Los Angeles, CA | Sleep Disorders : Doctors Chat : MD-VOD | Dr. Avi Ishaaya Centers

Today on MD-VOD, Dr. John Kennedy is joined by board-certified sleep expert, Dr. Avi Ishaaya to answer your questions on facebook and twitter about sleep disorders, including sleep apnea. Together they examine the cause of sleep apnea, who is at risk, the symptoms, how it's diagnosed and available medications, treatments and therapies. They further discuss the consequences and the realities of living with sleep apnea, including insurance coverage and related costs. Dr. Ishaaya points out that it is best to start with lifestyle changes such as diet and exercise when addressing sleep apnea. Although for those with more advanced cases, many doctors recommend additional treatments as well. There are several methods to treat sleep apnea, including various surgeries and dental devices, but the most common treatment is Continuous Positive Airway Pressure (CPAP). CPAP is a treatment in which the patient wears a breathing mask, hooked up to a machine that delivers a constant flow of air into the nostrils. This positive pressure helps to keep the airways open so that breathing is not impaired.


Dr. John Kennedy: We're back with our sleep disorder segment, and we're talking to sleep expert, Dr. Avi Ishaaya. We're taking your questions from Twitter. Rebecca Greene asks, Dr. Ishaaya, "How can I be evaluated for sleep apnea and what steps should I take?" That's a good question.

Dr. Avi Ishaaya: That's a great question. The way to be tested is, I mentioned before, would be to do a sleep test. The nice thing about our National Home Sleep Apnea Program is that you could be tested at the home and literally be done very easily, with just a phone call or looking us up on the website. The website is sleep.aviisha.com which is A-V-I-I, two I's, S-H-A.com. And the phone number is 877-4AVIISHA, which is 4-A-V-I-I-S-H-A. This would be a very low-cost, very reliable way for you to be tested for sleep apnea, in the comfort of your own home.

Dr. John Kennedy: Well, that's great information. Next up is Brian 86. This is such a good question. "If I snore, does that mean I have sleep apnea?"

Dr. Avi Ishaaya: Great question. Everybody asks that question when they come and see me. And of course, the big reason is that most of the time, it's either the wife or the husband brings the other and says, "Hey, he or she snores too loudly and now we're sleeping in different rooms." That's usually a bad sign and that usually means that you do have sleep apnea. What we do say to most patients is, "When you do snore so loudly that your bed partner has to move to a different room, that usually suggest you have sleep apnea, or if the snores are so loud that they wake the bed partner up."

Dr. Avi Ishaaya: Most of us will snore at one point in our lives because we've had too many drinks, or we're very congested, but when you snore regularly and it is fairly loud, and what we call a heroic, it usually suggests that you should probably be evaluated.

Dr. John Kennedy: Heroic snore, really?

Dr. Avi Ishaaya: Yeah, heroic, which is really loud, like a hero.

Dr. John Kennedy: Okay, good stuff. Jesse J., "Sometimes I fall asleep for an hour or two, and then can't fall back to sleep. Are there any in-home remedies or treatments available to me to help me fall back asleep?" That's a good question.

Dr. Avi Ishaaya: Yeah, there are certainly many home remedies. What we usually recommend to most patients who have difficulty with either falling asleep or staying asleep is to develop a regimen, much like with our children when they're young, develop a regiment before sleep. So taking it slow, playing a crossword puzzle, some hot milk, but most importantly, there are home remedies. There are over the counter remedies, things like valerian root and melatonin and many different types of combination therapy, which you can get in many of the health food stores and even in our offices, as far as being able to get enough sleep at night. These are non-addicting and you can take on a regular basis, as opposed to unfortunately, many of the prescription medications that we offer, that you become dependent on.

Dr. John Kennedy: Good stuff. So follow routine including counting sheep. It's got to be one of them. Luke Harden, "If I have trouble falling asleep at night after a long day at work, what can I do to make my house and bedroom more conducive to sleep?" That's another good question.

Dr. Avi Ishaaya:
A good question. Dr. Kennedy, you touched on that a little bit, which is making the bedroom a safe zone, if you will. So, a dark bedroom, white noise is actually really good, which you can also buy very easily either on an internet or some of the stores, where it makes noises like water or rain, that helps dampen out the outside noise. Having a very comfortable bed. And most importantly, you have to look at your bed partner. Many times your bed partner may snore and that alone, may make it very difficult for you to stay asleep. Pets who may snore or jump onto your bed. Neighbors who are very loud. And you have to look at your medications and medical history. Because the idea behind getting a good night's sleep is to make sure everything that potentially can affect sleep is controlled.

Dr. John Kennedy: So great advice, make your bedroom a place to sleep. Ingrid 87, "I find myself extremely exhausted around 2:00, almost every day. But then once it comes time to go to sleep, I can't. Are there any suggestions?"

Dr. Avi Ishaaya: Well, that's a very question because you actually have to look at your sleep schedule and see exactly what it is that you're doing. Most of us will, as Dr. Kennedy, you alluded, require about eight hours of sleep, one way or another, give or take about an hour. What happens is, if we don't get that amount of hours of sleep, then we find ourselves sleepy. So if for some reason you are sleeping only five hours per night for whatever reason, then you will need to take a nap during the day. And alternatively, if you're unable to fall asleep because you're staying up late watching movies, then of course, you'll find yourself sleepy.

Dr. Avi Ishaaya: What we do know is that we actually have two times zones where we are very sleepy. The biggest one, of course, is at night, when most of us sleep. But if you look at the Europeans, and even the Middle Easterners, they commonly would take an afternoon nap. It's not uncommon for all of us to feel a little sleepy around 2:00 and we would if we could, and all of us should probably take a small little nap at that time.

Dr. John Kennedy: So the kindergarten nap is something that we should be continuing to do in our everyday life.

Dr. Avi Ishaaya: Yeah.

Dr. John Kennedy: Next up is Pat Kelly, "I've been taking Benadryl to help me sleep for a few weeks now. Is it possible to get addicted?"

Dr. Avi Ishaaya: Yeah. Benadryl is an antihistamine and it is also sedating, as we all know, so it does help with sleep. And unfortunately, what does happen with Benadryl, much like any other sedatives, if you will, is that you do get addicted. Your body will get used to taking a pill on a nightly basis, and when you just try to stop, it makes it very difficult. You almost have what we call rebound insomnia, where not only do you go back to how it was before you took the Benadryl, but it's actually even more extreme and you had even more difficulty sleeping, and you instead, will take more and more Benadryl, or you will seek other alternatives such as prescriptive medications from doctors to help you fall asleep.

Dr. John Kennedy: Wow. That is some incredible information. I want to thank you so much, Dr. Avi Ishaaya, sleep expert, for joining us here today. And please, if you missed anything from today's show, make sure you visit, emPOWERme.TV MD-VOD, because he talked all about sleep, why we don't get enough of it, sleep apnea, how to diagnose it and treat it. That was outstanding information. Thank you so much. And please join us next time on MD-VOD.