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Can you get hooked on OTC sleep aids?

In your search for a good night's sleep, you might think the easy solution is one of those sleep drugs on store shelves -- Advil PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom SleepMinis or perhaps the popular ZzzQuil, from the makers of NyQuil.

These drugs contain diphenhydramine, a decades-old antihistamine often used as a remedy for seasonal allergies, explains Consumer Reports. It works by blocking the histamine receptors in your brain that also control wakefulness -- so drowsiness is a side effect for some people.

Over-the-counter sleep aids that contain this drug (as well as doxylamine) might help you get to sleep. And what's more, their packaging suggests that they are "non-habit-forming."

But diphenhydramine can create a psychological dependence, says Carl W. Bazil, M.D., Ph.D., director of the Epilepsy and Sleep Division at Columbia University's Department of Neurology. "The pills are not 'addictive' in the physical sense," he says, "but there can certainly be a risk for a psychological dependency."

Side Effects to Take Seriously

A 2015 Consumer Reports national survey of 4,023 adults found a troubling trend: Of the 20 percent who took an OTC medication within the past year to improve sleep, almost 1 in 5 respondents, or 18 percent, said they took it on a daily basis. Most concerning: 41 percent said they used the drugs for a year or longer.

That's a problem because diphenhydramine can cause constipation, confusion, dizziness and next-day drowsiness, according to the drug's FDA labeling. Another concern is the "hangover effect" -- impaired balance, coordination and driving performance the day after you've taken the drug, heightening the risk for falls and accidents. And in a January 2015 study in JAMA Internal Medicine, the frequent, long-term use of first-generation antihistamines, including diphenhydramine, was linked to an increased risk of dementia, including Alzheimer's disease.

What to Try Instead

Should sleep problems persist beyond 14 days, it's time to see your doctor. Insomnia can be due to an underlying condition, such as heartburn, depression or heart disease.

For those whose chronic insomnia is not so easily fixed, a new analysis by Consumer Reports Best Buy Drugs recommends cognitive behavioral therapy (CBT) instead of sleeping pills as a first-choice treatment. With CBT, you work with a licensed sleep therapist, learning about habits that may compromise your sleep. CBT also uses techniques like journaling to help you feel more optimistic about sleep. Studies suggest that CBT helps 70 to 80 percent of people with chronic insomnia, and effects are long-lasting, with few -- if any -- downsides.

If you still decide to take insomnia drugs, do so for only a few days at a time, at the lowest recommended dose. Never drink alcohol while taking them, and don't take an extra pill to get back to sleep -- doing either can worsen the drug's side effects. Avoid mixing them with other sleep drugs or supplements, including OTC nighttime pain relievers and antihistamines. Use caution if you drive the next day; you might still be drowsy.

To learn more, visit ConsumerReports.org

How to avoid being gouged when buying eyeglasses

For the approximately 64 percent of Americans who wear them, prescription eyeglasses are part medical device and part fashion accessory. But when it comes to buying them, the choices -- and the trade-offs -- can be overwhelming.

Consumer Reports surveyed more than 91,000 readers and also shopped for glasses themselves, online and in walk-in stores, to discover the pros and cons of different vendors. Here's what they learned:

-- Doctors' offices and independent eyeglass shops. Nearly 40 percent of survey respondents bought their glasses from one of these sources. They gave these sellers high marks for lens and frame fitting, employee knowledge and follow-up service. But frames and lenses tended to cost more than elsewhere: Readers shelled out a median of around $400, two to three times what you might pay online or at a discount store.

-- Major eyewear chains. Since they have many locations, buying eyeglasses at eyeglass chains can be convenient. Consumer Reports' readers reported good follow-up service from most chains, too. But in other areas, survey ratings varied depending on the company.

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-- Warby Parker and Zenni Optical. Each of these stores sells only its own brand of glasses. Warby Parker retails both online and in brick-and-mortar locations in 18 states, the District of Columbia and Ontario, Canada. In the seven years since it launched, Warby Parker has become a major player, offering glasses with single-vision lenses for $95, including an anti-reflective coating. But if you order progressive lenses, those prices can rocket to nearly $300 -- far more than the prices Consumer Reports found at some other retailers.

As for all-online retailer Zenni Optical, you can try on frames only virtually, by uploading a photo of yourself. And it, too, has a 30-day warranty. Still, Zenni's frames with basic single-vision lenses start at less than $10, and upgrading to progressives begins at just $28. Survey respondents who bought from Zenni spent a median of just $69 for a complete pair of glasses, making them the survey's lowest-cost retailer.

-- Large discount chains. Costco and Wal-Mart are low-cost one-stop spots for buying eyeglasses where you can do everything from having your eyes examined to getting your finished glasses adjusted for fit. Frames can be inexpensive at these stores. At Wal-Mart and Sam's Club, Consumer Reports found basic, plastic progressive lenses for as little as $79. Costco charges $130 for high-definition progressive lenses, which, as with all Costco lenses, include an anti-reflective coating. That's about half what you'd pay at many walk-in stores. But if you need basic, plastic single-vision lenses, you can pay as little as $29 at Wal-Mart, about half as much as at Costco.

-- Online retailers. While only about 5 percent of respondents bought their glasses online, nearly twice as many browsed online before purchasing at a walk-in store. Even if you don't plan to buy from a website, the price information you get might help you negotiate your way to a discount from a walk-in store.

To learn more, visit ConsumerReports.org

How much sugar is OK in kids’ food?

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Recently, there has been even more evidence of the health risks of added sugars, especially for children, according to Consumer Reports.

"I'm seeing fatty liver and other metabolic problems, like high triglycerides and insulin resistance -- which are precursors to later heart disease -- in children as young as 5, and scores of children developing Type 2 diabetes by their mid-teens," says David Ludwig, M.D., Ph.D., the director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital.

That's why the American Heart Association recently recommended that children consume fewer than 25 grams (about 6 teaspoons) of added sugars per day, which amounts to 100 calories' worth. And it recommended no added sugars at all for kids younger than 2.

Added Sugars Are the Real Problem

Many of the foods we eat contain naturally occurring amounts of sugars -- especially dairy, fruit and some vegetables. But when experts talk about reducing the intake of sugars, they're referring to added sugars, which is any type that's added to a food to increase the sweetness.

What's so unhealthy about added sugars? The problem, Consumer Reports notes, apparently goes beyond the concern of empty calories pushing more nutritious ones out of the diet.

"Certain foods affect the body in other ways beyond just calories," Ludwig says. The most common sugars are a combination of fructose and glucose. The liver is supposed to convert the fructose into energy, but when the body is flooded with too much of it too fast, it instead creates new fat molecules that can lead to fatty liver, high triglycerides and insulin resistance.

Ludwig also notes that reducing foods that are high in added sugars (like candy and soda) and replacing them with other highly processed carbohydrates (like white bread) is not much better. The key is to shift the dietary focus away from added sugars and all processed carbohydrates.

Hidden Sugars in Kids' Foods

Until you can get your children to trade sweet treats for an apple, Consumer Reports says, it's even more important to sleuth out hidden sources of sugars in their diets. You already know you should limit their intake of candy, soda, sugary cereal and the like, but what about some of the seemingly "healthier" snack foods and organic treats? In many cases, they are no less sugar-laden -- even if their sweetness comes from added sugar in one of its many other guises (like organic cane sugar, fruit juice concentrate, agave nectar, honey or brown rice syrup). And sugar can lurk in places where you least expect it, such as bread and spaghetti sauce.

This doesn't mean that your family can never indulge in sweets again, or that it's crucial to eliminate almost all added sugars. So even if the AHA recommendation seems unattainable, any reduction you make will still benefit your health. "If you're going to have sweets, have them after a balanced meal, serve a reasonable portion size and do it only occasionally," Ludwig says.

To learn more, visit ConsumerReports.org

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