By Dr. Larry Chiaramonte
A few years ago I thought about training in the specialty of sleep medicine because I was concerned about the close relationship between sleep and other preoccupations of mine—allergy, asthma, and even the obesity epidemic.
As we say in our book, a good night’s sleep is one of the measures of whether asthma is controlled or not. A child who wakes up at night wheezing and coughing cannot get the ZZZs he needs to perform well at school. The same is true for sneezing and itching—the hallmarks of allergic rhinitis and eczema, obviously. The link between allergic conditions and sleeplessness is very explicit. Histamine, naturally produced in the brain, is one of the neurotransmitters that regulate wakefulness. It is a natural part of our circadian rhythm, the cycle of sleep and waking, so it is higher during the day and diminishes at night. The reason Benadryl puts you to sleep is that it penetrates the brain-blood barrier and suppresses the histamine that you need to stay alert, whereas newer antihistamines do so to a much lesser extent. A nighttime allergic episode releases histamine that would normally be at a low level, so the waking effects are chemical as well as comfort related.
As for obesity, overeating will often result in gastric reflux, also an impediment to good sleep. Digestion can also disturb you at night. Obstructive sleep apnea (OSA)—breathing literally stops during sleep–afflicts an estimate 1-4% of children. It activates the fight-or-flight response; the body gives itself a jolt of adrenaline to clear the airways of its own tissue, which is blocking the airways. This also contributes to weight gain and high blood pressure. Overweight is the biggest contributor to OSA because a thick neck crowds the airways, so the trend to weight gain is self-reinforcing.
If these conditions overlap in your child, or yourself, don’t take care of them one at a time.
(For more on how sleep affects your child and you, read Sleep to Save Your Life: The Complete Guide to Living Longer and Healthier Through Restorative Sleep by friend of Allergies Asthma Children. com, Dr. Gerard T. Lombardo, available here)
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