Tag Archives: Insomnia

Straight, No Chaser: Insomnia – You Are Not Getting Sleepy

Insomnia-picture

This is part of a Straight, No Chaser series on sleep disorders. 

So the pendulum swings from hypersomnia to insomnia. Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle.
insomnia
Unfortunately, there are many mental factors that can disrupt your ability to sleep. Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

insomnia comps

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): good night and good luck.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, narcolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

Straight, No Chaser: Insomnia – You Are Not Getting Sleepy

Insomnia-picture

This is part of a Straight, No Chaser series on sleep disorders. 

So the pendulum swings from hypersomnia to insomnia. Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle.
insomnia
Unfortunately, there are many mental factors that can disrupt your ability to sleep. Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

insomnia comps

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): good night and good luck.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, narcolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

hyperinsomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from yesterday’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia? 

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Insomnia – You Are Not Getting Sleepy

Insomnia-picture

This is part of a Straight, No Chaser series on sleep disorders. 

So the pendulum swings from hypersomnia to insomnia. Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle.
insomnia
Unfortunately, there are many mental factors that can disrupt your ability to sleep. Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

insomnia comps

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): good night and good luck.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, nacolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Insomnia – You Are Not Getting Sleepy

Insomnia-picture

This is part of a Straight, No Chaser series on sleep disorders. 

So the pendulum swings from hypersomnia to insomnia. Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle.
insomnia
Unfortunately, there are many mental factors that can disrupt your ability to sleep. Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

insomnia comps

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): good night and good luck.
Thanks for liking and following <em>Straight, No Chaser</em>! This public service provides a sample of what 844-SMA-TALK and www.sterlingmedicaladvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
<div>
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, nacolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Insomnia – You are Not Getting Sleepy…

hypnosis

Talking about insomnia makes me, well, tired. You know what the problem is. You either can’t fall asleep or you can’t stay asleep. You’re tired when you wake and throughout the day. Lack of sleep saps your energy and your productivity.

Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle. There are so many mental factors that can disrupt your ability to sleep.

insomnia

Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).

hyperinsomnia

The thing is, whether acute, intermittent or chronic, any type of insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember: If it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might try. In fact, consider this my Top Ten Tips presented in the order you might consider implementing them.

  • Adhere to good diet and exercise habits, which make your body perform as it should and which will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says “no sleep” like heartburn all night. (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.)
  • Avoid nighttime stimulants (e.g., cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Don’t drink and sleep. Although alcohol is a sedative, it’s also on the “don’t do” list, because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music … or all of them.
  • Set the alarm for the morning. Then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use “white noise” for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born),

Good night and good luck.

Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Week In Review

WeekInReview_thumb2
Based on the response to this week’s posts, I’d say it was an informative week for you.  Remember to click the underlined topics to go to the mentioned post.  Let’s recap the week.
On Sunday, we reviewed night terrors and differentiated them from nightmares.  Remember, if your child develops these, it’s very important to protect them from harm during the episode, and try to identify the source of any increased stress.
On Monday, we reviewed the late Dr. Martin Luther King, Jr.’s comments on healthcare and its relevance today.  Injustice in healthcare is still shocking and inhuman, as health care disparities abound.  Monday also brought a review of the Patient Protection and Affordable Care Act (ACA), also known as Obamacare.  As the time of implementation gets closer, I will revisit implementation of the ACA, particularly health care exchanges, what your options are, and what’s to be done with the 20 million Americans who will still be uninsured.  I will also be discussing how this blog and my national efforts will dovetail into these considerations.  Stay tuned.
On Tuesday, we began our series on toxins and detoxification.  The first post discussed the power our body naturally and normally has to detoxify and to defend us from harm.  The second post offered specific, natural Quick Tips to enhance your body’s capabilities.  Taken together, I strongly recommend you internalize this information (no put intended).  All the other exotic methods typically promoted are, at best, enhancements to what we already do unless disease limits us.  At worst, they can cause damage themselves.
On Wednesday, we looked at some of the environmentally toxic dangers to our bodies, focusing on various toxins affecting our lungs, skin, kidneys, liver and intestines.  If knowledge is power, your brain should be stuffed after reading that post.  Stop smoking (Yes, you.).  Wednesday also brought a review of detox diets.  My advice is simple.  Proceed with caution, and don’t expect any miracle cures.  In fact, the better course of action is to use any such efforts as a launch into a more modest long-term regimen of healthy diet and exercise.
On Thursday, we reviewed colon cleansing, looking at oral solutions and rectal colonics.  These were turbulent topics, to say the least.  Please consult your physician before starting any of these diets or cleansing programs.  They are not without risk and consequence in certain patients.  Thursday also brought a review and wrap-up of the toxin/detoxification series.  I enjoyed your questions, comments and thoughts.
On Friday, we reviewed insomnia.  Do you remember the difference between primary and secondary insomnia?  There are important treatment considerations attached to each, so consider reviewing.  I also gave you 10 Quick Tips to help your difficulty sleeping and answered your questions. 
On Saturday, we peeled back the brains of physicians and taught you how we decide if and when ankle x-rays are needed.  I really do want your feedback when you mention the Ottawa Ankle Rules to your physicians.  I’m sure you’ll have stories about hearing them muttering “Damn internet!” under their breath!  Saturday also brought a review of a normal calorie intake.  I think this is a pretty important topic for several reasons.  I hope you learned the different between sedentary, moderately active and active lifestyles.  Also, many of us have no idea how much we should be eating and how many calories we should have daily.  Also, this will serve as a nice launching pad for my review of obesity next week.
Speaking of the next two weeks, I will be focusing on revisiting some fundamental bread and butter topics (no pun intended).  I continue to hope you enjoy Straight, No Chaser and appreciate your supporting this blog, which has now reached readers in 60 countries around the world in every continent.  I’ll keep bringing the information, and you keep taking advantage of it.

Straight, No Chaser: Your Rebuttals and Questions about Insomnia

You are certainly an entertaining group behind the scenes. Here are some of your questions on insomnia. Be reminded that should you want to leave me a private question, just go to the Home Page, or type https://jeffreysterlingmd.com into your browser. Here’s five questions from this morning’s post on insomnia.
1. Aw, hell! You’re telling me I can be dying from something causing insomnia?

  • It’s way more likely that level of stress you’re displaying is keeping you awake at night.

2. How is it that sex makes you sleepy?

  • When you do exert yourself vigorously, the greater utilization of muscles will deplete glycogen (energy) stores and make you drowsy. Also, it’s well established that certain hormones (e.g. prolactin, GABA and oxytocin) that promote sleep are released after an orgasm.

3. You mentioned tea. A good cup of tea at bedtime helps me sleep.

  • If that works for you, go for it. Some people have paradoxical effects to stimulants (In fact, stimulants are the most common treatment for ADHD – a topic for another day.)

4. What about giving my baby Benadryl?
I’m giving information here, not practicing medicine, so that’s a question for your physician. I will say there are many drugs (most notably those in the anticholingeric class) that have drowsiness as a side effect, and many emergency departments will give Benadryl to adults for that purpose. That said, these medications are not primarily used for drowsiness, and you’ll have to deal with other drug effects (such as the intended purpose for the medication) in addition to any possible drowsiness that occurs.
5. Sex at night keeps me wide awake.
That’s why a lot of you are shy about putting comments in the inbox… Sorry, but the answer to that question was not meant for public consumption.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Insomnia – You are Not Getting Sleepy…

insomniahypnosis

Talking about insomnia makes me well, tired. You know what the problem is. You either can’t fall asleep, or you can’t stay asleep. You’re tired when you wake and all throughout the day. Lack of sleep saps your energy and your productivity.
Insomnia really isn’t very cool to deal with, either as a person or as a physician. Patients are frustrated and sometimes cranky from being tired, or they can be extremely nervous and stressed, which will perpetuate a vicious cycle. There are so many mental factors that can disrupt your ability to sleep.
Medical professionals tend to think of insomnia in two forms for purposes of evaluation. Either the insomnia is the main problem (primary insomnia), or it’s secondary to another condition (secondary insomnia) such as reflux, uncontrolled asthma, arthritis or other pain syndromes. It could be due to medications, depression or just stress. It could be due to some undiagnosed condition, such as cancer, an enlarged prostate (making you have to get up to urinate throughout the night), thyroid disease or sleep apnea. Then there’s the caffeine (coffee/tea), nicotine (cigarettes) and drunk scene (alcohol).
The thing is, whether acute, intermittent or chronic, any insomnia really is an inconvenience and can even be incapacitating. Before you subject yourself to a million dollar medical workup, just remember, if it’s secondary insomnia, and you know (for example) that your pain is keeping you awake, try dealing with the primary issue. Alternatively, if it’s primary insomnia, there are a lot of things you might consider trying. In fact, consider this my Top Ten Tips, presented in the order you might consider implementing them.

  • Good diet and exercise habits make your body perform as they should and will clean up a lot of potential problems that will affect sleep.
  • Avoid naps during the day. You want to be good, tired and ready to sleep when night comes.
  • Develop the habit of only using your bed for sleep or sex. That conditions your body to be ready to sleep when confronted with the stimulus of your bed.
  • Get your snoring partner some help if s/he is part of what keeps you awake. Check here for tips to deal with snoring.
  • Try not to eat for several (3-4) hours before you sleep. Nothing says ‘no sleep’ like heartburn all night (By the way, this is the real reason you shouldn’t eat after a certain hour – not concerns about your weight.).
  • Similarly, avoid nighttime stimulants (e.g. cigarettes, coffee, tea and exercise close to the time you want to sleep, if this proves to be a problem).
  • Although alcohol is a sedative, it’s also on the don’t-do list because it can cause restless sleep and interrupt the sleep cycle.
  • Find a way to relax before sleep. Consider a bath, sex, a book or soothing music. Or all of them.
  • Set the alarm for the morning, then hide your clock. You don’t need to have a clock to remind you that you aren’t sleeping all night.
  • Use ‘white noise’ for background if you’re bothered by other sounds.

Here’s a bonus tip: If you fell asleep during the reading of this post, keep it for future reference.
As Edward R. Murrow used to say (well before I was born): Good night, and good luck.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress