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What Is The Remedy For Sleeping Issues With Episodes Of Severe SOB?

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Posted on Tue, 4 Mar 2014
Question: My MRI shows scattered white matter T2/flair hyper intensities predominantly in the frontal lobes.there is also nonspecific T2 hyperintense signal of the corticospinal tracts bilaterally. No one can tell me what's wrong. I have trouble sleeping at night and have had several episodes of severe SOB which awaken me from my sleep. I'm scheduled for a sleep study but they said my severe SOB doesn't sound like sleep apnea because I don't fit the criteria. All I know is that I keep having these "symptoms" and no one can figure out what's going on. I'm sleeping with 4 pillows now because when I lay flat my breathing gets labored but I don't have asthma or heart failure. I've seen a cardiologist and she has ruled out heart disease. I most recently started having problems with remembering numbers and now my PCP and the cardiologist said they are puzzled. I was told to make an appointment with vascular which I'm doing but I know something is wrong and I want to figure it out before it gets worse.
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Answered by Dr. Indu Kumar (56 minutes later)
Brief Answer: Hyper intensities less than five can be ignored. Detailed Answer: Hello XXXX Thanks for writing to XXXXXXX FLAIR or T2 weighted hyper intensities less than five in number in deep white matter of brain can be ignored. Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation. Hyper intensities more than five in number should be the cause of concern and it need investigations. In your case,most likely it is due to ischemic changes resulting from hypertension. You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. If there is any more physical problems then it should be treated. Respiratory problem during sleep also need proper evaluation.It is good that you don't have any cardiac problem,however pulmonary causes should also be ruled out.You should also consult pulmonologist. Over weight is also a contributing factor so it should be ruled out. You should also consult neurologist for detailed evaluation. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Indu Kumar

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Practicing since :2004

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What Is The Remedy For Sleeping Issues With Episodes Of Severe SOB?

Brief Answer: Hyper intensities less than five can be ignored. Detailed Answer: Hello XXXX Thanks for writing to XXXXXXX FLAIR or T2 weighted hyper intensities less than five in number in deep white matter of brain can be ignored. Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation. Hyper intensities more than five in number should be the cause of concern and it need investigations. In your case,most likely it is due to ischemic changes resulting from hypertension. You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. If there is any more physical problems then it should be treated. Respiratory problem during sleep also need proper evaluation.It is good that you don't have any cardiac problem,however pulmonary causes should also be ruled out.You should also consult pulmonologist. Over weight is also a contributing factor so it should be ruled out. You should also consult neurologist for detailed evaluation. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX