By Keith Roach, M.D.
Signal Contributing Writer
Dear Dr. Roach ow are sleep apnea, sighing and heart failure related? Recently, I was told that I have severe sleep apnea and that I must use a CPAP machine. I have noticed that during the day I frequently take a spontaneous deep breath. Is that sleep apnea while awake? I have coronary heart disease and have three stents. Will the CPAP machine help me in any way?
— A.P.
Answer t’s complicated.
By far, the most common type of sleep apnea is obstructive sleep apnea. This happens in people who are overweight, or in people whose neck anatomy predisposes them to the condition. During sleep, the upper airway collapses, preventing proper inspiration. This can be noticed by a sleep partner as choking, gasping or just not breathing for a prolonged time. The person eventually will wake up enough, due to lack of oxygen, to be able to take in a good breath, but will then fall back asleep. The process may happen hundreds of times a night, with the person often unaware.
Sleepiness during the day (from never sleeping properly at night) and snoring are the most common symptoms of obstructive sleep apnea. A CPAP (continuous positive airway pressure) machine, which uses high pressure to keep the airway open, is the most common initial treatment for obstructive sleep apnea.
In severe sleep apnea, the oxygen level in the blood can be so low for so long that the heart and lungs can be damaged, eventually leading to a type of heart failure of the right side of the heart.
However, the situation is even more complex. People who have other kinds of heart failure, such as from repeated heart attacks, can develop the less common form of sleep apnea, central sleep apnea. Although this also may be treated by CPAP, it is critical to treat the underlying heart failure as well. Your doctor can tell you whether you have central or obstructive sleep apnea.
Spontaneous deep breaths, sighs, are a part of normal human physiology. Sighs have several purposes, but the most important is to help keep the lungs properly expanded. Sighs might be more common in people with heart failure, but I do not know of any correlation with sleep apnea.
Dear Dr. Roach re deodorants containing aluminum safe to use? The brands that do not contain aluminum are much less effective. I am concerned about absorbing the aluminum from the deodorant and its effect on the brain.
— D.M.
Answer hat’s a myth.
The amount of aluminum in antiperspirants is negligible. Deodorants that aren’t also antiperspirants don’t contain aluminum. The aluminum mechanically blocks the sweat glands in the armpit, and 99.99% of it is not absorbed into the body. Long-term studies of people taking aluminum-based antacid (which is also poorly absorbed) have shown no increased risk of dementia. The body has several ways of removing the small amounts of aluminum we absorb, mostly via the kidneys. Aluminum toxicity IS a potential problem for people with kidney disease on dialysis, but the small amounts of aluminum in antiperspirants is too small to worry about even in those cases.
There is absolutely no reason to be concerned about the health effects of aluminum on the brain.
Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. 
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