Provided that we are healthy, our energy level to the big extend is modifiable.
Insufficient sleep, excessive stress, inappropriate meal schedule and poor time management make us waste energy for nothing.
1. Everybody has a unique 24 hours circadian rhythm encoded in their clock in the brain making some people be morning and some night person. This predisposes one to certain times of the day when they are at their peak performance and times when they are less efficient. This is to some extent modifiable. Imposed on us daily schedules are often incompatible with our own cycle and make us miserable. TV or the computer light used late at night affects our sleep. It increases stage 2 sleep and decreases deep sleep necessary for memory consolidation and processing. Partly this and partly natural for all teenagers delayed phase disorder contribute to the problems they may have at school. Going to bed late on the week nights and sleeping late on the weekends they develop the sleep pattern when their deepest sleep falls into the early morning hours( typically during math or science class). Majority of teenagers suffer from severe sleep deprivation, which can lead to mood disturbances, depression attention and memory problems. Maintaining as regular as possible wake up time, diminishing nighttime light exposure and promoting morning light exposure can improve quality of sleep and eliminate effects of sleep deprivation
2. Human body is equipped with autonomic nervous system, which regulates the function of organ systems and the level of our arousal. Sympathetic part of it, originally developed for “ Fight or Flight “ reaction enhances blood flow to the brain and muscles, but suppresses digestive system. It is helpful when we have to run away from a lion, but it was meant to be activated only for the brief periods of time. If prolonged it leads to multiple health problems( stomach ulcers, HTN, anxiety and many others)
In the modern civilization we learned to activate the “ stress system” but we lost the ability to shut it off. We function like the car being on park, constantly pressing gas pedal. We don’t go anywhere and we use our energy for nothing. At the same time we eventually get ourselves sick.
Parasympathetic nervous system( the counterpart of sympathetic helps to maintain basic body functions and sleep) It is the right balance of the two systems that gives us harmony and health.
Good news is that with the practice and the use of simple physiological exercises we can restore our ability to regulate our bodies. Regular exercise also facilitates this regulation.
3. Regular meal schedule with appropriate amounts of proteins, carbohydrates, unsaturated fatty acids and appropriate omega 3/ omega6 ratio is as critical as putting gas in your car. Also it is important to keep your meals glycemic index low. If you eat a meal comprised of pure carbohydrate, ( eg. bagel or donut) it activates insulin secretion and inevitably leads to hypoglycemia 1-2 hours later in a lot of people, with all signs and symptoms of it. That’s why to add to your carbohydrate protein and fiber, to lower this hypoglycemic response. 1.W/u for FATIGUE
Complete BW, Lyme, Mono, Arthritis panel
Physical exam
Review medications as possible cause( beta, sleeping pills, antihistamines) screen for substance abuse
Review eating habits ( hypoglycemia)
WE TRY TO DIFFERENTIATE FATIGUE FROM EDS to see if we should proceed with the cardiac and pulmonary w/u
We screen for depression if this is still (-):
Sleep Log and screening for OSA ( not everything that happens at night is a OSA)
EXPLAIN the sleep needs( 8 hours and 20 min) and sleep architecture. The purpose of deep stages of sleep
1. Why