DEAR DR. ROSENBERG: My 10-year-old snores and was recently diagnosed at a sleep lab with a mild case of sleep apnea. It was recommended that he have his tonsils and adenoids removed. Would there be any other options besides surgery?

A: Actually there may be. First of all, let me say that removal of the tonsils and adenoids is the treatment of choice. However, there have been a few recent studies that show a good response to nasal sprays in the pediatric population that contain topical corticosteroids; examples being Flonase, Rhinocort and Nasonex. Please keep in mind this applies to children with mild sleep apnea only.

DEAR DR. ROSENBERG: My dad lives with my husband and me. He has dementia and is gradually losing his memory. Dad snores so loudly that I can hear him down the hall. Recently, we took him to a neurologist, who recommended an MRI and a sleep study. I understand the MRI but why the sleep study?

A: Your neurologist is aware of the relationship between sleep apnea and dementia. Recent studies have shown that many patients with sleep apnea have what are called "silent strokes." These are areas of brain injury too small to result in obvious neurological deficits such as paralysis or loss of feeling. However, when recurrent they may result in loss of cognitive function such as memory or attentiveness. It is believed to be a result of repetitive episodes of low oxygen during sleep, due to airway obstruction. The good news is that with treatment further progression can be halted. In a loud snorer such as your dad it is certainly worth looking into.

Dr. Rosenberg, board-certified sleep medicine specialist, will answer individual reader questions by incorporating them in future columns. Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Flagstaff, 1110 E. Route 66, Flagstaff, AZ 86004 or at 214-7400.