Prairie Doc Perspective Week of February 22nd, 2026
“The Not-So Silent Struggle of Sleep Apnea” 
By Andrew Ellsworth, MD


Take a moment to breathe. Close your eyes. Slowly inhale through your nose, pause, and gently exhale through your mouth. After a few steady breaths, you likely feel more relaxed and ready for the day.
Now imagine plugging your nose and trying to breathe with your tongue pressed against the roof of your mouth, blocking the airway. You would quickly feel stressed and uncomfortable. Now imagine that happening over and over again, all night long.
That is what occurs with obstructive sleep apnea.
Obstructive sleep apnea happens when relaxed throat muscles and soft tissues collapse and block the airway during sleep. These temporary pauses in breathing—called apneas—cause lower oxygen levels. The brain senses the drop and briefly arouses the body to reopen the airway. This cycle can repeat dozens, even hundreds, of times per night. The result is fragmented sleep, low oxygen, and a body that never truly rests.
Sleep is when the body resets and restores itself. It supports immune function, heart health, metabolism, memory, mood, and emotional regulation. When sleep suffers, so does overall health. Poor sleep increases the risk of high blood pressure, heart disease, stroke, diabetes, cognitive decline, and even dementia. People who are chronically tired are also less likely to make healthy choices.
The gold standard treatment for sleep apnea is CPAP—continuous positive airway pressure. A bedside machine delivers steady air through a mask, keeping the airway open during sleep. Some patients benefit from BiPAP, which provides different pressures when breathing in and out. When used consistently, these therapies can dramatically improve sleep quality, energy, focus, hormone balance, and cardiovascular health.
Other treatments may help in selected cases. Weight loss, dental appliances, side sleeping, and certain surgeries can reduce airway obstruction. For patients who cannot tolerate CPAP, hypoglossal nerve stimulation (often known by the brand Inspire) is an option. This implanted device stimulates the nerve controlling the tongue, helping maintain an open airway during sleep.
Although sleeping with a mask may not sound appealing at first, some people feel better quickly and do well with it. Others improve once they are used to it. It often takes patience—trying different masks, adjusting pressure settings, or adding humidification. With proper support and follow-up, most people adapt well.
The benefits of treating sleep apnea far outweigh the risks of ignoring it. Restful sleep improves energy, protects the heart and brain, and enhances overall quality of life.
If you or someone you love snores loudly, stops breathing during sleep, or feels tired despite a full night’s rest, consider visiting your medical provider. Restoring healthy breathing at night may be one of the most important steps toward better health.
Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of February 15th, 2026
“The Bones of the Matter”
By Deb Johnston, MD


When I was in medical school, I learned that a shocking number of people would die or be admitted to a nursing home after a hip fracture. 


Even today, a hip fracture can be a devastating event for an older American. Up to 30% will die within the next year. Many more will loose independence and require admission to assisted living or a nursing home. Estimates vary, but it may approach 50%. As hard as it is to believe, these statistics are improved from my long ago medical school days.


As a doctor in training, the solution seemed obvious. If osteoporosis caused hip fractures, and hip fractures caused premature death and disability, then my mission as a primary care physician would be to prevent osteoporosis. I’ve been nagging my patients about their calcium and vitamin D intake and their weight bearing exercise ever since.


To be fair, the reality is a bit more nuanced. It’s true that osteoporosis is a major factor in hip fractures, but it is often accompanied by other issues: poor nutrition, poor balance, low muscle mass, and more obvious serious health conditions like dementia, heart disease, kidney disease, and diabetes. 


Similarly, preventing osteoporosis isn’t as simple as urging everyone to drink enough milk. Generally we can build stronger bones up until about age 30. After that, the goal is to maintain bone mass. Those critical years are often decades before a person starts thinking about their bones, and sometimes well before they start thinking about their health at all! 


Other habits also influence how strong your bones are at their best. Smoking and alcohol reduce bone mass. Weight bearing exercise increases it; while being sedentary has the opposite effect. Your body needs vitamin D to make bone, too, and deficiencies are surprisingly common. 


Other health conditions, and their treatments, can have significant influences on your bone health. The list is long: eating disorders, premature menopause, inflammatory bowel disease, seizure disorders, asthma, rheumatoid arthritis, chronic kidney disease, thyroid disease, cancer.


While preventing osteoporosis starts in childhood, hope is not lost just because you are well into middle age, or older. Talk with your doctor about what you should be doing to keep your bones healthy. Do you need help getting rid of nicotine, or cutting back on alcohol? Are you having trouble getting enough calcium or vitamin D? Are there medications you are taking that could be changed? Is it time to start screening?


While many people think about osteoporosis as a woman’s disease, it affects men too, albeit at lower rates. In fact, men may have a higher risk of death after a hip fracture. We all need to be thinking about our bones. It’s never too early. Or too late.


Dr. Debra Johnston is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of February 8th, 2026
“Spring into Seasonal Allergies”
By Jill Kruse, DO
The groundhog may have seen his shadow, but Spring will be here soon.  While many of us look forward to warmer days and blooming flowers, those who suffer from seasonal allergies know that the return of grass, budding trees, and blooming flowers can lead to more sneezing than smiles.  Welcome to the Spring allergy season.  
If your seasonal allergies seem to be getting worse each year, it is not in your head.  A Study from the National Academy of Sciences in 2021 found that over the last 30 years the North American pollen allergy season has increased by approximately 20 days.  Pollen concentrations have also risen 21%.  The Spring tree pollen season has been starting earlier and the Fall ragweed season has been ending later.  
Seasonal allergies can develop at any time in one’s life.  The most common risk factor for developing seasonal allergies is family history.  If have family members with allergies, you have an increased risk of developing them as well.  Seasonal allergies are the sign of an overactive immune system that has mistakenly identified harmless substances, like pollen, as dangerous threats to the body.  This triggers an inappropriate defense response that leads to the common symptoms of allergies like runny nose, congestion, watery eyes, itching, and sneezing.  The immune system is trying to fight pollen like it would fight a cold. This is why it can be difficult to differentiate between allergies and illness.  
There are a few ways to help decrease the risk of children developing allergies.  Several studies have shown that children who visit a farm in their first year of their life or have furry pets have a lower risk of allergies.  In that first year of life, the immune system is busy trying to figure out what things the body needs to defend against and what things are safe to ignore.  The environment on the farm has so different allergens, that it allows the immune system to become tolerant of the harmless pollen and animal dander. However, once someone has allergies, and the immune system is sensitive to these substances, further exposure to allergens that are on a farm will not help.  It will just make the allergy sufferer more miserable.  
The first line over-the-counter treatment for seasonal allergies is intranasal corticosteroids such as Fluticasone (Flonase), Mometasone (Nasonex), and Budesoninde (Rhinocort).  These nasal sprays have been shown to be more effective than over-the-counter oral antihistamines such as Loratidine (Claritin), Fexofenadine (Allegra), and Cetirizine (Zyrtec).   If the spray does not give adequate control, then adding an oral antihistamine can help. 
If these medications are not effective, then seeing an Allergist is the next step to enjoying everything that comes with April showers and May flowers.  The groundhog says we have six more weeks to prepare for Spring.  Regardless of when it comes, everyone can enjoy Spring if they understand seasonal allergies and how to treat them.  
Dr. Jill Kruse is a hospitalist at the Brookings Health System in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on  YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of February 1st, 2026
“Insomnia”
By Kelly Evans Hullinger, MD, FACP
Difficulty sleeping is an common concern we hear about in primary care. Many of us will have trouble sleeping on occasion, but when that is a persistent pattern causing distress or functional impairment, we call it insomnia. Insomnia can mean difficulty falling asleep, difficulty maintaining sleep, or waking early unable to fall back asleep. 
First and foremost, is the difficulty sleeping causing problems? If it is not resulting in problems with daily functioning, we may need to manage expectations around sleep. Not every person needs 8 hours per night, and if your imperfect sleep is perfectly tolerable, it is probably best to leave it alone. As we age, we need less hours of nighttime sleep; again, as long as you feel well during the day, that is just fine.
For those whose poor sleep is resulting in intolerable drowsiness or difficulty functioning at work or home, I have more questions. Is an acute illness or stressor contributing? Might there be another sleep disorder like sleep apnea or restless leg syndrome? Is pain, an urge to urinate, or some other physical symptom causing your awakenings? Is there underlying depression, anxiety, or other mental health concerns? Are you taking any medications or substances that might cause sleep disruption? Addressing any of these may significantly improve sleep. Alcohol is a common culprit; often assumed to help people fall asleep, alcohol actually yields poor quality rest.
Most patients with insomnia can be helped with behavior changes alone, or “sleep hygiene.” There are a few basic tenets, some more intuitive than others. First, optimize the sleep environment; ideally this means a dark, cool, quiet bedroom. Second, a consistent bedtime and wake time are very important, even on the weekends. This is particularly difficult for our patients who have jobs requiring rotating shifts. Next, find a bedtime routine which helps your brain wind down; think less screen time, and more reading, meditating, or listening to calming music. 
Finally, and less intuitive to most, if you do find yourself lying in bed for 20 minutes without falling asleep, get out of bed, try a calming routine over again, then get back into bed. More time spent not sleeping in your bed is more time your brain spends learning the bed is a place to be awake. Furthermore, it fuels anxiousness when we lie awake yearning for sleep, so it is best to break that cycle.
I see a lot of people tracking sleep with their smartwatch or other wearable device, and my advice is to be aware of potential pitfalls. We don’t have good evidence that the information all devices provide on sleep is accurate, and for most people tracking those statistics actually tends to increase anxiety around sleep which may worsen the problem.
Have you followed all the above advice but still suffer from insomnia? The gold standard treatment is cognitive behavioral therapy for insomnia (CBT-I) provided by a mental health professional. Beyond that we do have pharmacologic options, but medications for sleep can be fraught with potential problems, especially for our patients over age 65. Even some over-the-counter sleep medications can have significant risks in older patients, so please use caution and talk you your primary care provider.
Dr. Kelly Evans Hullinger practices internal medicine at Avera Medical Group in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).