Ask the Doctor: September 2022
Q: I’ve heard of obstructive sleep apnea (OSA), but my husband was recently diagnosed with central sleep apnea (CSA). What’s the difference?
A: OSA and CSA both lead to pauses in breathing while sleeping, but they have different causes. With OSA, which is a much more common condition, soft tissue in the back of the throat relaxes during sleep, causing the upper airway to become blocked. The diaphragm and chest muscles work harder to force open the airway and allow for continued breathing. With CSA, the problem originates in the brain. Essentially, the brain repeatedly stops sending the proper signals to the muscles that control breathing.
The use of continuous positive airway pressure (CPAP) therapy may be useful for both OSA and CSA. CPAP uses a small bedside machine to pump air through a tube that fits over the nose and mouth (or just the nose). If CPAP or other similar treatments are ineffective or not tolerable, your husband’s doctor may prescribe a medication such as acetazolamide, which can stimulate breathing during sleep.
Q: When I started taking statins 10 years ago, there seemed to be conflicting information about whether they cause memory loss. I don’t really hear that anymore. What is the latest?
A: Statins are remarkably effective medications in lowering LDL (“bad”) cholesterol levels, which in turn reduce heart disease risk. You’re right that for a long time, there was much debate about the side effects of statins, especially regarding complications such as “brain fog” and memory loss.
In recent years, however, several studies have found no direct link between statin use and cognitive problems. And one study, involving more than 57,000 older adults, suggests that statins actually may offer some protection against dementia. However, there remains some debate among health experts about whether this issue is settled. Individuals who take statins and experience memory lapses or other cognitive changes may be dealing with conditions that have nothing to do with the medications. Likewise, some people may start taking statins and notice changes in their cognition soon afterward. The Food & Drug Administration has approved labeling for statins that include memory loss and confusion as “non-serious and reversible” side effects. This suggests that if those side effects develop, stopping the drug—or switching medications or changing doses—may reverse any cognitive changes that occurred. What is clear is that if your doctor prescribes a statin because you have high LDL cholesterol, the cardiovascular benefits of taking the medication probably far outweigh any risks.
Q: Throughout the COVID-19 pandemic I’ve seen references to older people facing risks of isolation and loneliness. The terms seem to be used interchangeably, but don’t they mean different things when it comes to mental health?
A: Yes, loneliness and isolation (specifically “social isolation”) are different, but they are related. Loneliness refers to a feeling, a sense of being alone and disconnected from others. Isolation is actually having few, if any, regular social contacts with other people.
People can feel lonely even while they are surrounded by others. Think of individuals who move to a big city without knowing anyone there. Similarly, a person might have few social contacts on a regular basis but feel contented because of hobbies, pets, and telephone or social media interactions with relatives and friends.
It’s important to note, however, that social contact is an important component of good mental and cognitive health for everyone, regardless of how content they may appear. Ideally, you want to have regular in-person contact with friends, neighbors, relatives, and other people who bring positive energy and emotional support to your life.
The post Ask the Doctor: September 2022 appeared first on University Health News.
