People's Pharmacy on husband's nightcap and sleep disturbances; the pros and cons of beta blockers; and using urea cream to treat spider veins.
Q: My husband frequently has a nightcap before going to bed. He says scotch relaxes him and helps him fall asleep. The only trouble is that he frequently wakes up in the middle of the night and then has a hard time getting back to sleep. That wakes me up, and it ruins my sleep as well.
I suspect the nightcap is to blame, but he disagrees. He says he just has to get up to urinate. Can you settle this argument?
A: This question is more complicated than it seems. Conventional wisdom is that alcohol before bed helps people fall asleep but disrupts sleep in the second half of the night. There’s surprisingly little research on this issue.
The best study we could find examined sleep in 20 healthy people, half of whom were insomniacs. A modest dose of alcohol before bed did not seem to have a negative impact on sleep later in the night (Neuropsychopharmacology, March 1999). On the other hand, it didn’t make people fall asleep faster either.
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Many men do have to get up at night to urinate because of an enlarged prostate. His doctor may be able to assess this and prescribe a drug to ease this symptom if it is waking him.
Q: My father takes atenolol to control his blood pressure. He has had terrible difficulties with respiration in addition to low-grade depression and a lack of energy. Is there an alternative class of drugs that he could try?
He is by nature a very active, energetic man and feels virtually immobilized by this drug, so he’s very anxious to seek out better options.
A: Although beta blockers like atenolol, metoprolol and propranolol are frequently prescribed, such drugs are rarely appropriate as first-line blood-pressure medications (Cochrane Database of Systematic Reviews, Aug. 15, 2012). They may not reduce the likelihood of heart attacks or strokes (Archives of Internal Medicine, Oct. 8, 2012).
Beta blockers can make breathing more difficult, especially for people susceptible to asthma (Journal of Asthma, November 2012). Fatigue and depression also are potential side effects.
Your father must not discontinue atenolol without medical supervision.
Q: I developed a skin condition on my lower leg for which my dermatologist recommended skin cream with 20 percent urea (OTC). The area was near some spider veins, and during the course of treatment, the spider veins faded where some of the urea cream got on them.
I began to cover the entire spider-vein area with the urea cream and now they are almost completely gone. Have you heard of using urea cream to treat spider veins? The change was really dramatic.
A: Yours is the first report we’ve received about urea-containing cream making spider veins (telangiectasia) fade. There is good evidence that topical urea can strengthen the skin’s barrier function and boost its resistance to microbes (Journal of Investigative Dermatology, June 2012). That may be why it is often helpful for conditions such as eczema.
Although we don’t know why or how urea-containing cream could make small red or blue veins on the legs become less visible, the cream is readily available as a moisturizer.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website: www.peoplespharmacy.org