What could cause disturbed sleep and morning drowsiness?

Question

Hi doctor,

I am 56 years old and self-employed. I have not had much work for the last few months, as I have reduced my business for a gradual retirement. I go to bed at about 10 PM. I get up once in between for urination.

Most of the day, in the last few months, my sleep gets disturbed at about 4 AM and after that till 6 AM I am unable to sleep and remain in bed tossing around. I feel tired and drowsy, sometimes uncomfortable, between 8 AM to 12 PM.

I allow myself to sleep in a bent-down position, sitting on the chair for about 30 to 45 minutes in the mornings on most days when I am drowsy. Irrespective of the morning rest, I take regular rest in the afternoon.

Nowadays, I do not get sleep during this time either and keep tossing around. I feel fresh in the evenings.

What is the reason for this disturbed sleep, tiredness, and morning drowsiness?

Can you suggest any medicine for this?

I am anemic and my hemoglobin is 10.6. I also have high bilirubin (total 3) and non-alcoholic fatty liver. I have neither jaundice nor any other liver problem.

I am currently taking LIV APT, Xaria Plus, and Pan-D. I have been getting nose blockage for the last few months when I use AC or a fan in the lying-down position.

During yawning too, I get a nose block for a few minutes. The allergy doctor had given Xaria Plus for this problem. Please let me know whether anything else is required for this.

How long should I take Xaria Plus?

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query. You are suffering from two problems. One is nasal block, and the other is sleep disturbance, which may be insomnia. To manage these, suggest you the following:

You can stop Xaria Plus (a combination of Montelukast and Fexofenadine). Instead of that, you can take Flutiflo-FT - Fluticasone nasal spray once daily, along with Nasoclear nasal drops as and when required.

Sleep disturbance may be due to insomnia, and so sleep hygiene is needed.

Stop drinking coffee or tea in the evening, do regular exercises in the evening, and sleep in the lateral position.

Try simple changes to your daytime and pre-bedtime routine. Keep a regular sleep schedule; go to sleep and get up at the same time each day, including the weekends.

Set aside enough time for sleep. Most people need at least seven to eight hours each night in order to feel good and be productive.
Make sure your bedroom is dark, cool, and quiet. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to shield your eyes.
Turn off your television, smartphone, and computer a few hours before your bedtime. The type of light these screens emit can stimulate your brain, suppress the production of melatonin, and interfere with your body’s internal clock.

We will try conservative management initially, and if it does not improve, you may need a sleep study and medications such as Melatonin. Also, I want to know whether you snore.

As you said, you are anemic, and your hemoglobin is 10.6. I suggest you take foods rich in iron and folic acid to manage your anemia.

I hope this helps.

Answer 2

Hi,

Welcome back to icliniq.com.

Good, it mostly looks like insomnia. There is no need for any medications now; you only need relaxation exercises, such as yoga, and to avoid work stress.

I hope this helps.