Dear Dr. Garner,

I am a big fan of the TV show and column.

I’m writing because, for some reason, I just can’t fall asleep like I used to. I occasionally wake up short of breath, thinking I am going to die.

I constantly hear ads on the TV for sleep apnea. Could you please tell me what this means and also give me any tips you might have to fall asleep?

I know about going to sleep at the same time each night, but I need something that will really help.

Sleepless in Sheepshead Bay

 

Dear Sleepless,

First of all, it is very unlikely you will have sudden death while sleeping as a result of insomnia or sleep apnea. Some studies, regarding sleep apnea, published during the past summer, indicate a slight increase in sudden death. It is not prevalent enough for you to obsess about. It will help if you stop worrying and take action to address your problems of sleep apnea and insomnia.

While you mentioned a sleep habit that people should strive for, it will not work unless it is part of a plan to identify why you are not sleeping properly.

Sleep apnea is a condition in which the muscles of the throat block the air pipe leading to the lungs.

This gives the feeling of suffocating that you are describing. It usually occurs in people who are obese.

In sleep apnea, breathing repeatedly starts and stops. Snoring is often a tip-off that you have a problem. People with sleep apnea often feel extremely tired even after they have had a good night’s sleep.

Other symptoms are: awakening frequently with a dry mouth or sore throat; morning headaches; difficulty staying asleep and attention problems that your family or co-workers will notice.

Risk factors include being obese, having a big and thick neck, being a male over the age of 60, having a family history of sleep apnea and being African American.

People with high blood pressure and heart problems often have sleep apnea. Those who use alcohol, sedatives or tranquilizers are at increased risk as well.

From your question, it sounds as if you have reviewed sleep apnea and insomnia, so I will suggest two treatment suggestions you may not have heard about.

The first is to lose five to 10 pounds, no matter how much you weigh. This helps alleviate the problem without the large masks and devices you may have tried for sleep apnea.

Lying on your side is helpful as the muscles of the throat are more likely to obstruct when you lie on your back.

Finally, there are nostril devices available in the pharmacy which are almost as helpful as the big sleep apnea machine for some people.

Insomnia is usually the result of an underlying condition. Some tips right from the top are:

Do not use any alcohol to go to sleep. The alcohol may get you to sleep, but you will be up in two hours and unable to fall back asleep.

Stay away from sleep aides, either over the counter or by prescription. They will eventually cause problems for most people, making them feel dependent on the pills and experiencing difficulty going to sleep without them.

If you can’t fall asleep, I recommend staying in bed and trying meditation or thinking about pleasant thoughts. You will eventually fall asleep and get the rest you need.

Some underlying causes of insomnia include:

• Stress and anxiety. Work concerns, financial and family matters top the list.

• Depression. This can cause too much or too little sleep. Your body actually does not work as well with too much sleep (more than eight hours).

• Medications. Side effects of many medications include interfering with sleep such as blood pressure medications and antihistamines.

• Caffeine too close to bedtime.

• Medical conditions either diagnosed or undiagnosed.

To treat the problem appropriately, the underlying cause must be sought. Treating the underlying cause will alleviate the problem in the safest possible manner.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.