DEAR DR. DONOHUE: My cardiologist wants to send me to a sleep doctor because I snore. I snore only when I am on my back. My doctor says snoring might have something to do with heart trouble. Can you shed more light on this? – W.H.

ANSWER:
Your doctor has sleep apnea in mind. It is a condition where breathing stops for 10 or more seconds many times during the night. Quite often, snoring is a major sign of it. The snoring gets louder and louder until it suddenly stops. The stop occurs because the snorer stops breathing.

During the no-breathing (apnea) spells, blood oxygen levels fall. A drop in blood oxygen can promote erratic and seriously abnormal heartbeats. It can cause a rise in blood pressure. These spells are associated with an increased incidence of heart attacks and strokes. They also can cause memory deficits.

People with sleep apnea never wake refreshed. The spells interrupt the normal stages of sleep, so a full night’s rest never happens. Apnea people find themselves dozing off during the day in places where and at times when it is most inappropriate to do so.

Snoring with or without sleep apnea comes from redundant tissues in the throat. As air rushes through the air passages, which are narrowed due to excess tissue, it causes the tissue to vibrate like the reed of a wind instrument.

Treatments for ordinary snoring and for sleep apnea snoring are similar. Sleeping on one’s side, just as you say, can put an end to snoring. The CPAP – continuous positive airway pressure – mask might also end snoring and apnea spells. The mask contains air under pressure that pushes its way through the narrowed air passages without vibrating the tissues. Weight loss is another way to enlarge the air passageway. Doctors can pare away the excess tissue surgically or with a laser.

See the specialist. Snoring and sleep apnea are no jokes.

DEAR DR. DONOHUE: I have been so tired I can barely do my job. The doctor thinks I might have an adrenal gland problem. What do the adrenal glands do, and what happens when they don’t do it? – B.P.

ANSWER:
The right and left adrenal glands sit above the right and left kidneys. They produce hormones that are involved with every body function.

Cortisone is one of those hormones. People think of cortisone as a medicine, but we do make our own cortisone. It regulates the metabolism of sugar, protein and fat. Prodded by cortisone, for example, the liver increases its production of glycogen – body sugar – which is then stored in muscles as their source of fuel.

Cortisone tones down an overly exuberant inflammatory response. A surge of cortisone helps us weather stressful situations – both physically and mentally stressful.

Another adrenal gland hormone is aldosterone. This hormone regulates body levels of potassium and sodium. Aldosterone is intimately involved in maintaining normal blood pressure.

Adrenal gland malfunction can occur in the glands themselves or in the pituitary gland. The pituitary is located at the base of the brain, and it produces hormones that keep most of the body’s other glands working smoothly.

Treatment is based on where the problem of adrenal insufficiency lies. If it is the adrenal gland, then supplying the missing hormones in tablet form restores body functions and shakes off the exhaustion that adrenal gland malfunction causes. Will you let me save the pituitary gland failure for another day?

DEAR DR. DONOHUE: I work with a young, wed mother-to-be. She runs around the office all day pulling up her top and asking everyone if he or she wants to feel her stomach. I can’t take it much longer. We have told her to cool it, but it does no good. She is in her fifth month. I can’t take it for four more months. Please answer this. – Anon.

ANSWER:
Anon, I have to beg off. I don’t think this is a medical problem. I would be happy to come up with a solution, but I don’t have one and don’t have the background to furnish you with one. How about writing to Dr. Brothers?

DEAR DR. DONOHUE: My 19-year-old niece has just been diagnosed with Guillain-Barré syndrome. She was having trouble walking and was unable to go up and down stairs. Please tell me more about this illness. I have read that it can be fatal. – M.

ANSWER:
Most often, the first symptoms Guillain-Barré (gee-YAWN-buh-RAY) patients notice are peculiar sensations in their feet and legs. Some say they feel as though ants were crawling under their skin. Others describe tingling sensations. Still others complain of numbness. In short order, muscle weakness sets in. The weakness begins in the feet and lower legs and then ascends to thighs, back and even breathing muscles. The muscles can become so weak that the patients are paralyzed.

When the breathing muscles are involved, GB victims must be put on an artificial respirator.

The majority of GB patients had a respiratory infection – such as a cold – or a minor digestive disturbance – such as diarrhea – from one to three weeks before the signs of GB took hold. One explanation of the illness postulates that the preceding minor infection primes the immune system to make antibodies that attack nerves. The antibodies strip myelin off the nerves. Myelin is the outer, insulating coat of nerves. The loss of myelin short-circuits the transmission of nerve impulses, and that’s why muscles become limp.

Muscle paralysis reaches its peak in two to three weeks, and then muscle function begins to recover. Most patients make a complete recovery. GB leaves 5 percent to 15 percent with permanent disability of varying severity. It can be lethal for 3 percent to 5 percent.

Early treatment hastens recovery. One such treatment is gamma globulin given by intravenous infusion. Think of gamma globulin as being a protective antibody.

The Guillain-Barré Syndrome Foundation International can provide comprehensive information. Its number is (610) 667-0131 (not toll-free), and its Web site is www.gbsfi.com.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.