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Ask Dr. Gott 10/18

Bladder spasms may be cause of sleeplessness

DEAR DR. GOTT: We were interested in the question sent by the 80-year-old registered nurse about older people having difficulty getting back to sleep after waking up during the night. In my case, I have to get up in the night for bladder relief, then lay awake or finally turn on the light to read for two hours. I have been helped by taking sleep aids. They all have the ingredient diphenhydramine. The product is labeled nonhabit-forming but is recommended for only occasional sleeplessness. I am concerned that frequent use might be detrimental. Would every third night on a continual basis be too often?
    DEAR READER: It appears to me that your basic problem is not insomnia. Rather, I believe the bladder spasms are to blame. So the first thing I would do is restrict your fluid intake. Specifically, don't drink anything after dinner (7 p.m. to 9 p.m.). In addition, you may wish to have your primary care physician check your urine for infection, which may cause no symptoms other than urinary frequency. I cannot comment on your use of diphenhydramine.
    For young folks, it is a safe, inexpensive over-the-counter antihistamine that causes sleepiness. However, in people over 60, it can cause side effects such as grogginess and confusion the next day, so its use should be questioned in this age group. You don't mention your age. Quite honestly, I'd be surprised if your PCP failed to come up with a solution to your bladder problem. In any case, I'd pay attention to your evening/night hydration as a starter. To give you related information, I am sending you copies of my Health Reports "Urinary Tract Infections" and "Sleep/Wake Disorders."
    Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 for each report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

    DEAR DR. GOTT: My 27-year-old grandson travels all over the world, including Europe, Australia and Korea, as well as the United States, teaching swing dancing. He is a college graduate and is in good health. What specific shots should he have to protect his health while visiting these countries? He was born and raised in the Central Valley of California, an agricultural region, and currently lives in Los Angeles.
    DEAR READER: The recommendations for avoiding and treating infections and other illnesses in world travelers vary frequently. Therefore, most experts advise such people to check with an infectious-disease authority or the Centers for Disease Control and Prevention (www.cdc.gov; 877-394-8747) to receive the most up-to-date information prior to leaving the United States on pleasure or business.

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