Ask the Sleep Doctor

Ask the Sleep Doctor – Topics: Pulmonary Embolus, Epilepsy, Heart Failure & Pre-Eclampsia and Sleep

Dear Dr. Rosenberg,

My mom had a pulmonary embolus and is now off blood thinners. She snores and my dad says she occasionally stops breathing. Her doctor wants her to get a sleep test since sleep apnea and pulmonary embolus can be related. Does this make any sense?

Answer:

Yes, there are several recent studies demonstrating that sleep apnea is three times more common in people with pulmonary embolus. Even more impressive is a recent study showing that after stopping blood thinners, those with untreated sleep apnea were far more likely to experience a recurrence of pulmonary embolus.

Dear Dr. Rosenberg,

My husband has epilepsy and despite medication, he continues to have frequent seizures. The cause is unknown. He snores and his neurologist is telling him to have a sleep study. He is resistant at this point. Is there a relationship between the two?

Answer:

Yes, most definitely. A study published in this month’s journal Chest demonstrated a 50% reduction in seizures in those with epilepsy and sleep apnea when the sleep apnea was treated with CPAP. The authors feel that sleep disruption contributes to seizures and note that sleep apnea is a major cause of this. I would urge your husband to get tested. The authors concluded that all patients with epilepsy should be screened for sleep-disordered breathing.

Dear Dr. Rosenberg,

My husband has a weak heart and central sleep apnea. He was placed on a machine called ASV (Adaptive Servo Ventilation) in 2014. Now his new cardiologist is concerned and thinks he may need to get off it. He wants to refer us to a sleep specialist. I don’t understand why.

Answer:

In 2015, a study was performed on patients with weak hearts (ejection fractions of 45% or less) on ASV for central sleep apnea. They found that patients treated with this therapy had a 2.5% higher death rate yearly than patients with equally bad hearts not being treated with ASV. As a result, until new evidence comes along, it is recommended that people such as your husband be advised of the risks and that alternate forms of therapy be considered.

Dear Dr. Rosenberg,

My daughter is pregnant and has developed hypertension during the pregnancy. In fact, they have found protein in her urine and are calling it pre-eclampsia. My son-in-law says her snoring has gotten progressively louder during the pregnancy. I read where sleep apnea could cause problems during pregnancy. I don’t like to interfere, but shouldn’t she tell her OB about the snoring?

Answer:

Yes…and I say that emphatically! Many recent studies show sleep apnea, if untreated, can cause significant problems for both the mom and the fetus. Women with sleep apnea are twice as likely to develop hypertension during their pregnancy and three times more likely to develop diabetes. At the very least she should mention her snoring and be screened for sleep apnea. A simple home sleep test may suffice.

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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