Q: I have trouble sleeping because I snore so much. My wife says I could have sleep apnea. I just read an article about at-home testing kits. Are any of them any good? I really don't want to go to a sleep clinic (it sounds creepy). Any advice? — John W., Stuart, Florida
A: We know that sleeping on your back in a hospital bed, attached to a dozen wires with people staring at you in the dark can cause anxiety, and even errant readings, but a sleep clinic is a good place to have your snoring evaluated. They can diagnose you and set up a treatment program that could save your life!
Obstructive sleep apnea happens when your airway becomes blocked while you sleep. In addition to snoring, gasping and choking, it can cause low blood oxygen levels and increase your risk for heart attack, stroke and high blood pressure; diabetes and obesity; and mental health problems that go along with disturbed sleep.
But if you're reluctant to go to a sleep clinic, using an at-home testing kit can be your best first step. Choose an at-home apnea tester that monitors your breathing from your nose and mouth, your blood oxygen levels and heart rate. It should use the Apnea/Hypopnea Index to measure your number of blocked breathing episodes per hour and determine the severity of your OSA. Also, make sure the readings from the monitor are transmitted to a reputable firm for evaluation. Don't settle for the first test kit you come across. When you get the results, share them with your doctor. If you have OSA, implementing the right medical solution is a second (and essential) step.
And think about this: People who are overweight, have a neck circumference of greater than 17 inches, don't eat right or get enough exercise, smoke, drink caffeine after noon or drink excess alcohol are most likely to develop sleep apnea. If any of these describe you, take heart. Losing just 5 percent of your body weight and changing your habits can relieve, and sometimes cure, OSA.
Q: My daughter just received her first HPV vaccine on her 11th birthday. Our doctor says her second shot is due in six months. Does she need it? — Arlene, F. Somerset, N.J.
A: Great question, and the answer is, "Yes!" And schedule a third one, too. Spacing the shots six months apart offers optimal immunity. True, new studies are popping up from Canada, the U.S. and the World Health Organization about the efficacy of the second and third shots in the standard three-shot regimen for this anti-cancer vaccine. Some results indicate that two shots (given with the correct interval, and in some countries) may be as effective over 10 years as three shots. But no one knows for sure. And over 20 years, two is less effective than three.
Getting the full inoculation is smart. While it's tough to convey the risk of not getting the vaccination, getting cervical and throat cancer that is caused by some strains of HPV (human papilloma virus) is far, far more dangerous than the risks associated with the vaccine. We hope all docs will start to regularly schedule the first HPV vaccine along with the DTaP booster kids get at age 11 — and then make shots two and three part of a regular schedule.
Unfortunately, even though more adolescents in the U.S. are now getting the first HPV shot (54 percent of girls and 21 percent of boys received theirs in 2012; 57 percent and 35 percent in 2013); rates have stayed steady for second shots — when they should have gone up, too. And for the third shot, rates for boys fell from 35 percent in 2011 to 33.4 percent in 2012.
We know you don't want your (sooner-than-you-know) adult daughter to be at risk for cancer caused by the HP virus (the most common sexually transmitted virus in the U.S.), so follow up that first inoculation at six months — and then six months later.