Q: I have trouble sleeping. I rarely get more than four to six hours, but I’d love at least seven. The first good night’s rest I’ve had in a long time is when I took a muscle relaxer my doctor prescribed for a back problem. Any tips? — Carmen, Los Angeles
A: You have lots of company, waking with early birds. About 30 percent of Americans complain of disturbed sleep. They may fall asleep for a few hours, but then their eyes pop open way too soon for them to feel really refreshed.
There are lots of possible reasons for this premature wake-up call. You could be drinking caffeine too late: It stays in your system for five or more hours, and it both slows falling asleep and causes easy arousal. Or you could be worrying about almost anything — from the mortgage to the Mets.
But since you mention a back problem, we’re going to make a guess that a move that triggers pain is your inner alarm clock. Back discomfort may not keep you from falling asleep, but it may be enough to cause what doctors call microarousal, meaning you’re nudged from a deep sleep into a lighter stage. One loud birdsong, and you’re awake.
What’s called “good sleep hygiene” — no caffeine after lunch, having a soothing bedtime ritual like taking a hot bath or meditating, and making your bedroom a calm, media-free zone (no TV, no computer, no cellphone, no anything) — helps many sleep problems. Talk to your doc about taking a 12-hour pain reliever before bed.
Try de-tensing your back and brain with muscle relaxation: Starting at your toes, gradually tighten and release your muscles, one by one, until you feel like a limp rag doll. And position pillows so you cannot move into a painful position.
Q: Do dried herbs like oregano, sage and garlic powder have any health benefits? We pick ours from our summer garden and dry some to use in the winter. — Vilma, McDonough, Ga.
A: The bounty from your garden definitely qualifies as medicinal, so call yourself a “pharmer” and enjoy the healthy perks of those herbs, fresh or dried.
In lab studies, oregano kills off microorganisms like E. coli. Add oregano to a veggie burger, chicken or a salmon steak before grilling, and it also will nip production of a cancer-causing chemical called malondialdehyde in the grilled foods and people who eat them.
Garlic may help reduce lousy LDL cholesterol and decrease inflammation in your body, thereby protecting artery walls and lowering cancer risk.
Sage, that great flavor staple of turkey stuffing, is a powerful protector: It defends your cells against “rusting,” which is a kind of oxidative damage that can lead to cancer, heart disease and more.
Q: I have osteoarthritis in both knees. My left knee is the worst (bone is hitting bone). My doctor wants me to have a knee replacement, but I understand that it will last only about 15 years. I’m only 61. I don’t know what to do! — Katherine
A: If you’re in a lot of pain and your daily activities are limited, going a little bionic is probably a good choice. About 85 percent of total knee implants last 20 years, depending on a mix of factors, including weight and activity level.
Being able to stay active is one reason more knee replacements are being done earlier. You’ll probably be told not to ski moguls or run marathons (were you planning to?). But likely you’ll be able to do many things you probably can’t do now, including light hiking, biking, even ballroom dancing.
Need more reasons to consider a surgical repair? Chances are, you’re putting yourself at high risk of an ulcer or gastrointestinal bleeding by regularly taking anti-inflammatory drugs for your knee pain. And we bet you’re not working out regularly, and exercise is good for your whole body.
With help from your doc, weigh the benefits and risks of the surgery. Also discuss other measures to help slow osteoarthritis. These include taking one dose of vitamin C (500 mg), vitamin D-3 (1,000 IU), calcium (600 mg) and magnesium (200 mg) in the morning — and a second dose of each at night.
Work with a physical therapist to build up the muscles above and below your knees, which will help support the joint. Take an anti-inflammatory one to two hours before and after each exercise session. If you still have persistent pain, you may opt for a new knee.
Dr. Mehmet Oz and Dr. Michael Roizen are authors of “YOU: On a Diet.” Submit questions at .
