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I've experienced daytime drowsiness that tends to occur

I've experienced daytime drowsiness that...

I've experienced daytime drowsiness that tends to occur under particular situations. This is a partial re-post of the same topic seeking a more information and a second opinion (edit: I was satisfied with the previous doctor's answer); I don't want to lay the burden on one doctor for a complex issue when I have unlimited questions at a flat rate anyway. See here: http://www.justanswer.com/health/81jlj-hi-experience-daytime-drowsiness-reoccurring-basis.html I don't have health insurance so I'd like to see if either I can solve the problem without clinical tests or to otherwise limit time and cost. What possible solutions should I look into first? I'll add to the previous exchange that I have had depression and anxiety and that has interfered with my sleep at times, but I notice little-to-no relation between my sleep quality/quantity and this drowsiness. The one thing that has helped a lot is the aforementioned bit about leaving work for a bit and then returning. I'll tend to feel more relaxed and refreshed. I could eventually tip, depending on the degree your advice leads to a solution and to what degree of time and cost were saved; the amount could go up to over three figures. Thanks in advance.

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Answered in 22 minutes by:
10/11/2013
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16,374
Experience: Board Certified NP, MS, RN. 25 years private practice & hospitalist
Verified

Hello,

Answers provided are for informational use only and don't confer patient-provider relationship. My name is***** and I will do whatever I can to help you.

Dr. Saha has given you some excellent possibilities. However, none of them (thyroid, sleep apnea, electrolyte imbalance, anemias, hormone imbalance, etc.) can be detected or eliminated without testing with a primary care provider to determine what the problem is. Blood tests (CBC, metabolic panel, thyroid panel) would be the very minimum required.

Since you don't have insurance, I would suggest you try one of the free clinics. There is a list below, but you will probably find others in your local telephone directory since not all local clinics make the national lists. The clinic where I volunteer weekly isn't on the national list, for instance, although we see thousands of patients per year. These clinics are staffed by providers who volunteer their time from their regular practices to see patients who could not otherwise afford medical care. They often have some specialists who they can refer patients to if the diagnosis is a complicated one after routine lab tests are done. The specialists work with the patients to make care affordable if it isn't pro bono.

http://bphc.hrsa.gov/

http://www.freeclinics.us/freeclinic.php

Actually, a lot of people will become sleepy when bored with routine tasks. There are also things like reactive hypoglycemia (low blood sugar) that can make one feel tired and inattentive an hour or so after a high starch meal. The solution for that one is to divide your diet into 5-6 small meals a day, each containing protein so you don't have this. Most people associate hypoglycemia with a diabetic who has had too much insulin or not enough food, but people without diabetes can have reactive hypoglycemia that they completely control by what they eat and when. For instance, a salad with some chicken for fish is a better lunch for a hypoglycemic than a sandwich or pasta. When you get hungry later in the afternoon, a peanut butter cracker or some non-fat yogurt are better choices than a candy bar or a soda. These are changes you can make that require no testing at all. A brisk walk around the hallway every couple of hours may also keep you more alert and attentive. In fact, that is something recommended for anyone doing repetitive work.

Please let me know if you have questions.

Best regards,

Schuyler

~

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Customer reply replied 4 years ago

Hi, I'm preeetty sure that I don't have hyperglycemia; I did a little quick research as verification, though it's better you list too many possibilities than not enough. I had blood drawn months ago as a requirement to volunteer at the hospital and resident care facility I'm currently at; could that blood be used to test these issues? Thank you.

No. Blood drawn a few months ago has long since been destroyed - probably the same day the test was run. You would need a fresh blood draw to test for any of the things mentioned. For instance, a thyroid hormone panel would most likely not have been a part of a routine blood test.

Also, I referenced reactive hypoglycemia. You determine that with a glucose tolerance test. It would not show up on a routine fasting blood test. Since you presumably had glucose test as part of the blood draw some months ago, hyperglycemia wasn't a consideration. Reactive hypoglycemia comes from eating a high carbohydrate meal. In response the pancreas secretes insulin. However, it over-reacts and secretes too much insulin which makes blood sugar too low (i.e. hypoglycemia) an hour or two after eating. This can lead to feelings of fatigue, drowsiness, etc.

Please let me know if you have questions.

Best regards,

Schuyler

~

A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16,374
Experience: Board Certified NP, MS, RN. 25 years private practice & hospitalist
Verified
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A. Schuyler, NP
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16,374
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