Dr. Donohue: Sleep apnea's consequences can be serious

Syndicated Columnist
Published Thursday, September 16, 2004

DEAR DR. DONOHUE: I think my husband has sleep apnea. I have observed him while he sleeps, and he has long spells during which he doesn't breathe. He is also a very loud snorer. I can't convince him to see a doctor. Can you say something about this that might get him motivated? -- R.C.

ANSWER: The literal meaning of "apnea" is "no breathing." Sleep apnea is the condition where people suffer from long periods -- 10 or more seconds -- of no breathing during sleep. During the apneic intervals, the blood oxygen level drops, and that can have grave consequences.

The apneic spell ends with a gasp, and normal breathing resumes. Loud snoring is another symptom of sleep apnea. Snoring, naturally, stops abruptly with the onset of apnea.

What happens during the day as a result of sleep apnea is as important as what happens during the night. Due to fractured sleep cycles, daytime sleepiness is inevitable. Affected people nod off while reading the paper or watching TV. Accidents on the road, at work and at home are common.

Sleep apnea has important health consequences. During the breathless pauses, abnormal and even dangerous heart rhythms can occur. Apnea can lead to a sustained rise in blood pressure. It can also cause a rise in lung blood pressure -- pulmonary hypertension, an issue not related to ordinary blood pressure elevation.

Your husband ought to see a doctor to check out these possible sleep apnea effects. If he refuses, then he should at least adopt some suggestions to help with the problem. If he is overweight, weight loss will lessen apnea attacks. He should not sleep on his back, and he should not drink alcohol before bedtime or take sedatives to get to sleep.

He might, like many others, have to wear a mask that keeps pressurized air flowing into his lungs at night. And there are a number of surgical and laser procedures that rid the throat of redundant tissue that blocks the flow of air into the lungs during sleep.

DEAR DR. DONOHUE: Two years ago they did a triple bypass operation on me, and everything went fine. The surgeon removed a vein from my leg and used it to bypass the clogged arteries. Are veins smaller than arteries, or is there little or no difference between an artery and a vein? -- J.R.

ANSWER: Arteries and veins are pipes for the circulation of blood throughout the body. Arteries receive blood pumped from the heart, and the pumped blood comes with a high head of pressure. Arteries must have thick and strong walls to withstand that pressure.

By the time blood reaches veins -- the pipes that bring circulated blood back to the heart -- pressure has greatly fallen. Veins, therefore, are more delicate than arteries. They have much thinner walls.

The two are not the same.

Veins make good substitutes for arteries, however, and they have been the standard replacement for clogged heart arteries. Now, some heart surgeons are using an arm artery as a replacement for blocked heart arteries. Artery grafts might last longer. Time will tell.


DEAR DR. DONOHUE: Heart disease and high cholesterol run in my family. I have been taking Lipitor for a number of years. Perhaps, as a result of this, my liver function levels have been elevated. In order to determine if this is due to Lipitor, my doctor instructed me to stop it for three months. I am concerned about stopping it, fearing that my cholesterol will rise. Are my concerns justified? -- L.C.

ANSWER: Three months without Lipitor is not going to put you in any danger. Not taking it will tell you if the drug is the cause of your liver function abnormalities. It's about the only way to determine that.

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