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I suffer sleeplessness due to breathing problems.

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Doctor,

I am a 66 year old man with normal weight and healthy built. Now, the problem with me is that I can’t sleep well at night. The problem lies with some problems associated with my breathing. As soon as I fell asleep, total air supply to my lungs is blocked completely. I suffer from severe attack of rhinitis, which causes a blockage of my nose. It used to occur in summer periods then. But now, I am very allergic to many aerial particles. Almost every airborne allergies affect me. I think I also have some hereditary problem with my muscles which obstruct it from relaxing of throat and airways. This blockage occurs usually when I fall asleep. Sometimes I would be left with many days without sleep. I take a heavy dose of prednisolone of upto 40mgs, as a relief from this. It calms down the inflamed membranes of my throat and nose, but I also suffer from chronic osteoporosis. It thinks this is because of cortisone I have been using for the last 25 years. My conditions are becoming worse and I am not getting even a bit of good sleep. I am sure that this is not anything related to psychological issues or sleep phobias. Doctors I have consulted say that I have no problem with my nose or respiratory system. They suggested me to use some mandibulary mouthpiece for making things better. Can you spot out any genuine reason for this? I think that my doctors have never investigated much into my problem. Any suggestion for the betterment of my illness is welcomed. Help me please.


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Category: Family Physician-GP
Dr. John Monheit is online now

Expert:  Dr. John Monheit replied 4 Days.

Thank you for using Ask a Doctor Services from Doctor Spring.

You could most porbably be suffereing from a condition called sleep apnea. It is a condition which occurs due to narrowing of upper airway. As you have mentioned it clearly that you suffer frequently from rhinitis, even this could precipitate the airway obstruction. Normally, the upper throat still remains open enough during sleep to let air pass by. However, some people have a narrower throat area. When the muscles in their upper throat relax during sleep, their breathing can stop for a period of time causing apnea. As you mentioned that you have problem associated with relaxing muscles in your throat, this could also precipitate the obstruction of airways. I would advise you to consult with a GP, who would ask you for a special test called polysomnography( sleep study). This test is usually enough to confirm obstructive sleep apnoea. Following this evaluation, the doctor might advise you for various modality of treatment. You will be allowed to choose according to your comfort in undergoing such treatment for your benefit.

Certain life style changes can help you with good sleep such as

Avoiding alcohol or sedatives at bedtime, which can make symptoms worse

Avoiding sleeping on the back

Losing weight if you are over weight.

Continuous positive airway pressure (CPAP) is now the first treatment for obstructive sleep apnea in most people. CPAP is delivered by a machine with a tight-fitting face mask. Many patients have a hard time sleeping with CPAP therapy. Good follow-up and support from a sleep center can often help overcome any problems in using CPAP.

Some patients may need dental devices inserted into the mouth at night to keep the jaw forward like the one advised by your doctor.

Surgery may be an option in some cases which is refractory to all the above treatment methods. This may involve:

Uvulopalatopharyngoplasty (UPPP) -- to remove excess tissue at the back of the throat.

Evaluation for the specific cause for your airway obstruction and treating it appropriately will be beneficial for you. So Consult with a GP who will need to do a thorough evaluation on you for the cause of your sleep disturbance and he will be able to guide you furthur.

Hope this helps. Please feel free to ask if you need further help.

Thank you.


Dr. John Monheit
Category: Family Physician-GP
Experience: 
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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