Ask The Sleep Doctor: Sleep Apnea in Child, Depression and Sleep, MVA and OSA, Morphine & Sleep

Dear Dr. Rosenberg,

Can sleep apnea cause problems in a child’s ability to focus and concentrate and cause behavioral problems? My granddaughter snores loudly and stops breathing. She has not been diagnosed or treated.and is having a very hard time in school. She is failing everything and is disruptive in class.

Answer:

It sounds like she should be tested for sleep apnea. Several studies using MRI technology have demonstrated acute damage to brain areas involved in cognition, behavior, and maintaining alertness in children to be due to low oxygen, elevated carbon dioxide, and the release of inflammatory mediators. If left untreated, we fear some of these changes could become permanent. I would discuss this with her pediatrician and arrange for a sleep study. A few labs  conduct pediatric, as well as adult sleep studies.

Dear Dr. Rosenberg,

My mother suffers from depression. She also has sleep apnea but refuses treatment. Her depression is not responding to antidepressants. Could the sleep apnea be contributing to it?

Answer:

Yes. Several studies have shown that sleep apnea is three times more likely in patients with depression. Even more important are the studies that show significant improvement and some resolution of depression and anxiety when sleep apnea is treated. I would urge your mother to seek treatment if she wants to see improvement in her mood disorder.

Dear Dr. Rosenberg,

Is it true that sleep apnea can contribute to motor vehicle accidents? My husband snores and stops breathing. Lately he is having trouble staying awake while driving.

Answer:

Yes, in fact the incidence of MVAs is three to five times higher with untreated sleep apnea. The good news is that when treated it quickly returns to normal. I would strongly advise you have your husband discuss this with his health care provider.

Dear Dr. Rosenberg,

My wife is on morphine for chronic pain. She is always sleepy and spends much of the day napping. I have observed that when sleeping, she has frequent long pauses when she does not breathe. We have been told it is the medication that makes her sleepy but I’m concerned about her breathing. What do you think?

Answer:

I think you are on to something. Usually, sleepiness from chronic opioid use resolves in a few weeks. However, a form of sleep apnea called central sleep apnea occurs in up to 50% of patients on chronic opioids. In this form of the disorder, the individual has frequent episodes where they make no effort to breathe. Based on your observations, this seems to be a likely explanation for your wife’s sleepiness. I would recommend you discuss this with your health care provider and get a referral to a sleep specialist. It can be treated with special CPAP-type machines called Adaptive Servo-Ventilation.


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 offers a wealth of information on sleep topics.

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