Dear Dr Rosenberg,

There is a an increases incidence of Sudden Infant Death Syndrome in my family.  I understand it can be in part genetic. I am thinking about having a baby. Any advice?

Yes, first of all avoid exposure to cigarette smoke during the pregnancy. Get good prenatal care. Do not use illicit drugs. When the baby is born, make sure the infant sleeps on their back. A firm mattress is recommended and avoid soft bedding materials. Finally, breast feeding and use of pacifiers have been found to be protective.

Dear Dr Rosenberg,

Is it true; that poor sleep in teenagers can predict alcoholism? I’m worried about my 16 year old son. He has trouble getting to sleep and lately we suspect he is drinking at night.

The answer is yes. Several recent studies have shown that poor sleep, especially an inability to fall asleep; may result in adolescent alcoholism. The reasoning behind this is twofold. First some teenagers use the alcohol to help them fall asleep. Secondly, the lack of sleep results in irritability and poor impulse control. Both of which set the teenager up for drinking. If you suspect this to be true, discuss this with your son and get him help to avoid this spiraling out of control.

Dear Dr Rosenberg,

We started our five year old on Tylenol PM for Insomnia. He has a lot of trouble falling asleep. However, we find he is groggy during the day and becoming constipated. Could this be due to the medication?

Yes, most certainly. Tylenol PM contains an old antihistamine called Diphenhydramine. The dose in the adult form you are giving him is probably double the maximum a child of five years old should receive. Common side effects include drowsiness, blurred vision, constipation and urinary retention. I’d advise you to stop it immediately and consult your Health Care Provider about the problem.

Dear Dr Rosenberg,

I have Restless Legs Syndrome and have been on a medication called Sinemet for two years. Over the last few months, the discomfort in my legs is coming on earlier. My doctor has been having me take additional doses of the drug earlier in the day. However, it’s not working. In fact, the pain is coming on earlier and earlier. Any ideas, because I’m at my wits end.

Yes, what you are describing is called Augmentation. It is very common with the medication Sinimet. Basically, the symptoms of Restless Legs Syndrome come on at earlier times and may spread to other parts of the body. The treatment is to stop the Sinemet (Carbidopa-LDopa) and switch to another medication such as Reqip, Mirapex or Gabapentin. Increasing the dose and frequency of Sinimet will only make matters worse.

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.