DEAR DR. ROACH: My husband, age 65, had a sleep apnea test done overnight in the hospital a year ago, and they said he does not have it. Lately, when I wake during the night, I listen to him breathe. He snores only some nights, not all. It sounds like he breathes five or six times, then his feet or legs shake a little. I told him about this, and he thinks he might have restless leg syndrome. What do you think? Could he have sleep apnea now? — E.K.

ANSWER: Restless leg syndrome, also called Willis-Ekbom syndrome, is a common and highly variable condition. With RLS, a person has an overwhelming urge to move the legs and an unpleasant sensation in the legs, which worsens when lying down or sitting. Sometimes it’s described as “a creepy-crawling sensation.” The feeling gets better upon moving the legs. These sensations happen more at night than during the day.

The diagnosis is made based on history, but the same sleep study your husband underwent to diagnose sleep apnea would have been abnormal if he had RLS. Abnormal findings on the sleep study alone don’t make the diagnosis.

The sleep study is the best diagnostic tool we have for sleep apnea, but it isn’t perfect. It may be worthwhile to have the doctor take another look at the results of your husband’s sleep study. There is a great deal of information there, and even if it didn’t make the diagnosis of sleep apnea at the time, it may suggest RLS enough to consider a retest.

DEAR DR. ROACH: What is the best way to remove a skin tag on the eyelid? My dermatologist recommends a scalpel with a local anesthetic. I hate pain and am afraid of scarring, or that the needle or scalpel will slip and injure the eye, making me blind. What is the best treatment: laser, freezing or surgery? — B.R.

ANSWER: Perhaps the question you might want to ask is whether the skin tag needs to be removed at all. A skin tag is a benign growth of skin, commonly found in areas that fold, such as the armpit or groin. The eyelid also is common. They are not cancer, and usually are removed only when they are in a cosmetically important place. Given how leery you are of getting the skin tag removed, I wouldn’t do it if it isn’t significantly bothering you.

If you do decide to get it removed, find a dermatologist, an ophthalmologist or a plastic surgeon with the most experience. Once you have someone you are comfortable with (and it’s OK to get a second opinion), trust that person’s expertise. Telling a surgeon to use a laser rather than a scalpel is like to telling your mechanic which wrench to use. Let him or her pick the right instrument for your case. All of the modalities — laser, freezing, scalpel — are very safe when done by an expert.

DEAR DR. ROACH: Could you please explain the difference between a brain tumor and brain cancer? — N.N.

ANSWER: The word “tumor” is Latin for “swelling.” Doctors use the word to describe any kind of mass. A neoplastic tumor (“neo” means “new,” and “plasia” means “growth”) can be benign, premalignant or malignant. Only a malignant tumor is a cancer.

In the brain, there are many kinds of benign tumors, such as meningiomas. Because there isn’t much room inside your skull, any tumor is of concern. Benign tumors are usually treated, if they need to be, with surgery or radiation. However, a brain cancer is much worse than a benign tumor, because they keep growing and invade the important structures in the brain. Brain cancers often are very resistant to treatment, but some of them are curable with surgery, radiation or chemotherapy, often in combination.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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