Don't Sleep on Sleep Apnea

Welcome to the Ask Dr. V Show, where you can be informed and empowered about health issues that are important to you. Today we are going to talk about sleep apnea. If any of you guys have are new to our show, I'm Dr. V. I'm an emergency medicine physician. I've been practicing now for 30 years. And I talk about a lot of things that are preventable and things that we can do things about. My goal is to actually give you something in this programming that you can actually use or actually be helpful for your family. Sleep apnea is a serious disease in which breathing repeatedly stops and starts while you're sleeping. These pauses can last for a couple seconds, or they can kind of really last for minutes and they can occur several times through the night. I'm going to talk to you today about the health implications and why this is so important that you actually recognize it, get it diagnosed, and get treatment so that it can make a difference in your overall health outcome and your overall life expectancy. So sleep apnea is a very, very widespread condition. It affects millions of Americans in the United States and many, many more millions worldwide. It's estimated that about 80% of the people that have moderate or severe sleep apnea go undiagnosed. And mainly they go undiagnosed because most people think that they're just snoring at night, or they think that maybe they're just getting not getting a good night's rest, and they're not recognizing the signs and symptoms of sleep apnea. This means that millions of individuals may be unaware of their condition, often attributing symptoms like excessive daytime sleepiness or snoring to other causes, or they may think that those things are benign. It is estimated that 22 million Americans suffer from sleep apnea, with about 80% of them, again, being moderate or severe. There are three types of sleep apnea, which is important. The most common type of sleep apnea is obstructive sleep apnea, and that is where the muscles in the throat relax, and they actually cause an actual physical blockage of airflow. So what you'll often hear is that people may snore very loud, then they may stop breathing, and then they may suddenly take like a big gulp of air, right? So it'll sound something like and then you don't hear anything. And then suddenly they go uh uh and go back to snoring, right? So men are more likely to have sleep apnea, although, you know, we do see it in women as well. And you're also more likely to have this obstructive sleep apnea if you're uh overweight or uh obese. The other type of sleep apnea that you get is uh central sleep apnea. This is really less common. We do see it in babies and children when they're when their brain is first being developed. And this is where the brain actually fails to send the proper signal to your muscles that control breathing. So the apnea occurs because literally the message doesn't go where it should to actually tell you to inspire and take a deep breath in. Lastly, there is a third type, which is complex sleep apnea, and that's kind of like a mixture of the central and a mixture of the obstructive sleep apnea. It's a combination of uh both. So while sleep apnea can affect all ages, we see it more commonly in adults. We see it usually those people that are over 40. Um, as I said, you can see it sometimes in small children or babies, particularly if they're premature. They may have an apneic episode and uh can have some forms of sleep apnea. Men are more likely than women, and as we get older, men and women are more likely to have it at equal proportions. We will find that African Americans, Hispanic, and Native Americans have a higher prevalence of sleep apnea, um, particularly at younger ages, and this is often due to elevated uh BMIs or excessive weight. About 70% of the people who have obstructive sleep apnea are obese. And about 30% of them are not obese. So let's get into it, and I want to talk to you on the show right after this. We're gonna take some questions and everything. Okay, it's time for some questions and some answers. If you have questions or topics that you would like for us to discuss, please call me at 1-800-450-7876. That's 1-800-450-7876, or email me at info at asdrv.us. We've got a couple of questions that actually came in by email, so I want to try to go over those first. All right, my first question is from uh Charlene from Silver Spring. And Charlene says, Dr. V, is snoring a form of sleep apnea? And if so, I'm in trouble. I had no idea that I snored, let alone snored really loud. I found out when I went on a girls' trip after I woke up with everyone looking at me with evil eyes. Apparently I snored so loud that nobody else got any sleep that night. They said they contemplated smothering me but decided to give me a pass. Um I attributed to having late-night drinks, but when I checked when I was checked out by an ENT, they said I had a severe deviated septum which would require surgery. Everyone who I talked to that previously had surgery said that that surgery is extremely painful and that the snoring eventually came back. What do you think, and are there any good alternatives to surgery? All right, so Charlene, this is a good question. So, first of all, you don't know if a deviated septum is actually causing you to snore. What's really important, you know, if you're s if you're having problems with snoring or if you're having problems with getting up at night and you can't sleep all the way through the night, you want to actually go get a sleep study. And a sleep study actually measures your breathing because you can go and get a deviated nasal septum fixed and still have a problem with sleep apnea. So it's really important to actually, you saw the ENT, that's the first step. The second step would be to actually go and actually get a sleep study. You asked your primary care doctor, you tell them you've been snoring a lot, and you want to get a sleep study, you want to know whether or not you have sleep apnea. So let me describe to you what a sleep study is. So you literally go into a sleep lab, you bring the normal things you go to sleep with, and you go in, they hook you up to machines and you sleep like you would normally sleep at home. And they have monitors on you that actually measure your breathing, your depth of breathing, et cetera. And that is the study that actually diagnoses you as sleep apnea. Um, I would actually, before I actually got surgery for deviated septum, I would actually make sure I had a sleep study as well as the information from the ENT, and then sit down with your primary care physician when you have the information from both uh studies, and then kind of decide what is the best, uh what is the best uh clinical route for you. Thank you, Charlene. Next we have a question from Gretchen, and Gretchen is calling from College Park. So Gretchen's question is, Dr. V, I've been using the CPAP machine for years, but it's loud and hard to sleep with, not to mention a turnoff to my husband. But I don't know what else to do. Any recommendations? So, very good question. So there are a lot of uh new technologies now related to uh sleep apnea, but you have to actually see whether or not, I go back to the fact that there's three types of sleep apnea, right? The obstructive, the central, and the uh combination. So you have to work with your physician to find out are some of these new technologies that are coming out, could you get rid of your CPAP machine? Because they are very loud, clonky, you have to clean them regularly, et cetera. So a couple of new technologies that are available. There is a thing called Aspire, and Aspire is for obstructive sleep apnea. It is actually an implantable device, and it basically stimulates your hypoglossal nerve, and it stimulates the nerve which actually controls your tongue muscles and it prevents your airway from collapsing and it opens up your airway during sleep. Again, this is not for everyone, but you want to actually, but it is something that is new on the market that is a treatment for uh sleep apnea. Other types of new devices are there's positional therapy devices. These are wearable or special pillow alerts so the user knows then when to roll onto their back and encourages them to sleep on their side. There's also an adaptive uh servo ventilation and there's bipap. Now these actually deliver um these deliver continuous pressure and are a little bit more clonky as far as devices. Lastly, there's also oral applications. So there's mandibular devices. These are more popular than the CPAP, and people like them because what it does is it actually is a device that you put in your mouth that actually lowers your jaw and prevents your airway from collapsing. And lastly, some people actually have surgery and they have surgery to actually deal with the excess tissue in their throat and soft palate, and they go, they get actual uh ENT or oral surgery treatment in this area to actually deal with wherever they have the excess or redundant tissue. Lastly, a lot of people experience improvement and their sleep apnea almost goes away with actually weight loss. So those are some of the things that you can do with sleep apnea. You want to make sure to speak with your primary care doctor and explore what other options are there available since there's so many new treatments now for sleep apnea. It used to be that CPAP machine was the only thing available. Now there's a lot, there's a lot of different choices, and you want to pick a choice that actually works well with your lifestyle. All right, we've got a question from Celia in DC. And uh she's asking, hey Dr. V, does having a big stomach affect your sleep? So this is kind of interesting because in general, uh obesity leads to an increased likelihood of having sleep apnea. But if you're specifically talking about, you know, weight around your stomach, right? So that sort of central obesity or abdominal weight, that can actually push pressure on your diaphragm and your airway, making it harder to breathe while you sleep. Um, and so abdominal weight certainly doesn't help the situation, and in some situations, it can actually make it actually worse. However, usually when someone has uh central obesity and they have obesity sort of around their abdomen, then they also have obesity around their head and neck, which then leads to the obstructive sleep apnea. Thanks for the question. All right, my next question is from June, and June is from Potomac, Maryland. She says, uh Dr. V, you know, when I'm really sleepy, I get cranky and I started having, I started having heart palpitations. Why is that? Alrighty, so um, sleep deprivation leads to an increase in all of your stress hormones. And your stress hormones are like cortisol, adrenaline, all of your fight and flight uh hormones. So these hormones can cause irritability, mood swings, and they do cause physical symptoms like heart palpitation or feeling like your heart's racing. Anything, all of the feelings that you get when you feel like you're under attack are the sorts of feelings that you're gonna get when your stress hormones are released from sleep deprivation. So you will, those symptoms are actually your normal body working physiologically the way that it should. Thanks for the question. All right. Ben from DC, he wanted to know uh, Dr. V, what is it about sex that seems to make me be able to sleep more deeply than I normally can sleep? So, good question. Uh so let me get let me go over this. So sexual activity actually promotes the release of a totally different hormone, which is oxytocin. And oxytocin is released with sexual activity. It's also released in women with breastfeeding, et cetera. And this hormone is associated with feelings of calm, well-being. Um, it makes you feel more connected to people, it makes you feel more loving, generous, and altruistic. And in general, all of these feelings happening at once actually make you fall into a deeper sleep. So you are more likely with the release of oxytocin to actually go into a really, really deep sleep fast. And um, so yeah, that's why people actually get more uh sleepy after after having sex. It has nothing to do with anything else that people get upset about because they say, oh, you know, you know, now you just go to sleep. It's actually a physiologic reaction to the hormone being released in your body, and you really can't resist it. So um, that is what happens after you have sex, is that uh some people, because they're more affected by oxytocin than others, they immediately go into a very, very deep sleep because of the feelings of calmness and well-being that overtake them related to this hormone. Great question. All right. Mohammed from DC sent in a question. Uh, and he's asking, he says, I'm now in my 50s, and I'm one of those dudes that has a hard time sleeping through the night, particularly if I'm stressed out. But in general, my brain is always going and I'm always thinking about everything all the time. Uh my lady is worried that I don't sleep enough. What do you think? This is very interesting. So there's a lot of people that have a hard time actually shutting down for the day to actually sleep. And I think that what is really, really important is to have good sleep hygiene. So I want to describe what is good sleep hygiene. So, good sleep hygiene is one, you have a very dark room that you sleep in. There's no TV and there's no devices. Screen time and light from the screen will actually disrupt your sleep. The other thing you want to do is you want to make sure that you try to have almost the same bedtime every night and almost the same awake time every day. It's also important that you don't just try to actually like you're doing your day, you're doing your day, and then you plop in the bed and go to sleep. You want to have about 30 or 45 minutes of sort of a wind down. Now, people wind down different ways, right? So you can wind down meditating, some people wind down, you know, talking with families or playing with a dog, or some people wind down, they sit in a massage chair, but you want to have 30 or 45 minutes of wind down before you actually go to sleep. Now, what's also important is that you don't want your window to include wine or alcohol. Because although you may go to sleep fast with wine or alcohol, you don't go into a deep sleep. So when I talk about a window, I'm talking about a windown that does not include any beer, wine, or alcohol. So I think that, you know, part when I hear about people feeling like they're stressed out and they can't sleep and they're thinking about things all the time, they usually don't have really good sleep hygiene and they usually don't have a pattern. So you've got to set up a pattern and you've got to actually make sure that you don't have the TV going in the background and your phone is needs to be in a different room so you're not reaching for it in the middle of the night. And those are sort of the things that you need to have to have really, really good sleep hygiene. So if you do that and then you're still having trouble, then you do want to talk to your primary care physician about using things that are a little bit more natural like melatonin or things like that to actually help with calming down and going to bed at night. So uh thanks for the question, Mohammed. All right, we have a question from Monica next. And uh she said, uh, Dr. V, it seems like I don't get a good night's sleep. Um I'm cranky and I have brain fog the next day. Part of the problem is that I get up to use a bathroom in the middle of the night. I know I should probably not drink water before I go to bed, but I keep a glass on my nightstand because I stay thirsty. What does this mean? So this is a really good question. So so a couple things. One is that you're if you're frequently urinating at night, you want to make sure that you see your primary care doctor because you want to make sure that there's no medical reason for this frequent urination, right? So people can have urinary tract infections and they urinate a lot at night. Also, diabetes, undiagnosed diabetes, and people have elevated blood sugar and they're urinating a lot. So you want to make sure first that you go to your primary care doctor and you want to actually check it out and make sure that there's no medical reason that needs to be treated. Once you actually make sure that there's no medical reason that needs to be treated, then there's other things that actually lead to frequent urination at night. And you you talk about water, but it's actually usually uh caffeine or caffeine-related products. So when I'm talking about caffeine and caffeine-related products, I'm talking about coffee, I'm talking about tea, I'm also talking about sodas. Um, these things can really uh make you have to urinate at night. And it's really, really important that if you are someone who really has this problem, you might want to start first with taking these things completely out of your diet. You can get uh decaffeinated teas. Decaffeinated coffee still has a significant amount of caffeine. Also, beware, there are some caffeinated sodas that you wouldn't think of, like Mountain Dew, etc. So you want to actually look at the caffeine content that you're taking throughout the day. And it's really important to take it completely out, see if it makes a difference. And then if you want to put it back in, you could put it back in, but you say, okay, I'm only gonna have caffeine products, let's say before noon, and see if that still works. Um, some people have to actually take caffeine products completely out of their diet to actually stop urinating at night. But the main thing is you want to go to your physician first and make sure you don't have a medical problem like diabetes or urinary tract infection that's actually causing your urination at your frequent urination at night. All right, we've got a uh question from Butch from Anacostia, and he says, uh, hey Dr. V, uh, how long can a person go without sleep before it starts affecting their brain? Um, this is a really good question. Um, I I can tell you that um, you know, they they've done some sleep deprivation studies, and some of them were done a long time ago and were so severe that they're actually not repeating them again. But basically, um, you know, after 24 hours of sleep deprivation, and some and some people it will come sooner, some people it will come, you know, at 18 to 24 hours, you start to get a decline in your cognitive performance. So your ability to think and solve problems uh begins to decline. Then the other thing you'll find is that it begins affecting your memory. Some people get start getting almost like amnesia or almost like dementia-like symptoms, and they can't pay attention, um, and they get moody. When sleep deprivation occurs over a period of days and it's much longer, people get more severe symptoms. People actually begin to get paranoid, they begin to hallucinate, they can even have suicidal thoughts, and they can almost really almost go into almost like a bipolar mood disorder. I've actually seen people in the emergency department where I actually practice where they've had severe sleep deprivation because they're chronically working overtime. Like if they work in warehouses, et cetera, and they're chronically working overtime, and some of them have actually had full-blown psychosis. So, and and hallucinations and visual and auditory uh hallucinations. So they start seeing things, they start hearing things, and we've actually had to admit them for a psychiatric admission. So severe sleep deprivation can cause a lot of problems, and you want to really um it doesn't, some people think it increases or enhances their performance, but it really does, it really does not. Um, so uh thank you, Butch, for the question. All right, I've got a uh question from Tanisha. She says, Dr. V, I'm a very light sleeper. I even wear white noise earplugs to help me sleep better. Any recommendations on how I can become a deeper sleeper? Great question. So good that you're using the white noise earplugs because those are actually really good. Um, you want to make sure that they're actually noise canceling. Um, the other thing that actually really helps is to make sure that you have a very dark room and that you're going to sleep around the same time, all of the stuff that I talked about earlier about good sleep hygiene. The other thing that helps for people who can't who sleep very light is you want to actually consider either meditating or exercising before you. Go to sleep. I know some people for myself, I actually sometimes, you know, if I if I'm on vacation or something, I'll go on, I'll go to a hot tub. I find that that really relaxes me. Find what is the thing that really relaxes you. For some people, uh, they exercise and afterwards they can really get a good deep sleep. For some people, they actually meditate or journal. So try to actually add in a particular practice like that and see if that actually makes a difference. If you find that that doesn't make a difference, again, then I would go to your primary care doctor and I would actually start talking to him about melatonin and other things that are known to increase your amount of REM sleep. So REM sleep is the really deep sleep where you wake up and you actually feel refreshed and rejuvenated. Great question. I've got another question here from Tom calling from Gaithersburg, and he sent in an email question and he said, if I don't do a sleep study, how exactly would I know if I stop breathing at night? Really, Tom, you really wouldn't know unless you had somebody watching you and they actually notice that you stop breathing. But sometimes you stop breathing and it's not necessarily noticeable by someone actually watching you. They may just think you're breathing more slowly. I don't know of any way to get diagnosed with sleep apnea without actually going in and actually getting a sleep study. It really is the foundational piece of information that you need to determine whether or not you have sleep apnea. Thanks for the question. All right, we've got a question from uh Oliver from Baltimore. Um, and Oliver wants to know: is there anything that makes your symptoms of sleep apnea worse? Is there a better sleep position? What is the safest position to sleep in if you have sleep apnea? Is there anything that I can do around my positioning? So this is actually uh this is a great question. So um, so when you sleep on your back, that usually makes sleep apnea worse. And as you can imagine, if you're sleeping on your back, all of the tissues from your throat and your tongue also go towards the back of your body. So that can actually lead to more obstruction and more obstructive sleep apnea. Um often side sleeping. If you sleep on your side, those with sleep apnea find that it helps to actually keep their airway open. And um, some of the newer technology around sleep apnea is actually a technology that actually reminds you to actually change your position. And some people who are married to people with sleep apnea, you know, kick them or slap them and tell them, turn over, turn over, uh, get off your back. Um so if you're doing that and your your loved one does not have a diagnosis of sleep apnea, but they're snoring at night, and then you're tapping them and making them change their position, that person probably has undiagnosed sleep apnea, and you need to go get a sleep study. All righty. So we have another question here that came in, and this is from Craig, and this is really important. He said, Is there a connection between sleep apnea and high blood pressure? Yes, there absolutely is, and this is why it is so important to get sleep apnea diagnosed. So, sleep apnea leads to systemic high blood pressure, which is the blood pressure that you measure when you go into the doctor's office and they put the blood pressure cuff on you. So it also leads to pulmonary high blood pressure, and that is hypertension in your lungs. And so people with actually undiagnosed sleep apnea that do not get treatment for it, they get elevated blood pressure in their lungs, which then actually leads to a feeling of shortness of breath. And what's important is pulmonary hypertension is extremely difficult to treat. Some people only get treated with pulmonary hypertension with a lung transplant. So the medications that we have to treat pulmonary hypertension just are not as effective as the medications that we have to treat systemic hypertension. So this is why it is so, so important to actually get sleep apnea diagnosed. And that pulmonary hypertension then leads to stress and strain on your heart. People actually get valve disorders, they get uh congestive heart failure. Sleep apnea causes a wide range of problems with your heart, lungs, and high blood pressure. So it is really, really important to actually get sleep apnea diagnosed and treated. Thanks for the question. All right, the next question is from Bertha, and she's from Catonsville, and she sent in a question and she said, My sleep apnea is really bad. Personally, I feel like it's a disability because it's hard for me to function. But I've been told that I cannot get Social Security benefits as a result of it. What needs to be done to change this? So good question, good question. So usually what happens is sleep apnea causes, impacts, impacts your daily function, and it impacts the functioning of your heart and of your lungs. So usually you can't get social, usually it's difficult to get social security benefits related to sleep apnea, but you can sometimes get social security benefits related to the things that sleep apnea causes. So for instance, if your sleep apnea has gotten so bad that it has caused congestive heart failure and you cannot work, if your sleep apnea has gotten so bad that it's caused pulmonary hypertension and you cannot work. So what's important is that you keep a detailed record of your condition, including the sleep studies, and also what have you tried to actually treat your sleep apnea? What has worked? What has not worked? And what are the impacts that you have related to your sleep apnea? Do you have pulmonary hypertension? Do you have congestive heart failure? Do you have elevated blood pressure? How are these things limiting your ability to work? So usually what happens when you actually apply for Social Security benefits is it actually is your documentation of the impact of these things on your ability to work. It's really important that you document that. Okay, I love answering your questions and empowering you and your family with health information that can improve your overall health. So be sure to continue to send in your questions. Email me at info atasdrv.us. That's info ataskdrv.us.

Does your business believe in the empowerment of the community? Do you want to be a part of advancing their understanding of health and overall well-being? Maybe you're ready to reach more people while also growing your brand and visibility. You can do that with our audience. Advertise on the Ask Dr. V Show. 30 second and one-minute spots are available. Email our team at info at askdrv.us. That's info ataskdrv.us. And find out how you can advertise on the Ask Dr. V Show today. We'd love to see how we can work together to reach and empower more people.

All right, we've got a question from uh Raquel. Uh she's asking, Dr. V, I heard that changes in hormone levels can cause sleep apnea, but why? Alrighty, so so so let's take a look at this. It's not necessarily that changes in hormone levels cause sleep apnea, but the changes in the hormones cause other changes that make it more likely for you to have sleep apnea. So let me give you an example. So in menopause, so aging with women, um, you get a decline in estrogen and progesterone. So these hormones actually make your muscles more stable. So when these muscles decline, then your muscles become less stable. And those muscles become less stable in your entire body, including in your upper airway, neck, tongue area. So that increases the risk of uh sleep apnea. Uh similarly in men, testosterone, um, decreased levels in testosterone lead to more muscle relaxation, which then narrows your airways and increases your likelihood of actually having uh sleep apnea. Um we find the same thing occurs in pregnancy. Uh pregnancy uh you have higher levels of progesterone and estrogen, but you also have weight gain and you have changes in your upper airway that can increase the likelihood of sleep apnea, particularly when women are in the last trimester of their pregnancy. So it's not necessarily that hormones cause sleep apnea, it's that hormones cause change, changes to your body that then actually increase the likelihood of you having sleep apnea. So thanks for the question. All right, my next question was from Lewis, and uh Lewis is uh sending in a question, uh, and he wanted to know what is the percentage of fatalities from sleep apnea? So, so this is kind of interesting because people don't actually really die of sleep apnea. What they die from is the impact of sleep apnea. For instance, let me give you an example, right? So I said that sleep apnea causes pulmonary hypertension, it causes the blood pressure in your pulmonary tree to be higher. And that then will cause you to have right heart failure. So people then die of right heart failure. They don't necessarily die of sleep apnea. The other thing is sleep apnea is known to increase the risk of you having a stroke. So again, you don't necessarily die of sleep apnea. What happens is those temporary drops where you're not breathing and you're not getting oxygen, so those temporary drops in oxygen concentration can then cause damage to your vascular system over time, and it increases the likelihood of you having a fatal stroke. So you die of a fatal stroke, not necessarily sleep apnea. Sleep apnea is just the thing that tips the scale in the wrong direction. There have been uh some people who, because of frequent daytime sleepiness, um, they have actually uh had car accidents or uh they have had drowning accidents as a result of their uh sleep apnea. So one of the things I do in the emergency department is we put down what someone's actual cause of death is on death certificates. So we would never put sleep apnea, we would actually put the heart failure, we would put the drowning, we would put the stroke, the end cause. So sleep apnea is just one of the things at the beginning of the chain that that starts all of these things occurring, uh, but you won't actually, or you would rarely see an actual cause of death as sleep apnea. Thanks for the question. Crystal from Fredericksburg wanted to know. She is asking a question. My children have breathing issues. Do children also have sleep apnea? So, yes, children also do get sleep apnea. And there's several things. Um, some children just genetically have enlarged tonsils or enlarged adenoids, and that can cause sleep apnea. We also see a lot of obesity in children, which um they can get obstructive sleep apnea just like adults can get obstructive sleep apnea. And with children, um particularly with obesity, if it's early on and they're young, um their airways are not as uh not as large as an adult, so sometimes weight can really make a difference. Um, you also have some kids that have anatomical issues. They may have a small jaw, they may have a high arched palate, and these things can also narrow the airway and contribute uh to sleep apnea. There's also certain conditions that affect muscle tone. Um, if a child has Down syndrome or cerebral palsy, they have uh more flexible muscles and their muscles aren't as stable, and they're also more likely to get sleep apnea. So, again, if you're if you're whether or not it's a child or an adult, if they're having very, very loud snoring, you want to make sure to go get them a sleep study. It is, it is one of the most important things to actually get done in your life to make sure that you're not causing other problems with your heart and lungs, is to get a sleep study and see what's actually going on. Next question is from Vicky. After three days of not sleeping, I feel crazy. Wine seems to be the only thing to help me sleep. Is that bad? So, this is really, really important. It is so important that you get regular sleep at regular intervals. When you have long periods of time that are greater than 18 to 24 hours, and you start not getting sleep during that time period, it doesn't make you feel crazy. You actually become psychotic, hallucinogenic. These are what our body does when we actually don't have sleep. It is really, really, really important that you actually get sleep at regular intervals. Let me just say something about alcohol, because alcohol will make you relax and go to sleep, but you will not get REM sleep. So you will not get into the relaxing, restful sleep that makes you wake up and feel rejuvenated. So if you're using something like wine, then all that's gonna happen is you're gonna kind of like sleep for a little while, not get the deep sleep, and wake up and feel and wake up and not feel rejuvenated again. So you want to actually put together a sleep regimen, look at your sleep hygiene that we talked about. Are you actually going into a dark space? Are you are you winding down without alcohol? Um, the other thing you want to actually look at is if all of those things actually have, you've been doing all those things and you're still having problems. You really do want to talk to your doctor about other things like melatonin and natural things that you can actually do that actually will make a difference with your uh with your sleep. Thanks for the question, Vicki. Dr. V, why do babies smile when they are sleeping? This is a great question. So babies do often smile when they're sleeping, and it is usually occurring during the phase of sleep that we call REM sleep. And REM, which is REM, stands for rapid eye movement, and it's often a phase of sleep that's associated with dreaming, right? So when people say they had a dream, that often occurred during REM sleep. But with babies, um researchers believe, but they're not certain, that during REM sleep, there's sort of a relaxation of the facial muscles, which then give the baby sort of like a smiling appearance. So um it unfortunately doesn't have to do anything with them actually smiling or dreaming good dreams. It seems to be more associated with relaxation of facial muscles. But great question. All right, next question. Uh, Dr. V, it's the weirdest thing. I have never slobbered when I sl when I sleep. I'm in my 50s, and now I seem to be waking up with a wet mouth and a wet pillow. Why is this happening? What what do you what do you think? So it's kind of the same thing as the sleeping babies, because what happens is as you get older, you begin to lose muscle tone. Um, and your face kind of relaxes, and it particularly relaxes when you are uh sleeping. And so um so that's how come as you get older, you can you'll see people they'll sometimes uh sleep more with their mouth open or they'll have more drooling. But if it's something that becomes persistent or it's waking you up from sleep, or you're having difficulty breathing or difficulty swallowing, it's really important to go get it checked out. So you can't assume that it's automatically benign. It is something that you should get checked out if it's something that's really causing you difficulty. All right, next question. Is there something that changes as we age? My husband and I, as well as our friends, sleep with water at our nightstands because we get super thirsty in the middle of the night. This is really kind of funny. Is this a sign of something that we should be concerned about? So the answer to this question is it it really depends. So becoming thirsty and also urinating a lot at night can be associated with diabetes or other electrolyte abnormalities. So it is really important to go to your primary care doctor if you feel like you're thirsty more than usual or if you are actually uh urinating more than usual at night, because it can be associated with uh a disease. So you do want to nest you do want to get it checked out. The other thing that happens is that as our bodies age, we produce less saliva. Sometimes people have changes in their kidney function. Um so they can get these types of symptoms. It can be a part of normal aging, but it can also uh signify a significant disease such as diabetes. So you always want to be uh for sure and uh go to your primary care doctor, have him get you checked out. He can check you out for your kidney function, your uh blood sugar, your hemoglobin A1C, and make sure that everything is okay. All right, Dr. V, have you heard of the NASA nap? What do you think about naps in the middle of the day and when you're really sleepy? So, so yes, I have heard of this, and I've actually uh tried this myself. A NASA nap is something that uh NASA worked on with the astronauts in their training, and it was really about taking a very, very short nap, like 10 to 20 minutes, to boost your alertness and your performance. And it's a strategy that they developed to it's a strategy that they developed to stay alert and awake during long missions and long flights. Um it's it's very supposed to be very beneficial. I tried it myself. I had a very hard time falling asleep just for 10 to 20 minutes. I I have I have a tendency of being difficult to arouse. So I found this particularly difficult, but I encourage people to try it. But the short nap, 10 to 20 minutes, is beneficial because it increases your focus, it increases your productivity. Um you don't enter into the very, very deep stages of sleep, like the REM sleep that we were talking about earlier. And um, you wake up and apparently you're supposed to feel, you're supposed to feel energized and not feel sleep sleep deprived. And some people use it so they can kind of uh be more productive during the day. So it is uh an interesting strategy. I tell people it it's an innocent thing that you can sort of try and see how it works for you. Great question. Thank you. Dr. V, I'm about to travel to Dubai. Does the body adapt easily to different sleep schedules, for example, during travel across several time zones? So this is uh this is uh this is something that I actually struggle with. Um I I had took a couple of long trips and I really had a problem with uh readjusting my circadian rhythm and um having uh jet lag. And so, you know, the the body's internal clock takes a little bit of time to adjust to new time zones. Some people are able to adjust faster than others. Um, one thing that helps is to make sure that you actually stay hydrated. So drinking water, specifically water, um, and also exposing yourself to sunlight during the day when you're in a new time zone really helps so that you can actually adjust to whatever the new time zone is. Um also, you know, people say to adjust your your sleep schedule a little bit before you go on the trip. So if you know you're gonna be, if you know you're gonna be uh, let's say, for instance, you're going from New York to West Coast, then you start to stay up a little bit later before you actually make the trip, so that that way when you actually get to California, you are actually a little bit more adjusted to actually that particular time zone. In general, though, they say that you need about a day for every time zone that you cross to sort of re-acclimate your body. So, you know, if you're going, let's say, from New York or Washington, D.C. to Dubai, um, you really want to make sure that you take some time and that you're you have a long enough trip to really acclimate to the new time zone once you get there. And enjoy yourself. All right, thanks for the question. Does your business believe in the empowerment of the community? Do you want to be part of advancing their understanding of health and overall well being? Ready to reach more people while growing your brand and visibility with your audience? Maybe you want to help eliminate racial medical disparities. Advertise on the Ask Dr. V show. 30 seconds and one minute spots are available. Email our team at info at askdrv.us. That's info ataskd. And find out how you can advertise on the Ask Dr. B show today. We'd love to see how we can work together to reach and empower our audience. Time for today's edition of That's What I Think with comedian Damon Williams. Hey Damon, what do you think about today's topic? What do you think about sleep apnea, sleep, snoring? I know you've got something for us on this topic.

Hey, it's Damon Williams. Today's topic is sleep. And we all know that sleep is very important, but it's hard to come by these days. See, it used to be a time when you would get eight hours of sleep and go to bed, but now we got too much TV and too many devices and distractions. Hell, I remember when TV used to go off. Midnight would come, you see the American flag, and then the TV would go blank. And that meant take your butt to bed or possibly read. But now we got 800 channels, and they cost 200 a month, so you're trying to watch it. Plus, the people at work have watched the shows already, so they're doing spoilers, so you have to try to catch up. But now you have eight years worth of TV to catch up in one night. But your plan is we're not gonna be up all night. We're gonna get some sleep. But the show's always in exciting. You're like, oh snap, pause. You go use the bathroom, I'll get some snacks. You look up, it's 3 15 a.m. Your eyeballs is bloodshred, and you ain't got no sleep. And let me tell you, I love sleep. I try to get all the sleep I can. Let me wake up and have three extra minutes left. I look over at that clock and see 6.57. Ha! I bet you I don't get up because three extra minutes in the morning is a nice little nap. The only problem with that is you convince yourself you know how to sleep three minutes. When you wake back up, it's 1030. That's right. You like, it's 1030? Oh snap, I'm fired. And you know you're late when you look at the clock and you look at your phone. Once you see it on your phone, it's official. And let's face it, you can't call in late at 1030. Nobody's even looking for you at 1030. By 1030, you are absent. But you need your job, so you call in with the worst lie you can come up with. Like, yeah, uh, it's me. Yeah, they like, who is me? 800 people work here. Yeah, it's me. Uh I went to an emergency last night and they gave me medication that made me a little drowsy. Really? Yes, please just put me down for a sick day. And speaking of drowsy, sleep is also beneficial to your safety, especially if you drive. Sleepy driving is dangerous. Matter of fact, I feel like sleepy driving is worse than drunk driving. Because you know what? Drunks, get home. Yeah, you might knock off a mirror or two or side-swipe three or four cars, but you make it to the house. See, sleepy, sneak up on you. You ever been out on the highway, a dark road, and those lines, the highway lines, start talking to you? Yeah, they start coming at you and trying to hypnotize you. Like, go ahead, close the eye. You got another one. And you start listening to the lines. Yeah, I do have another one, don't I? Next thing you know, you are on the shoulder. And once you hear that sound, it will wake your butt up. I don't know who thought of, but it is genius. Those little ruffles on the side of the highway have saved a lot of lives. Imagine yourself texting and driving. You hit that shoulder, you throw your phone like, man, let me focus. I was almost in the grass. My point is, you gotta get some sleep to make yourself overall more healthy and more safe. Now, that might not be right, it might not be true, but that's what I think.

Well, folks, that's a wrap. I had so much fun talking to you today. Thank you for joining me. So be sure to email me or send me an audio message to info at askdrv.us, INFO at askdrv.us. You can also follow me on Twitter and Instagram, and it's ASKDR underscore V. That's at askdoter underscore V. We'll be back next week right here where you can be informed and empowered about your health.