Archive for General Health

Are You Getting Enough Sleep?

Altaf Husain

Unable to stay awake after completing the Fajr prayer? Struggling to barely make it through the day?

Do you find yourself nodding off at your desk during idle moments at work? Are midday meetings becoming your favorite naptimes?

The hustle and bustle of our fast-paced lives leaves little time for rest. While college students are perhaps among the most sleep-deprived, more and more people are failing to get enough sleep. And for Muslims, living in a society that does not revolve around prayer timings poses an additional challenge.

Despite it being such a crucial part of our 24-hour day, we pay little attention to this often taken-for-granted activity. How many of us have seriously contemplated questions such as, “How much sleep do I need?” “What can I do who about insomnia?” “Can I really catch up on sleep?”

Believe it or not, there is actually an organization called the National Sleep Foundation (www.sleepfoundation.org) that is dedicated to “improving the quality of life for the millions of Americans who suffer from sleep disorders, and to the prevention of catastrophic accidents related to sleep deprivation or sleep disorders.”

Sleep has been mentioned by Allaah Subhaanahu wa Ta`aala in Sura An-Naba (78), verse 9, “And We have appointed your sleep for repose.” And indeed, Prophet Muhammad (Sall Allaahu`alayhi wa sallam) himself emphasized that our bodies have a right over us. The carefully recorded biographies of the Prophet inform us that he spent most of the day in service to his community and most of his night in prayer to Allaah Subhaanahu wa Ta`aala. It is said that the Prophet slept very little during the night, but encouraged a short nap between the Dhuhr and ‘Asr prayers. One wonders how it was possible for the Prophet to function with such little sleep; however, having had prophethood bestowed upon him, he was commanded by Allaah Subhaanahu wa Ta`aala to prepare and train himself for that tremendous mission.

Stage 1 Muscles relax, irregular, rapid brain waves
Stage 2 Larger waves, bursts of electrical activity
Stage 3 Large, slow waves (delta)
Stage 4 Continuation of large, slow waves (delta)
Stage 5 1 hour or later, REM – rapid eye movement (brain waves as active as if one were awake. Dreams occur.
Stage 6 Recurring REM cycles until one awakens 
75% Non-REM sleep, 25% REM (dreaming)

In today’s society, people devote little effort to monitoring their sleep patterns. Indeed, most of us do not know what actually happens during sleep (refer to diagram). We do know, however, that if we do not get enough sleep, we can feel irritable and drowsy. Consider a typical summer day when daylight hours are long, and nights are short. In North America, the beginning time for Fajr prayer can be as early as 4:30 am while the time for ‘Isha prayer can be as late as 10 pm. By the time we wrap up the day and go to bed, it may be after midnight – technically, the next day. Waking up for Fajr prayer under these circumstances can be a struggle, to say the least.

And then, what does one do after completing the prayer? This can actually be the real dilemma. Consider this scenario: if you complete Fajr prayer at 5 am, yet you do not have to prepare for work (which starts at 9 am) until 7:30, what do you do during those 2-1/2 hours? Chances are you haven’t had enough sleep so you’d like to return to bed; however, you feel uneasy, recalling that the Prophet Muhammad Sall Allaahu`alayhi wa sallam frowned on the habit of sleeping after the Fajr prayer.

Try, though, as we may to follow the Prophet Sall Allaahu`alayhi wa sallam’s Sunnah, for many of us, those extra hours of sleep in the morning have become a source of revitalization. If you are fortunate enough to be able to fall asleep again, you may feel more rested and ready to take on a full day of work. If, however, it takes you a half hour or more to fall back to sleep, you may actually find yourself awakening later feeling groggy.

This scenario is just one of many, and addresses the individual who doesn’t make it to bed until late but still wakes for prayer. What about the individual who does not wake for prayer? The fact is that many of us, for a combination of reasons, rarely get a good night’s sleep.

We will now discuss the dangers of sleep deprivation, recommendations for sleep management, and the wisdom behind the habits of the Prophet Muhammad Sall Allaahu`alayhi wa sallam. 

Scientists have conducted various studies on sleep patterns in which the most common finding is that not getting enough sleep is a threat to both our physical and mental health. A typical work day lasts approximately 9 hours. Adding another hour or so for commuting time means the average person requires at least 10 hours a day of alertness, notwithstanding family responsibilities and extra-curricular activities after work. A working mom may find it necessary to stay awake continuously for 18 hours or more, making it impossible for her to get more than 5-6 hours of sleep every night. And we’re assuming that her sleep is not disrupted by stress or any other physical ailments. As this cycle repeats itself over the duration of the workweek, it is not uncommon for many people to suffer from sleep deprivation. 

Many Muslims experience increased bouts of sleep deprivation during the month of Ramadhaan. Waking up an hour before the Fajr prayer, eating suhoor, staying awake through the day until iftaar, praying the Taraweeh prayers, and repeating this cycle for an entire month can cause shock to a body that is unprepared. 

Are You Sleep Deprived? 

Do you want to know if you are sleep-deprived? One simple test is to see how fast you are able to fall asleep. Spouses of people who are sleep-deprived report that they fall asleep almost immediately after their heads touch the pillow. They often cannot sit still during prolonged meetings else they risk falling asleep. And often, the irony is that they are sleep deprived because of intense periods of activity without breaks or pauses. 

As mentioned above, sleep deprivation poses risks for both physical and mental health. For example, research has shown that two out of three road accidents in the U.S. may be linked to drivers who are sleep-deprived. Slower reactions combined with an inability to think clearly often puts sleep-deprived drivers at a higher risk for road rage and, even worse, of missing important cues such as slowed traffic or unsafe road conditions. 

Recent studies in the West have also reported that starting schools later in the morning may help reduce discipline problems while increasing academic performance.  This finding sits at odds with the traditional notion in the Islamic culture which emphasizes rising early for Fajr prayer, and memorizing Qur`aan, for example, in the early hours of the morning. 

Sleep and Teenagers 

Sleep deprivation is not uncommon among teenagers as well. Ever wonder why teenagers enjoy slumber parties so much… during which they comfortably stay awake all hours of the night and sleep in until the Dhuhr prayer? Over the past few years, various studies have indicated that adolescents, in their prime years of development, need more sleep than they are getting. Some scientists have based this finding on the possibility that teenagers have internal clocks that prompt them to stay awake late at night and sleep later in the morning (Washington Post, 10/19/00). Recent studies in the West have also reported that starting schools later in the morning may help reduce discipline problems while increasing academic performance. This finding sits at odds with the traditional notion in the Islamic culture which emphasizes rising early for Fajr prayer, and memorizing Qur`aan, for example, in the early hours of the morning. Perhaps one explanation could be that in Islamic cultures, typically very little activity takes place between the ‘Isha and Fajr prayers. A household that abides by this tradition is likely to produce youth who are more alert and effective in the early mornings. On the other hand, non-Islamic lifestyles socialize the youth to stay awake for hours on end after the ‘Isha prayer. In this lifestyle, the night comes to life – ceasing to be a time for rest. 

Sleep and University Students 

University students are perhaps among the most vulnerable to sleep disruption and deprivation. Muslim students try especially hard to juggle strenuous schoolwork, Islamic study circles, and extracurricular and social activities. We asked two seniors and a first year student at Georgetown University about their own sleeping habits. The three students averaged approximately five-and-a-half hours of sleep per night. Admittedly, senior Shaheen Kazi added that her six to seven hours of sleep a night are reduced drastically during peak exam times. As vice-president of the campus Muslim Student Association, and coordinator of the Muslim Housing Co-op, Kazi has to maintain a delicate balance between excelling academically while fulfilling her obligations to the Georgetown Muslim community. 

But exactly how do such students make it through the day with such little sleep? Rehenuma Asmi, a first-year student majoring in Arabic and pre-medicine says she does not usually have to take a nap during the day. Kazi and her roommate, senior Nadia Chaudhri indicate that they take power naps (20-30 minutes) during the day. 

Prophet Muhammad’s Sleep Patterns 

The Prophet Muhammad Sall Allaahu`alayhi wa sallam was known to sleep very little. There are several authentic reports regarding his sleeping habits. During the early period of revelation, he was commanded to spend most of the night or some part of the night in prayer. After the initial years of revelation, the Prophet Muhammad Sall Allaahu`alayhi wa sallam continued the night prayers in the last third of the night. He would stop, and rest lying on his right side until his companion and the caller to prayer, Bilal, came to wake him for the Fajr prayer. He did not sleep after Fajr prayer, but we learn from the Sunnah of the Prophet Muhammad Sall Allaahu`alayhi wa sallam that he recommended a nap between Dhuhr and ‘Asr prayer. Indeed, the reader is invited to further explore the blessed habits of the Prophet Muhammad Sall Allaahu`alayhi wa sallam in the various books of seerah and throughout the books of Hadeeth. 

Overall, we would all agree that our bodies deserve their share of rest. As Muslims, we are reminded by Prophet Muhammad Sall Allaahu`alayhi wa sallam that our bodies have a right over us. We must monitor our daily activities to ensure that we are getting enough sleep. Most of all, our sleep patterns should not make us miss either Fajr or ‘Isha, as they mark the beginning and the end of our days. So make sure that from time to time, you ask yourself, “Am I getting enough sleep?” 

Editor’s Note: There are several sleep disorders (like insomnia, parasomnia, or hypersomnia for example) and the reader is invited to visit the American Sleep Disorders Association at http://www.asda.com/ to learn more about them.

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Migraine Pain

Heading Off Migraine Pain

By  Mona Nada

Professor of Neurology

 
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It is very rare to find someone who has never suffered from a headache before. A lifetime prevalence study revealed that as many as 99 percent of women and 93 percent of men experienced a headache one time or another (Rasmussen).Fatima Fouad, a 24-year-old lady, burst one day into my clinic, desperate and in agony. She was suffering from a severe headache that had kept her at home for two days.

As she slowly took a seat, she began explaining the onset of the headache. Before the attack, she started seeing flashes of light and irregular zigzag lines. She thought there was something wrong with her eyes. A few minutes later, these flashes disappeared. However, they were replaced by a severe headache on the right side of her head.

Fatima said she used to have these attacks for almost four years. They usually occurred when she was stressed or overloaded. But this time, it came over the weekend. She was out with her friends for pizza. Since then, she got a severe attack of headache.

“What is the possible trigger for the headache this time?” She wondered. “Is it pizza?”

The simple answer is yes. A slice of pizza can trigger an attack of headache. Other types of food can do so as well. These foods are called migraine triggers.

From Fatima’s story, she was suffering from an attack of migraine which was preceded by what is called an “aura”. This headache attack was most probably triggered by the pizza she ate.

Many people suffering from migraines have higher frequency of attacks during the weekends. This is called a “weekend migraine.” This is probably due to less coffee intake over weekends. The decreased caffeine is considered one of several migraine triggers. Another possible cause is changes in one’s sleeping pattern over the weekends. Sleeping late, which could lead to either oversleeping or sleep deprivation, could trigger a migraine episode.

Relaxation after a period of stress is also suspected of causing migraines, but no explanation has been found. These could have been triggers for Fatima’s migraine attack as well.

To understand what migraine triggers are, we first need to understand what migraine and aura mean.

What Is migraine?

A headache is a pain or discomfort anywhere between the eyebrows and the upper part of the back of the neck. Migraines are one of the most common types of headaches.

The word “migraine” comes from the Greek word “Hemikrania” where “hemi” means half and “crania” means head. This word was changed to “Hemigrania,” finally becoming “migraine.”

Migraine is characterized by repeated attacks of headache, usually on one side of the head. It is frequently pulsating in nature. The pain of a migraine attack can actually feel like several headaches put together. It is usually associated with nausea, loss of appetite, and/or vomiting. It is also often accompanied by abnormal sensitivity to light and noises.

A migraine attack can last 4 – 72 hours. The frequency of attack is very variable. It could be a few each week to a few in a lifetime.

There are several types of migraines, according to the International Headache Society (IHS). The most important of these types are classic migraine and common migraine. The main difference between the two types is that classic migraine is preceded by an “aura” while common migraine is not (Blau).

Aura refers to a group of symptoms that the person experiences before the onset of the headache itself. The aura can start right before the headache and up to one hour before it. These symptoms usually consist of sensory or visual problems, such as the flashes of zigzag light that Fatima mentioned seeing.

A normal tension headache may sometimes be confused with migraine. This type of headache consists of an overall dull, persistent pain throughout the entire head. It can occur as often as once a week. People usually complain of a feeling of pressure, heaviness, or tightness, and describe it as a “band-like headache.” This is different from migraines, which are centered on one half of the head.

Migraine attacks can result in lost workdays and a disrupted family life. Knowing its triggers and alleviating them can help sufferers and their families lead a better life. This can break the vicious circle of suffering and treating migraine attacks and worrying about the next attack, which eventually leads to stress that could trigger another attack.

What Triggers a Migraine Attack?

Most neurologists agree that food can affect headaches. Food is particularly suspected of playing a major role in migraines. According to the Lancet, 93 percent of migraine sufferers find an improvement on eliminating allergenic foods from their diet. This improvement can come in the form of less severe attacks and/or decreased frequency of attacks.

The connection between food and migraine is a negative relation. This means that eating certain foods will likely cause migraine attacks. Studies implicating food as a trigger for migraines date back to the 1920s when researchers began to examine and manipulate the diets of individuals suffering from migraines (Vaughan). Headache experts have estimated that 10 to 30 percent of headaches are related to food sensitivities.

Although the list of foods implicated as headache triggers is quite long, there are some that are commonly known to affect migraines.

The “three Cs” are the most well-known foods that trigger migraines. These three types of food are cheeses, chocolate, and citrus fruits.

Ripe cheese contains a type of protein called tyramine. Sensitivity to tyramine depends on both the dose and the presence of other food triggers. This substance affects blood vessel elasticity and the brain’s serotonin system. Serotonin is a substance in the brain known to be involved in migraine (Smith).

Tyramine is also found in beers, wines, overripe bananas, beans, onions, and some nuts.

Chocolate and citrus fruits contain compounds similar to tyramine that are believed to trigger headaches by the same mechanism.

In addition to cheese, other pizza ingredients, such as pepperoni, salami, and hot dog, are also possible migraine triggers.

Nitrites and nitrates, preservatives used in most meat preparations, are responsible for migraines. They can be found in pepperoni, salami, bacon, smoked fish, and seasoning mixes. Some people develop what is called a “hot dog headache.” This is a headache attack accompanied by flushing in the face, occurring after having hot dogs or lunch meats.

Foods containing monosodium glutamate (MSG), a flavor enhancer, are also a trigger for migraine. Presence of MSG in food may be unclear because on some food labels it may simply be listed as “natural flavoring” or “seasonings.”

Aspartame, a popular artificial sweetener, can be a headache trigger for some people.

Caffeine-withdrawal headaches may occur when a heavy, daily coffee drinker skips their morning cup. It is due to the release of a substance called adenosine into the bloodstream. It increases blood flow to the brain, hence causing headaches.

Alcohol (especially beer and red wine) is also a common trigger, probably due to a substance present in it called histamine. It is also present in egg whites, some types of fish, strawberries, tomatoes, and citrus fruits.

Identifying Food Triggers

Food triggers can be very variable as mentioned above. The best way to identify them is through keeping a “headache record”. A person writes down any type of food or drink, plus any exposure to other triggers, in the 24 hours before the headache begins (if they can remember them).

If a certain food is suspected of acting as a trigger, then the person should try the “Two-Weeks Test”. They avoid the suspected trigger for two weeks then reintroduce it to their diet for two weeks, and then eliminate it for another two weeks. They then observe any changes in headache frequency that does not seem related to other factors and record them in their headache diary.

The detective work of identifying a food trigger can be mind-numbing. However, it’s wise not to remove an important food, such as dairy products or cheese, until a certain connection is established.

Preventing a Migraine Through Food

Just as food can be a trigger for headaches, some types of food can also offer relief. The best advice is to simply eat a balanced diet with plenty of fresh, non-processed foods with no added preservatives. Here are a few specific foods that are believed to reduce pain:

· Cayenne pepper

· Ginger

· Peppermint

· Seafood and fish oil

· Calcium-rich food (such as spinach, broccoli)

· Oatmeal

· Wheat

· Garlic

· Vitamin E

· Magnesium-rich food (such as milk, green leafy vegetables, nuts, beans, and peas) 

· Nuts (almonds and cashews)

· Legumes (soybeans)

· Whole grain cereals and breads

· Riboflavin (vitamin B2) (found in dairy products, liver, meat, dark-green vegetables, eggs, and dried beans and peas)

There are two ways to determine if these natural remedies are helping decrease migraine:

1. Maintain a headache diary; preferably, start noting before you start using the headache remedy. This will give you an idea if things are improving or not.

2. Try removing only one suspected food item at a time from your diet. Remember, it may take 2-3 months before things actually start to improve.

By time, migraine sufferers are usually able to develop their own coping mechanisms. These suggestions can be fine-tuned by each individual until they are comfortable with them. While migraines do not usually go away by time, there are ways to be able to live with them.

Sources:

Blau JN. “Migraine.” Theories of Pathogenesis. The Lancet. 1992; 339 (8803):1202-7.

Rasmussen BK, R Jensen and M Schroll, Epidemiology of Headache in a General Population – A Prevalence Study. J Clin Epidemiol 1991; 44, 1147-1157.

Smith I, AH Kellow, and E. Hannington. “A Clinical and Biochemical Correlation Between Tyramine and Migraine Headache”. Headache. 1970; 10:43-51.

Vaughan TR. “The Role of Food in the Pathogenesis of Migraine Headaches”. Clinical Reviews in Allergy. 1994; 12(2):167-80

Courtesy: islamonline.net

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