Ask the Sleep Doctor

Ask the Sleep Doctor – Topics: Pediatric Sleep Apnea, Obesity, and Nightmares

Dear Dr. Rosenberg,

My eight-year-old son was recently diagnosed with sleep apnea and our pediatrician recommends an adenotonsillectomy. Our son has problems with behavior and is hyperactive. We were told he has ADHD but our pediatrician says this could be due to sleep apnea. I am afraid of surgery. What do you think?

Answer:

I agree with your doctor. Numerous studies have shown that children with sleep apnea can present with the same symptoms as ADHD. Moreover, in many of these studies when sleep apnea is treated, up to half no longer have ADHD. I would recommend you heed the advice of your pediatrician.

Dear Dr. Rosenberg,

I am quite overweight. In fact, my doctor told me I am classified as morbidly obese. I have had several tests which show that I have low oxygen levels when I am asleep, but not during the day. My doctor wants me to get a sleep test done to see if I have sleep apnea. Wouldn’t wearing oxygen at night do just as much?

Answer:

No, not if you have sleep apnea. Based on your weight, you already have about a 70% chance. When one has sleep apnea stress, referred to as hemodynamic stress, the strain on the heart, brain, and kidneys continues even in the presence of supplemental oxygen. In fact, studies have shown that oxygen alone is not sufficient to treat sleep apnea and that the incidence of heart attack and stroke is still very high. I would listen to your doctor’s advice and get tested.

Dear Dr. Rosenberg,

My husband returned from Afghanistan with PTSD. He has severe and frequent nightmares. On more than one occasion, he has punched or kicked me during these nightmares. I mentioned it to our healthcare provider but he had never heard of this and frankly did not have an answer. I love my husband and do not want to move out of the bedroom but I am afraid of being injured. Any ideas?

Answer:

Yes, what you are describing is called REM Behavior Disorder. It is uncommon in PTSD. We become paralyzed during dream sleep that prevents us from acting out our dreams. Unfortunately, in RBD, patients lose this normal inhibition of movement during dream sleep. It is treatable and I would recommend you request a referral to a board certified sleep specialist who should be able to diagnose and treat this condition. In the meantime, you must take measures to protect yourself, even if only temporarily. You need to sleep in a separate bed. Your husband has no conscious control of these behaviors.

Dr. Robert Rosenberg, D.O., FCCP, DABSM

Robert S. Rosenberg, DO, FCCP, is the medical director of the Sleep Disorders Center of Prescott Valley, Arizona and sleep medicine consultant for Mountain Heart Health Services in Flagstaff, Arizona. Dr. Rosenberg is board certified in sleep medicine, pulmonary medicine, and internal medicine. His book Sleep Soundly Every Night, Feel Fantastic Every Day  is a best seller. Dr Rosenberg’s latest book is The Doctor’s Guide to Sleep Solutions for Stress & Anxiety. Visit Dr Rosenberg’s website WWW.AnswersForSleep.com which is a wealth of information on sleep topics.

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