Dear Drs. Donohue and Roach: Every day, I depend on a pill to keep my blood pressure down and one to keep my cholesterol down. So what's wrong with my depending on a pill every night to get a good night's sleep (triazolam)? I am a male, age 87.
L.D.
It sounds like someone, maybe your doctor, is trying to get you to cut down on your sleeping pills.
Both blood pressure and cholesterol medicines reduce your risk of heart disease and stroke, and the side effects are weighed against that. With sleeping medications, the risks are higher than they are for most blood pressure and cholesterol medicines. The big risk is falling: The risk of a fall is substantially higher for people who take sleeping pills than for those who don't.
So, in the case of blood pressure and cholesterol medicines, they may make you live longer, but can make you feel worse (but with any luck, not much worse). Sleeping pills, on the other hand, make you feel better but have a higher risk of falls and even death (but very small). That's why your doctor may be trying to get you to cut down.
Good bedtime habits - including taking no caffeine in the evening and avoiding bright lights, the television and your computer at least an hour before bed - can help people sleep, sometimes better than sleeping pills.
Dear Drs. Donohue and Roach: I have herpes HSV-2 (genital herpes). I learned this in 1984, when I was 39. I've been fortunate to get only one or two outbreaks per year. Now, I'm in my late 60s and wonder if I should get a shingles shot.
G.F.
That's an easy one. You should get the shingles shot.
Herpes simplex virus, both type I (usually in the mouth) and type II (usually genital), are related to the virus that causes shingles, Varicella-Zoster. But having HSV doesn't protect you from getting shingles, and the shingles vaccine doesn't affect the frequency of HSV outbreaks. Shingles is common and can be very painful and even debilitating, especially in the elderly. The vaccine reduces your chances of getting shingles, but even if you do get it, the vaccine reduces the duration and intensity of pain.
