What is the reason for my disturbed sleep and morning drowsiness?

Patient's Query

Hi doctor,

I am 56 years old and self-employed. I do not have 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, sometime uncomfortable in 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 of the day when I drowsy. Irrespective of the morning rest, I take regular rest in the afternoon.

Nowadays, I do not get sleep during this time also 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 neither have jaundice nor any other liver problem.

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

During yawning too, I get nose block for a few minutes. 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

Dr. Duraikannan

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine

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.

You can stop Xaria plus (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 need sleep hygiene.

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.

Will try conservative management initially and if not improving, then you may need sleep study and medications like Melatonin.

I want to know whether you have snoring.

The Probable causes:

Stress related sleep disorder.

Investigations to be done:

Sleep study after one month.

Differential diagnosis:

Obstructive sleep apnea (OSA).

Probable diagnosis:

Insomnia.

Treatment plan:

Conservative management like sleep hygiene, avoid coffee and tea and do regular exercises.

Regarding follow up:

Revert back after a month to a sleep medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/sleep-medicine-physician

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Patient's Query

Thank you doctor,

Nasal blockage is not always there. It happens after a few hours of AC or fan usage in the lying down position. Steam Inhalation clears the blockage; we use it when not in medication. Xaria plus is effective most of the times. I never drink tea or coffee. We have regular sleeping habits. I do snore, but not loudly. I sleep mostly on the lateral position only.

Answer

Dr. Duraikannan

Allergy Specialist Pulmonology (Asthma Doctors) Sleep Medicine

Hi,

Welcome back to icliniq.com.