Q. I wake up every morning with extreme tiredness, mild headache, feeling very sleepy and have no interest in work. Please give me advice.

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.

Hi,

I sleep at 10 PM at night and get up at 7 AM. I am getting adequate sleep. But for the last few days, I wake up very tired in the morning and this is causing me to sleep in office.

Please give me advice regarding this.

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology

Hi,

Thanks for posting a query at icliniq.

The problem you described can be caused by multiple factors.

One of them is subclinical viral infection that wisely affects during change of season. This is generally also associated with generalized myalgia, easy fatigability and decreased interest in work. If these symptoms are present along with sleep problem, I advise you to wait for two weeks from the first day of your symptoms and if you have suffered more than two weeks by the time you raise a query that it is matter of concern.

If you are overweight, you may be suffering from Obstructive Sleep Apnea (OSA) which causes hypersomnia during the day. OSA is characterized by snoring and cessation of breathing while sleeping. If your family members or room partner complain of snoring while you sleep then, this could be the reason for your symptoms.

Another condition that presents with hypersomnia is depression. In this, people have unrefreshing sleep. Depression is also associated with increase or decrease of appetite, feeling sad, loss of self esteem, loss of pleasure in activities that were pleasurable in past to name a few. If any of these symptom criteria applies for you, then you need to meet a psychiatrist online or in person for further course of action.

If all the above descriptions do not meet your other symptoms then please repost the query with more details such as your age, weight, duration of symptom, gender, any psychosexual stress in the recent past, sleep attacks, any medical history kind of medicines you received or receiving. I will help you with the direction.

Dear Doctor,

I am not overweight. During the weekend (saturday and sunday), I usually go for sleep in the afternoon for about 4 hours from 12PM to 5PM. And after that sleep also, I feel very tired. And today morning, I am feeling very sleepy, tired and feel like being sleepy.

I am an ex alcoholic. So I am having disulfiram in night every day. I am also having Clonotril 2mg for anxiety. I do snore in the night. The symptoms which I feel now is extreme tiredness, mild headache and loss of interest in work.

Age 25/ male. Height 6 feet and weight 68 kg.

Please advise me in this.

 

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology

Hi,

Few details are still missing in your narration, but I will try my best to analyse your problem.

There are three possibilities in your case that may be responsible for your symptoms.

1) First of all it may be just normal reaction to your hectic week days. If you were burdened during the week days, most of the time we try to refresh ourself with excess sleep on week ends. But in case of having excessive sleep, it is also possible that the Paradoxical Effect will occur. That means "more we sleep more we feel tired". This appears to be the most likely problem in your case as no change of situation or medication reported by your side.

Now what you need to do is, wait for next two days and try to resume your usual routine. Just increase your caffeine intake if you like. Try not to think about it. Have involvement in some activities that you use to enjoy like playing, gardening, exercise, watching TV or whatever you like. Probably you will be fine by the next three days.

2) The second most obvious problem may be related to your Clonotril. If you have recently started taking this, it might be the most likely cause. Clonotril having half life of more than 15 hours, that have some hang over kind of effect on next morning. I advise you to take only 1mg rather than 2mg. Wait for at least one hour and then take another 1mg if required.

If you take this at bed time then reducing the dose might be beneficial for you. But, If you take during the day shift, then your dose will be at usual 2mg dose.

3) The third possibility is depression. The symptoms you described in last sentence favour towards depression. If you have these symptoms along with other symptoms described in my answer to your query previously for more than two weeks, then you are suffering from depression.

Diagnosis of depression requires further evaluation and appropriate management. Have your thyroid profile done from a nearby laboratory and do contact me after this. The treatment of depression is long process and you need lots of psycho education for the same.

The last possibility is that, it might be because of the side effect of Disulfiram. If you have these symptoms after starting disulfiram, then you need to change the medication or at least reduce the dose of disulfiram.

I hope I have answered your query but still if you feel something left do contact a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

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