Her car is racing at a terrifying speed through the streets of a large city, and something gruesome, something with giant eyeballs, is chasing her, closing in fast. It was a dream, of course, and after Emily Gurule, a 50-year-old high school teacher, related it to Dr. Barry Krakow, he did not ask her to unpack its symbolism. He simply told her to think of a new one. “In your mind, with thinking and picturing, take a few minutes, close your eyes, and I want you to change the dream any way you wish,” said Krakow, founder of the PTSD Sleep Clinic at the Maimonides Sleep Arts and Sciences center in Albuquerque and a leading researcher of nightmares. And so …

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Too much debate and discussion on health care reform ignores a singularly important fact about the advent of alternative medicine; namely, it was not fostered by the government, insurance carriers, the pharmaceutical industry, or trial lawyers. Its exponential growth is largely due to the actions of people (both patients and practitioners) living in a land of liberty and opportunity who were looking for new choices to better health. It is without caveat one of the finest examples of the free enterprise system in the United States—a place where the market worked its magic by offering that which is now perceived by much of the public as an affordable, safe, and potentially higher-quality service or product than that provided through conventional fields of medicine.

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When Do Nightmares Become A Sleep Disorder?

One in 20 adults in the US complain of disturbing dreams, and more than twice that many children and adolescents also experience frequent nightmares, yet few chronic nightmare sufferers imagine that it is a treatable problem. We’ll talk about nightmares with leading sleep disorder specialist Dr. Barry Krakow.

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Many doctors unaware the sleep disorder boosts urine production, experts say

“When you ask people about symptoms like snoring and gasping, they tend to say, ‘No, I don’t have them’,” said study author Edward Romero, research coordinator at the Sleep & Human Health Institute in Albuquerque, N.M. “But it’s very easy for them to realize that they wake up at night to go to the bathroom.”

SUNDAY, Nov. 29 (HealthDay News) — People who wake up during the night to urinate shouldn’t automatically blame a urological problem. Sleep apnea, a breathing-related sleep disorder, could be the cause.

A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.

Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.

Purpose: Current screening for obstructive sleep apnea (OSA) emphasizes self-reported snoring and other breathing symptoms. Nocturia, a symptom with a precise pathophysiological link to sleep apnea, has not been assessed as a screening tool for this common disorder of sleep respiration. In a large sample of adults presenting to area sleep centers, we aimed to determine the predictive power of nocturia for OSA and compare findings with other markers of OSA commonly used to screen for this disease.

Methods: This was a retrospective chart review. A consecutive sample of 1007 adult patients seeking treatment at 2 sleep centers in New Mexico completed detailed medical and sleep history questionnaires and completed diagnostic polysomnography testing. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of nocturia, snoring, high body-mass index, sex, and age for OSA were determined. Hierarchical linear regression determined unique variance contribution to the apnea-hypopnea index, the objective measure of sleep apnea severity.

Results: Sensitivities: snoring, 82.6%; nocturia, 84.8%. Specificities: snoring, 43.0%; nocturia, 22.4%. PPVs: snoring, 84.7%; nocturia, 80.6%. NPVs: snoring, 39.6%; nocturia, 27.9%. With hierarchical linear regression, patient-reported nocturia frequency predicted apnea-hypopnea index (OSA severity) above and beyond body-mass index, sex, age, and self-reported snoring (P < .0001).

Conclusions: Nocturia appears comparable to snoring as a screening tool for OSA in patients presenting to a sleep medical center. Research in urology and primary care clinics is needed to definitively clarify the use of nocturia as a screening instrument for obstructive sleep apnea.

Introduction: Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction that occur during sleep, leading to repetitive bouts of sleep fragmentation, oxygen desaturations, and resultant daytime sleepiness[1]. A decrease in pharyngeal dilating muscle activity during sleep leads to greater airway collapsibility, a major contributor to obstruction[2]. This pathophysiology produces classic breathing symptoms such as snoring and breathing cessation. Therefore, the upper airway draws the most clinical attention when assessing OSA risk[3,4]. Other factors routinely used to assess risk are body-mass index (BMI) and neck circumference[5], yet snoring is likely the single most common question posed to patients during an assessment for OSA[6-8].

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