Q: How can I power through a day after barely any sleep? I often do a face-plant on my keyboard in the afternoon.
A: The best thing to do—as you well know—is to get seven to eight hours of shut-eye a night, because lack of sleep negatively affects nearly all body systems. To get your sleep on track—after you lift your forehead from the G key—try these tactics:
➨ Make every meal count. When your body doesn’t get the sleep it needs to rejuvenate, the brain’s neurons don’t secrete normal amounts of serotonin or dopamine. To compensate, your body craves sugary foods that deliver an immediate release of serotonin and dopamine. As if that weren’t enough to send you to the vending machine, as you age, the pineal gland in your brain produces less of the sleep hormone melatonin, resulting in a craving for carbohydrates. To manage all this—and to avoid the crash-and-burn blood-sugar roller coaster caused by sugary carbs—try not to eat foods with added sugars or syrups, and grain that is less than 100 percent whole. Foods with fiber (whole grains), protein (legumes, lean poultry) and healthy fats (avocados, fish, nuts) help keep your blood sugar more constant—and you more alert.
➨ Try a little caffeine. We said a little. The Sleep Foundation says up to 250 mg a day is fine (three 8-ounce cups of average-strength coffee). The foundation says it takes six hours for half the caffeine to be eliminated. It might sustain afternoon attention but also might keep you from going to bed on time, creating a worse energy dip the next day.
➨ Take a midafternoon catnap. That is, if you can swing a snooze without losing your job. Timing is important: Humans’ circadian rhythm hardwires us for an energy low between 1 and 4 p.m. Scientists call it the postprandial dip, aka the post-lunch dip, although you can’t just blame lunch—the post-lunch dip can even hit people who skip that meal. A quick shot of shut-eye during this window—20 to 30 minutes is ideal—can temporarily boost your physical and mental energy without making you groggy or affecting your nighttime routine.
➨ Go for a hike. Or just walk to lunch the long way. People in one study felt less afternoon fatigue on days when they worked out during lunch. And regular activity is key; one workout on one drowsy day won’t give you afternoon energy all month.
Q: I get eight hours of sleep every night (although my wife doesn’t—my snoring wakes her up!). But I’m still sleepy and tired during the day. What gives?
A: Are you chubby in the neck and around the waist? Fat at the waistline correlates with a thick neck, which can obstruct your breathing, causing snoring and even sleep apnea. To find out, grab a tape measure: You’re at higher risk if your neck size is more than 17 inches in circumference for men (16 for women). Mild snoring is benign—you can still move air through your throat—but if you generate a kazoo sound that startles people in other ZIP codes (not to mention your bedmate) you could be causing marital strife and permanent hearing loss to anyone in range.
In some cases that obstruction can worsen until eventually no air can pass into the lungs for up to 10 seconds at a time and up to 30 times a night. This is the definition of sleep apnea, a serious condition now facing more than 9 percent of North Americans older than 50. To make matters worse, with age, the tissue in your throat softens, and the area around your tonsils attracts fat. When you’re asleep and your muscles fully relax, the tissue collapses, so there’s less room in the back of your throat.
Fortunately, the body instinctively awakens before suffocation, but sleep apnea makes you miss out on deep, restorative REM (rapid eye movement) sleep. This leads to frequent awakenings (you’ll probably never feel yourself waking), lack of sleep and daytime drowsiness. You’re also more likely to develop high blood pressure (resulting from your lungs hanging on to carbon dioxide when you stop breathing).
The bitter irony is you’re also more likely to get fatter, because sleep apnea is like a chain-reaction collision—one accident after another. Lack of sleep makes you tired. You crave energy. You eat foods that give you quick energy but have high sugar and fat. You don’t feel like exercising. You get fatter. You continue to have sleep apnea. The cycle continues.
Your doctor may be able to diagnose you based on just your symptoms. He or she may also send you to a sleep specialist who can pinpoint your issue and monitor you during treatment. Once diagnosed, you should shed pounds right away. It’s no surprise that weight loss helps limit sleep apnea; part of the problem is obstruction of the airflow through passages in the back of the mouth. A waistline reduction of a few inches will probably prevent or reduce sleep problems by 30 percent. If this doesn’t work, your doctor may recommend a device to help open the airway while you sleep or—in severe cases—surgery to remove tissue from the back of the throat.
Q: I’ve felt exhausted—like my legs are weighted down—since I started taking blood pressure medication. What gives?
A: Your leaden legs and fatigue could very well be a side effect of the medication. Depending on your prescription, the drug could slow your heart rate, relax your arteries or dilate your blood vessels, any of which could cause fatigue.
To deal with your symptoms, first visit your doctor to rule out other fatigue-causing conditions like depression or heart disease. Then, assuming everything else is fine, consider lifestyle changes to reduce or eliminate medication use without compromising your health. We usually don’t promote meds as the first solution. That’s not a critique of pharmaceuticals, which are among of the most important medical developments in history. But we’d prefer to teach ways to beat the problem before you need medication. And even though you’re already on a drug, you can still employ some natural methods. Many of the things that blood pressure meds do—reduce fluid in your arteries, create a less forceful pumping of fluid into them, or enlarge the arteries—can also be done through physical activity. Lowering your weight by 10 pounds can trigger a significant dip in blood pressure.
As for exercise, cardio works your heart muscle, making it stronger and better able to pump blood without putting so much pressure on artery walls—sometimes the results are as dramatic as those with drugs. Shoot for 150 minutes of moderate exercise or 75 minutes of vigorous exercise weekly (or a combo).
As for diet, some people with hypertension are salt-sensitive (meaning salt intake raises their blood pressure). Ask your doctor whether you are one of them and follow her advice accordingly.
If these lifestyle approaches don’t work, there are more than 150 medications approved for BP control, each with unique side effects and benefits. So talk with your doctor about the side effects you don’t want—like leg exhaustion. She can prescribe an alternative and monitor your BP (and you can monitor BP at home with devices costing less than $40) to restore your energy and keep your BP down.