Q. What is the reason for my disturbed sleep and morning drowsiness?



Hi doctor,

I am 56 years old and self-employed. I do not have much work for the last few months as I have reduced my business for a gradual retirement. I go to bed at about 10 PM. I get up once in between for urination. Most of the day, in the last few months, my sleep gets disturbed at about 4 AM and after that till 6 AM I am unable to sleep and remain in bed tossing around. I feel tired and drowsy, sometime uncomfortable in between 8 AM to 12 PM. I allow myself to sleep in a bent down position, sitting on the chair for about 30 to 45 minutes in the mornings on most of the day when I drowsy. Irrespective of the morning rest, I take regular rest in the afternoon. Nowadays, I do not get sleep during this time also and keep tossing around. I feel fresh in the evenings. What is the reason for this disturbed sleep, tiredness and morning drowsiness? Can you suggest any medicine for this? I am anemic and my hemoglobin is 10.6. I also have high bilirubin, total 3 and non-alcoholic fatty liver. I neither have jaundice nor any other liver problem. I am currently taking LIV APT, Xaria plus and Pan-D. I am getting nose blockage, for the last few months, when I use AC or fan in the lying down position. During yawning too, I get nose block for a few minutes. Allergy doctor had given Xaria plus for this problem. Please let me know whether anything else is required for this. How long should I take Xaria Plus?





Welcome to dr.sitehome.info.

I have gone through your query.

  • You are suffering from two problems. One is nasal block and the other is sleep disturbance, which may be insomnia.
  • You can stop Xaria plus (combination of Montelukast and Fexofenadine). Instead of that you can take Flutiflo-FT – Fluticasone nasal spray once daily along with Nasoclear nasal drops as and when required.
  • Sleep disturbance may be due to insomnia and so need sleep hygiene.
  • Stop drinking coffee or tea in the evening, do regular exercises in the evening and sleep in the lateral position.
  • Try simple changes to your daytime and pre-bedtime routine. Keep a regular sleep schedule, go to sleep and get up at the same time each day, including the weekends.
  • Set aside enough time for sleep. Most people need at least seven to eight hours each night in order to feel good and be productive.
  • Make sure your bedroom is dark, cool, and quiet. Cover electrical displays, use heavy curtains or shades to block light from windows or try a sleep mask to shield your eyes.
  • Turn off your television, smartphone and computer a few hours before your bedtime. The type of light these screens emit can stimulate your brain, suppress the production of melatonin and interfere with your body’s internal clock.
  • Will try conservative management initially and if not improving, then you may need sleep study and medications like Melatonin.
  • I want to know whether you have snoring.

  • The Probable causes:

    Stress related sleep disorder.

  • Investigations to be done:

    Sleep study after one month.

  • Differential diagnosis:

    Obstructive sleep apnea (OSA).

  • Probable diagnosis:


  • Treatment plan:

    Conservative management like sleep hygiene, avoid coffee and tea and do regular exercises.

  • Regarding follow up:

    Revert back after a month to a sleep medicine physician online.—> https://www.dr.sitehome.info/ask-a-doctor-online/sleep-medicine-physician




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