My wife has always been a noisy sleeper, but she is currently on prescribed sleeping tablets and her snores, groans and grunts are getting louder and go on for longer. Even in the spare room, I am getting very little sleep. Shall I just take a sleeping tablet, too?
Anyone who has been through a few days without sleep will know it can be torturous. A partner’s loud snoring is a common culprit and something I’ve had to deal with countless times in clinic.
The key is to try to avoid blaming a partner who can’t control something that happens when they are asleep.
Many noisy sleepers have a condition called obstructive sleep apnoea, which causes their breathing to stop and start. This triggers snorts, gasps and very loud snoring that increases until it reaches a crescendo.
Today’s reader wants to know whether he should take sleeping pills to help him at night because he is kept awake by his wife who snores loudly
Sufferers have very disturbed sleep and often feel exhausted, leaving them with difficulty concentrating and headaches.
If a GP suspects sleep apnoea, they will refer to specialists who will test for it by monitoring breathing and heart rate.
More from Dr Ellie Cannon for The Mail on Sunday…
A sleep mask, called CPAP, or a plastic device that sits in the mouth can both help to keep the windpipe open. Although these look rather alarming, the effects can be life-changing.
Sleeping pills are not a long-term solution for a serious sleeping problem – in fact, they usually make apnoea and snoring worse, as does smoking, alcohol and sleeping on your back.
Pills should be used only for respite from sleeplessness, and for not longer than a week. Any longer than this and they become addictive while rarely improving sleep quality. But for short periods at a particularly stressful time, they may be a solution.
A GP will help to weigh up the risks versus the benefits. And there is no guarantee you won’t hear a partner’s snoring if you take a sleeping tablet.
A non-drug option is ear plugs. A well-fitting pair really can make all the difference – ask your pharmacist for advice.
I have suffered hot and tingly sensations in my feet and legs – called sensory polyneuropathy – – for the past year. Is there any medication I can take to stop it?
When doctors use the term neuropathy it means the nerves in part of the body are not working properly, causing unusual sensations or pain, usually because of an injury or illness.
The term polyneuropathy means more than one nerve is affected, so the strange feelings might occur in both hands, for example, rather than just one.
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If you have a health concern, always consult your own GP.
There are two main types of nerves. Motor nerves control our muscles and movements, while sensory nerves are responsible for the sensations we feel, such as temperature and touch.
So sensory polyneuropathy implies there is a problem with the nerves responsible for feeding sensations to and from the brain.
Symptoms may include numbness, pins and needles, burning pain and loss of balance or co-ordination. Medication can help, but the type given depends on the underlying cause of the problem and the symptoms.
There are a range of painkillers designed to treat nerve pain, such as amitriptyline, gabapentin and pregabalin. But if the sensations are not painful, such as numbness or pins and needles, there are fewer options available.
Doctors will investigate to see if there is an underlying cause – of which there are many. This includes diabetes, B12 deficiency, too much alcohol, side effects of medications, viral infections such as shingles as well as thyroid, kidney and liver disease. Autoimmune conditions such as rheumatoid arthritis and lupus can also be to blame.
If doctors can’t determine the underlying cause, the condition can be very hard to treat beyond offering painkillers.
I am 74 and have suffered bouts of gout in my big toe for the past 15 years. The treatments all work, but every few months it comes back. Is there anything I can take to prevent it?
Gout is a type of arthritis that causes extreme pain in the joints, as well as redness and swelling.
It happens when a substance called uric acid builds up and forms small crystals that rub against the joints. It tends to occur in one joint at a time, which becomes intensely painful, red and warm to the touch, usually for a period of 24 hours.
Another reader is seeking advice on treating their painful gout, picture posed by model
Medication for gout is aimed at either treatment or prevention.
Treatment aims to curb the attacks – painkillers such as non-steroidal anti-inflammatories or a drug called colchicine. They should be used alongside other interventions, such as ice packs and resting with the affected body part elevated.
If a patient has had more than two attacks a year, doctors would instead focus on a prevention strategy. This involves different medications which are started when the acute attack is over. However, preventative strategies can be tough because the drugs can cause a short-term surge in acute attacks.
Anti-inflammatories can be given to help this, but most people who opt for prevention will be taking the medication for the rest of their lives.
Why I won’t be backing MPs’ calls for free HRT
Free prescriptions are available to a wide range of people: the over-60s and under-16s, pregnant women and women who’ve just had a baby, and people with a range of illnesses including cancer, diabetes and epilepsy.
There were calls from MPs last week for menopausal women to be added to this list – or at least to receive free HRT, rather than pay the £9.35 prescription charge.
In a perfect world, where the money was endless, I’d say yes, absolutely do this. But we’re not in that world. The reason diabetics, for instance, don’t pay for medicines is because if they don’t get them, they get ill very quickly and treating them would cost the NHS far more.
There were calls from MPs last week for menopausal women to be added to this list – or at least to receive free HRT, rather than pay the £9.35 prescription charge, but there are better ways of spending that money on patients with long-term illnesses who do not qualify for free prescriptions
And there is a whole host of patients with long-term illnesses who don’t qualify for free prescriptions who probably should: people with asthma, Parkinson’s disease and inflammatory bowel diseases such as Crohn’s and colitis, for instance.
Giving them medication would also save the NHS tens of millions in the long term, so this really does need to be looked at by policymakers. Given that HRT is usually not taken for more than a few years, it’s perhaps fair that patients shoulder the financial burden – particularly when NHS resources are spread ever more thinly. I’d like to know what you think.
Mask work, but not for us all
I’ve had a lot of response to my comments urging health chiefs to encourage patients to keep wearing masks in GP surgeries and hospital clinics.
Given the number of infections picked up in wards and waiting rooms every year – and not just Covid – it makes sense to me. But many of you pointed out the difficulties mask-wearing doctors may present for those who are hard of hearing or who rely on lip-reading.
I would never encourage people to wear masks in either consultations or in the waiting room if it affects their ability to communicate or inhibits their access to treatment.
Masks are only of benefit if they don’t cause extra harm, and patients should use their judgment as to whether they feel affected in this way. But if there are no issues, I see it as an easy way to keep infections down.