Ask the Sleep Doctor – Topics: Pregnancy, CPAP toleration, fibromyalgia, and sleep for school

Sleep doctor ready to answer questions

Dear Dr. Rosenberg,

My daughter is pregnant and is having a terrible time falling asleep. She is up until about 2 a.m. most nights and because of work she has to be up by 7 a.m. She is getting a little more than five hours of sleep a night. I am worried that this could affect her pregnancy. I have asked her to discuss it with her obstetrician but so far she has not. Could this be a problem?


Yes, it could. Insufficient sleep during pregnancy had been associated with a number of complications, especially in women getting less than six hours of sleep per night. This includes gestational diabetes, hypertension, prolonged and more painful labor, as well as an increase in premature births and C-sections. Just as important is the fact that postpartum depression is significantly increased in women who experience insomnia during pregnancy and the early postpartum period. I would urge your daughter to discuss her sleep issues with her obstetrician ASAP.

Dear Dr. Rosenberg,

My dad has sleep apnea and has tried CPAP but cannot tolerate it. He was told, because he has no teeth, that an oral appliance would not work. His doctor says that his heart condition is being negatively impacted by his sleep apnea. He is not a candidate, nor will he agree to surgery. Do you have any ideas?


Yes, two that come to mind. The first is to undergo a desensitization procedure done at some sleep labs called a PAP NAP. I know we have found it to be very successful in getting previously resistant patients acclimated to CPAP in our lab. The second is a TRD (tongue retaining device). These devices bring the tongue forward, utilizing suction, but do not require the presence of teeth. You might talk to your dentist or to a dental sleep specialist about this therapy.

Dear Dr. Rosenberg,

Is it true that insomnia and fibromyalgia are related? Can better sleep help with fibromyalgia?


The answer is yes to both parts of your question. We have known for years that patients with fibromyalgia have trouble sleeping. However, a recent study showed that the possibility of developing FM was two times as common in those with insomnia preceding the disorder. Improving the sleep of patients with FM does increase their pain threshold. In fact, several of the medications used work by increasing total and deep sleep.

Dear Dr. Rosenberg,

How important is sleep for a good day at school?


Enough sleep is very important; Consequences of getting too little sleep range from inattentiveness, problems with impulse control, insufficient working memory, lack of planning and organizing skills, and poor academic performance. Children ages 6 to 13 need 9 to 11 hours each night and teens need 8 to 10 to function their best at school.

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 which is a wealth of information on sleep topics.

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