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The Prescott Daily Courier | Prescott, Arizona

home : features : vitality November 25, 2015

1/5/2013 9:59:00 PM
Technique helps kids overcome fear of nightmares
Courier Columnist

Dear Dr. Rosenberg,

My 5-year-old has nightmares several times a week. It not only awakens him, but now he is becoming anxious about going to sleep.

Is there anything we can do?

A: Nightmare disorder is defined as one or more nightmares per week. A technique used in children is called imagery rehearsal therapy. You have your child draw a picture of the nightmare. Then have him add something to the drawing that makes it less frightening. In one example, a child drew two ghosts at the doorway of his home as he was walking up the path. He then drew a "super spider" by each ghost that he felt would chase them away. He went over this drawing with his mother for about 10 to 15 minutes each day for two weeks. By the end of this period, he was no longer experiencing the nightmare.

Dear Dr. Rosenberg,

I have heard that a warm bath before bedtime can help to induce sleep. Is this true? I have a hard time falling asleep.

A: Yes, the idea is to elevate your body temperature and then have it fall as your bedroom temperature cools you down. The brain interprets drops in body temperature as a stimulus to fall asleep. Our core body temperatures drop with the onset of sleep. Give this a try. It is a very natural method of inducing sleep.

Dear Dr. Rosenberg,

I get up to urinate four to five times a night. I have had a thorough work up by two urologists and they could not find a cause. I have a friend who had the same problem and he says it was caused by his sleep apnea. I snore but I am very skeptical of how sleep apnea could possibly cause me to have to urinate frequently. Is this true?

A: This is a great question and, yes, it is true! I am frequently confronted with the same skepticism by my patients. The mechanism however is quite clear.

When one attempts to breathe against a closed airway, blood flow returning to the heart increases. This causes the small upper chambers of the heart called the atria to stretch. The atria, in response to stretching, then put out a substance called atrial natriuretic peptide (ANP) that increases urination. Believe me when I tell you that with treatment of the sleep apnea the urinary frequency decreases remarkably. I would at least find out if I have sleep apnea if I were you.

Dear Dr. Rosenberg,

Is it true women have a higher incidence of trouble sleeping than men? I read this online. I have had insomnia for years and take pills. I am looking for some insight into my trouble.

A: Yes, it is true. In all age categories, women have a significantly higher incidence of insomnia. It is believed to be in part due to a higher incidence of mood and anxiety disorders. In some studies, women are found to have anxiety and depression at nearly twice the rate of men. Also, women were found to manifest difficulty sleeping as a symptom of these disorders far more often than men. Most importantly, attention to the underlying psychiatric disorder, if present, is necessary to resolve the insomnia.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him through the form at or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Drive, Prescott Valley, AZ 86314.

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