DEAR DR. ROACH: You’ve discussed sleep aids and your belief that it is best to get off all of this type of medication. I am healthy, 75 (take no meds), exercise with weights, do swimming and running regularly, and since 2007 have been taking an over- the- counter sleep aid called doxylamine nightly with no apparent side effects. Do you see a problem with continuing? — A.B.
ANSWER: Unfortunately, I do see a problem. Odds are that you won’t have a problem taking this medication; it’s cheap and is effective for you. However, there is unequivocal, abundant, incontrovertible evidence that antihistamines like doxylamine or diphenhydramine increase fall risk. If you drive, they increase accident risk. They also can cause confusion.
Although the benefit to you from quitting is small, if I can get enough people to minimize their sleep medications, I know I will prevent some falls. Falls are so often the first step in a progression from health to disability that I want to do all I can to prevent them.
Adequate lighting in the house at nighttime, especially between the bedroom and bathroom, avoiding obstructions like area rugs and the addition of stairway railings and tub grab bars all help reduce fall risk. Exercise programs — like the kind you are doing, but also tai chi — are great at preventing falls. So is getting your eyes checked.
No single one of these interventions can prevent all falls. All of them together will prevent many. Your medication list, even a simple over-the-counter sleeping aid, is the best place to start looking to reduce risk of falls.
DEAR DR. ROACH: My dad has an extreme case of COPD and is on oxygen. He gets winded just walking across the house. Dad lives in Montana; I live in Florida and would like him to come visit me during the cold Montana winters. I have heard that it would be easier for him to breathe at a lower altitude. But people have told him that if he comes to Florida, he would never be able to go back to Montana because he wouldn’t be used to the altitude any longer. Is this true? — D.W.
ANSWER: The lower oxygen levels at high altitude, like some cities in Montana, can be a real problem for people with any kind of chronic lung disease. In those cases, supplemental oxygen or a lower altitude can make people feel better and even live longer. Given that your dad is already on oxygen, a lower altitude would be similar to dialing up the oxygen a bit. He may certainly prefer Florida’s winters to Montana’s.
We begin to be accustomed to high altitude in a few days, but full acclimatization takes weeks. Your dad will be able to return home after his visit.
The booklet on COPD explains both emphysema and chronic bronchitis, the two elements of COPD, in detail.
Readers can obtain a copy by writing: Dr. Roach — No. 601W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75. with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.
©2015 North America Synd.