Annie's Mailbox for April 16, 2011: Snorers should get tested for sleep apnea

Dear Annie: You told "Upset," whose husband has no interest in sex, to have his testosterone level checked. Because "Upset" specifically mentioned their sleeping apart was due to his serious snoring, I suspect a much more likely cause of the problem is obstructive sleep apnea (OSA).

OSA is an insidious and treacherous health condition. The American Academy of Sleep Medicine estimates that at least 20 percent of adults are affected. Sleep apnea is now known to be linked to cardiovascular disease, heart attacks and strokes, diabetes, ED, depression and numerous other health problems. The fatigue from poor sleep increases the risk of traffic and work-related accidents by 300 percent or more. It makes sense that if one's breathing is being choked off hundreds of times a night by an obstructed airway, bad things happen.

Common signs and symptoms of airway obstruction affecting breathing and sleep include: excessive daytime sleepiness (EDS), snoring, hypertension, erectile dysfunction, personality changes, memory problems, a history of heart attack, stroke or other cardiovascular disease, and a history of diabetes. New research shows that more than 80 percent of diabetic patients may have sleep apnea.

Risk factors for sleep apnea include: age, gender (men are more likely to have sleep apnea, but women, especially after menopause, are at risk as well), neck size (more than 16.5 inches in men, greater than 15 inches in women), and BMI (Body Mass Index) over 30. (There are, however, many skinny people with sleep apnea.)

"Upset" should get her husband to a knowledgeable physician for appropriate testing. The best is a polysomnogram, which requires an overnight stay in a sleep clinic. Your readers can find out more by going to the American Sleep Apnea Association website (sleepapnea.org), the American Academy of Dental Sleep Medicine (aadsm.org) and the American Academy of Sleep Medicine (aasmnet.org).

— Thomas F. Armstrong, DDS, Bakersfield Dental Sleep Medicine-New Solutions for Snoring/Sleep Apnea/CPAP Intolerance, Bakersfield, Calif.

Dear Dr. Armstrong: We know our readers will benefit from your expertise on this common, but often undiagnosed condition. Thank you.

Dear Annie: My husband and I are in our 60s. An old girlfriend of his recently phoned and left her number. While traveling near her area, he called and invited her to meet him for lunch. He told me all about it when he returned. He thinks he was honest, but I disagree. He did not inform the ex-girlfriend that we were married, and he didn't tell me ahead of time that he was meeting her.

We have a good relationship. But, Annie, most women don't contact an old boyfriend unless they have something on their mind, and I think she does. And by not telling her he is attached to someone else, he is giving her the wrong message. What do you say?

— Curious in N.C.

Dear Curious: Of course he should have told you he was planning to call this woman and see her. And you are right that, deliberately or not, he may have given her the impression that he is available. If you trust him, put this behind you, but make it clear that you expect genuine honesty in the future.

Dear Annie: This is in response to "Following in His Footsteps." My wife takes forever to get out of the car and then takes her sweet time walking the short distance to our destination. I think it's rude and inconsiderate not to proceed at a reasonable pace. If my wife were old or disabled, that would be a different story.

Rather than calling him the king of England, maybe she needs to put some pep in her step.

— Normal Pace Walker

Dear Normal: In your case, it sounds like the two of you may have a control issue. But we thank you for informing us that, apparently, chivalry is dead.

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