Ask the Sleep Doctor – Topics: Autism, Support Hose, Weight Loss, and Hot Flashes

Sleep doctor ready to answer questions

Dear Dr. Rosenberg,

My son has been diagnosed with autism. No matter what we do, he is up until the wee hours of the morning. It is not only a problem for him but is very disruptive to the family. I have heard that melatonin might help. What do you think?


Great question. Yes, there are several studies showing that melatonin in low doses can be effective in improving sleep in children with autism and other neurodevelopmental disorders. In fact, a study published in this month’s Journal of Clinical Sleep Medicine interviewed parents of children with autism and found that the majority thought melatonin to be very helpful. I would discuss thus with your pediatrician before starting it.

Dear Dr. Rosenberg,

I know this may sound ridiculous but since my husband started wearing compression hose for his swollen legs, his snoring has decreased. Could there be any correlation?


Yes, actually several studies have shown that sleep apnea decreases at night in people with swollen legs that wear support hose. Apparently, if you go to bed with swollen legs, much of the fluid shifts to the neck. This increases snoring and sleep apnea as the airway is compressed by the fluid shifting into the neck when we lie down. Therefore, I would say your observation is very astute and might help others.

Dear Dr. Rosenberg,

I have sleep apnea and am very overweight. I have heard that weight loss can improve, and in some instances get rid of sleep apnea. Is that true, and how much weight loss is needed?


Everyone is different but some studies have shown that a 10% weight loss translates into about a 20% decrease in sleep apnea events. In the case of bariatric surgery where there is massive weight loss, we see about a 60% cure rate when patients achieve their target weight.

Dear Dr. Rosenberg,

I am going through menopause and hot flashes are waking me up throughout the night. As a result, I have become increasingly tired and moody. I don’t want to take hormone replacement therapy, as there is a high incidence of breast cancer in my family. Any ideas?


Yes, there are several options to treat hot flashes other than HRT. Several antidepressants, including venlafaxine as well as low dose paroxetine have been effective. In addition, a medication initially developed to treat seizures and nerve pain called gabapentin seems to work. A recent study showed the sleeping pill eszopiclone (Lunesta) was effective. Finally, some herbal products such as cohosh seem to work. What is most important is that you discuss with your health care provider what you are going through and take care of it. Many women with chronic insomnia and depression developed these problems because post-menopausal symptoms were ignored.


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. He is a contributing sleep expert blogger and his advice has appeared in Women’s Health, Prevention, Ladies’ Home Journal, Parenting, and O Magazine, among others. Dr Rosenberg is a weekly newspaper columnist addressing sleep Q&As. Dr. Rosenberg appears on TV and radio and lectures throughout the country on Sleep 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 which is a wealth of information on sleep topics.


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