Get Rid Of Tiredness and Sleep Less
As you allow yourself to continue to experience the comfortable weight of a deep, relaxed tiredness. And perhaps now, perhaps in a short time it becomes possible to discover a part of you that begins to see another way to be less tied to discover that tomorrow is not tied to today. That it is possible to allow yourself to discover that something else awaits you and you can begin to untie this waiting and find a way forward.
Recently it has been shown that patients with narcolepsy - who lack hypocretin -have selective deficits in the prefrontal or executive attention network.30 While older literature suggests that cognitive deficits in narcolepsy may simply be a result of tiredness, Rieger and colleagues show that the selective deficit in divided attention persists affect controlling for alertness.30 Furthermore, another recent study has showed abnormal frontal cortex physiology in narcoleptics during pre-attentive and attentive tasks.31
Leisurely travel and sightseeing remain a pleasant pastime for many people. Having to get somewhere on time is usually a hassle and, for many people, a major source of stress and an unpleasant part of their working day. Traveling in cities and to airports and using public transport at certain times of the day in cities contribute to tiredness and decreases the quality of life. It is not uncommon for people to get stressed driving on highways. It is not known whether travel stress increases the risk of heart disease.
Fascieulations appear as subcutaneous twitches overlying muscle bellies when the muscles arc at rest. They result from disease of lower motor neurones that innervate that particular muscle and are caused by brief contraction of single motor units. They may be coarse or fine in amplitude and are most commonly found in wasted muscles. They can occur in normal people after vigorous exercise. A similar usually benign phenomenon, myokymia, involves fasciculations of the orbicularis oculi. This condition is commonly caused by anxiety and tiredness.
Acute reactions during radiotherapy for pituitary adenoma in the form of acute edema are extremely rare and reversible. Early delayed reactions in the brain are characterized by a transient period of exhaustion, drowsiness, and anorexia, and this is described as the somnolence syndrome (1). The severity relates to the intensity of radiotherapy and the volume irradiated. Apart from tiredness, the full somnolence syndrome after small-volume pituitary irradiation is relatively uncommon.
A 30-year-0ld female schoolteacher was admitted for investigation of 7 kg weight loss, tiredness and malaise of 3 months' duration. Systemic enquiry was otherwise normal. She had two children by her partner in a stable relationship of 5 years' duration. There was no history of drug use and physical examination was initially normal. The diagnosis was unclear until after complaining of a sore throat, she was found to have oral candidiasis. Suspecting an immunodeficiency disorder, a sexual history was then taken and reveaied that 2 years previously, while her partner was abroad, she had unprotected sexual intercourse with a bisexual friend. An HIV test was performed and was positive her partner and her second child were also later found to be HIV-positive.
In a patient with anorexia nervosa an additional method of cognitive reframing is set up whereby we talk about 'gaining strength' instead of 'gaining weight.' The patient is instructed that each strength unit is equal to one pound of body weight. Since most patients with anorexia nervosa who are extremely emaciated get into treatment feeling tired and physically weak, these presenting symptoms are capitalized on by asking them, under hypnosis, whether they would be willing to regain their strength. Most patients respond positively to such a suggestion, and this method uses the principle of 'meet the patient where the patient is at.' Meeting the patient at her level means devising a treatment plan that will be accepted by the patient with minimal resistance. The patient with anorexia nervosa, who suffers from a low body weight, tiredness and physical weakness, engages more readily and is more cooperative in activities focused on supplying her body with healthy nutrition in wholesome...
Severe daytime sleepiness, often combined with nocturnal sleep fragmentation, leads to a feeling of constant tiredness in narcoleptics. This chronic sleep pressure coupled with poor sleep wake state boundary control may underlie the commonly observed sudden, uncontrollable bouts of sleepiness or sleep attacks during the day. Cataplexy (Gk., to strike down ), another cardinal symptom of narcolepsy, was first used by Loewenfeld (1902) to describe the sudden, bilateral loss of muscle tone without loss of consciousness. Triggered by any situation that requires sudden action or strong emotion (laughing and mirth are the most commonly reported triggers), these attacks may be partial (isolated muscle groups) or complete (causing complete collapse), but rarely involve all muscles simultaneously. The knees (buckling) and head neck muscles (head bobbing, jaw sagging and slurred speech) are most commonly affected, with such episodes lasting for seconds to (rarely) minutes. Muscle weakness...
In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. The lowered mood varies little from day to day, is unresponsive to circumstances and may be accompanied by so-called somatic symptoms, such as loss of interest and pleasurable feelings, waking in the morning several hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, weight loss, and loss of libido. Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe.
Although rare, the patient may develop hepatitis during itraconazole administration. The nurse closely monitors the patient for signs of hepatitis, including anorexia, abdominal pain, unusual tiredness, jaundice, and dark urine. The primary health care provider may order periodic liver function tests.
Symptoms which involve other systems may be the presenting features in patients with cardiac disease. Some of these are listed on Table 3.14. Undue tiredness may be a feature of ischaemic heart disease and the symptoms of infective endocarditis are often non-specific. They include weight loss and tiredness with night sweats.
The irritable bowel syndrome is a common cause of altered bowel function in patients under the age of 50 years. The principal symptoms include episodic constipation and diarrhoea associated with abdominal distension, intermittent abdominal pain relieved by defecation and often accompanied by non-specific symptoms including dyspepsia, urinary frequency, backache and tiredness (Table 5.11). A 45-year-old woman presented with breathlessness on exertion, tiredness and aches and pains in the back and limbs. Systemic enquiry revealed painless abdominal bloating, occasional loose stools, weight loss of 6 kg over 12 months and more recently, intermittent dysphagia. Ever since the menarche. she has had recurrent crops of mouth ulcers occurring especially at menstruation, As a teenager and subsequently during two pregnancies, she had been found to have an iron-deticiency anaemia for which no cause had been found.
Tlit complain of chronic polyarthralgia or myalgia, which is constant day and night and does not conform to any dear pattern, should raise the suspicion that this may be a somatic presentation of an underlying psychological or psychosocial problem, for which an explanation should be sought. Other clues include lack of objective abnormal clinical findings, such as reduced movement or joint swelling, and the prominence of features such as tiredness, lack of energy, change in mood, sleep patterns or appetite although such features may be the consequence of chronic pain.
Phyto-oestrogen (phytoestrogen) is a term applied to non-steroidal plant materials displaying oestrogenic properties. Pre-eminent amongst these are isoflavonoids. These planar molecules mimic the shape and polarity of the steroid hormone estradiol (see page 279), and are able to bind to an oestrogen receptor, though their activity is less than that of estradiol. In some tissues, they stimulate an oestrogenic response, whilst in others they can antagonize the effect of oestrogens. Such materials taken as part of the diet therefore influence overall oestrogenic activity in the body by adding their effects to normal levels of steroidal oestrogens (see page 282). Foods rich in isoflavonoids are valuable in countering some of the side-effects of the menopause in women, such as hot flushes, tiredness, and mood swings. In addition, there is mounting evidence that phyto-oestrogens also provide a range of other beneficial effects, helping to prevent heart attacks and other cardiovascular...
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