Sleep apnea and Meniere's Disease

Meniere's Disease involves the ear, and produces symptoms of hearing loss, tinnitus (ringing in the ears), and vertigo (a form of dizziness). Nausea and vomiting often accompany the vertigo. Meniere's Disease is usually treated with medications, but that does not always help. Some research has pointed to an association of poor sleep quality and Meniere's Disease. Obstructive sleep apnea (OSA) can result in poor sleep quality and could worsen Menierie's.

This small study looked at the effect of 6 months of CPAP therapy on Meniere's Disease. All 20 patients had failed medication management of Meniere's Disease. All had OSA diagnosed with a sleep study, and all used CPAP therapy only. They did not restart their Meniere's medications during this study. Results showed that CPAP therapy by itself reduced the impact of the vertigo and the low-frequency hearing loss associated with Meniere's disease.

The reason that treating OSA may help Meniere's is unknown. The study authors speculate that elimination of low oxygen levels when asleep may be the factor that improves the Meniere's. I also wonder if elimination of the snoring helps.

Pets and sleep

Lots of people sleep with their pets in their bed. This is fine unless it disrupts your sleep. This article discusses research at the Mayo Clinic showing that 18% of pet owners feel their pets disturb their sleep. The article goes on to discuss how you can get your pet out of your bed if it is bothering your sleep.

Control of dream sleep

The neurobiology of sleep is complicated - so many pathways in our brains seem to affect sleep and the different sleep stages. For example, the pons, a part of the brainstem, is thought to be the major part of the brain generating dream sleep. This article and abstract summarize elegant research demonstrating that a group of neurons in the medulla, which is below the pons, can generate signals that start dream sleep. The researchers postulate that these medullary neurons project up into the pons. This finding is interesting in that the medulla is responsbile for unconscious processes that regulate heart rate, blood pressure, and breathing, as well as other autonomic features. These research results may bolster the argument that dreams are not from the conscious brain, but more of an automatic process like breathing or heart rate. Unfortunately, these findings don't help us understand the function of dreaming any better than our current understanding.

Restless legs syndrome and cardiovascular disease and kidney disease

Restless legs syndrome (RLS) is a chronic neurological condition that causes discomfort in the legs in the evening before sleep. Studies have linked RLS with certain cardiovascular diseases such as high blood pressure. This article is about a study that examined RLS in veterans. Specifically, the researchers studied the relationship between RLS and stroke, heart disease, kidney disease, and mortality rate. The researchers compared about 3700 veterans with and without RLS. Results showed higher amounts of stroke, coronary heart disease, chronic kidney disease, and mortality in those that had RLS compared to those that did not.

The results are not surprising. And as the article points out, the findings don't show that RLS causes strokes, heart disease, or kidney disease. One issue is whether the RLS in these veterans was primary, or secondary to another disorder, such as obstructive sleep apnea (OSA). OSA can significantly worsen RLS, meaning that it may be the OSA that is increasing the incidence of cardiovascular or kidney disease - not necessarily the RLS. Also, RLS is known to be common in patients with chronic kidney disease, especially those on dialysis. More studies are needed to tease out the relationship between RLS and these other disorders.