Dear Dr. Rosenberg: I have had night sweats for the last year. I have been to many specialists and they have not found a cause. In fact, one asked me to keep track of my temperature, which I have been doing, and it is always normal. My primary care provider wants me to have a sleep study for sleep apnea. I am a widower and have not had a bed partner for a number of years. Do you think this test makes sense?
A: Yes, I do. Several recent studies have demonstrated the incidence of night sweats to be about 30 percent in people with sleep apnea. In fact, in one study, the prevalence of frequent nocturnal sweating was threefold higher in untreated OSA patients than in the general population. It was found that it decreased to general population levels with successful PAP therapy. The authors concluded that practitioners should consider the possibility of OSA in their patients who complain of nocturnal sweating.
Dear Dr. Rosenberg: My husband has a weak heart and central sleep apnea. He was placed on a machine called ASV (Adaptive Servo Ventilation) in 2014. Now his new cardiologist is concerned and thinks he may need to get off it. He wants to refer us to a sleep specialist. I don’t understand why.
A: In 2015, a study was performed on patients with weak hearts (ejection fractions of 45 percent or less) on ASV for central sleep apnea. They found that patients treated with this therapy had a 2.5 percent higher death rate yearly than patients with equally bad hearts not being treated with ASV. As a result, until new evidence comes along, it is recommended that people such as your husband be advised of the risks and that alternate forms of therapy be considered.
Dear Dr. Rosenberg: My daughter is pregnant and has developed hypertension during the pregnancy. In fact, they have found protein in her urine and are calling it pre-eclampsia. My son-in-law says her snoring has gotten progressively louder during the pregnancy. I read where sleep apnea could cause problems during pregnancy. I don't like to interfere, but shouldn't she tell her OB about the snoring?
A: Yes…and I say that emphatically! Many recent studies show sleep apnea, if untreated, can cause significant problems for both the mom and the fetus. Women with sleep apnea are twice as likely to develop hypertension during their pregnancy and three times more likely to develop diabetes. At the very least she should mention her snoring and be screened for sleep apnea. A simple home sleep test may suffice.
Dear Dr. Rosenberg: My mom had a pulmonary embolus and is now off blood thinners. She snores and my dad says she occasionally stops breathing. Her doctor wants her to get a sleep test since sleep apnea and pulmonary embolus can be related. Does this make any sense?
A: Yes, there are several recent studies demonstrating that sleep apnea is three times more common in people with pulmonary embolus. Even more impressive is a recent study showing that after stopping blood thinners, those with untreated sleep apnea were far more likely to experience a recurrence of pulmonary embolus.