Ask the Expert-- Sleep Disorder Q & A Forum - KPLC 7 News, Lake Charles, Louisiana

Ask the Expert-- Sleep Disorder Q & A Forum

Find answers to commonly asked Sleep Disorder Questions here:

Disclaimer:  The staff at Sleep Disorder Center of Louisiana will attempt to answer your questions to the best of their abilities based on the information you provide. This forum should not be considered a substitute for a medical examination by professionals and should not be used for diagnosis or treatment of any medical condition.  The answers on this forum may take 48-72 hours to reach you. They will also be posted here on kplctv.com.

QUESTION: I snore heavily at night, which keeps my wife awake, and I am getting up feeling tired in the morning. I have been to my family doctor about this and he says I do not have sleep apnea. My wife says it sounds as though I stop breathing at night. My family doctor put me on sleep medication, which made me snore even worse, but I got up feeling better in the morning. He said to cut the medication in half. The snoring has gotten somewhat better, but I am still concerned as to whether I have sleep apnea. Do I have to have a doctors referral to see you if you think I have this problem.

ANSWER: Thank you for your question. It appears that you have many of the signs of Obstructive Sleep Apnea (snoring, observed cessation or pauses in your breathing, and daytime fatigue and/or sleepiness). An overnight sleep study is often needed to evaluate the severity of the apnea and determine the best possible treatment options (I'm unsure if you've previously undergone a sleep study since your doctor feels you do not have sleep apnea). As you may know, Obstructive Sleep Apnea can have many negative effects on your overall health and well being (contributing to heart disease, high blood pressure, and possibly stroke, not to mention the toll on your energy level, sleep quality, work performance, memory, emotional well being etc....). Being placed on a sleep medication will allow you to temporarily feel like you are getting better sleep (you are actually sleeping harder due to the sedation), however the sedating side effects of the sleep aid can worsen the snoring and sleep apnea. It would be most beneficial for you to follow up with your physician or a board certified sleep specialist to have this evaluated further. Here at the Sleep Disorder Center of Louisiana, we do not require referrals from other physicians (patients can set up their own appointments) unless this is specific to your own insurance. If you would like to look into this you may call our office at 310-7378.

Thanks again for your question.
Dr. Jana Kaimal MD/ Michelle Zimmerman, NP

QUESTION: I am 23-yrs old and I have been working the graveyard shift for about almost 5 years now. I seem to have a little trouble when trying to rest whether it's daytime or night. My boyfriend tells me that I may be suffering from some type of sleeping disorder. I have been this way so long that I have just learned to adapt to and accept it. My sleep patterns may be that I sleep for an hour or two and wake up for and hour or two all night long. I can never sleep straight through a complete sleep cycle. Is there a problem?

ANSWER: Well, there are a few questions that need to be answered first. How do you feel while you are in your normal awake hours? Do you feel sleepy, fatigued, mentally drained or just ok? The simple fact is every person needs 6-8 hours of rest on a very regular basis. Even though you might say that you feel fine with only a few hours of rest, your mind and body are simply building up a tolerance to sleep deprivation which is not healthy. We all have circadian rhythms that control when we are to be awake or asleep. After you have worked for a couple of nights, you have to "train" your body to rest at the right time of the day. On your nights off you should try to continue this night schedule. We refer to this as good sleep hygiene. Try to go to bed at the same time every day regardless of your work schedule and wake up at the same time every day. If you continue to have problems after trying this for about 2 weeks, you may need to see a sleep specialist or consider working a day position. Thank you for your question.

QUESTION: My 8 year old granddaughter wakes 4 or 5 times during the night. She is healthy, does well in school and does not have any anxieties. She usually goes back to sleep soon after waking. This has been happening for several years. What could be causing this type of sleep pattern?

ANSWER: Many things (physical, emotional, and behavioral) can influence a child's sleep at night. Many sleeping patterns of children were established in the infancy and toddler years, however here are some things that may help: Caffeine intake in kids is often more than we realize (found in so many sodas, as well as chocolate, and iced tea). All caffeine should be restricted within at least 6 hours of the usual bedtime. Children function best when they are following a regular and consistent routine. This means wake time and bed time are generally the same time every day -- even on weekends. If this pattern is interrupted, or very inconsistent, the child can easily become used to napping too much or too little, waking frequently at night, or simply get used to being tired because they don't know any better. Napping. this applies more to toddlers and preschoolers, however excessive napping (or napping late in the day) can create problems for children during the night time hours. Napping should be restricted if it routinely lasts more than 1 hour and occurs later than early afternoon. Eating and drinking before bedtime. It is generally recommended that eating, drinking, and physical exercise too close to the bedtime can interrupt good sleep habits. Here are some other things to consider: Does she know why she wakes up? (Bathroom, nightmares, too cold or too hot?). Are there pets or other siblings in the bed or bedroom?, TV in the bedroom?, thirsty?, snoring?, asthma?, Does she kick or twitch her legs alot at night? Does she grind her teeth, sleep talk, sleep walk? These are some other things to consider. There are specific sleep disorders that can affect children's sleep such as sleep apnea or restless legs syndrome. If you feel that any or all of the above suggestions and tips have been tried or do not apply, please discuss this with the child's pediatrician or a board certified sleep specialist. Good luck and let us know how things work out.

Jana P. Kaimal, M.D.

Board Certified Sleep Specialist

M.Zimmerman, NP

QUESTION: I toss and turn all night long when I turn I wake up. I wake up as tired as when I went to bed. By the time noon rolls around I lie don to take a short nap because I'm tired and about 15 to 30 minute nap will get me going to do my work until I go back to bed at night to start all over again. What can I do to get a good night’s sleep?

ANSWER: It sounds like you've been sleeping very poorly. There are so many things that can contribute to a poor night's sleep and the excessive daytime sleepiness and fatigue you are experiencing. Firstly, if there is any presence of snoring and/or brief pauses or cessations in your breathing, this could represent Obstructive Sleep Apnea (one of the more common sleep disorders associated with poor sleep and daytime sleepiness/fatigue). Not everyone is aware that they snore or quit breathing also, so this may be tricky. Secondly, a condition known as Periodic Limb Movement Disorder in which your legs twitch, jerk, or slightly kick throughout the night can also be a treatable cause of your poor sleep and daytime sleepiness. Again most persons aren't even aware that they do this at night but these movements cause very, very briefs "arousals" from sleep. As these movements add up over the hours you are trying to sleep, you end up having dozens and perhaps more than a hundred of these brief arousals before you wake up: This is similar to your sleep essentially being "chopped" up throughout the night: YOU ARE NEVER ALLOWED TO SLEEP HOURS WITHOUT INTERRUPTION FROM THESE LIMB MOVEMENTS AND AROUSALS. Additionally, tossing and turning can also be related to heartburn or reflux, acute or chronic pain, among other illnesses. Shiftworkers are also prone to sleeping problems due to the constant change in their sleep habits. These are just a few things to think about Remember sleep disorder such as Sleep Apnea can be serious if left untreated. They can lead and contribute to high blood pressure, heart disease, and even stroke, not to mention the constant low energy, moodiness, headaches, and depression that often accompany this and other sleep disorders. Please think about where you fit in the descriptions provided here, and talk with your doctor or a board certified sleep specialist for further help. Thanks and good luck,

Jana Kaimal, M.D.

Board Certified Sleep Specialist

Michelle Zimmerman

QUESTION: What are Nasal Pillows?

ANSWER: Nasal pillows are one part of the facial gear that is used to deliver Continuous Positive Airway Pressure (CPAP) therapy. CPAP therapy is an effective therapy for the treatment of Obstructive Sleep Apnea. They are small, flexible tubes that are positioned in the nostrils. Air from a CPAP machine (usually at the bedside) passes through a small tube and then through the nasal pillows. Although traditional CPAP masks are more frequently used, many patients enjoy nasal pillows because they are smaller and the patient is free from having a nasal mask that typically fits entirely over the nose area. For more information on Obstructive Sleep Apnea, click on the additional areas of interest outlined in our Ask the Expert segment on kplctv.com, or contact the Sleep Disorder Center of Louisiana at 310-7378 or 1-877-597-7378.

QUESTION: How severe must Apnea be to require treatment?

ANSWER: During an overnight sleep study (Polysomnography), the severity of one’s Apnea is measured on several different fronts. Most importantly, the total number of complete obstructive apneas as well as partial obstructive apneas (think of this as a very shallow breath in which oxygen saturation levels are diminished) is calculated. These two totals are then calculated into what is referred to as a Respiratory Distress Index (RDI) or what many people refer to as the total number of events (complete or partial apneas) per hour. Your sleep specialist also takes into consideration the overall quality of your sleep; the amount of time it takes you to fall asleep, and the number of arousals (you may be unaware of these) you experience due to apneas, snoring, leg movements, etc… For most people having symptoms such as excessive daytime sleepiness, tiredness, snoring or observed cessation of breathing or pauses in breathing, there is sufficient clinical evidence of Obstructive Sleep Apnea serious enough to proceed with evaluation by a board certified Sleep Specialist, overnight sleep study and treatment if needed.

QUESTION: If I were awakening in the night and having these symptoms, wouldn’t I be aware of it?

ANSWER: Not necessarily. Some arousals are as short as 3 to 5 seconds in length. Immediately after most of these short periods, the patient falls back asleep and is unaware of the awakenings. These arousals can occur as often as 1 to 2 times per minute of sleep. Over the course of the night, you may have dozens or hundreds of these arousals. Most people typically don’t understand why they are so tired despite sleeping 6 or even 8 hours a night; however they don’t realize how disrupted or fragmented their sleep actually was.

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