Ask the doctor - tiredness

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

Click here to return to the main Ask the doctor page

 

Shift work sleeplessness

I've recently returned to shift work as a nurse and am having trouble sleeping; noisy traffic outside is the worst problem. Do you have any tips for me? 

 

 
Try using a mask that blocks out light and muffles sound, such as Hibermate (£21.95 from www.relax-uk.com or call 01206 767300). It covers your ears and reduces outside noise by 50 per cent - so you can still hear the alarm, a phone ringing or a child crying. You could also try valerian root extract, a traditional herbal medicine that can improve sleep quality and the regularity of sleep patterns. Try NiteHerb (£5.87 for 30 tablets from Boots, Superdrug or www.niteherb.co.uk). 

Dr Sarah Brewer, Prima (Nov 09) 

 

Will more sleep help me live longer?

Is it true that people who sleep most live the longest? If so, why is this?

That's not entirely correct, but it's close. Recent research involving 21,000 twins, who were followed over 22 years, found those who slept for between seven and eight hours per night lived longer than those who habitually slept for shorter or longer periods.

So both too much and too little sleep may be linked with a shorter life. Researchers have also found that people who sleep for five or fewer hours a night, or for nine or more, are almost 50 per cent more likely to develop Type 2 diabetes than those sleeping for a period somewhere in between. Sleep is when the body carries out repairs, and getting the right amount lowers blood pressure, improves glucose control and may even reduce your risk of heart disease and cancer. Getting too little or too much sleep may refl ect the fact that many illnesses can affect sleep quality.

Dr Sarah Brewer, Prima (Aug 09)

 

Should I be doing more?

I'm a busy mum and have two children aged two and six. I do a 10-minute walk for the ‘school run' four times a day, but walk slowly, at the pace of my toddler, so I don't get out of breath. I just don't have the energy to jog or swim, as I used to before I had children. Am I getting enough exercise to reduce health risks?

  

Being a mother is an exhausting business. Most parents of young children are constantly tired and, if they do have time off, they want to sit back and relax, not work up a sweat. But bizarrely, one of the best ways to conquer tiredness is through aerobic exercise - the kind that makes you mildly breathless. Everyone should do at least half an hour's aerobic exercise four times a week, although you can get most of the benefits for your heart from ‘bursts' of at least 10 minutes. Your walk to school and back will keep up your general level of fitness, but won't specifically protect your heart. Why not take your toddler for a really brisk 30 minute walk in the pushchair every day - perhaps while they're having a nap? As your level of fitness increases, you can up the pace.

Dr Sarah Jarvis, Good Housekeeping

 

I'm always tired

 

Can you suggest anything for constant tiredness? I'm a single mum of two children and I work full-time.

 

Tiredness is a common result of stress, overwork, lack of exercise and poor diet. It can also result from medical problems such as anaemia, diabetes, depression and immune disorders - so see your doctor for a check-up. If all is well medically, follow a healthy, high-fibre diet with plenty of fresh fruit, vegetables, whole grains and fish - you can assess the nutritional quality of your diet for free by visiting www.nutriprofile.org. Take a multivitamin and mineral supplement, and consider taking coenzyme Q10 and alpha lipoic acid. Evening primrose oil and omega-3 fish oils can also improve long-term fatigue.
Dr Sarah Brewer, Prima

I am 35 and have suffered from chronic sleep deprivation for the last few years. I travel a lot and often get jet lag. I've heard that the drug Almorexant may help. Can I buy it over the counter?

Almorexant is a new drug that has fewer side effects than some sleeping tablets and promotes a more natural descent into sleep. However, it isn't expected to be available until 2011. There's no doubt that jet lag disturbs sleeping patterns. This is because melatonin - the hormone produced by the pineal gland during the hours of darkness - controls your body clock and, if it's disrupted, it can affect your sleep. As an alternative to potentially addictive sleeping pills, I recommend Sominex, a sedating anti-histamine from Boots, priced at £2.55 for eight tablets. Or you can ask your GP to prescribe melatonin-based products, which are taken between 10pm and midnight local time on arrival and for four days thereafter. However, these are not a long-term solution, so you must tackle the root cause, which may involve reducing your international travel or taking night flights to limit the effects of jet lag. Bear in mind that lack of sleep, or poor quality sleep, can leave you tense, irritable and prone to anxiety and depression. It can also put your life at risk - 30 per cent of road accident deaths are caused by driver fatigue. Visit sleepcouncil.com for more advice or call 0800 0187923 for tips on how to improve your sleep quality.
Dr Louise Selby, SHE

 

Sleepless nights

I suffer from insomnia - I rarely get more than five hours' sleep a night. It doesn't really bother me, but I've read that not getting enough sleep can be bad for your health. Is this true?

Everyone needs different amounts of sleep, although five hours a night is on the low side, and missing out can do more than just leave you feeling tired and bad-tempered. A recent study has shown that sleep deprivation can put significant stress on your heart and increase your risk of cardiovascular disease. If you are stressed, relaxation exercises, yoga or meditation can be an effective way to calm down. Don't take stimulants before bedtime; have camomile tea instead of coffee and avoid alcohol. Exercising late in the evening can also keep you awake at night. Try to stick to a routine and make sure your bedroom is a restful place - without a TV - and keep the room cool. Sleeping pills are not a good idea, as they can be addictive, but you could try taking Natrasleep tablets (£4 for 50, from garden.co.uk). If all else fails, see your GP or visit The Sleep Council (sleepcouncil.org.uk).

Dr Louise Selby, SHE

 

Coping with kids

I am 37 years old with two children under two. I feel overwhelmed and exhausted most days, even though my partner, who works full time, helps out when he can. I used to manage a big department in a teaching hospital, but now I feel completely out of my depth. What is wrong with me?

Looking after young children can be a huge challenge, but if you can get some help with childcare - just half a day, once a week - it could make all the difference.

There is, however, a chance you may be suffering from postnatal depression, so it's important that you talk to your health visitor or GP.  There are support groups you can contact too, such as the Association for Post-Natal Illness (www.apni.org or Tel: 020 7386 0868). You can also talk to other mothers in the same situation via MAMA (Meet A Mum Association) 0845 120 3746, www.mama.co.uk. Just don't suffer in silence - there is support available to help you through this stressful time.
Dr Louise Selby, SHE

 

Help, I'm always tired!

Why am I constantly exhausted? I'm unable to concentrate, I'm always tired and often I can't remember what I was about to say. Am I just stressed?

These feelings can be due to being run-down and not sleeping properly, but they can also be due to medical problems such as depression, anaemia, undiagnosed diabetes or an underactive thyroid gland. It's important to see your doctor for a general check-up to make sure there's nothing going on that needs further tests and treatment. It's also a good idea to look at your general diet and lifestyle. Are you eating a healthy, regular and balanced diet? Are you getting enough sleep? Do you exercise regularly? Are you drinking enough fluid? If your doctor cannot find anything wrong, consider taking a multivitamin and mineral supplement, plus co-enzyme Q10, to help boost energy levels.
Dr Sarah Brewer, Prima

Sleepless nights due to stress

I have a very stressful job and work long hours. Every night I fall into bed shattered but I can't sleep. What can I do without resorting to sleeping pills?

There are a number of strategies and alternative remedies you can try. Firstly, cut down on caffeine and don't have any heavy meals or sugary drinks for at least six hours before bed. Also, cut out alcohol in the evening.

A regular exercise routine can help, but don't do it too close to bedtime. Give yourself time to relax before you go to bed and don't be tempted to work in your bedroom, it should be kept strictly for sleeping.

Try passion flower, camomile or valerian (A.Vogel Valerian Hops Complex 50ml, £8.49, www.healthstore.uk.com). There are acupressure points around the wrist that are believed to encourage sleep. Massage these or use adhesive cones, which put pressure on the points overnight (try Boots Alternative Sleep Well Cones, £7.75). Acupuncture may reduce stress and aid sleep. Make sure you visit someone who is fully qualified and a Member of the British Acupuncture Council or the British Medical Acupuncture Society. For further information contact www.sleepcouncil.org.uk; 01756 791089
Dr Louise Selby, SHE
 

Is too little sleep bad for me?

I rarely get more than five hours’ sleep a night. I have always been like this – my mother said she was a light sleeper too. It doesn’t bother me, but I read recently that not getting enough sleep can be bad for your health. Is this true?

Everyone needs different amounts of sleep, although five hours a night is on the low side. You are not alone – around a third of people in the UK are thought to have difficulty getting a good night’s sleep. Missing out on proper rest can do more than just leave you feeling tired and bad tempered – a recent study has shown that sleep deprivation can put stress on the heart and increase your risk of cardiovascular disease.

There are many things that you can do to improve your chances of sleeping through the night. If you are stressed, relaxation exercises, yoga or meditation before bedtime may help to put you more in the mood. Avoid stimulants such as caffeine in the evening; have a cup of camomile tea instead. Vigorous exercise less than three hours before bed can also keep you up at night. Try to stick to a routine and make sure that your bedroom is a restful place – keep the temperature cool, leave a window ajar and banish the TV to the living room. Sleeping pills are not recommended as they can be addictive.
If all else fails, don’t be afraid to seek professional help. A cognitive behavioural therapist (CBT) can help you understand negative thought patterns that may result in insomnia so that you can achieve restful sleep. The Sleep Council (www.sleepcouncil.org.uk; 0800 018 2923) also offers helpful tips.
Dr Louise Selby, SHE  

I’m so dozy in the afternoons

Although I get seven hours sleep at night, I find it hard to stay awake in the afternoon.  Is there anything I can take?

There’s a natural tendency to sleep mid-afternoon – hence the European custom of taking a siesta. Avoid too much carbohydrate at lunchtime as this can lead to low blood-glucose levels later in the day – a common cause of drowsiness. Guarana chewing gum, which includes the natural stimulant guaranine – similar to caffeine – has an alerting effect for up to six hours. The gum is flavoured with peppermint, which also acts as a stimulant, and the action of chewing helps keep you awake (try Rio Guarana Buzz Gum, £9.99 for 120, from health-food shops). Exercising in your lunch break – even just going for a walk – will also help.
Dr Sarah Brewer, Prima

 

Click here to return to the main Ask the doctor page

 

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk