Minimizing sleepiness

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masterjen

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The medication I take causes a certain degree of sleepiness, esp. the bedtime one which is the highest dose. Bedtime sleepiness is a non-issue since I'm planning on going to bed momentarily. The morning one I take with breakfast is the lowest dose, and no sleepiness occurs. The 4 PM dose is a killer now since a dose increase 6 months ago. Prior to the dose increase the 4 PM fatigue used to be manageable by ensuring adequate hydration through the day along with keeping my body active for the next hour by taking a walk, housework, timing my gym workout for that time, anything.

The only thing to combat the fatigue now is a piece of bread/toast. I had tried something healthier like protein or fruit, but didn't change the fatigue. Since bread is essentially a simple carbohydrate logic would say that any simple carbohydrate (eg. pasta, rice, a couple of crackers) would do the trick but not the case, at least not for me. I eat lunch in two parts: noon and 2 pm, so hunger is not a factor in the fatigue.

Anyway, I'm wondering if anyone has an explanation and/or has had a similar experience with a mid-day or mid-afternoon medication dose.
 
Hmmm... White bread (simple carb) or a whole grain (complex carb) variety? Any additives (in either the crackers or the bread)? Fiber content? There might be a few different factors that make the bread the winner for combatting your fatigue.

Generally, the net carbs in a slice of bread would be roughly comparable to 8 crackers, so you could try eating more crackers (in the spirit of science) to see if that has the desired effect.

Maybe also somehow related to glycemic load? Bread tends to have a much lower glycemic load than white rice or white pasta.
 
Your suggestion of simple vs. complex carbohydrate gave me something more specific to look up than what I had been trying to "google" up to now: I learned that the slower digestion of a complex carbohydrate slows down the absorption of the medication into one's blood stream, thereby reducing the "hit" (and hopefully the post-dose fatigue) of any medication side effects. The fact that bread has a lower glycemic load than some other carbs may very well factor in somehow as well.
 
It sounds like you've done all the recommended "stay awake" strategies (exercise, hydration, distraction etc.). One other thing you could try (if you want a break from the bread) is chewing gum. I've found that it helps keep me alert during late afternoon driving (chewing gum + singing really loudly with the car radio).
 
Haven't tried either of those before. Thanks for the ideas! As for the singing . . . definitely I'd want to be in the privacy of my car as I don't exactly have an in-tune singing voice LOL.
 
Coconut juice.is it pos see nuro explain situation put you on other staff that don't do that.You should start day with decent breakfast
 
Coconut juice.is it pos see nuro explain situation put you on other staff that don't do that.You should start day with decent breakfast

Thanks for the suggestion, but I don't like coconut juice (or coconut water).

Good thought on breakfast.

As for being put on other medications: another good thought, but on the current medications and doses I have the biggest reduction in seizure frequency than I've had in 6 years. I won't take the chance of messing with the possibility of poorer seizure control with different medications just for the sake of combatting afternoon sleepiness. Instead, I'm keeping record of what works to reduce sleepiness and what doesn't.
 
Oh I agree coconuts is pits I hate it but it the new wonder cure for everything
 
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