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Family Medicine (Expert Forum)
one more follow up set of questions
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
one more follow up set of questions
by mymomissick, Jul 10, 2004 12:00AM
Thank you again for your answers,
More questions:
1) Do people who suffer from sleep apnia (apnea) typically feel sleep deprived throughout the day? In other words, when you say, “if sleep apnia (apnea) is suspected,” well, what evidence would one have to suspect it? Would I feel sleep deprived? I do not feel sleep deprived. However, my girlfriend has said that in the past she recalls hearing me, while sleeping, stop breathing and then violently re-start breathing, though she says she doesn’t recall it anytime recently. If I do not feel sleep deprived and I feel as though I am getting good sleep, is there any reason to suspect sleep apnia (apnea)?
2) Let’s assume the worst case scenario, which is that I’ve had sleep apnia (apnea) for a couple years already. Let’s say through weight loss and other lifestyle changes I get rid of the sleep apnia (apnea). Will there have been long term damage to my heart from those couple years? (I don’t think it would be more than a couple years because I’ve only put the weight on in the past couple years.) What exactly are the possible long term consequences of sleep apnia (apnea)?
3) This whole issue about sleep apnia (apnea) came up from my concerns about my dry mouth. In the past couple weeks that I’ve gotten rigorous with my dental hygiene, my dry mouth problems have gone away 95% or more. There is no more issue with dry mouth waking me up earlier than I want to be. Here is my question for #3. If a) my dry mouth has gone away as a major problem in my life b) diabetes is ruled out c) I do NOT feel sleep deprived and I do feel like Im sleeping enough, is there any reason to go to a doctor now? I guess this is sort of like question #1. That is, what current reason would I have to suspect sleep apnia (apnea) now?
4) What is OSA?
5) Knowing Im obese but don’t have diabetes, then, it is your guess that the reason for my dry mouth is mouth breathing? I do know that I breath through my mouth while in bed.
6) If so, I haven’t lost weight yet. I am still mouth breathing. If mouth breathing was causing the dry mouth, why does good dental hygiene seem to be stopping the dry mouth? Does improved dental hygiene just relieve dry mouth as oppose to explain its cause?
7) Is mouth breathing in itself bad? Or is it that mouth breathing is okay generally, except for obese people? Or, is it that mouth breathing is by nature bad, and obese people are just more likely to be mouth breathers?
8) Help me with the order: Is it that being obese can cause sleep apnia (apnea), which can cause dry mouth, which can lead to heart problems down the road? I’m a little unclear. What is the precise order of cause and effect here?
9) Finally: What would you do if you were me? Im just looking for your medical opinion. Would you just lose weight and go from there, or would you see a doctor as of now?
More questions:
1) Do people who suffer from sleep apnia (apnea) typically feel sleep deprived throughout the day? In other words, when you say, “if sleep apnia (apnea) is suspected,” well, what evidence would one have to suspect it? Would I feel sleep deprived? I do not feel sleep deprived. However, my girlfriend has said that in the past she recalls hearing me, while sleeping, stop breathing and then violently re-start breathing, though she says she doesn’t recall it anytime recently. If I do not feel sleep deprived and I feel as though I am getting good sleep, is there any reason to suspect sleep apnia (apnea)?
2) Let’s assume the worst case scenario, which is that I’ve had sleep apnia (apnea) for a couple years already. Let’s say through weight loss and other lifestyle changes I get rid of the sleep apnia (apnea). Will there have been long term damage to my heart from those couple years? (I don’t think it would be more than a couple years because I’ve only put the weight on in the past couple years.) What exactly are the possible long term consequences of sleep apnia (apnea)?
3) This whole issue about sleep apnia (apnea) came up from my concerns about my dry mouth. In the past couple weeks that I’ve gotten rigorous with my dental hygiene, my dry mouth problems have gone away 95% or more. There is no more issue with dry mouth waking me up earlier than I want to be. Here is my question for #3. If a) my dry mouth has gone away as a major problem in my life b) diabetes is ruled out c) I do NOT feel sleep deprived and I do feel like Im sleeping enough, is there any reason to go to a doctor now? I guess this is sort of like question #1. That is, what current reason would I have to suspect sleep apnia (apnea) now?
4) What is OSA?
5) Knowing Im obese but don’t have diabetes, then, it is your guess that the reason for my dry mouth is mouth breathing? I do know that I breath through my mouth while in bed.
6) If so, I haven’t lost weight yet. I am still mouth breathing. If mouth breathing was causing the dry mouth, why does good dental hygiene seem to be stopping the dry mouth? Does improved dental hygiene just relieve dry mouth as oppose to explain its cause?
7) Is mouth breathing in itself bad? Or is it that mouth breathing is okay generally, except for obese people? Or, is it that mouth breathing is by nature bad, and obese people are just more likely to be mouth breathers?
8) Help me with the order: Is it that being obese can cause sleep apnia (apnea), which can cause dry mouth, which can lead to heart problems down the road? I’m a little unclear. What is the precise order of cause and effect here?
9) Finally: What would you do if you were me? Im just looking for your medical opinion. Would you just lose weight and go from there, or would you see a doctor as of now?
Doctor's Answer
by Kevin Pho, MD, Jul 13, 2004 12:00AM
, Jul 13, 2004 12:00AM
To answer your questions:
1) Yes, daytime sleepiness can be a feature of sleep apnea.
2) The long-term effects of sleep apnea are not known, but the results of continual poor sleep can lead to the following: depression, irritability, loss of memory, lack of energy, a high risk of auto and workplace accidents, and physical problems such as high blood pressure, cardiac arrest, and in some cases, death.
3) Tough to say without examining you. When in doubt, I would also recommend going to a physician. There is very little risk in that.
4) OSA = obstructive sleep apnea
5) Mouth breathing is one of the more common causes of dry mouth. I cannot be more specific without examining you.
6) I cannot be sure why good dental hygiene is stopping the dry mouth. I do not have a good explaination why improvement in hygiene is helping the dry mouth.
7) Mouth breathing can increase the risk of gingivitis (gum disease).
8) There are several possibilities - the order you presented is certainly possible and the most likely scenario.
9) I would see a physician and obtain a sleep study to definitively rule out sleep apnea. Losing weight can only help and is recommended.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
1) Yes, daytime sleepiness can be a feature of sleep apnea.
2) The long-term effects of sleep apnea are not known, but the results of continual poor sleep can lead to the following: depression, irritability, loss of memory, lack of energy, a high risk of auto and workplace accidents, and physical problems such as high blood pressure, cardiac arrest, and in some cases, death.
3) Tough to say without examining you. When in doubt, I would also recommend going to a physician. There is very little risk in that.
4) OSA = obstructive sleep apnea
5) Mouth breathing is one of the more common causes of dry mouth. I cannot be more specific without examining you.
6) I cannot be sure why good dental hygiene is stopping the dry mouth. I do not have a good explaination why improvement in hygiene is helping the dry mouth.
7) Mouth breathing can increase the risk of gingivitis (gum disease).
8) There are several possibilities - the order you presented is certainly possible and the most likely scenario.
9) I would see a physician and obtain a sleep study to definitively rule out sleep apnea. Losing weight can only help and is recommended.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
