DEAR DR. ROACH: You recently wrote that “nearly everybody born before 1957 had measles and mumps (but not rubella).” I was born in the early 1950s, so I fall into this category. A few years ago, at my request, my primary care physician did a test to check for immunity for the MMR diseases.

While the mumps and measles tests came back indicating the positive presence of antibodies, the rubella antibodies test showed no immunity. My physician indicated that because I was not a woman of childbearing years, I did not need to be concerned about getting a rubella vaccine. I have no recollection of having rubella, nor of being (or not being) vaccinated for this.

Do you agree with my doctor’s advice? And if you do recommend being vaccinated, should I try to find a vaccination just for rubella? Or should I get the MMR vaccine, even though I don’t need the measles or mumps vaccines? — A.M.

ANSWER: While the United States is not experiencing a rubella outbreak now, low rates of childhood immunization in certain communities mean that future outbreaks are possible. Fortunately, rubella is not as contagious as measles, and the risk of complications is much smaller. For this reason, vaccination or testing for immunity is not needed outside of an outbreak except in health care workers and women who are of childbearing age. I agree with your doctor.

If you choose to get immunized, or if there were an outbreak, I recommend immunization, and you would need the MMR vaccine since no manufacturer makes an individual measles, mumps, or rubella vaccine that is licensed in the U.S.

DEAR DR. ROACH: Is magnesium glycinate a better alternative to melatonin for insomnia? — E.B.G.

ANSWER: Although I have heard magnesium recommended for insomnia, the data supporting its use are weak, so I can’t give a definitive answer. Some studies show a modest benefit, while others show no benefit at all compared to a placebo.

The data are stronger for melatonin, and we know that it is very modestly effective compared to a placebo. Both supplements are generally safe. The major side effects of magnesium are gastrointestinal, especially diarrhea, and the major side effect of melatonin is unwanted sleepiness (such as during the day).

The best treatment for insomnia remains good sleep hygiene, regular exercise, avoiding troublesome medications and in people who need more help — cognitive behavioral therapy for insomnia.

What I mean by good sleep hygiene includes maintaining a consistent sleep pattern (waking up and falling asleep at the same time on weekends as the weekdays); avoiding bright light (televisions, phones and tablets) in the hours before sleep; avoiding substances that can keep people awake (especially caffeine but also alcohol and nicotine) before bed; and getting out of bed if you know you can’t sleep since you don’t want to associate being in bed with lying awake. A cooler and darker bedroom tends to me more amenable to sleep.

I greatly prefer behavioral techniques for insomnia since prescription medications have the potential for side effects as well, including falls and motor vehicle accidents for those who drive the day after taking sleep medication.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.(c) 2025 North America Syndicate Inc. All Rights Reserved