Tag sleepiness

Sleepy During the Night Shift? Try These Tips.


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“How can I stay alert at 3 am?” asks Twilight, an ICU nurse who has been working nights for years. She knows that our internal pacemaker (SupraChiasmatic Nucleus) makes us sleepy at night and alert during the day. How can you go against the might of Mother Nature? Well, it is tough, but you can summon the help of these seven friends.

  1. Stay Active
  2. Take a PREM nap
  3. Massage Your Tender Points
  4. Look at the Light Often
  5. Enjoy a Cup of Coffee
  6. Snack Smartly
  7. Seek Spiritual Help (My All-time Favorite)

And beware of a formidable foe in alcohol when faced with insufficient sleep and long days. Let us discuss them one by one.

Stay Active

The Alertness starts declining the longer you stay still. One way to prevent this is to “deskercise” every hour. Deskercising will also help you to reduce muscle tension and stress while helping you preserve the flexibility, strength, and muscle tone you already have. The following are some simple deskercising techniques to try:

The Wrist Muscle Stretch

When working at the computer, stop occasionally and deskercize using the wrist muscle stretch. Slowly stretch your wrist muscles by using a full range of motion. Joints that have become sore and stiff because of repetitive motion activity will respond to slow stretches. Do not risk pulling a muscle by attempting the stretch rapidly. Get the full benefit of the stretch by doing it slowly.

The Pectoral Stretch

The following is an easy stretch you can do at your desk. Simply clasp your hands behind you head and slowly move your shoulders and elbows back. Repeat this a few times. It is a great way to stretch your pectoral and chest muscles.

Wrist Flexion

Using your left palm, gently apply force to the right hand, causing the right wrist to stretch toward the underside of the right arm. Hold it there for five seconds and then release and repeat on the left hand. Repeat the exercise five times.

Wrist Hyperextension

Using the left palm, slowly apply force to bend the right hand backward. Hold it there for five seconds and then release and repeat to the left hand. Repeat the exercise five times.

Sitting Bend

In a sitting position, with your feet flat on the floor, your knees about ten inches apart and hands at your sides, bend over as far comfortable with your hands reaching toward the floor. Hold the position for five seconds and then slowly pull back into a sitting position while tightening your abdominal muscles. Repeat four times. This exercise stretches your lower back muscles and hamstrings.

Vertical Stretches

Vertical stretches provide an excellent way to reduce tension and activate all of your major muscle groups. With your feet shoulder-width apart, lift yourself upward on your toes and extend your arms over your head. Reach each hand as high as possible for about seven seconds and then relax. Repeat four times.

Get Up and Walk Around

Sitting too long can have several negative effects. It’s important to get up and walk around at least once each hour. A ten-minute walk around the office would be excellent. But, when that’s not possible, shorter walks to the water cooler, filing cabinet, or restroom are better than nothing.

When you are working at desk, get up at least once every twenty minutes and move around. 

  • Take a PREM (Patel’s Relaxed Eye Muscles) Nap. Studies have shown that a fifteen-minute nap can improve alertness and last for almost three hours.  This can be life saving when taken before driving back home after bight shift.
  • Massage Your Tender Spots. Gently massaging your calf muscles, your neck, and your temple area can improve alertness by relieving muscle aches, back pain, headaches, burning in the eyes, and other distracting physical symptoms precipitated by sleep deprivation. Untreated, these symptoms can drag your energy level and your alertness down.
  • Look at the Bright Light Often. It has a tremendous alerting influence. Use this to your advantage. Sit facing bright light. Put a bright light lamp behind your desktop while working on it.
  • Enjoy a Cup of Coffee. Caffeine has alerting property, but it has the duration of action of twenty-four hours, so a cup of coffee consumed at 2 AM is still in your bloodstream at 8 AM when your brain is trying to fall asleep. Because of this reason, caffeine should not be used indiscriminately. It should be used as medicine, at the right dosage, at the right time, and for the right reason.
  • Snack Smartly. Eat a Protein Snack Every 2-3 Hour. I will maintain your energy and alertness while eating a large starchy meal will degrade your alertness. Avoid rice, pasta, and dessert.
  • Seek Spiritual Support. Spiritual support has helped me the most during my drives to ER at 2 AM. I would ask for divine help. “Give me energy, my Lord, to serve my patients well.”

Do you have a particular trick that works best for you? Which of the above intervention has helped you most?

This blog post is dedicated to my good friend Mahesh Patel MD who has devoted his life to saving premature babies in Bismarck, ND, and millions like him who have spent nights after nights serving others. God Bless You All.

Adopted from the book “Sleep Well, Lead Well” now available on Amazon

7 Tips for an Alert, Energetic, & Enjoyable Monday


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Have you noticed how sleepy, tired, lethargic, and complacent you feel on Mondays? Medical studies indeed have shown reduced productivity and increased errors on Mondays secondary to disrupted sleep schedule on weekends.

Here is how you can enjoy and excel at work even on Mondays.

  1. Keep moving. Staying physically active all day will energize your Mondays. Exercise in the morning. Take stairs at work. Go for an evening walk. Do deskercize.
  2. Face the light. Look at the bright light in the morning both at home and at work as light has alerting influence.
  3. Take a PREM nap. A 15 min power nap will provide you alertness, energy, vitality, and vigor lasting for 155 minutes. Leave some room on your schedule for it preferably in the afternoon.
  4. Get a relaxing massage. Insufficient sleep results in aches and pains which can be easily treated with a relaxing massage, which can be combined with a nap if the situation permits.
  5. Snack smartly. Eat high protein snacks. Avoid heavy meals on Mondays especially at lunch. Grilled or baked fish or chicken is great. Avoid rice, pasta, and dessert as it can make afternoon sleepiness worse.
  6. Consume caffeine judiciously. Caffeine has alerting properties, but it should be consumed sparingly as it can rob you of your deep sleep. Avoid caffeine after 1 PM.
  7. Seek spiritual support. You are going against the might of Mother Nature trying to excel and enjoy Mondays with disrupted sleep schedule and sleep debt. Tap into your enormous spiritual reservoir. At every unguarded moment, look up and say, “Help me God serve my customers with joy.”
Have a wonderful week. Sleep Well, Lead Well.

Your Valentine Wants You to Get Treated for Sleep Apnea!


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She has been telling you for months to get your sleep apnea diagnosed and treated, but you have been putting it off. You have argued, “I don’t snore. I am not tired. It is just stress. I have been working too much.”

But, you have been dozing off in the recliner. You are cranky, nervous, and irritable. You are inattentive to her needs. Your sex drive is down. Your problem-solving skills, innovative ability, interpersonal skills, and your energy level are down. It is about time you listened to her and got treated. That would be the true Valentine’s day gift that will keep on giving for the rest of your life.

Sleep apnea, a serious and fatal yet severely under diagnosed disorder affects approximately 20 percent of the adult population. Snoring, daytime fatigue, witnessed apnea (cessation of respiration for more than ten seconds), morning headaches, dry throat, and waking up gasping for air are common features of this disorder, which is being increasingly recognized as a formidable enemy of a full and joyous life. It prevents the person from reaching deep and restorative stages of sleep, making the person grumpy, irritable, nervous, forgetful, inattentive, and tired.

It also increases your risk of stroke, heart attack, and early death because of nightly struggle to breathe, which causes frequent elevation of blood pressure and sustained drop in blood oxygen level while simultaneously increasing the oxygen consumption of the heart muscles. Untreated, the sleep apnea increases the risk of motor vehicular and industrial accidents. It can also contribute to erectile difficulties.

Use the STOP questionnaire to determine your risk for obstructive sleep apnea.

  • S … Do you snore loudly?
  • T … Do you often feel tired, fatigued, or sleepy during the daytime?
  • O … Has anyone observed you stop breathing during sleep?
  • P … Do you have or are you being treated for high blood pressure?

If you answer yes to two or more of these questions, then you are at high risk for obstructive sleep apnea, and you should talk to your doctor.

To make an accurate diagnosis, you may need an overnight sleep study in a sleep lab where your respirations, the oxygen level, heart rate, EKG, leg movements, and sleep stages will be monitored all night long without using needles. Now, there is also a convenient and economical alternative in Apnea Link, a home sleet test. Talk to your doctor about it.

The commonest and most successful treatment includes wearing a mask hooked to a machine, continuous positive airway pressure (CPAP), which acts as a pneumatic splint and prevents your throat from collapsing at night. Weight reduction, oral appliance (a customized denture that keeps your lower jaw pulled forward), and ENT surgery are the other options.

It is extremely rewarding to be treated for sleep apnea. Patients tell me:

  • “Doc, I did not know how sleepy I was until I started wearing CPAP.”
  • “A hazy screen has been lifted off from my eyes.”
  • “I thought it was all stress and aging, but now I feel young again.”
  • “I am thinking clearer. I am planning better. I am getting more done at work and home.”
  • “I have so much energy that I don’t know what to do with it.”
  • “My blood pressure is better; my sugars are better controlled.”
  • “I should have done this a long time ago.”

Listen to your Valentine and please talk to your doctor and get treated. It will give you a new life.

If you need additional information, please visit http://www.md4lungs.com. If you are in Michiana, please call our clinic at 574-534-9911.

Happy Valentine’s Day!

5 Tips to Treat Excitement Insomnia



Suppose that the innovative new product your team has been working on is ready for the big launch, which will open up new markets, increase your market share, put your company in the lead, and skyrocket your stock prices. Prelaunch testing and research have all been positive. Popular media have given rave reviews, and they are covering the launch like the first iPhone launch. Your colleagues and your suppliers are all optimistic and excited about the new product. Can you turn off the adrenaline at bedtime? Can you shut off your mind when you put your head on the pillow? Can you sleep well during these times?

Here is another scenario: You have had a productive and very satisfying day at work. You are relaxing with your spouse. The kids are doing their homework. Then you get a text message from your star performer: “Sorry, I have decided to move on. I have accepted a job at another company.” You knew this might happen, but did not expect it so soon and at a time when things were going so well for the company and for your star employee. You have been through this before. It does give you an opportunity to find someone with a different skill set, but in the short run, it increases your workload. “I can handle that, too. I’m not worried about this. I have built this company from scratch. I can tough it out until we can find someone good,” you tell yourself. That night, you do not sleep well. The next morning, you wake up achy and tired.

Can you prevent this? Can you uncover anxiety when it is underneath the surface? And then can you successfully detach yourself from the troubles? Can you sleep well no matter what? You will have to, if you want to maximize your leadership during these exciting times. The following are a few helpful tips for those exciting or anxious times:

  1. Assign ten o’clock at night to six o’clock in the morning as sacred time, reserved for resting and recharging instead of planning and worrying.
  2. Get rid of all work-related material from your bedroom, including your laptop and smartphone.
  3. Continue your relaxing bedtime ritual: shower, relaxing reading, cookies and milk, and meditation, per your preference.
  4. Read your favorite lines from the Bible or any other religious book to calm your nerves.
  5. Turn off the lights and go to sleep.

Sweet dreams!

            If you continue to have problems sleeping during exciting times, talk to your physician about using a mild sleep aid. This will prevent mounting sleep debt and, more importantly, prevent formation of an unhealthy conditioned reflex, which can perpetuate insomnia.

11 Tips for Deeper Sleep


Sleep does not differentiate us from animals, sleep hygiene does!

Overworked humans are not only getting insufficient sleep but also poor quality sleep secondary to their poor sleep hygiene.  And what exactly is sleep hygiene? Sleep hygiene is your personal set of habits that together determine the quality of your sleep. Sleep hygiene helps you stay healthy by keeping your brain (most importantly, the executive center) and your body rested and strong. In order to get the most return on your investment in sleep, you will have to follow sleep hygiene fanatically.

The following tips will help you improve your return on investment in sleep:

  1. Create a sanctuary for sleep. Make sure your bedroom is dark, cool, and quiet.
  2. Reserve your bedroom for sleep and sex only.
    Keep work related items out of bedroom. Do not take Excel spreadsheets and PowerPoint presentations to bed. Keep Smartphone and laptop out of your bedroom.
  3. Use the might of Mother Nature to your advantage. Going against Mother Nature by ignoring circadian rhythm will result in reduced duration of your deep sleep (stage three and REM sleep). Always maintain a consistent time to rise, even when circumstances prevent you from going to bed at your normal time. And, yes, that includes weekends. There is no point in going to bed two hours late on weekends and waking up two hours late the next day. There is no net gain. In fact, there is a net loss because it disrupts your intrinsic rhythm, the sole cause of reduced productivity on Monday mornings.
    Alcohol robs you of your deep sleep.
  4. Recognize that alcohol induces sleep, but is a poor quality sleep marked by frequent arousals, leading to lighter sleep at the expense of REM sleep.  Alcohol induces sleep but robs you of your deep sleep. Because of this, general recommendation in sleep medicine practice is to avoid consuming alcohol six hours before bedtime.
  5. Make every effort to quit smoking completely because it affects your sleep, too. Nicotine is a stimulant that would rob you of your deep sleep. But if you cannot quit, certainly avoid smoking within three hours of your bedtime.
  6. Avoid eating a heavy meal before bedtime because the process of digestion will interfere with falling asleep and may reduce the amount of deep sleep.
  7. Sweat for sound sleep.  Regularly exercising even for twenty minutes a day has been shown to improve your sleep architecture. Not only does it make you fall asleep quicker, it also increases the duration of deep sleep and thus makes your sleep immensely more restorative.
    Caffeine has a 24 hour duration of action. It robs you of your deep sleep.
  8. Stay away from caffeine, certainly after one o’clock. Caffeine has the duration of action of twenty-four hours, so a cup of coffee in the morning will still be lingering in your bloodstream when you are trying to go to sleep at ten o’clock. Some of my colleagues argue, “I can drink a cup of coffee and go right to bed and fall asleep.” The fact remains, though, that it is still going to rob you of your REM sleep, making your sleep non-restorative. Please taper caffeine off slowly over three to four weeks to avoid withdrawal symptoms. Switch to decaf coffee if you must drink it.
  9. Follow the 2-20 rule of napping. Do not nap after two o’clock, and do not nap for longer than twenty minutes. A ten to fifteen-minute power nap in the early afternoon can energize your day and give you two days in one. But even a brief ten-minute nap in the evening will deconsolidate your sleep at night.
  10. Develop a relaxing bedtime routine. Listen to the music. Read a nice book. Take a warm shower because the cooling off promotes sleep. Cookies and a glass of milk can help, too, because milk contains tryptophan, a naturally occurring sleep-promoting agent.
    Prayers lead to positive emotions, which get amplified during REM sleep.
  11. REM sleep is a powerful amplifier of emotions, especially negative ones like fear, anxiety, hatred, and anger. To use this amplifier to our advantage, we need to focus on positive emotions all day and then, at bedtime, purge our mind of whatever negative emotions it has collected all day. This is where even a short prayer comes in the picture. Matthew 18:23–26 says, “Have faith in God. I assure you: If anyone says to this mountain, ‘Be lifted up and thrown into the sea,’ and does not doubt in his heart, but believes that what he says will happen, it will be done for him.” Faith drives away fear. Also, do not carry a grudge to bed with you. Bedtime is not the time to review your anger against others who have hurt you in some way. Luke 6:27–29 says it best, “But I say to you who listen: Love your enemies, do good to those who hate you, bless those who curse you, pray for those who mistreat you. If anyone hits you on the cheek, offer the other also.” Forgiveness always brings peace, and there is no better sleep aid than a soul that is at peace. Forgive yourself; forgive others.

Ignore Sleep, Ignore Life.

Sleep Well, Lead Well.

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