I can't pay attention if paying attention makes me sleep!

February 21, 2012 2:24 PM

Does this happen to anyone else: Long periods of concentration result in a creeping headache that eventually prevents me from functioning until I can take a nap. If so, what can I do about it?

This particular quirk has handicapped me for most of my life. The need to nap can arrive at the most inappropriate times - in the middle of a lecture, during a client meeting, and worst of all, on the road after driving any longer than an hour (which is the reason I'm feeling it now). The headache feels like a fog rolling in - it starts at the neck and creeps from back to front until my eyes start to black out. The funny thing is, it only takes two minutes of sleep to clear out, but if I don't get it, the fog can stay all day. Armchair diagnoses, prescriptions and research are welcome.

posted by Popular Ethics to Health & Fitness (21 answers total)

Do you get enough sleep at night? Maybe it's something like sleep apnea where your sleep is disturbed. Have you ever talked to a doctor about it?

I get headaches after prolonged intense concentration but I just take a couple advil and move on. Maybe you could do a sleep study.
posted by sarae at 2:28 PM on February 21, 2012

Do you drink a lot of caffeine?
posted by empath at 2:29 PM on February 21, 2012

This happens to me sometimes. Not necessarily in the same way because it doesn't creep up from the neck all the way to my head. But, I still get it.

I have been told to practice breathing as a grounding technique. I have also been told to practice the 5-5-5 technique where you focus on five things that you can see, five things that you can touch, and five things that you can hear. You change it to 4-4-4 and keep doing it until you have grounded yourself and are in the 'now' moment.

A quick fix like Advil also helps.
posted by livinglearning at 2:30 PM on February 21, 2012

"until my eyes start to black out"

Do you mean you literally lose vision?
Or do you mean the impulse to lower your eyelids becomes stronger and stronger?
posted by LobsterMitten at 2:31 PM on February 21, 2012

How long of a period of concentration does it take for the headache to start creeping? You said an hour of driving can do you in, is this common across all your activities?

I'll also second the "are you getting enough sleep at night?" question. The feeling you're describing sounds kind of like the feeling I have all day if my alarm goes off in the middle of my REM cycle. I feel like crap all day, but if I take short nap, I'm all better for the rest of the day. The feeling can be especially pronounced if I get less-than-adequate sleep a few days in a row.

Or maybe this is sort of a dietary thing. Does this feeling usually show up after a meal, or during the early/midafternoon circadian dip?
posted by Geppp at 2:37 PM on February 21, 2012

Response by poster: Do you get enough sleep at night?

More than many people, but not enough for me. I get 6-7 hours a night on worknights, but on the weekend, without appointments, I don't wake up until I get 10-12.

Do you drink a lot of caffeine?

At least two cups of coffee a day. More when I'm battling fatigue.

Do you mean you literally lose vision?
Or do you mean the impulse to lower your eyelids becomes stronger and stronger?

The latter, but if I push my attention-allotment (such as driving after the headache has started, or straining to read another chapter of a manual) the impulse can come up strong enough to knock me out even if I'm fighting the impulse.

Do those answers help?
posted by Popular Ethics at 2:37 PM on February 21, 2012

Long periods of concentration can use a lot of energy. I've tended to find that I get hungry after prolonged concentration, and if you're getting hungry, a headache can be a pretty clear symptom. Between that and tension, I think the two things could conspire to give you headaches.
posted by ambrosen at 2:38 PM on February 21, 2012

Response by poster: How long of a period of concentration does it take for the headache to start creeping? You said an hour of driving can do you in, is this common across all your activities?

That's about right. I used to have trouble making through an hour long lecture in University. Most of the time though I can find a way to break up the concentration into digestible chunks - Such as walking away from my desk for coffee.

Does this feeling usually show up after a meal, or during the early/midafternoon circadian dip?

between waking and 10 am is rough, as is 1-3pm. Unfortunately that's a good chunk of the workday. Paradoxically, I don't usually get it after dark, which is usually my most productive time.
posted by Popular Ethics at 2:42 PM on February 21, 2012

Response by poster: Re: seeing a doctor - I've described fatigue problems to a clinic doctor a few years ago. We did a battery of blood tests (looking for blood-sugar issues, iron deficiencies and whatnot), but nothing came up.

Even if I can't avoid it, I'd love to learn the bio-mechanics of these symptoms. It's seems weird to me that I can actually feel brain fatigue, and weirder still that it can be cleared in such a specific way.
posted by Popular Ethics at 2:47 PM on February 21, 2012

As you describe the timing of it, your periods of sleepiness occur after eating, which is really quite common- driving exhaustion happens to everyone, too (though 1 hr is kinda short...) The other effects, though... I'd go with less caffeine, more exercise in the evenings, more water throughout the day; gingko is at least rumored to help w/ such symptoms
posted by MangyCarface at 2:52 PM on February 21, 2012 [1 favorite]

Do you wear glasses/contacts? I get crushing headaches and fatigue when my prescription needs to be updated.
posted by corey flood at 3:06 PM on February 21, 2012 [1 favorite]

When were your eyes last checked? Because everything you describe is eye strain possibly.
posted by OnTheLastCastle at 3:16 PM on February 21, 2012 [1 favorite]

You need a sleep test. I have this problem except it doesn't take too long a time for this to happen and sometimes a lose a whole day because I wake up like this. For me, sleep apnea was the culprit but I still suffer because the CPAP is impossible for me to sleep with. Miraculously I stumbled upon Excesrin Migraine which is the best short term antidote for this condition for me.

For you I repeat- SLEEP TEST
posted by spicynuts at 3:17 PM on February 21, 2012 [1 favorite]

This sounds odd to me - especially that just two minutes of sleep can cure it. I'm wondering if it is a type of narcolpsy, in which you would need to see a sleep specialist to get help. (It wouldn't show up in blood work etc.)

I would be really, really worried about the driving part - you could kill yourself and/or others. (OK, you probably know that already since I assume you weren't driving and posting to Metafilter at the same time.) But be really careful. Does taking a short break at 45 minutes keep it from happening? Pulling off the road for a couple minutes would be totally worth it to avoid trying to drive through that crushing sleepiness.
posted by metahawk at 3:20 PM on February 21, 2012 [1 favorite]

I get a fairly similar effect -- it feels like my brain just runs out of energy and shuts down. Not to freak you out, but for me it was one of the early-ish symptoms of what turned out to be a disabling autoimmune disease. Fatigue is a big part of the package, and it seems that my brain tires in much the same way as a muscle would with overuse. So a thorough medical going-over would be a good idea. The fact that blood tests were fine a few years ago doesn't necessarily mean they're still fine now.

I was low on vitamin D -- supplementing enough to bring my blood levels up to normal made me feel a little more clear-headed.

I've tried a few antidepressants, because for a while there it was impossible to have a doctor take any complaint involving "fatigue" seriously without going down that road. Sertraline (Zoloft) made me feel a little more awake. Many people report that modafinil (Provigil) works wonders, but it can give you headaches and other unpleasantness. If you can get a doctor to take you seriously, there are many drugs that can affect feelings of alertness, and it might be productive to experiment with small doses.

A couple of simple techniques that help me cope:

1. Schedule regular breaks for preemptive mini-pseudonaps. Say, every 1/2 hour, even if you feel fine, close your eyes and take 3 slow, deep breaths. There's always time for 3 breaths. It's much more helpful to take the break BEFORE the fatigue hits you -- when you feel your brain start to sputter out on you, you know you waited too long. It requires some retraining, but get in the habit of thinking "I feel fine! I better take a break right now!"
2. Drink. Cold water works almost as well as hot coffee.
3. Get more rest. Sounds like you may be short on sleep during the week.
posted by Corvid at 3:43 PM on February 21, 2012 [1 favorite]

My second year of college, I was getting a good amount of sleep, not consuming much caffeine, eating well, and getting regular exercise, but in the afternoons and evenings, I'd often find myself struggling to keep my eyes open, which was a problem, because I had a lot of studying to do. A short nap (more like 10-20 minutes for me) would make a huge difference. I had my eyes checked, but they were fine.

I finally concluded that the problem was that concentration takes a lot of effort, and that my brain needed a break.

It is definitely worth looking into things like sleep apnea, or whether you have big swings in your blood sugar after eating. The headache makes me wonder if there is some sort of thing you do while focusing that causes muscle tension, like clenching your jaw, or locking your neck, or holding your head in an odd position. Also consider that you may just be built that way and that your best bet in the long run is to find ways of working with it.

Also, from my own experience, and from observing others, Caffeine isn't a bonus so much as it is a loan that you have to pay back later in the day.
posted by Good Brain at 3:46 PM on February 21, 2012 [1 favorite]

I agree - Eye Test & Sleep Test. Narcolepsy is a real thing.

I sometimes get sleepy after an hour of driving, esp. on the highway, but fresh air, music, maybe some coffee, etc., all work for me.

I recommend you consume caffeine strategically. 1/2 cup at a time, and no more than once an hour or 2. Stop any caffeine 12 hours before bedtime. For 1 week, try getting 10 hours a night; if you see a real improvement, then alter your life to get more sleep. And, seriously, Eye Test & Sleep Test.
posted by theora55 at 3:53 PM on February 21, 2012

between waking and 10 am is rough, as is 1-3pm. Unfortunately that's a good chunk of the workday. Paradoxically, I don't usually get it after dark, which is usually my most productive time.

I'll be honest, this sounds exactly like me. I'm pretty sure I'm just more of an afternoon/evening person. A quick google search brings up this article. There are other things that me be affecting how you feel throughout the day, but your body itself is one of them. The fact that you're sleeping 6-7 hours a night weekdays and 10-12 weekends might suggests that you have a sleep debt to repay every week too.

I'd also suggest cutting back on the coffee and simply getting more sleep at night. That's actually helped me the most. If you still feel like you need a caffeine boost in the morning, try switching to something with less caffeine like tea.
posted by Geppp at 3:56 PM on February 21, 2012 [1 favorite]

Ha! I do get this, too. Lectures, client meetings, driving, check. Sleepiness + headaches is an irritating combination.

No diagnosis for you but I avoid it where possible by a) scheduling meetings in shorter chunks wherever possible and b) taking tons of breaks while driving (eating while driving helps).
posted by Pomo at 7:36 PM on February 21, 2012 [1 favorite]

I sometimes need naps as a reset and will, if necessary, sneak out to my car for a 20 minute nap.

I have found that eating more (healthy) food is a better solution than caffeine.
posted by jander03 at 9:30 PM on February 21, 2012

I agree with the sleep test. Sleep disorders can be subtle, and even something like narcolepsy doesn't always present in the stereotypical fall asleep suddenly way. Do you feel rested when you wake up in the morning? Do you ever randomly lose tension/control of a limb or something? Particularly when laughing? Those can point to the narcolepsy sorts of disorders. A good number of primary care doctors will dismiss the possibility of sleep apnea if you're not older or overweight, since that's the common presentation. But it's a possibility even if those aren't factors for you. My dad has had serious sleep apnea since he was young, skinny, and fit.

A couple of other ideas that aren't as likely, but still possible. Do you have ADHD, or could you? It doesn't always include the hyperactive elements, and can be overlooked into adulthood. That's the case for me. And, since focusing takes more energy for me, after awhile I can get tension headaches, or just an overwhelming mental fatigue. There are other neurological conditions that can have this effect, as well. For example, I have some issues with sensory integration, so loud or busy areas, or just random ambient noise, can tire my brain out like this.

If you have problems with fatigue I'd try to limit caffeine intake to 2 cups a day. Also, are you taking over the counter meds like excedrin or tylenol with every headache? My neurologist limits me to twice a week at the most. Taking pain meds too often causes rebound headaches. For me, rebound headaches are the same sort of headache pain you're describing.

It's good that you've checked out the fatigue before, and ruled out a few possibilities. That's valuable info. But if it's still going on, emphasize to your doctor that it's affecting you, and request a specialist. Sometimes doctors don't listen if you aren't emphatic about what you're experiencing.
posted by f_panda at 8:55 AM on February 22, 2012 [1 favorite]