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Have alteration in sleeping pattern. Started feeling tired and fatigue. What should I do?

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Practicing since : 2003
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Hello. i just turned 21 years old and i am female. I always have loved sleep every summer i could sleep until 11 12 o clock in the noon and then stay awake until really late at night . but now i am at university and i find it really difficult to deal with my sleep.i mean i sleep at 11 or 12 midnight and i feel that i got enough sleep because i wake up and i am refreshed but i still feel "tired". without doing anything only 4 hour lectures i go back home and i sometimes feel really tired . i do not know what is wrong with me and this starts to worry me. i drink a lot of fluids, my meals are okay i have breakfast snacks lunch dinner lots of fruits and i take multivitamins. i also started taking vitamin B. when i seeked help from a nurse in the university she started talking about thyroid and multiple sclerosis. i have no thyroid problems and i re-examined everything during summer. also no heart problems because i had a doppler last summer and i am just worried. is it just that i like sleeping? or is it anything else? i can think normally i can function normally when i go out i feel fine. the only thing i noticed is when i feel tired my leg is shaking without reason when i put it in a certain position. yesterday i was at my university from 9 till 4 o clock and i came home and i could not move!i could not even go to have a shower. do you think its all in my mind (maybe stress). we need to sort this out soon..because it tortures me.
Posted Tue, 6 Nov 2012 in Sleep Disorders
Answered by Dr. Jonas Sundarakumar 4 hours later
Hello and welcome to Healthcare Magic. Thanks for your question.

It is likely that your altered sleep timing and pattern could be contributing to your tiredness and fatigue. Though you may feel temporarily refreshed after you wake up, this does not necessarily mean that your body has got adequate sleep and rest. The normal sleep cycle has to include the right proportion of REM and NREM sleep patterns in order to be adequate. Any alteration in this proportion or pattern may result in disturbed sleep. So, in your case a combination of factors like a recent change in your sleep-wake rythm, change in environment and maybe added stress could all be resulting in your symptoms.

In addition, if you also have noticed that you are feeling more disinterested, feeling low or irritable, finding it difficult to concentrate, etc. or if you are going through a period of significant stress, then we have to consider the possibility of an underlying depression also.

Since all your medical tests are also negative, and since your symptoms are quite distressing, I suggest that it would be best to consult a psychiatrist for a detailed evaluation. You may need medication for a temporary period, just to regularise your sleep rythms and make sure that you get a proper sleep. If you have a stress-related problem, then appropriate therapy to enhance your stress-management and coping skills can also benefit you.

I would also suggest that you follow a strict sleep schedule and 'sleep hygiene' as very often, this itself is sufficient to put your sleep rythms back in place.
- following specific timings for going to bed and waking up
- make sure you get at least 8 hours of sleep and avoid staying up late night
- avoiding 'snoozing' after the wake-up time
- avoiding daytime naps
- avoiding large meals, coffee, alcohol, etc. before going to bed
- arranging a sleep evironment that is dark, quiet and free of disturbance
- avoiding the use of your bed for any other activities like watching tv, reading, etc.
- having a daily exercise routine in the evenings
- avoiding psychological stress and trying relaxation techniques

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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