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Answers to questions about restless legs, ACE inhibitor cough, and sinusitis.

Q What is restless legs syndrome, and can it be treated?

A Also known as Willis-Ekbom Disease, restless legs syndrome (RLS) affects as many as one in 10 American adults, according to the National Sleep Foundation. The disorder is characterized by unpleasant burning, pulling, or creeping sensations in the legs that cause an urge to move them. The symptoms are set off when you sit or lie down, are most severe in the evening, and can significantly disrupt your sleep.

RLS is most common among middle-aged and older adults, and it usually develops between the knee and ankle. The cause of RLS often is unknown, but it tends to run in families. Low iron levels or anemia, kidney failure, diabetes, Parkinson's disease, and peripheral neuropathy also are associated with RLS.

Conversely, getting up and moving, stretching, taking hot baths, and reducing your intake of caffeine, alcohol, and tobacco may help improve symptoms. The U.S. Food and Drug Administration (FDA) has approved the drugs gabapentin enacarbil (Horizant[R]), pramipexole (Mirapex[R]), ropinirole (Requip[R]), and rotigotine (Neupro[R]) to treat moderateto-severe RLS. The FDA also has approved Relaxis[R], a pad placed under the area of discomfort that vibrates for 30 minutes to relieve RLS symptoms. Talk to your physician about which treatment is right for you.

Q I've had a dry cough since I started taking an ACE inhibitor. Is the drug to blame?

A Angiotensin-converting enzyme (ACE) inhibitors are widely used to treat high blood pressure. They include benazepril (Lotensin[R]), captopril (Capoten[R]), enalapril (Vasotec[R]), fosinopril (Monopril[R]), lisinopril (Prinivil[R], Zestril[R]), moexipril (Univasc[R]), perindopril (Aceon[R]), quinapril (Accupril[R]), ramipril (Altace[R]), and trandolapril (Mavik[R]).

The drugs typically are well tolerated. However, a common side effect is a persistent dry, hacking cough, which can affect up to about a third of patients using the medications. The cough may begin within hours after first taking an ACE inhibitor or may occur weeks to months later. The coughing usually abates within a month of stopping the medication, although in some cases it may persist a few months longer.

ACE inhibitors are one of several effective classes of blood-pressure-lowering drugs. If your cough continues to bother you, especially if it keeps you up at night, ask your doctor about switching to a different class of blood pressure medication. Do not stop taking the medication without talking to your physician.

Q What can I do to prevent chronic sinusitis?

A Chronic sinusitis occurs when the sinuses (the cavities surrounding the nasal passages) become swollen, inflamed, and painful. Several conditions can cause or contribute to chronic sinusitis, including upper respiratory infections (colds), nasal polyps, a deviated nasal septum, nasal allergies, and facial trauma that obstructs the sinus passages. If you experience frequent bouts of sinusitis, see an ear, nose and throat specialist to check for nasal abnormalities and other contributors.

Several home remedies can ease sinusitis and may help you avoid a recurrence. Maybe the most important preventive measure is to avoid upper respiratory infections by washing your hands and avoiding contact with people who have colds. And, if you have nasal allergies, work with your doctor to manage your symptoms.

Use saline nasal sprays and a humidifier to keep your nasal passages moist. Also, using a bulb syringe or a neti pot to flush out your sinuses may provide some relief.


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Editor-in-Chief Richard S. Lang, M.D., M.P.H., F.A.C.P

Vice Chairman, Cleveland Clinic Wellness Institute
COPYRIGHT 2016 Belvoir Media Group, LLC
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2016 Gale, Cengage Learning. All rights reserved.

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Title Annotation:ASK DR. LANG
Author:Lang, Richard S.
Publication:Men's Health Advisor
Date:Jun 1, 2016
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