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The Prescott Daily Courier | Prescott, Arizona

home : features : vitality May 22, 2015


2/23/2013 9:58:00 PM
Sleep problems in pregnancy a danger to fetus
DR. ROBERT ROSENBERG
Courier Columnist
askthesleepdoc@yahoo.com



Dear Dr. Rosenberg,

My wife is in her 25th week of pregnancy.

She has developed what our obstetrician calls gestational hypertension. She has gained an excessive amount of weight and is snoring for the first time since we have been married. I have heard that sleep apnea can cause hypertension. Can that happen in pregnancy as well?

A: Yes, it certainly can. In fact in a study published in the August 2011 issue of the Journal Sleep, over 50 percent of pregnant women with hypertension were found to have sleep apnea as opposed to 12 percent of similarly matched pregnant women without hypertension. Then, in a more recent study in the same journal, treating the disorder lowered blood pressure and improved fetal viability. So I would bring your observations to the attention of your obstetrician. Given your wife's circumstances either an in-lab or home sleep study might be advisable.



Dear Dr. Rosenberg,

My husband has a lot of trouble falling asleep. He read where combining protein with carbohydrates in a snack before bed might help to induce sleep. He started eating pepperoni pizza before bedtime and now his problem is worse than ever. Why?

A: The combining of protein with carbohydrates is valid but is dependent on the type of food. The pepperoni, like all cured meats, contains a lot of the monoamine tyramine. This stimulates the release of wake-promoting chemicals in the brain. In addition, spices tend to raise the body temperature, which also wards off sleep. A snack of cheese and whole-wheat crackers or yogurt and fruit, or oatmeal is far more likely to induce sleep. These snacks combine the sleep promoting substance tryptophan, found in protein rich foods such as meat, fish and dairy products with complex carbohydrates, which promotes its absorption into the brain.



Dear Dr. Rosenberg,

My son returned from Iraq a few years ago. He was diagnosed with post traumatic stress disorder (PTSD) by the VA. He also snores and they are concerned that he may have sleep apnea. They want him to be studied and treated if he has it. The VA doctor told him that sleep apnea seems to be very common in veterans with PTSD. Why would that be?

A: We are not sure, but in most studies, the incidence is much higher than it is in men and women of a similar age and weight. One theory is that the sleep apnea was present before the PTSD. It is felt that by disrupting sleep repeatedly sleep apnea makes it more difficult to deal with the emotional trauma associated with the development of PTSD. As a result people with sleep apnea are more likely to go on to develop PTSD.



Dear Dr. Rosenberg,

I have high blood pressure. I was diagnosed with sleep apnea but can't wear one of those CPAP masks because I'm claustrophobic. I'm thinking of getting an oral appliance for my sleep apnea. Will it help my blood pressure?

A: Excellent question and the answer is yes. Several studies have demonstrated blood pressure reductions comparable to those achieved with CPAP with oral appliances. It is also important to appreciate that small drops in blood pressure can have a major effect in decreasing the incidence of heart attack and stroke.



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



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