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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25 Ways to Deal with Stress and Anxiety

Stress is life. Stress is anything that causes mental, physical, or spiritual tension. There is no running away from it. All that matters is how you deal with it. This article does not deal with the factors of stress, anxiety, and depression, nor is it a clinical advice. If you feel depressed, you are not alone. It has been estimated that 75 to 90 percent of all visits to primary care physicians in America are for stress-related problems. This is why it is wise to consult a doctor if you are having physical symptoms of stress. However, here are some tips that can help from a spiritual perspective. Please send us your feedback so that we can improve this article Insha Allah.

Torture. Beatings. Loss of property. The death of loved ones. These were just some of the enormous challenges the Muslims of Makkah faced in the seventh century following their acceptance of Islam in fiercely tribal and polytheistic Makkah.

Detention. Harassment. Beatings. Discrimination. Loss of Job. Profiling. Hate Crimes. Constant media attention. Surveillance. These are just some of the challenges Muslims in America today face, post-9/11. Like our predecessors in Makkah, we have begun to face great stress, anxiety, and pressure, more than ever in our recent history on this continent, although Muslims who were brought here as slaves faced worse than what we can even imagine.

  1. Ask Him. He Listens: Dua

    Turn each anxiety, each fear and each concern into a Dua (supplication). Look at it as another reason to submit to God and be in Sajdah (prostration), during which you are closest to Allah. God listens and already knows what is in your heart, but He wants you to ask Him for what you want. The Prophet said: Allah is angry with those who do not ask Him for anything (Tirmidhi).

    The Prophet once said that in prayer, he would find rest and relief (Nasai). He would also regularly ask for God’s forgiveness and remain in prostration during prayer praising God (Tasbeeh) and asking for His forgiveness (Bukhari).

    Allah wants you to be specific. The Prophet advised us to ask Allah for exactly what we want instead of making vague Duas. Dua is the essence of worship (the Prophet as quoted in Tirmidhi).

    “Call on your Lord with humility and in private: for Allah loveth not those who trespass beyond bounds. Do not make mischief on the earth, after it hath been set in order, but call on Him with fear. And longing (in your hearts): for the mercy of Allah is (always) near to those who do good”  (Quran 7:55-56).

  2. Tie your Camel: Do your Part

    One day Prophet Muhammad, peace and blessings be upon him, noticed a Bedouin leaving his camel without tying it. He asked the Bedouin, “Why don’t you tie down your camel?” The Bedouin answered, “I put my trust in Allah.” The Prophet then said, “Tie your camel first, then put your trust in Allah” (Tirmidhi).

    Muslims must never become fatalistic. Although we know only Allah is in control and that He has decreed all things, we are each responsible for making the right choices and doing the right thing in all situations of our lives. We must take action (link to planning articles on SV). We must work to alleviate the hardships we, our families and our communities face.

    Ask yourself the following questions if you are worried about the state of the world: are you part of the peace movement? Is your Masjid part of the peace movement? Are you part of an interfaith group with an agenda of peace and justice? Are you working with a group fighting discrimination? If your answer is no, it is time that you sat down to plan your share of time and money in finding solutions to the problems you face. “Verily Allah does not change men’s condition unless they change their inner selves” (Quran 13: 11).

    Turn each worry into a Dua and each Dua into an action plan. That will show your commitment to your request and will focus your energy in the right direction.

  3. Remember that human responsibility is limited

    While we need to carry out our duty to the best of our abilities, always remember that you don’t control the outcome of events. Even the Prophets did not control the outcome of their efforts. Some were successful, others were not. Once you have done your duty, leave the results to Allah. Regardless of the results of your efforts, you will be rewarded for the part you have played.

    However, never underestimate your abilities. Understand the concept of Barakah (blessings from Allah) and remember that Allah can and Insha Allah will expand them if you are sincerely exerting your energies for the right path.

  4. Leave the world behind you five times a day

    Use the five daily prayers as a means to become more Hereafter-oriented and less attached to this temporary world. Start distancing yourself as soon as you hear Adhan, the call to prayer. When you perform Wudu, keep repeating Shahada, the declaration of faith, as water drops slip down your face, hands, arms, and hair. When you stand ready to pray, mentally prepare yourself to leave this world and all of its worries and stresses behind you.

    Of course, Shaytan will try to distract you during prayer. But whenever this happens, go back and remember Allah. The more you return, the more Allah will reward you for it. Also, make sure your Sajdas (prostrations) are talking Sajdas, in which you are really connecting to God and seeking His Mercy, praising Him, and asking His forgiveness. (link to Sajda article…ramadan page)

  5. Seek help through Sabr

    Seek help through Sabr and Salat (Quran 2:45). This instruction from Allah provides us with two critical tools that can ease our worries and pain. Patience and prayer are two oft-neglected stressbusters. Sabr is often translated as patience but it is not just that. It includes self-control, perseverance, endurance, and a focussed struggle to achieve one’s goal. Unlike patience, which implies resignation, the concept of Sabr includes a duty to remain steadfast to achieve your goals despite all odds.

    Being patient gives us control in situations where we feel we have little or no control. ‘We cannot control what happens to us but we can control our reaction to our circumstances’ is the mantra of many modern-day self-help books. Patience helps us keep our mind and attitude towards our difficulties in check.

  6. Excuse Me! You are Not Running the World, He is.

    It is important to remind ourselves that we don’t control all the variables in the world. God does. He is the Wise, the All-Knowing. Sometimes our limited human faculties are not able to comprehend His wisdom behind what happens to us and to others, but knowing that He is in control and that as human beings we submit to His Will, enriches our humanity and enhances our obedience (Uboodiah in Arabic) towards him. Read the story of the encounter of Moses with the mysteries behind God’s decision (Quran: 18:60-82). Familiarize yourself with God’s 99 Names, which are also known as His Attributes. It is a powerful way of knowing Him.

    “God-there is no deity save Him, the Ever-Living, the Self-Subsistent Fount of All being. Neither slumber overtakes Him, nor sleep. His is all that is in the heavens and all that is on earth. Who is there that could intercede with Him, unless it be by His leave? He knows all that lies open before men and all that is hidden from them, whereas they cannot attain to aught of His knowledge save that which He wills them to attain. His eternal power overspreads the heavens and the earth, and their upholding wearies Him not. And He alone is truly exalted, tremendous.” (Quran 2:255).

    The Prophet recommended reading this verse, known as Ayat al kursi, after each prayer, Allah’s peace and blessings be upon him. Once Ali, may Allah be pleased with him, approached the Prophet during a difficult time and he found the Prophet in Sajda, where he kept repeating “Ya Hayy Ya Qayyum”, words which are part of this verse.

  7. Birds Don’t Carry their Food

    Allah is al Razzaq (the Provider). “How many are the creatures that carry not their own sustenance? It is Allah Who feeds them and you, for He hears and knows all things (Quran 29:60).” By reminding yourself that He is the Provider, you will remember that getting a job or providing for your family in these economically and politically challenging times, when Muslims are often the last to be hired and the first to be fired, is in God’s Hands, not yours. As Allah says in the Quran: “And He provides for him from (sources) he never could imagine. And if anyone puts his trust in Allah, sufficient is (Allah) for him. For Allah will surely accomplish His purpose. Verily, for all things has Allah appointed a due proportion (Quran 65:3).

  8. God controls Life and Death

    If you fear for your physical safety and security, remember that only Allah gives life and takes it back and, that He has appointed the time for it. No one can harm you except if Allah wills. As He says in the Quran: “Wherever you are, death will find you out, even if you are in towers built up strong and high!” (Quran 4:78).

9. Remember that life is short

It’s easy to get caught up in our own stress and anxiety. However, if we remember that our life is short and temporary, and that the everlasting life is in the Hereafter, this will put our worries in perspective.

This belief in the transitory nature of the life of this world reminds us that whatever difficulties, trials, anxieties, and grief we suffer in this world are, Insha Allah, something we will only experience for a short period of time. And more importantly, if we handle these tests with patience, Allah will reward us for it.

  1. Do Zikr, Allah, Allah!

    “… without doubt in the remembrance (Zikr) of Allah do hearts find tranquility” (Quran 13:28).

    If you commute, use your time in Zikr. Pick any Tasbeeh and do that instead of listening to the radio or reading the newspaper. Maybe you can divide it up between Zikr and planning. Personally, I recite the Tasbeeh of “Subhana Allahe wa be hamdihi, subhan Allahil Azeem” 100 times as I drive. The Prophet taught us these two short phrases which are easy to say but will weigh heavy on our scale of good deeds in the Hereafter.

    When your heart feels heavy with stress or grief, remember Allah and surround yourself with His Zikr. Zikr refers to all forms of the remembrance of Allah, including Salat, Tasbeeh, Tahmeed, Tahleel, making supplication (Dua), and reading Quran.

    “And your Lord says: ‘Call on Me; I will answer your (prayer)…” (Quran 40:60)

    By remembering Allah in the way He has taught us to, we are more likely to gain acceptance of our prayers and His Mercy in times of difficulty. We are communicating with the only One Who not only Hears and Knows all, but Who can change our situation and give us the patience to deal with our difficulties.

    “Remember Me, and I shall remember you; be grateful to Me, and deny Me not” (Quran 2:152).

  2. Relying on Allah: Tawakkul

    When you awaken in the morning, thank Allah for giving you life after that short death called sleep. When you step out of your home, say ‘in Your Name Allah, I put my trust in Allah, and there is no power or force except with Allah’ (Bismillahi Tawakal to al Allah wa la hawla wa la quwwata illa billah). At night, remember Allah, with His praises on your lips.

    Once you have established a plan you intend to follow through on to deal with a specific issue or problem in your life, put your trust in the most Wise and the All-Knowing. “When you have taken a decision, put your trust in Allah” (Quran 3: 159).

    Rely on Allah by constantly remembering Him throughout your day. When you lay down to sleep, remember that sleep is death. That is why one of the recommended supplications before going to sleep is “with Your (Allah’s) Name I die and become alive”.

  3. Connect with other human beings

    You are not alone. Muslims are not alone. We are not suffering in silence. There are millions of good people who are not Muslim with beautiful hearts and minds. These are people who have supported us, individually and collectively, post-9/11, by checking up on us and making sure we are safe. These are individuals and organizations who have spoken up in defense of Muslims as we endured harassment and discrimination.

    We must think of them, talk to them, connect with them, and pray for them. Through our connections, we will break the chain of isolation that leads to depression and anxiety.

  4. Compare your dining table with that of those who don’t have as much as you do

    The Prophet said: Whenever you see someone better than you in wealth, face or figure, you should look at someone who is inferior to you in these respects (so that you may thank Allah for His blessings) (Bukhari, Muslim).

    Next time you sit down to eat, eye the table carefully. Check out the selection of food, the quality, the taste, the quantity, and then think of the millions of others who don’t have even half as much. The Prophet’s Hadith reminds us of this so that we can appreciate and thank God for all that we have.

    Also remember that the Prophet only encouraged us to compare ourselves to others in two respects: in our Islamic knowledge and level of belief in God (Deen). In these two areas, we should compare ourselves with those who have more than what we do.

  5. Say it Loud: Allahu Akbar, Allahu Akbar: Takbirat & Adhan

    Find a corner of a lake, go out in the wilderness, or even stand on your lawn at your home and call the Adhan with your heart. While driving, instead of listening to the same news over and over again, say Allahu Akbar as loudly as you can or as softly as you want, based on your mood. Year ago, I remember calling Adhan on a Lake Michigan shore in Chicago after sunset as the water gushed against my knees. I was calling it for myself. There was no one else accept the waves after waves of water with their symphony. It was relaxing and meaningful. Allahu Akbar, Allahu Akbar.

  6. Pray in congregation (Jamat)

    Pray with other people instead of alone. If you can’t pray all five prayers in congregation, at least find one or two prayers you can pray with others. If you are away, establish Jamat in your own family. During the Prophet’s time, even though the Muslims endured great persecution, including physical beatings, they would sometimes meet on the side of a mountain or valley and tried to pray together. This is a great morale booster.

16. How is your Imam’s Dua?

Does the Imam at your local mosque make Dua silently or out loud? Ask him to supplicate with the whole congregation. Suggest Duas for him to make. Ask him to make Dua for other people.

  1. Work for the Unity of Muslims

    Bringing Muslims together will not only help the Muslims, but it will also encourage you to focus your energies on something constructive versus zeroing in on and consistently fretting about difficulties you are going through.

    Invite Muslims from other ethnic groups to your functions. Visit Masjids other than yours in your city. When you meet a Muslim leader, after thanking him for his efforts, ask him what he is doing for Muslim unity. Ask Imams to make Dua for this. These are just small ways you can help yourself and the Muslim community.

  2. Sleep the way the Prophet slept

    End your day on a positive note. Make Wudu, then think of your day. Thank Allah for all the good things you accomplished, like Zikr and Salat. Ask yourself what you did today to bring humanity together and what you did to help Muslims become servants of humanity. For everything positive, say Alhamdu lillah (Praise be to Allah). For everything negative say Astaghfirullah wa atoobo ilayk (I seek Allah’s forgiveness and I turn to You [Allah]). Recite the last two chapters of the Quran, thinking and praying as you turn on your right side with your hand below your right cheek, the way the Prophet used to sleep. Then close your day with the name of Allah on your tongue. Insha Allah, you will have a good, restful night.

  3. Begin the Day on a Positive Note

    Get up early. Get up thanking God that He has given you another day. Alhamdu lillahil lazi ahyana bada ma amatana, wa ilaihin Nushoor (Praise be to Allah Who gave us life after death and unto Him will be the return). Invest in an audio tape driven alarm clock so you can get up to the melody of the Quran. Or Let Dawud Wharnsby’s joyful notes put you in a good mood. Sing along if you like. Develop your to do list for the day if you didn’t do it the night before. Begin with the name of Allah, with Whose name nothing in the heavens or the earth can hurt you. He is the Highest and the Greatest. (Bismillahillazi la yazurru maa ismihi shaiun fil arze wa la fis samae, wahuwal Alee ul Azeem). The Prophet used to say this after every Fajr and Maghrib prayers.

  4. Avoid Media Overexposure: Switch from News to Books

    Don’t spend too much time checking out the news on the radio, television or internet. Spend more time reading good books and journals. When you listen to the persistent barrage of bad news, especially relating to Muslims nowadays, you feel not only depressed, but powerless. Cut down media time to reduce your stress and anxiety. It’s important to know what’s going on but not to an extent that it ruins your day or your mood.

  5. Pray for Others to Heal Yourself.

    The Prophet was always concerned about other people, Muslims and non-Muslims, and would regularly pray for them. Praying for others connects you with them and helps you understand their suffering. This in itself has a healing component to it. The Prophet has said that praying for someone who is not present increases love.

  6. Make the Quran your Partner

    Reading and listening to the Quran will help refresh our hearts and our minds. Recite it out loud or in a low voice. Listen to it in the car. When you are praying Nafl or extra prayers, pick it up and use it to recite portions of the Quran you are not as familiar with. Connecting to the Quran means connecting to God. Let it be a means to heal your heart of stress and worries. Invest in different recordings of the Quran and their translations.

    “O humanity! There has come to you a direction from your Lord and a cure for all [the ills] in men’s hearts – and for those who believe, a Guidance and a Mercy” (Quran 10:57).

  7. Be thankful to Allah

    “If you are grateful, I will give you more” (Quran 14:7).

    Counting our blessings helps us not only be grateful for what we have, but it also reminds us that we are so much better off than millions of others, whether that is in terms of our health, family, financial situation, or other aspects of our life. And being grateful for all we have helps us maintain a positive attitude in the face of worries and challenges we are facing almost daily.

  8. Ideals: One step at a time

    Ideals are wonderful things to pursue. But do that gradually. Think, prioritize, plan, and move forward. One step at a time.

  9. Efforts not Results Count in the Eyes of Allah

    Our success depends on our sincere efforts to the best of our abilities. It is the mercy of Allah that He does not demand results, Alhamdu lillah. He is happy if He finds us making our best sincere effort. Thank you Allah!

Abdul Malik Mujahid

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Islamic Perspective in Stress Management

Islamic Perspective in Stress Management

by Shahid Athar, M.D. 

While stress may be necessary for human survival, the excess of it certainly affects our health and productivity. It is claimed that in the United States nearly 20 million people suffer from stress in terms of attributing their illness or symptoms to it. Stress related compensation cost nearly $200 million per year. Loss of productivity and stress related illness directly or indirectly amounts to $50 billion per year. Many corporations and individuals are spending nearly $15 billion per year on stress management of their employees. (Newsweek 042588)

There is enough medical evidence to link stress to the causation of peptic ulcer disease, hypertension, coronary artery disease and depression. In addition, many common problems like tension headache, insomnia, impotency (in man), frigidity (in women), are stress related to causation of diabetes, suppression of immune system and development of cancer.

In our day to day life, stress affects peace at home, job performance at work, grades in school and even our eating and mating behavior.

Warning Signs Of Stress 

The earliest signs of stress are irritability, mood swings, difficulty in sleep, lack of concentration, abdominal distress, extreme sensitivity to criticism, weight gain of weight loss, fear of failure, poor appetite, or hunger, and increase dependence on tranquilizers or alcohol for sleep. 

Conditions  Which Cause Stress

Psychiatrists have identified some 50 stressors. In fact any change, good or bad, is stressful. A change in job, or job description, in school, residence, financial status, loss or gain of a family member or close friend, injury or illness, national calamity or news of riots or violence all can be extremely stressful. Muslims living in a non-Muslim society may acquire some additional stress. These may include such factors as preserving their identity, practicing Islam (i.e. in food matters or timing of prayer), defending Islam on a hostile media and settling conflicts between family members: the spouse, parent /child, and practicing / non practicing factions.

Who Are Prone to Stress

Although stress spares no one including children, certain professions get more then their share. They include the sales person, the stock broker, the secretary, the inner city school teacher, the air traffic controller, the medical intern, the police officer and those handling complaint departments. It is interesting to note that qualities like being ambitious, compulsive, high achieving, productivity oriented are looked upon as signs of efficiency by the employer, are also type A personality traits, so dangerous to our health. So the art is to have these qualities, with a cool type B personality in order to live happily and have a longer time.

Coping With Stress

Although we are all exposed to stress, why can some of us cope with it better then others ? Is it the way we deal with the stressor, or the way we are built? There is some evidence to suggest that some of us may be genetically predisposed to depression, or have deficiency in the level of neurotransmitters, the mood regulating hormones, or just do not produce enough adrenalin on demand. 

A person’s religious belief has an important bearing on his personality and his outlook in life. By putting the trust in God, a believer minimizes the stress on him by reducing his responsibility and power to control his failures. 

Proven ways to handle stress as being practiced now range from meditation, sleep, exercise, socialization, biofeedback, psychotherapy and tranquilizers. In this article we are going to discuss how to deal with stress in the light of the Qur’an and the Sunnah. 

Psychologically the stress results from the following factors.

  1. Fear of the unknown, and our inability to recognize, foresee and control it.
  2. Loss of things, and people in our life dear to us, and our inability to recover these losses or accept them.
  3. Our inability to see through the future. In fact we might be more stressed if we do see the future.
  4. Conflicts between the mind, and the reality and our failure to accept the reality (i.e. the phase of denial). It is the lack of the inner peace due to our internal conflicts which leads to the external disturbances in our behavior and affects our health.

Let us examine how the Qur’an deals with such situations. Our losses are a part of trial for us:

“Be sure We will test you with something of fear and hunger, some loss in goods or lives, but give glad tidings to those who are steadfast, who say when afflicted with calamity: To God we belong and to Him is our return. They are those on whom (descend) blessings from God and mercy and they are the ones that receive guidance.” (Qur’an 2:155)

Whatever we are given is a gift from God. We are not their owners. Everything belongs to God and returns to Him. So if we don’t own these things why mourn their loss or wax proud on receiving them.

  1. Only God knows what our ultimate destiny is. We cannot peek into our future. We do, however, have a limited free will; we are free to choose between good or bad, to believe in God or not to believe in Him, but we have no control over future not related to our ability to act in the present – whether my wife will have a son or daughter, whether his / her eyes will be brown or black, or whether I will have an accident tomorrow or not. Worrying over such things is of no use.
  2. Rejection of faith in the Qur’an is described as a disease, its cause being arrogance and reluctance to accept truth.

“In their heart there is a disease and God has increased their disease and grievous is their penalty because they lie to themselves”. (Qur’an 2:10)
 

Thus when a man lies to himself, he creates an inner conflict – between his heart and the mind. In order to contain that conflict, the mind sends signals to glands for secretion of hormones like adrenalin which leads to rapid heart rate, perspiration, tremor, the basis of a lie detector tests.

This conflict could be due to “small” crimes like theft or adultery, or big crimes like rejection of God.

Three Stages Of Spiritual Development Of Soul Age

  1. Nafsul Ammara: The Passionate Soul

    “I do not absolve myself. Lo the (human) soul is prone to evil, save that whenever my Lord has mercy. Lo, my Lord is forgiving; merciful”. (Qur’an 12:53)

    This soul inclines toward sensual pleasure, passion and self gratification, anger, envy, greed, and conceit. Its concerns are pleasures of body, gratification of physical appetite, and ego. In a hadith we are told, “Your most – ardent – enemy is your evil self which resides within your body”. (Bukhari)

    If this evil soul is not checked, it will lead to unusual stress and its resultant effects. 

  2. Nafsul Lawammah: The Reproaching Soul 

    “Nay, I swear by the reproaching soul” (Qur’an 75:1)

    This soul is conscious and full aware of evil, resists it, asks for God’s grace and pardon, repents and tries to amend and hopes to achieve salvation.

    “And (there are) others who have acknowledged their faults. They mix a righteous action with another that was bad. It may be that Allah will relent toward them. Lo Allah is relenting, merciful”. (Qur’an 9:102)

    “There are two impulses within us. One, spirit, which calls towards good and confirms the truth. He who feels this impulse should know that it comes from Allah. Another impulse comes from our enemy (devil), which leads to doubt and untruth and encourages evil. He who feels this should seek refuge in Allah from the accursed devil” (Hadith). 

    This soul warns people of their vain desire, guides and opens the door to virtue and righteousness. It is a positive step in spiritual growth.

  3. Nafsul Mutma ‘innah: The Satisfied Soul

    “O (you) soul in (complete) rest and satisfaction. Come back to your Lord, well pleased (yourself) and well pleasing unto Him. Enter you then among My devotees, enter you in My heaven”. (Qur’an 89-27-30)

    This is the highest state of spiritual development. A satisfied soul is in the state of bliss, content and peace. The soul is at peace because it knows that in spite of its failures in this world, it will return to God. Purified of tension, it emerges triumphant from the struggle and resides in peace and bliss.

What Should We Do In Panic And Despair? 

In panic situations non-believers behave differently from believers. They have no one to turn to, to ask for mercy and forgiveness, they know and believe not in nay life other then this worldly life, over which they have no control. Naturally they get more depressed which in turn leads them to even more wrong doing. If they were used to casual drinking, after drinking,  they will increase their consumption of alcohol and end up as alcoholics or habitual criminals.

In a state of depression a believer, on the other hand, is advised to do the following:

  1. Increase Dhikr (remembrance of God).
    “He guides to Himself those who turn to Him in penitence – Those who have believed and whose heart have rest in the remembrance of God. Verify in the remembrance of God, do hearts find rest”. (qur’an 13:27-28)
  2. Be constant in their prayers.
    “O you who believe, seek help with steadfastness and prayer. For God is with those who are steadfast”. (Qur’an 2:153)
  3. Pray to God for Forgiveness.
    “And I have said: Seek forgiveness from your Lord. Lo He was ever forgiving”. (Qur’an 71:10)

In addition to the above believers are also expected to constantly struggle to better ourselves.

“Surely God does not change the condition in which people are until they change that which is in themselves”. (Qur’an 13:11)

Qur’anic Recitation  In Reducing The Stress

“O mankind! There has come to you a direction from you Lord, and a healing for (the disease in your) heart, and for those who believe a guidance, and mercy. (Qur’an 10:57)

The echo of sound has a medical effect, and is now widely utilized. The recitation of Qur’an or listening to the same has a wholesome effect on the body, the heart and the mind. It is said that the letter ‘alif’ echoes to the heart and latter ‘ya’ echoes in the pineal gland in the brain. Dr. Ahmed El Kadi of Akbar Clinic, at Panama City, Florida, conducted and has published the effects of listening to the Qur’anic recitation on physiological parameters i.e. the heart rate, the blood pressure and the muscle tension and reported improvement in all, irrespective of whether the listener is a Muslim or a non- Muslim, Arab or non-Arab.2 Obviously it can postulated that those who can understand and enjoy the recitation, with a belief in it as word of God, will get maximum benefit.

Prophet Muhammad’s Prayer During Stress

All the prophets, being human beings, had to undergo tests and trials which resulted in temporary stress. They constantly remembered God and received peace through His remembrance. The Prophet Muhammad (pbuh), for example, himself used and advised his followers to use the following D’ua (prayer) in times of distress.

  • “Allah is sufficient for us, and He is an excellent guardian, and we repose our trust in Allah.”
  • “Surely we belong to Allah and to Him shell we return. O Allah, I beseech you for the reward of my hardship. Reward me, and compensate me for it with something good.”

Dr. Shahid Athar is a Clinical Associate Professor at Indiana University. He has written and published over 110 articles on Islam, authored “Peace Through Submission” and edited “Islamic Perspective in Medicine”. He is a frequent speaker at many Muslim institutions, mosques, universities and churches all over the USA.

  1. The above article was first published in Hamdard Medicus, Volume XII, No. 4, Winter 1989
  2. For more details, please refer to Dr. Ahmed El-Kadi’s article on this subject in this book. Islamic Perspectives in Medicine (pages 135 -140 )

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Islamic Oases from Daily Stress

Islamic Oases From Daily Stress

By Sahar Talaat, MD*

 

In our highly regimented, fast moving, competitive environments, we frequently complain of unresolved feelings of alienation, inadequacy, and personal powerlessness. Many face a constant feeling of insecurity, and worry about their own basic survival and ability to measure up. This stressful lifestyle produces many types of mental and physical illnesses in modern societies(1).

As it is not possible to change the style or pace of our modern life, we need to discover suitable mechanisms to cope with daily stress(2). The Prophet Muhammad (may the peace and blessings of Allah be upon him) told us that we could find this internal peace and relaxation during praying.

It was reported by Imam Ahmad in (Al Musnad) that the Prophet (May peace and blessings be upon him) has told Bilal “call for the prayers, it will comfort us.”

This raises very important questions: Why do different forms of worship lose their capacity to help us cope with stress; and how can they be performed in a better way to improve their capacity to help us cope with stress?

Before considering the different types of worship and their mechanisms in combating stress, let’s define the different types of stress, their mechanisms of action and their adverse effects on human beings.

Psychological Stress: Types and Effects

The body tends to show signs of chronic stress very gradually, so the onset of stress may actually go unnoticed in its early stages. Symptoms of stress may appear so gradually that some people are unaware of the severity of their stress condition until they suffer a general nervous breakdown(3).

It was found that when one is experiencing stress, one’s brain produces high levels of two specific hormones: adrenaline and cortisol. This response is called the “Fight or Flight response”. The body prepares itself for a fight or for an escape from a fight by releasing these two hormones, which gives the body a temporary increase of strength and energy(2).

This hormonal response mechanism is considered to be “the general stress response syndrome”. This chemical stress response is entirely appropriate for the short-term. It is these hormones that make one able to respond more efficiently, both physically and mentally, to the hazards in one’s environment (4).

These hormones are not normally dangerous in the short-term. The problem only begins to surface when these messages of danger or emergency continue to be broadcast from the psyche over long periods of time. The situation gets worse when there seems to be no option to confronting the stressful situation directly, or to escaping from it in any way. Feeling trapped by the circumstances, the mind responds to the permanent warnings of impending emergency by manufacturing more and more of these hormones. Ultimately, these hormones have no physical or mental outlet and the energy just implodes, collapses in on itself, and produces a chaos of energy(3).

The response to stress can be divided into three stages:

1. The alarm stage: in which there is an increase in the level of previously mentioned hormones.

2. The resistance stage: during which the body utilizes the produced energy.

3. The exhaustion stage: which results from persistency of the stresses over a long period of time (2).

Stresses can be classified according to their period of exposure into temporary intermittent stresses and chronic persistent stresses. Considering sources of stresses, they can also be classified into internal stresses (which are related to personal characteristics) and external stresses. In addition, they can be classified according to their effects on individual health into a good type of stress (eustress) or a destructive type of stress. Good stress is defined as the ability to respond to the challenges of life in a way that promotes stimulation and encourages personal growth; stress management tools can facilitate this reaction. Examples of destructive, unhealthy reactions to stress are feeling overwhelmed or anxious (2).

This stressful life can produce many types of mental and physical illnesses and imposes its effects on body, psyche and mind. Some of the possible symptoms of prolonged exposure to stress are headache, brain tissue damage, high blood pressure, heart disease, weakening of the bones, general immune deficiency, muscle tension, menstrual disorders, miscarriage, depression, anger, fear and nervousness. If the body’s immune system is allowed to deteriorate because of stress, it may lead to other serious medical conditions such as a variety of malignancies (3).

Coping With Stress: Islamic Viewpoint

Those who are extremely stressed can find peace and relaxation by utilizing different Islamic ‘oases’

Medicine has been proven to be inefficient in dealing with the original causes of stress,  nor can it adequately eliminate all of its symptoms. Medicine may be necessary for a person in the most critical stages of chronic stress, but medicine alone may not be enough to achieve a cure for all its symptoms. Scientists are trying to find new strategies to cope with stress and minimize its effects. These include relaxation techniques, meditation, imagination (2, 5) and Yoga (6). These techniques are extensively studied to determine their effects and mechanisms of action. Different studies have confirmed the efficacy of these techniques in coping with stress and eliminating its effects. These techniques are now entering the medical mainstream and are included in many treatment programs (2).

Most of these techniques are rooted in Islamic spirituality and different Islamic forms of worship, ‘ibadatat, which can be – if performed in the correct manner – considered as good tools for coping with life’s stresses.

Those who are extremely stressed can find peace and relaxation for their minds, body and soul utilizing the following different Islamic ‘oases’; in terms of a safe place where one can seek refuge from the ‘desert’ of life:


Different Islamic forms of worship, if performed in the correct manner – are considered as good tools for coping with life’s stresses.


1. The Faith (iman) Oasis: Some people are more able to cope with stress than others. The determining factor of the level of stress experienced is the perception of something as a threat, which triggers the stress response, and not the threat itself.

It seems that the stress response is not created by any particular type of event or situation but rather by the way that event is perceived. It turns out then that stress response is a matter of perception, or awareness. The stress reaction is activated by neural perceptions or by what amounts to one’s worldview. A worldview can be described as the prism of ideas and beliefs through which the world is perceived and judged. This means that your worldview becomes central to the way any stressful circumstance is handled (2, 3). Islamic spiritual practices can dramatically alter your worldview and thereby restore your feelings of self worth and personal meaning, giving you a feeling of deeply rooted power and control.

Control has been found to be a key factor in the psychology of chronic stress. It has been observed in clinical studies that the extent to which you feel that you are in control of your environment, is the extent to which you will, or will not, experience the hormonal stress response. Those who feel most powerless or unable to control their circumstances tend to experience the highest levels of stress. On the other hand, those who feel they have great personal control and power over themselves and their environment will be much less likely to experience the hormonal stress response, and this is regardless of the potential seriousness of the threat (2). In Islam, Muslims feel Allah, Who controls the whole world and all the creatures in it, supports them.

It was reported by Omar may Allah be pleased with him that the Prophet has said: “if you people depended on Allah as you should, He would provide for you as he provides for the birds leaving their nests hungry and coming back satisfied.”

2. The Meditation and Relaxation Oasis: Meditation is being riveted on any one idea or object to the exclusion of all other ideas or objects. Meditation is really a natural quality of the mind. With meditation, the mind is trained to pay attention and to follow commands. In this way one learns to quiet the thought traffic in one’s mind, thereby freeing up mental and physical energy. The basis of meditation is to adopt a posture of body and mind that allows one to remain comfortable for long periods of time without expending significant amounts of energy (7).

Dr. Herbert Benson, a Harvard University physician, researched the physiologic effects of meditation in the early 1970s. He coined the term “relaxation response” to refer to the stress-reducing effects of meditation, which we now know can be elicited through a variety of relaxation practices including meditation (8).

In the mid-1980s, Dr. Dean Ornish, clinical professor of medicine at the University of California, incorporated an extensive meditation program into a comprehensive lifestyle program for patients with heart disease. Data published from his five-year trial revealed reductions in total and low-density lipoprotein (LDL) cholesterol, decreased anginal symptoms, and regression of coronary artery disease (9).

Meditation works by eliciting the relaxation response. The relaxation response is characterized by decreased heart rate, respiratory rate, oxygen consumption, and muscle tension. Meditation seems to produce these changes to a greater extent and more efficiently than sleep. For example, reports from Dr. Benson’s work show that oxygen (O2) consumption diminishes by 8 percent during restful sleep over the course of four to five hours, while the relaxation response results in a 10 to 17 percent reduction of O2 consumption in a matter of minutes (4).

Other studies demonstrate significant reduction in total peripheral resistance (TPR) and systolic blood pressure in those practicing meditation regularly. TPR is the maximum degree of resistance to blood flow caused by constriction of the systemic blood vessels. Reduction of TPR will reduce the overall blood pressure (10). Studies also showed diminished lipid peroxide levels resulting in reduced oxidative damage(11). Also, meditation was used intensively and effectively in control of cases with chronic pain (12) and anxiety disorders (13). Meditation by concentrating on Allah’s creatures (plants, animals, space, human body, etc.) is considered one of the most efficient and powerful forms of Islamic worship.

In this form of meditation, one concentrates on an object or group of objects from the same category (categorical meditation).  

Those who remember Allah standing and sitting and lying on their sides and reflect on the creation of the heavens and the earth: Our Lord! Thou hast not created this in vain! Glory be to Thee; save us then from the chastisement of the fire: (3: 192)

3. The Remembrance (zikr) Oasis: As we mentioned in the previous paragraph, meditation can be done by concentrating our thoughts on an object or group of objects of the same category. Meditation can also be performed by concentrating on one word or a few words that give the person a sense of internal peace and calm; for example by repeating the words subhan Allah (glory be to Allah) or al-hamdu lillah (all praise be to Allah). Deep and silent repetition of such words produces the same physiological effects of meditation (7). It also adds an additional factor that helps in stress elimination and that is giving the individual the feeling that he or she is in extreme proximity with Allah, the Controller of the whole world.

Those who believe and whose hearts are set at rest by the remembrance of Allah; now surely by Allah’s remembrance are the hearts set at rest. ( 13:28)

4. The Imagination Oasis: this is considered one of the most powerful methods of stress reduction. During this practice, the person imagines that he or she is in a place, which gives him internal peace, calmness and rest. Muslims can find their safe place through imagining what will be present in the Paradise.

Abu Hurairah, may Allah be pleased with him, reported:
Allah’s Messenger (may peace be upon him) said: Allah, the Exalted and Glorious, said: I have prepared for My pious servants’ bounties which no eye (has ever) seen, no ear has (ever) heard and no human heart has ever perceived.”

5. The Praying Oasis: This includes all of the previously mentioned oases including meditation, remembrance and imagination. While praying, each one of us feels that we are in extreme connection with the controlling power of this world (Allah) and that from Him we receive maximum support.

O you who believe! seek assistance through patience and prayer; surely Allah is with the patient.(2: 153)

It was reported by Gaber may Allah be pleased with him that the Prophet has said: “your prayers are like a flowing river at your doorstep you wash yourself in it five times a day”

Recent scientific investigations show that praying reduces post-operative complications following open-heart surgery. Praying also markedly reduces the percentage of patients exposed to depression following hospitalization (14).

Nowadays, doctors suggest that praying can be used as an alternative therapy as successfully as meditation, exercise, or herbal treatments. According to Koenig of Duke University, “when prayer uplifts or calms, it inhibits cortisol, epinephrine, and norepinephrine – hormones that flow out of the adrenal glands in response to stress. These fight-or-flight chemicals, released over time, can compromise the immune system, upping the odds of developing any number of illnesses, including heart disease, stroke, peptic ulcers, and inflammatory bowel disorder (IBS).”

Many experts feel that the immune system is strengthened and nourished by a sense of peace elicited during praying. Many doctors believe that praying with their patients before and after surgery or before administering a course of powerful drugs might actually assist in the patient’s recovery (15).

Five prayers have been prescribed to us daily. This is a good chance to make use of that time not only for spiritual enhancement but also for physical and psychological healing. Although Ramadan has passed, its spirit should still be fresh in our hearts and minds. Investing this spirit into our daily prayers and meditations could well be the way to a stronger and more relaxing mental health.

Sources:

1. Relaxation techniques-stress management techniques from mind tools. http://www.mindtools.com/stress/RelaxationTechniques/IntroPage.htm

2. Sultanoff BA & Zalaquett CP. Relaxation therapies. In: Novey DW, ed. Clinician’s Complete Reference to Complementary and Alternative Medicine. St. Louis, Mo: Mosby; 2000:114-129.

3. Stress at Williams (and Elsewhere . . .) http://wso.williams.edu/orgs/peerh/stress/index.html

4. deLeon D. The relaxation response in the treatment of chronic pain. In: Micozzi MS, Bacchus AN, eds. The Physician’s Guide to Alternative Medicine. Atlanta, Ga: American Health Consultants; 1999:335-337.

5. Alive and healthy – meditation. http://www.aliveandhealthy.com/meditation.html

6. Faheem MA,Yoga and Human Being’s Spiritual Energy (Arabic).

7. Learning meditation. http://www.learningmeditation.com/

8. Meditation. http://1stholistic.com/Meditation/hol_meditation.htm

9. Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280(23):2001-2007.

10. Barnes VA, Treiber FA, Turner JR, Davis H, Strong WB. Acute effects of transcendental meditation on hemodynamic functioning in middle-aged adults. Psychosom Med. 1999;61(4):525-531.

11. Schneider RH, Nidich SI, Salerno JW. Lower lipid peroxide levels in practitioners of the Transcendental Meditation program. Psychosom Med. 1998;60(1):38-41.

12. Kabat-Zinn J, Lipworth L, Burney R, Sellers W. Four-year follow-up of a meditation-based program for the self-regulation of chronic pain: treatment outcomes and compliance. Clin J Pain. 1987;2:159-173.

13.Kabat-Zinn J, Massion AO, Kristeller J. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149(7):936-943.

14. Prayer and spiritual healing. http://1stholistic.com/Prayer/default.htm

15. International network on personal meaning. http://www.meaning.ca/conference04/presenters/koenig.htm

www.islamonline.net

 

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Migraine Pain

Heading Off Migraine Pain

By  Mona Nada

Professor of Neurology

 
Image

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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