with a physician and no inferences of any diagnoses should be made from these very general discussions. My only goal is to inform you, and perhaps point you in the right direction.

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    Question:

    I have sleep apnea and had a follow-up polysomnogram five years after my original diagnosis. I previously had a "split study", but have lost 31 lbs. and the most recent study was not "split". I think that this is a good thing. Can you give me an idea what the results mean?

     

    Answer:

     

    Firstly, it is a good thing that the most recent study was not split and congratulations on your weight loss. A split night polysomnogram is performed when the severity of obstructive sleep apnea (OSA) or the associated drop in oxygen level is so severe that we try to expedite the treatment by doing a diagnostic test and treatment trial in one night. Normally this is performed over two separate nights (refer to blog on polysomnogram and OSA). If you no longer met criteria for a "split night", that means the severity of sleep apnea is not as serious as on your original test. Obviously, it would be tough for me to teach all of sleep medicine in this blog, but the main numbers to be aware of on a polysomnogram are the lowest oxygen level that occurred and the AHI (or apnea-hypopnea index) which means how many times you stopped breathing for more than 10 seconds in an hour. If the number is 5-14, then the OSA is considered mild, 15-24 is moderate, and 25+ is considered severe. Occasionally, even if the number is below 5, treatment may still be needed if sleep is significantly disrupted by respiratory-related events.

     

     

    Question:

     

    My wife has been diagnosed with narcolepsy and suffers from "pressure in her head". She says it feels like air bubbles or air pockets. She has had CAT scans and sleep studies, but they have not identified a cause of these problems. What type of doctor should she see for this problem?

     

    Answer:

     

    Your wife has been diagnosed with narcolepsy and describes "pressure" in her head. For reasons that are not totally clear, narcoleptics seem to have headaches more frequently then people who do not have narcolepsy. Some reports show an increase in "tension-type" headaches, likely as a result of poor sleep, while others seem to show an increased risk of migraine headaches, possibly from genetic reasons. A neurologist, particularly one trained in sleep medicine, might be able to help.

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    Question:

     

    I am 18 years old and in the past was a "cutter". I have stopped and am now on an antidepressant but I am having violent recurring nightmares, sometimes about me cutting myself and my parents watching without concern, sometimes my best friend or boyfriend dying. What I can do to stop these nightmares from coming back? I would love a good nights rest. Please help!!

     

    Answer:

     

    The situations you describe so vividly and frighteningly may be related to Post-Traumatic Stress Disorder (PTSD) which is an anxiety disorder that develops after exposure to a terrifying ordeal in which physical harm occurred or was threatened. People with PTSD tend to have recurrent frightening thoughts and nightmares of their ordeal. PTSD can usually be fairly well managed with both therapy and medication. A mental health professional may help you get your life back. Good luck.

     

    More of your questions to come in the next blog.

     

     

     

Published On: April 15, 2008