FAQ

Prevalence varies according to age. Ten percent of 7-year-old children still have incidents of bed-wetting. Two to three percent of 12-year-old children still experience bed-wetting.

Taking iron correctly is extremely important to ensure optimal absorption. Iron should be taken on an empty stomach either withvitamin C or orange juice. All dairy products should be avoided for one hour afterward. Stools may turn black and constipation may be a side effect.

Improvement should be expected if iron is taken daily as directed within 8 weeks. Resolution of symptoms is slow and gradual and may only be recognized in retrospect.

An otolaryngologist or ENT (Ears, Nose and Throat) doctor may be appropriate if /when your child has been diagnosed with Obstructive Sleep Apnea and evaluation for removal of your child’s tonsils and adenoids needs to be considered.

Securing the home, windows and doors, is the most important task parents should do to protect a child that is sleepwalking.

Snoring is an indication of resistance of airflow through the upper airway but may not necessitate a sleep study. Unfortunately, despite a thorough history and physical exam, we are not able to completely predict the degree of Obstructive Sleep Apnea (OSA) a patient may have, therefore sleep study is the most comprehensive way to rule out OSA.

Yes. We often see multiple members of the family that have RLS.

Yes, though obesity a significant contributor to OSA, even patients who are not overweight can have a predisposing boney structure of the face and jaw that can lead to OSA.

Yes, sleep talking can be normal and simply a manifestation of a short arousal out of sleep. If sleep talking is excessive, this can be an indicator that perhaps another underlying sleep disorder is contributing to these arousals.

A child’s initial bedtime routine at the start of the night, if it requires parental presence to fall asleep, will determine the child’s need to repeat that same routine in the middle of the night. Addressing this initial bedtime routine is key to stopping children from seeking parents in the middle of the night.

This is one of the most common problems we deal with and simply discussing the sleep schedule is often quite revealing. Parents are often completely unaware of what their adolescents are doing once they go to their rooms for the night.

With early school start times the risk of automobile accidents on the way to school are very real. Adolescents who are not well rested may struggle academically or with emotion management. Ultimately, learning to maintain healthy sleep/wake schedules leads to better quality of life during and after school.

Our biological clocks are the most sensitive to light whether it be sunlight or artificial light. Lights from electronic device screens can shift our biological clocks can shift our clocks to fall asleep later and conversely bright light in the morning can shift our clocks backwards helping us fall asleep sooner. One form of treatment includes use of a light-box.

You must have excessive daytime sleepiness as the main presenting symptom to be considered to have Narcolepsy. That presentation could be as subtle as taking a nap when you never needed one before or as severe as falling asleep while eating with friends.

Sleep paralysis is just like it sounds—while asleep or waking up out to sleep you are fully conscious but cannot move. It can be extremely frightening for the individual. Sleep paralysis is directly related to falling asleep or waking up out of REM (Rapid Eye Movement) sleep. Sleep that has paralysis is part of that sleep stage. You can experience sleep paralysis by simply not getting enough sleep. Sleep paralysis can also be part of the set of symptoms associated with Narcolepsy.

Cataplexy is most commonly associated with the diagnosis of Narcolepsy. Patients experience cataplexy when they develop muscle weakness such as weak knees, slumping over or simply having an internal feeling of weakness in association most often with laughter or excitement but can occur with other strong emotions.

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OSA is typically thought of as a mechanical blockage in the back of the throat which can be at the level of the soft palate or tongue during sleep. OSA is much more complicated than this and includes the patient’s overall airway muscle tone; the patient’s response to arousals; and the patient’s response to carbon dioxide called “loop gain.”

OSA is just like it sounds—an obstruction in the airway while the patient attempts to continue to breath despite that obstruction. CSA is different in that the patient’s brain does not send a message to breath so there is just a pause in breathing. Common causes of CSA include Congestive Heart Failure, opioid usage, traveling to high altitudes.

This is a syndrome that includes both Obstructive Pulmonary Disease and Obstructive Sleep Apnea or both.

Untreated sleep apnea can lead to hypertension, elevated blood sugars, congestive heart failure, pulmonary hypertension and strokes.

RLS typically presents in the evening/night with an uncomfortable “urge” to move your legs. Movement will bring momentary relief but the symptoms then return leading to an inability to fall asleep or stay asleep. Optimizing ones’ ferritin levels (the body’s form of stored iron) can lead to significant resolution of symptoms.

All good doctors should respect and encourage the pursuit of a second opinion if you have concerns about the recommended course of treatment. If you would like to discuss whether asking for a second opinion is reasonable, we can help.

Your doctor should have a patient portal you can send your questions to. I would send your most important question and not abuse this access.

Most doctors understand that as a spouse, or adult child, that you are the best person to know what your loved one has communicated their desires for care. Most situations don’t require a medical power of attorney but having one is always helpful and would be best have one in anticipation of a possible need.

The limits of that role are totally determined by the friend that asked you to accompany them to the doctor.

Patients have a tendency to not question a doctor’s recommendation or ask for further explanation of terms or plans of action. We always recommend that before proceeding with any plan to get ALL your questions answered.

Doctors should welcome any questions and encourage you to seek a second opinion if you would like to do so.

We recommend talking directly to the doctor. Medicine is complex. Even nurses may not completely understand why certain decisions are made. It’s always best to take directly to the doctor to get a complete explanation from their perspective to rule out misunderstandings. If you want to make a complaint within the doctor’s organization this is generally done through the patient advocacy office at a hospital. If your concern is more serious and you fear that malpractice has occurred, you will need to seek legal advice or talk to the medical licensing board in your state.

- Someone trying to decide what nursing home is best for an aging parent - Someone who has a critical ill loved-one that would like to discuss the pros and cons of a tracheostomy or feeding tube placement - Someone who has a critical ill loved-one who would like to discuss the complex terminology the doctor uses to describe what is going on with your love one in the ICU or hospital - Someone who would like advice on how to advocate for accommodations for academic testing for college entrance.