Ask Dr. Rosenberg

Dear Dr. Rosenberg,

 

When I had my yearly physical last month, my doctor said a blood test called C-Reactive Protein was elevated.  He asked if I snored and when I told him yes, he said I should be tested for sleep apnea.  He said this elevated blood test could increase my risk of heart attack or stroke.  What does that have to do with my snoring?

 

A:

 

C-Reactive Protein is a marker of inflammation, especially of the blood vessels.  It has been associated with an increased risk of heart attack and stroke.  It is frequently elevated in sleep apnea and some think it may be one of the major links of sleep apnea to atherosclerosis.  Therefore, I understand your physician’s desire to get you tested.  Most studies have shown that with treatment of sleep apnea, the C-Reactive Protein normalizes.

 

Dear Dr. Rosenberg,

 

My six-year-old has sleep apnea.  I have been told that he should have his tonsils and adenoids removed but I am a bit reluctant to do this.  What type of benefit might he get from having this done?  He is somewhat hyperactive.

 

A:

 

A recent study funded by the NIH done on 464 children demonstrated the benefits of the surgery in children with sleep apnea.  Children who underwent surgery showed improvement in sleep quality, impulse control, and quality of life.  Beneficial effects were observed, even among overweight children in whom there has been particular uncertainty about the role of surgery.  I hope that answers your question.

 

Dear Dr. Rosenberg,

My three year old resists going to bed every night.  As a result, he is sleeping less than he should.  My friends say not to worry about it since he will grow out of it.  What do you think?

A:

Yes, it is true that many children with sleep problems improve as they get older.  However, there may be a problem with that.  According to a study published in the British Medical Journal, children with irregular sleep schedules before the age of three continued to lag developmentally, even by age seven.  So it may be that the crucial first three years for brain development in a child is sleep dependent.  Therefore, I would urge that you try to maintain a regular sleep schedule with your toddler.

Dear Dr. Rosenberg,

Since my son has returned from a recent deployment to Afghanistan, he is having a lot of trouble sleeping and many nightmares.  He won’t discuss them with us but we are concerned.  Do you think a sleeping pill might help?

A:

No, it sounds like it is much more complicated than that.  I can’t make a diagnosis based on your question but certainly you are describing the sleep-related symptoms of PTSD.  I would urge you to have him seen either at your local VA or by a psychiatrist.  The sooner this is attended to the better for your son.

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