I wake up in the night with a dry mouth – I’m worried it’s serious after three years of symptoms

WHEN we want to lose some weight, we turn to our diet. But sleep is vitally important – and often overlooked. Dr Zoe gives you health advice A reader wakes up in the night with a dry mouth and is worried it’s serious after three years of symptoms Credit: Getty A recent study showed that when adults reduced their shuteye by about 80 minutes for six weeks, they gained an extra pound. It may not sound like a lot, but it adds up over a year or a lifetime – and more severe sleep deprivation is likely to do far worse damage. Sign up for the Health newsletter Thank you! According to the US study, tired people spent an extra 17 minutes sedentary each day. They also reached for unhealthier food because, research shows, tiredness increases your appetite hormones. Weight loss aside, getting a decent night’s rest is also linked to a lower risk of heart disease, type 2 diabetes and dementia. So make sure you try to get at least seven to eight hours each night. Here’s what readers have been asking me this week . . . Q) THREE and a half years ago, I had what the GP suspected was Covid. It seems to have left me with a very cold sensation in my mouth, and also a dry mouth upon waking in the morning. Most read in Health Over the years, I have had various trips to the GP, tried dry mouth sprays and medicines, but nothing has made a difference. It is not bad during the day, but I wake in the night and my mouth is so dry. Now I’m worrying that this is serious. A) I can understand why you’re worried, as no explanation for three and a half years would make anyone wonder whether something has been missed. It is reassuring, though, that there has been no deterioration, which makes some serious causes less likely. But that does not mean you should simply have to put up with it. A common cause of dry mouth at night is mouth breathing, often due to nasal blockage, rhinitis, sinus problems or snoring. If your mouth is open for much of the night, it can become extremely dry even if saliva production is normal during the day. Your GP or pharmacist should review everything you take, including over-the-counter medicines and antihistamines, to assess medication side-effects. Medical causes of reduced saliva include diabetes, thyroid disease, vitamin deficiencies and auto­immune conditions such as ­Sjögren’s syndrome, which can cause dry mouth and eyes. The cold feeling may be nerve-related, and some people report altered mouth sensations after viral infections, including Covid. Reflux, oral thrush, dental problems and burning mouth syndrome can also cause unusual sensations. I would ask for a focused review rather than another spray. This might include examination of your mouth, nose and throat; review by a dentist; and blood tests such as glucose or HbA1c, thyroid function, B12, folate, ferritin and markers for inflammation or autoimmune disease if symptoms fit. In the meantime, avoid alcohol mouthwash, keep well hydrated and try sugar-free gum in the day. You might also consider a bedroom humidifier. SYMPTOMS MYSTIFY ME Q) FOR months I have been getting pins and needles in my hands, as well as brain fog and extreme ­tiredness. I also get a weird stabbing pain in my head and a strange sensation in my face on the same side, as well as feelings of a drop from my head to my feet. I am a woman and complete blood counts [CBCs] are all normal. My folate was extremely low but is now in normal range. A) I’m sorry you’re experiencing all of this. Pins and needles, unusual head pains, strange facial sensations, “rushes” through the body and extreme fatigue can feel frightening without an explanation. Some of your symptoms could be neurological, like the tingling, altered sensation and dropping sensations. But neurological symptoms do not always mean something sinister. They could be linked to vitamin deficiencies, thyroid problems, migraine, anxiety or panic, medication effects, infections, blood sugar issues and other causes. Perimenopause and menopause can cause brain fog, fatigue, headaches, poor sleep, palpitations and strange adrenaline-like “rushes” through the body. However, the one-sided facial symptoms and persistent pins and needles that you mention need proper assessment. The very low folate is relevant because it can contribute to tiredness and nerve-type symptoms. It is important to know why it was low, because even if the level is now back in range, symptoms can take time to settle, or there may be another deficiency alongside it. You need a proper ­follow-up appointment to bring these symptoms together, rather than looking only at the CBC result. Book a GP review and ask for a neurological examination, checking for strength, reflexes, sensation, coordination, vision and facial nerves. Ask whether your previous blood tests have included vitamin B12, ferritin/iron stores, thyroid function, vitamin D, HbA1c for diabetes, liver and kidney function, inflammatory markers and coeliac screening. Seek urgent help if you develop facial drooping, weakness down one side, speech problems, loss of vision, a sudden “worst ever” headache, confusion, collapse or persistent numbness. Don’t panic, but don’t dismiss your symptoms either. Is kidney issue doom and gloom? A reader was diagnosed with chronic kidney disease stage 3 (CKD3) three years ago Credit: Getty Q) I WAS diagnosed with chronic kidney disease stage 3 (CKD3) three years ago and told not to worry as it’s an old-age thing. I am 80. In February, I was told to cut down my metformin – taken for 12 years for controlled diabetes – as it was affecting my kidneys, and that I was anaemic. If the metformin was damaging my kidneys, why wasn’t it stopped a long time ago? I was tested for bleeding and cancer and the results were clear. My iron is now back to normal but my kidney level is 32. Medics insist they don’t want it below 30, but won’t say what it would mean at that level. Is it all doom and gloom? A) BEING told “don’t worry” but not being told what the numbers mean can leave you imagining the worst. CKD3 is common as people age, but I wouldn’t call it “just an old age thing” as it still deserves monitoring and explanation. An eGFR (estimated glomerular filtration rate) of 32 means your kidneys are filtering less well than normal, but people can live for years with stable CKD3. The number 30 matters as it’s a point where medication is reviewed more ­carefully. Metformin is usually safe in mild to moderate kidney disease, but as kidney function falls, the dose often needs reducing. Reduced kidney function means the body clears metformin less efficiently, so the dose may need adjusting to be safe. Your anaemia may be connected to kidney disease, but it is good that bleeding and cancer have been checked. To help protect kidney function, you should control blood pressure, and diabetes, stay active and avoid smoking and dehydration. Also shun anti-inflammatory painkillers such as ibuprofen or naproxen unless your doctor says otherwise. I would ask your GP for a proper CKD review looking at blood pressure, urine ACR, medication, diabetes and kidney blood tests for a clear monitoring plan. If eGFR falls below 30, it doesn’t mean disaster, but it may mean more medication changes and kidney specialist advice. TIP OF THE WEEK DON’T skip breakfast if you are chronically stressed. A balanced breakfast with protein, healthy fats and fibre can help stabilise blood sugar and reduce stress signalling. Avoid sugar (cereal, pastries, white bread) and wait until after to drink coffee. Comment now