Dear Doctor: My son and his wife have a 13-month-old son, born at home, whom they refuse to have vaccinated. In fact, the only time he's seen a doctor was a month ago when he had a bad cold. How can I convince them of the merits of vaccination?

Dear Reader: Our human lives have diverged significantly from that of our ancestors, meaning everyday existence is much more controlled and mechanized than ever before. It is thus understandable to want to live and raise one's children in a more "natural" way -- and to have control over our lives when so much is governed by the society around us. This conflict is evidenced by many parents' reaction to vaccine guidelines for children.

Your son and daughter-in-law may feel that these vaccines are harmful and unnecessary. But, if you ask generations who saw the ravages of polio or the infant deaths from pertussis, there would be no question as to the benefits of vaccines. Consider:

Polio: Prior to the development of a vaccine, polio led to thousands of deaths and even more cases of paralysis in this country alone. The illness has no cure, so the best option is to be vaccinated.

Measles: Before there was a vaccine, more than 90 percent of children acquired measles by the age of 15. In the decade prior to 1967, when the vaccination became widespread, 48,000 children were hospitalized for measles each year; 1,000 developed permanent brain damage; and 500 died. Since the vaccine, the number of measles cases has dropped 99 percent.

Mumps: Prior to routine vaccination in the late 1960s, this was a very common illness, affecting about 186,000 children per year. For most children, it was mild, but if the virus invaded the brain, children could develop irreversible hearing loss. Further, in males, if the virus affected both testes, chronic sterility ensued. Routine vaccination has reduced the incidence of the disease by, again, 99 percent.

Rubella (German measles): Prior to widespread vaccination against rubella, a disease transmitted from pregnant woman to fetus, an epidemic in the early to mid-1960s caused 2,100 deaths in utero; 11,250 spontaneous abortions; and more than 20,000 babies born with a syndrome that leads to hearing loss, heart disease, vision loss, liver dysfunction and developmental delays.

Pertussis: This disease, known as whooping cough, was also devastating, with a high mortality rate.

That's not to say all vaccines are perfect. Some can cause Guillain-Barre syndrome, which can have devastating neurologic consequences. They can also lead to inflammatory reactions such as hives and breathing problems. But these side effects are very rare -- and are significantly dwarfed by the benefits of vaccination to the individual and to the general population. There is no evidence that vaccines lead to autism, as many people believe.

Because vaccination has largely eradicated many of the above diseases, an unvaccinated child may have a lower likelihood of getting the illnesses. But the more people refuse vaccination, the greater the risk to individuals and the general public.

I understand that it's difficult for you, knowing that your grandson isn't vaccinated. All you can do is to provide your son and daughter-in-law with the evidence of the benefits of vaccination. It's up to them to make the decision.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My doctor offered to prescribe sleeping pills because I'm under a lot of stress at work and am suffering from insomnia. I'm tempted, but the side effects scare me. How often do people sleepwalk or binge-eat or do other activities after taking sleeping pills? I even heard that one woman drove across the country!

Dear Reader: When it comes to having trouble getting a good night's sleep, you're not alone. It's estimated that at least one-third and perhaps up to one-half of all Americans experience some kind of sleep problem. These range from the occasional sleepless night to the chronic -- and at times debilitating -- insomnia that affects up to 10 percent of the U.S. population. To deal with this unwanted wakefulness, an estimated 9 million Americans now turn to sleep aids of one kind or another. And considering the complex physiological mechanisms that regulate sleep, it's not that surprising that there would be some side effects associated with these medications.

The medications most commonly associated with the odd behaviors you mentioned are zolpidem, sold under the brand name Ambien, and eszopiclone, sold under the brand name Lunesta. They fall into a class of drugs known as hypnotics. These work by binding to certain receptors in the brain, which affects neural activity in a way that allows the user to slip into sleep.

Although the majority of users experience few if any side effects, some people have reported a range of peculiar and potentially dangerous behaviors that they had no memory of taking part in. These include waking up with food or dirty dishes in their beds, then finding a mess in the kitchen that indicated they had prepared a meal sometime during the night. Other anecdotes include a man waking up in the family car in his pajamas, parked miles from home with no idea of how he got there. A woman reported receiving clothing deliveries from a $2,200 online shopping spree she had no memory of, and another woman woke up shivering in a bathtub filled to the brim with cold water and surrounded by burning candles.

As we mentioned, these side effects are considered to be rare. The labels of the relevant drugs now carry prominent warnings that, while under the influence of the medication, it's possible to walk, eat or even drive and have no memory of it afterward. Also carried in the warning labels is the possibility that varying levels of cognitive impairment, as well as physical symptoms like headache, nausea and a bad taste in the mouth, can persist into the following day.

While the temporary respite these sleep aids can offer from a bout of insomnia is helpful, it's important to note that they are not intended for long-term use. Rather, they are meant for occasional use, to help someone who is struggling with sleeplessness to get through a rough patch. However, because the drugs are quite effective and also potentially habit-forming, it's possible to become dependent on them over the long term. If you do decide to try them, please keep that -- and the label warnings -- in mind.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My 40-year-old grandson has just been diagnosed with celiac disease after months of feeling poorly and being underweight. What's next? Where can he go for guidance and what should he do? I want to help, but don't know where to start.

Dear Reader: Let's begin with the basics: Celiac disease is an inflammatory reaction within the small intestine. The reaction is caused by gluten, a protein found in wheat, rye, spelt and barley, and occurs in people genetically prone to the disease. Symptoms vary depending upon the extent of inflammation.

In years past, celiac disease was diagnosed only in people with the classic, or severe, form of the disease, which damages the finger-like projections of the small intestine that help absorb nutrients. When those projections are damaged, the body is unable to absorb fats, leading to increased abdominal gas; stools that are bulky, foul-smelling and float; and poor absorption of vitamins and nutrients. The ultimate result can be anemia, weight loss, nerve dysfunction and osteoporosis. Today, we've realized that the prevalence of celiac disease is much greater than initially thought because many patients have milder symptoms, such as fatigue and generally loose stools.

Your grandson probably suffered for months prior to his diagnosis because his symptoms were mild. In less-debilitating forms of the illness, symptoms can be either misdiagnosed or not severe enough to push someone to seek medical attention.

Regardless of severity, however, celiac disease can be addressed. The cornerstone of treatment is removing gluten from the diet. That means avoiding wheat, rye and barley, which are in a surprising number of foods -- not just breads, pastas, crackers and snacks, but also sauces, vinegars, salad dressings, marinades, seasonings, soup stocks, soy sauces, and even beers, ales and lagers. For that reason, anyone with celiac disease should carefully read the labels of all prepared foods and condiments that they consume. Although such restrictions can make going out to restaurants more difficult -- and potentially affect a person's ability to socialize -- the health benefits outweigh the difficulties.

On the plus side, many condiments and beers are increasingly available without gluten, as are breads and pastas. The latter foods are made with quinoa, tapioca, rice, soybeans or buckwheat, all of which are safe to eat. In fact, over the past 20 years, a whole industry has developed to cater to people who are intolerant to gluten, and many restaurants now provide gluten-free options as well.

In 70 percent of patients with celiac disease, following a gluten-free diet leads to a reduction in symptoms within two weeks, and levels of inflammatory antibodies decline substantially after six weeks.

Among people who continue to have symptoms, 90 percent either don't adhere properly to a gluten-free diet, or they consume foods they mistakenly believe are gluten-free. For those who are strict about a gluten-free diet but still have severe symptoms, oral steroids or other medications to suppress the immune system can relieve symptoms.

Your grandson is probably already seeing a gastroenterologist who is monitoring his symptoms and evaluating him for nutritional deficiencies, but he also should consult a nutritionist to review the types of foods and drinks he is consuming. With a gluten-free diet, he should be feeling better soon.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)