Dear Dr Rosenberg,

I have had some trouble getting to sleep for a few years now. It is worse, when I am stressed; such as before meetings at work or when I feel overwhelmed. Recently, I started taking an over the counter sleep aide called Unisom. It helps me get to sleep, but I have been waking up with weird feelings in my legs that are relieved by rubbing. I do not see this listed as a side effect. Could this be causing my problem?

Yes, it could be. Unisom, like most OTC sleep aides contains a first generation antihistamine. These antihistamines get into the brain and cause sleepiness. Unfortunately, they can cause Restless Legs Syndrome; which is what you are describing. I would stop taking this OTC preparation and I expect the leg problem will resolve. If not, please see your Health Care Provider for a further workup.

Dear Dr Rosenberg,

For the past year or two, my husband has been complaining of sleepiness and fatigue. I have noticed that he is taking Tums throughout the night. He tells me he gets heartburn. He says the Tums work well, so he does not need to see a doctor. Could his fatigue and sleepiness be related to this?

Most definitely! Nighttime heartburn is a major cause of fatigue and sleepiness during the day. Taking Tums is not the answer. It is treating the symptom after the fact. More importantly, untreated it can lead to complications such as scarring of the esophagus and even cancer. Additionally, he may be mistaking chest pain that is cardiac in origin, for heartburn. I would urge your husband to see his Health Care Provider to get this evaluated and treated.

Dear Dr Rosenberg,

I am 54 years old. I have just gone through menopause. I am having some trouble falling asleep. However, my main problem is staying asleep. It seems, I am up every hour or two for at least 15 minutes. Is this unusual and is there anything I can do for this?

No, it is not unusual; 30 to 40% of Perimenopausal and Menopausal women develop Insomnia. In some cases, it is due to hot flashes and sweating. In some women; it is due to the development of Sleep Disordered Breathing. However, in many it is due the loss of Estrogen and Progesterone. These hormones do have sleep promoting effects on the brain. So in many cases, a trial of Hormone Replacement Therapy if not contraindicated, for a year or two may be helpful. Very low doses have been found to be effective.

Dear Dr Rosenberg,

My 12 year old son has trouble falling asleep. It is beginning to effect his school work. He is having trouble staying awake in class. He gets into bed at 9 pm, but is unable to fall asleep till 1 am. On the weekends, he sleeps until noon and feels much better. Any ideas? I have been thinking of trying some of those over the counter sleep aides like Tylenol pm.

Sounds like your son has developed a disorder called Delayed Sleep Phase Syndrome. It is very common in adolescence and pre adolescence. Basically, the clock gene in an area of the brain called the Hypothalamus has drifted to a later sleep time. I would definitely avoid the OTC sleep aides. They have numerous side effects and are not approved in this age group. The best treatment is exposure to bright light upon arising in the morning. Next get the environment ready for bed before getting into bed. No computers, no television in the bedroom, no playing videos games and no bright lights. Most importantly, keep his Sleep/Wake schedule the same on weekends.

Dr. Robert Rosenberg, Board Certified Sleep Medicine Specialist, will answer readers’ questions by incorporating them in furture columns.  Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Sedona, 210 S. Sunset drive, suite A-1, sedona, AZ 86336.