Anyone have trouble with afternoon drowsiness?

[i61164]

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I always get really tired after lunch and just can't get anything done. I can sit in lectures all morning no problem and pay attention (most of the time). Then after lunch I sort of drag through the rest of the day until dinner (accomplishing very little). After dinner, I can usually get some studying in but I have to quit around 11:00 pm so I can go home and get a decent amount of sleep because I have to wake up early. The frustrating thing is that I could probably get a lot of good studying done until midnight or 1:00 a.m. some nights, but I need to get to sleep because of 8:00 a.m. lectures.

It's like my body refuses to conform to an 8:00 - 5:00 work day. Sometimes if I'm getting a lot of studying done late at night I just keep going, but then I pay the price when I have to get out of bed the next morning for that 8:00 a.m. class. I wish I could just turn my afternoon "down-time" into super productive time. Then I wouldn't need to study later in the evening. So the root of my problem is the afternoon fatigue. I have tried naps unsuccessfully. If I take a long nap, I wake up tired. If I try to take a 20-30 minute nap, I lay awake until about 2 minutes before the alarm goes off. Plus, with a wife and two kids at home, it's not really feasible to take a nap in that environment.

I am not a coffee drinker. It keeps me up at night. I have tried drinking tea in the mornings (because it has less caffeine), but I still get tired after lunch. I have tried drinking soda at lunch, but that doesn't help either.

So far I have been able to sort of "tough it out" and deal with my body's natural productivity rhythm for my first two years of med school. My concern though is that when I take step 1 I am going to need to concentrate from 9:00 - 5:00. I don't want to blow 150-200 questions because I'm tired. Maybe I will have enough adrenaline that day (from panic) to keep focused, but then I will start third year and again, I will need to concentrate and work all day. The world is just not set up for me to be able to "tune out" for 5 hours in the middle of every day.

Sometimes I think I'd like to try Adderall. I've been to a psychologist who specializes in study skills. I actually see him regularly just to talk about how med school is going. I don't really meet the clinical definition of ADHD (although he's not saying that I wouldn't get some benefit from it), so Adderall is not really an option that I can try.

Any ideas or suggestions? I really don't want my energy fluctuations to affect my performance.

By the way, I eat eggs in the morning so I don't think it's an insulin/glucose related energy level issue.

 

[Anasazi23]

1. Vault
2. Red Bull
3. Mountain Dew
4. NoDoze

Those are what have worked, and still work for me.

 

[TheWowEffect]

I always get really tired after lunch and just can't get anything done. I can sit in lectures all morning no problem and pay attention (most of the time). Then after lunch I sort of drag through the rest of the day until dinner (accomplishing very little). After dinner, I can usually get some studying in but I have to quit around 11:00 pm so I can go home and get a decent amount of sleep because I have to wake up early. The frustrating thing is that I could probably get a lot of good studying done until midnight or 1:00 a.m. some nights, but I need to get to sleep because of 8:00 a.m. lectures.

It's like my body refuses to conform to an 8:00 - 5:00 work day. Sometimes if I'm getting a lot of studying done late at night I just keep going, but then I pay the price when I have to get out of bed the next morning for that 8:00 a.m. class. I wish I could just turn my afternoon "down-time" into super productive time. Then I wouldn't need to study later in the evening. So the root of my problem is the afternoon fatigue. I have tried naps unsuccessfully. If I take a long nap, I wake up tired. If I try to take a 20-30 minute nap, I lay awake until about 2 minutes before the alarm goes off. Plus, with a wife and two kids at home, it's not really feasible to take a nap in that environment.

I am not a coffee drinker. It keeps me up at night. I have tried drinking tea in the mornings (because it has less caffeine), but I still get tired after lunch. I have tried drinking soda at lunch, but that doesn't help either.

So far I have been able to sort of "tough it out" and deal with my body's natural productivity rhythm for my first two years of med school. My concern though is that when I take step 1 I am going to need to concentrate from 9:00 - 5:00. I don't want to blow 150-200 questions because I'm tired. Maybe I will have enough adrenaline that day (from panic) to keep focused, but then I will start third year and again, I will need to concentrate and work all day. The world is just not set up for me to be able to "tune out" for 5 hours in the middle of every day.

Sometimes I think I'd like to try Adderall. I've been to a psychologist who specializes in study skills. I actually see him regularly just to talk about how med school is going. I don't really meet the clinical definition of ADHD (although he's not saying that I wouldn't get some benefit from it), so Adderall is not really an option that I can try.

Any ideas or suggestions? I really don't want my energy fluctuations to affect my performance.

By the way, I eat eggs in the morning so I don't think it's an insulin/glucose related energy level issue.

It seems to me that you need another hour of sleep at night. Try going to bed an hour earlier for a few days and see if it makes a difference.

 

[50960]

1 word..."exercise"

 

[OldPsychDoc]

More sleep? Exercise!?

C'mon--quit with this stuff already!
This is a psychiatry forum, and we want pills, pills, PILLS!!!

 

[maranatha]

1 word..."Coffee"!!!!

Ok, better yet...."Starbucks"!!!!!



[On all of my interviews, I've been asking if they have a Starbucks or equivalent in their hospital...]

 

[raspberry swirl]

... and when you get that starbucks coffee, asking for a double shot of expresso will definitely do the trick 😳
doesn't everybody have afternoon fatigue? when i look around the conference room during noon lecture, everyone has their eyes closed and heads are nodding. and then we bumble around like idiots all afternoon until a half hour before sign out, when we run around like mad fools trying to follow up on people.

 

[maranatha]

doesn't everybody have afternoon fatigue? when i look around the conference room during noon lecture, everyone has their eyes closed and heads are nodding. and then we bumble around like idiots all afternoon until a half hour before sign out, when we run around like mad fools trying to follow up on people.

This is why I propose mandatory 20 minute afternoon siesta for all residents! 👍

 

[i61164]

1 word..."exercise"

I walk to school and back (1 mile each way). It doesn't sound like a lot but according to my PCP, the exercise goal is 30-45 minutes, 5-6 days per week. I meet that goal most of the time and when I walk I go pretty fast and there are some hills, so I actually work up a sweat. Sometimes when I go back to school to study at night, I take the bike so I will have walked two miles and biked two miles on those days. As it gets colder, though, Iv'e been taking the bike less at night and take the car instead.

The problem with exercise is that it's hard for me to stay motivated to do it. Walking seems to be the only thing that I have been able to consistently do. Anyway, unfortunately, walking doesn't seem to be enough to keep me from being tired in the afternoon.

 

[drwatson]

I walk to school and back (1 mile each way). It doesn't sound like a lot but according to my PCP, the exercise goal is 30-45 minutes, 5-6 days per week. I meet that goal most of the time and when I walk I go pretty fast and there are some hills, so I actually work up a sweat. Sometimes when I go back to school to study at night, I take the bike so I will have walked two miles and biked two miles on those days. As it gets colder, though, Iv'e been taking the bike less at night and take the car instead..

First off, don't worry about Step 1. You can choose what time you want to start. When I took it, I started at 7am and was done by about 2-3 in the afternoon. Some people started as late as 11am, I think.

Next, walking to school isn't exercise; it is movement. I think exercise is time you take to build up a sweat, without distractions (ie no cell phone). Try setting a goal like running a 10k. Then before you start training register for the race and buy some running shoes. Then you are locked-in. Or even better, do some yoga. Nothing like downward-facing-dog to bring the energy level up.🙂 🙂

 

[i61164]

Well, I'll start believing that walking isn't real exercise when America admits that baseball isn't a real sport.

 

[50960]

Make exercise an appt, not an option. You need to do CV exercise that really challenges you as well as weight training to really get the biochemical response you need to keep you awake. Sure 20-30 minutes of CV exercise is good for you, but it is also safe as are most of these guidelines. To get a good response, work out regularly.

 

[i61164]

You guys are probably right. Dr. Cruise also recommended that I step up the exercise and take some vitamins. 😛

 

[watto]

I used to get really tired after lunch, but found that changing my diet so that I ate a breakfast that was primarily carbs with a bit of protein thrown in and a lunch that was primarily protein with a bit of carbs kept me going with a higher level of alertness in the afternoon. Because I run mostly in the late afternoon, I'd snack on a carb around 3 or 4 to prevent the dreaded bonk.

Just because you mentioned you eat eggs in the a.m. but I don't think you said what you had for lunch?

 

[50960]

Baseball is the best sport.....who the hell is Dr. Cruise?😕

 

[i61164]

Tom Cruise, M.D.

 

[i61164]

It seems to be that you need another hour of sleep at night. Try going to bed an hour earlier for a few days and see if it makes a difference.

I am going to try this. Last night my sleep was total crap. It's a combination of my three week old son that makes noise while nursing all night, my wife's snoring, and my 4 year old daughter waking up at 5 a.m. whining. Now that I think about it, my afternoon drowsiness has definitely been exacerbated since late in the pregnancy when the snoring really started. As I was tossing and turning all night, I thought "TheWowEffect" is probably right that I need to get more sleep at night. The problem is that if I go to bed early, I cut into my late night study time. Obviously the idea is that I'll get more studying done the next afternoon when I am not so tired. I would be sacrificing some study time up front and hoping it would pay off in the long run. Because I have an exam this Friday, I'm reluctant to start going to bed earlier, but after this week I'm going to try it.

 

[OldPsychDoc]

I am going to try this. Last night my sleep was total crap. It's a combination of my three week old son that makes noise while nursing all night, my wife's snoring, and my 4 year old daughter waking up at 5 a.m. whining. Now that I think about it, my afternoon drowsiness has definitely been exacerbated since late in the pregnancy when the snoring really started. As I was tossing and turning all night, I thought "TheWowEffect" is probably right that I need to get more sleep at night. The problem is that if I go to bed early, I cut into my late night study time. Obviously the idea is that I'll get more studying done the next afternoon when I am not so tired. I would be sacrificing some study time up front and hoping it would pay off in the long run. Because I have an exam this Friday, I'm reluctant to start going to bed earlier, but after this week I'm going to try it.

Geez--if you have an infant in your room, all bets are off!
No wonder you're sleep deprived!
Separate bedrooms?

 

[i61164]

I tried moving onto the couch in the living room after my daughter was born. The wife was fine with it, but then changed her mind after 2-3 days. We are in this one together. If she's not sleeping (which she's not), I'm not sleeping. At least I get to leave the house every day. I get some extra sleep in lectures and in the study lounge at school, so I'm actually a little bit better rested than she is.

Some nights I wish I had hearing aids where I could just turn them off and be totally deaf. I don't mind getting up a couple times per night to change diapers. I just wish I could sleep through all the noise.

My wife and kids are going to bed at like 7:30 these days. I get home and crawl into bed around 11 or 11:30. My daughter then wakes up at 5:00 am because she's asleep for 9 hours already and she want's to get into bed with us. So we have the usual cranky discussion where she whines about wanting to come into bed with us and we say no. Eventually she goes back to sleep. Maybe she should be going to bed later than 7:30, but my wife seems to be in a contant state of sleep deprivation so she's ready for bed at 7:30 and I leave to go study at that time too.

So, maybe there's no help for it, but I'm going to try going to bed with them after this week. I'll be on break, so I won't have to study anyway. If going to bed at 7:30 gives me more energy during the day, maybe I'll stick with it.

 

[TheWowEffect]

...way to go👍

 

[sdn1977]

Baby 2 is always harder than Baby 1.

You both have to decide how to share your sleep issues. If there's a day you don't have to go in so early...have her get the kids out of the room to let you sleep. If you have to get going early....you get up at 5 & take sleepy Baby 2 with you so your wife gets a few hours of quiet time to rest. A bowl of dry Cherrios, early morning cartoons & a bottle of expressed milk can give you some time to do stuff while she sleeps. On the weekends, trade off days...one gets to sleep in &/or nap uninterrupted & the other gets the other day. Also....encourage mom to nap when baby 2 naps & if baby 1 doesn't nap....she needs to learn to have quiet time with a book or something equally quiet.

If your wife has always had a snoring issue....on her next dentist visit, ask about a nighttime appliance. It may cost you a bit, but will keep her soft palate from dropping & will help reduce the snoring. I know - my husband is a dentist & snores - this worked wonders!!!

This will go on for a few years, so you might as well get the negotiating done early.

Good luck & enjoy them!

 

[slope]

i61164, you really want to know what it sounds to me (and I've been working in sleep medicine for a long time now)? It sounds like OSA (obstructive sleep apnea). Now people can choose to look into it or rationalize it in all sort of ways (some of them being the replies you got to your original post). The fact of the matter is that the only way to find out what exactly is the cause of your excessive daytime sleepiness is to have a NPSG (nocturnal polysomnogram); in the differential diagnosis, the most likely diagnosis, so far, is OSA.

 

[dannyinaustin]

1 word..."Coffee"!!!!

Ok, better yet...."Starbucks"!!!!!



[On all of my interviews, I've been asking if they have a Starbucks or equivalent in their hospital...]

Agreed and beat me to it. It's the only thing that works for me, but I'm pushing the limit with caffeine these days. Hello kidney stones! 😀