By Keith Roach, M.D.
on
DEAR DR. ROACH: I have a problem I’ve never seen addressed in your column. Unlike many people who are my age (85), I get too much sleep. I am pretty healthy, and I work out three times a week. Until last year, when my husband died, I was always busy taking care of him at home. Even then, I was getting about seven and a half hours of sleep a night. Now I’m never busy, and I get about 10 hours of sleep a night. I wake up to go to the bathroom, but go right back to sleep.
My doctor said most people at my age get about six hours of sleep a night, but he didn’t seem concerned that I get so much more. Do you think it’s harmful to sleep so much? I am fine during the day. I am 5 feet, 3 inches tall and weigh 129 pounds. I have atrial fibrillation and take thyroid medicine. — C.C.
ANSWER: Too much sleep is associated with several medical problems, so when I see a person changing their sleep patterns to sleep more than nine hours per night, I definitely get concerned. But it would be much more concerning if you reported being sleepy all the time. The fact that you feel well during the day is reassuring, but I would still want to make a few simple checks for some common medical conditions that can cause people to sleep excessively.
Given your thyroid condition, that level should be checked with a simple blood test (your doctor may already have done that). Your doctor might also check you for diabetes. But the main concern I have, especially since your husband died, is major depression. Caregivers who lose the person they cared for are at high risk for depression, and sometimes it isn’t obvious that depression is the issue. Your doctor or a mental health professional can help evaluate this.
Your normal weight makes sleep apnea less likely, but it is another cause of excess sleep. Some further questions and an exam can help decide whether a sleep study is indicated.
Although people who sleep a lot are at a higher risk for heart disease, it isn’t clear the excess sleep is causing the heart problems. Many people with chronic medical issues sleep a lot, but that doesn’t seem to be your issue.
DEAR DR. ROACH: I am a 92-year-old woman. I take three prescriptions and four vitamins daily. My question is whether it is OK to take the medications with juice, Ensure, milk, etc., or should they only be taken with water? — V.B.
ANSWER: Most medications can be taken with any of the liquids you mention, but there are a few that can’t. For example, alendronate (Fosamax) isn’t absorbed if it’s taken with anything besides water. Tetracycline is bound by milk and can’t be absorbed with any kind of calcium-containing liquid. Grapefruit juice can increase the levels of some medicines.
Your pharmacist is your best resource for these questions. There are excellent computer programs that can identify drug-drug and food-drug interactions, but it takes expertise to interpret them — and pharmacists are the experts.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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