16F Sleep Rhythms PaJR
This is an online E-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's consent. Here we discuss our individual patient's problems through a series of inputs from the available global online community of experts with the aim to solve those patients' clinical problems with the collective current best evidence-based input.
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22/01/2023, 7:00 pm - PaJR PHR Moderator: Can the patient advocate share the patient's history, sequence of events, and the clinical images of her throat here?
22/01/2023, 7:33 pm - Patient Advocate: I went to marriage on 6jan. There I didn’t take any cold food. On 7jan I drank a cold soft drink after eating oily food in the evening. At night, at 3am I got a fever of 101 temperature, extreme body aches, and throat pain. I started paracetamol (taken 4 times) but the fever got down after 24 hours. My throat pain didn't go away. The body ache and the feverish-like condition got resolved after 3 days. I started amoxicillin and clavulanic acid tablet after 2 days and took them for 6 days (2 tablets a day), and then stopped taking them meanwhile severe cough started. Taking paracetamol for pain as required.
This antibiotic doesn’t work and the throat pain continues, only paracetamol works for pain. The pain is so much that I cannot speak without taking paracetamol. It’s been more than 15 days. Pain seems moderate and becomes severe again in the morning. I went to the doctor on 20 Jan. He gave me some meds and I started doing warm salt water gargle, steam, and honey water. Seems like the cough becomes worse due to irritation in the throat.
It is not getting any better. It feels like It is going away but it came back again today morning. Too much that I cannot speak again, right ear and right neck side, and right jaw seem heavy and painful. Ate two biscuits only as cannot open my mouth and took paracetamol which reduces the pain to a degree of mildness then took the doctor's prescribed medications. I am drinking warm water for more than 15 days. Yes, I was sleeping under the fan on and off until 3days ago. Not taking any cold food, drink, oily food, or rice since 8jan. I have an acid reflux issue so take omeprazole as needed.
22/01/2023, 7:33 pm - Patient Advocate: (file attached)
22/01/2023, 7:34 pm - Patient Advocate: (file attached)
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22/01/2023, 7:40 pm - Patient Advocate: After taking paracetamol and meds at 11am, there is only mild pain in the throat, no cough, no jaw ear n neck pain, no problem in speaking, and movement of the tongue. Everything seems mild and normal. Taking warm soup, steam, warm water, and warm salt water and gargling the whole day with a little gap which is also maintaining the pain.
22/01/2023, 8:15 pm - PaJR PHR Moderator: Good. This appears to be a self-limiting viral pharyngitis. You should recover soon. Antibiotics may not be indicated and their side effects can troublesome. Do continue to share your hourly activities and daily food plates here if possible.
23/01/2023, 7:32 am - Patient Advocate:
8pm: Had chicken soup with a boiled egg.
9:30pm: After half an hour had 2 little bowls of oatmeal with no masala chicken.
Have meds.
Nasal spray with Steam.
Read a book.
Slept again.
1:30am: Had a bowl of oatmeal with chicken again.
Have meds.
Honey water.
Read book.
Tried to sleep from 3am-6am
(I Slept all day so wasn't able to go into a deep sleep)
23/01/2023, 7:33 am - Patient Advocate: (file attached)
23/01/2023, 7:34 am - Patient Advocate:
7am: Had a nasal spray with Steam.
Ate custard.
Took paracetamol as the pain is increasing.
23/01/2023, 7:35 am - Dr Rakesh: Dose of Paracetamol?
23/01/2023, 7:44 am - Patient Advocate: 500mg
23/01/2023, 7:44 am - Patient Advocate: (file attached)
23/01/2023, 7:45 am - Patient Advocate: Yesterday I took the restricted diet (soft diet) so the pain is not too much severe in the morning.
23/01/2023, 7:53 am - Patient Advocate: And also no cough.
24/01/2023, 7:46 am - Patient Advocate:
8:30am: Salt water gargle.
Slept around this time and woke up around 12pm.
1:30pm: 1 small Bowl of soup with the bun in it.
Meds (course completed, only antibiotic and sprays left)
Spray with Steam.
10-15mins Sunlight.
Slept again around 3:30pm.
5pm: 2 small bowls of Oatmeal with minced meat in it.
Spray with Steam.
Salt water gargle.
Talked on call for a little while after 3 days. Didn't feel uncomfortable afterward.
6:30pm: One small bowl of soup with a boiled egg.
Slept again.
8:30 pm: 2 small bowls of oatmeal with minced meat and the bun in it.
Talked for a little while on a call.
Spray with Steam.
Salt water gargle.
Book reading.
Slept again.
1am: one small bowl of oatmeal with minced meat n bun in it.
Med.
Warm honey water.
Spray with Steam.
Salt water gargle.
Book reading.
Rest.
(Whole day was spent resting/sleeping and eating. Nothing much more.)
24/01/2023, 7:51 am - Patient Advocate: (file attached)
24/01/2023, 7:51 am - Patient Advocate: (file attached)
24/01/2023, 7:51 am - Patient Advocate: (file attached)
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24/01/2023, 9:06 am - PaJR PHR Moderator: Feel this patient is recovering well 👍
24/01/2023, 5:14 pm - Patient Advocate: Yes. Condition not severe for 3 days.
24/01/2023, 5:17 pm - Patient Advocate: Thank you so much ☺️☺️
26/01/2023, 12:34 am - Patient Advocate: (file attached)
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26/01/2023, 12:34 am - Patient Advocate: (file attached)
26/01/2023, 12:35 am - Patient Advocate: Had vegetable rice also.
26/01/2023, 12:37 am - Patient Advocate: This was yesterday's meal. Repeated the same today. There is no discomfort or pain in the throat today for the whole day. Seems like the virus is cured.
26/01/2023, 12:37 am - Patient Advocate: Wasn't on any medication except the nasal spray. Steam, gargle, and honey water continues.
26/01/2023, 12:39 am - Patient Advocate: Thank you so much for the great support and monitoring. Grateful to have you. 🙏
Be Blessed Always 😇
26/01/2023, 8:32 am - PaJR PHR Moderator: Please continue to share your patient's daily diary with food plates (energy inputs) and daily energy expenditure narratives which would be therapeutic for all the members in this PaJR group 🙂
26/01/2023, 11:34 pm - Patient Advocate: Ok. I will start doing that. 😊🙏
02/02/2023, 2:31 pm - Patient Advocate:
1:30pm-3pm
Woke up at 1:30pm
Got fresh
Organized room
Sunlight (15mins)
Had breakfast (onion paratha with one scrambled egg)
Took Vitamin D3 Med
Namaz
Skincare routine
3pm-5:30pm
Study (video lecture)
5:30pm-7:30pm
Daily have a Group call with sis & a friend.
Meanwhile
{
Namaz
Lunch (one plate of chicken n veg rice)
Namaz
Exercise 30mins (Treadmill)
}
7:30pm-9:15pm
Study (video lecture + Book Reading)
Had 1 small packet of chips
Had 2 pieces of Bakarkhani
9:15pm-11pm
Break
Nap for an hour
11pm-2am
Dinner (One plate of Chicken n veg rice)
Music/entertainment
4 small piece non-veg samosa
2am-4:30am
Study (Recommendation by others)
Slept around 6am
Water Intake = 1.5L
1st Feb Wednesday
02/02/2023, 2:34 pm - Patient Advocate: (file attached)
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02/02/2023, 9:14 pm - Patient Advocate: I usually start it from 2 and make it up to 3.5 gradually.
03/02/2023, 3:07 pm - Patient Advocate:
2pm-3:30pm
Woke up at 2pm
Got fresh
Organized room
Sunlight (15mins)
Skincare routine
Namaz
3:30pm-5:30pm
Study (video lecture + Book Reading)
5:30pm-7:30pm
Daily have a Group call with sis & a friend.
Meanwhile
{
Namaz
Exercise 30mins (Treadmill)
Namaz
Lunch (one plate of rice with minced meat n aloo)
}
7:30pm-9:30pm
Rest n nap
9:30pm-4am
Nothing (Random stuff)
4am-5am
Study
Slept around 6:30am
Water Intake 1.5L
2nd Feb Thursday
03/02/2023, 3:08 pm - Patient Advocate: (file attached)
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03/02/2023, 3:54 pm - PaJR PHR Moderator: Isn't this unusual sleep timings!!?
03/02/2023, 5:20 pm - Patient Advocate: Yes Doctor. I will try to improve it. As a late sleeper since always it's difficult to maintain that early rhythm.
03/02/2023, 7:57 pm - PaJR PHR Moderator: Late sleeper? How much late? 6:30 AM!
03/02/2023, 11:09 pm - Patient Advocate: Yes Doctor. My mistake. I will try to sleep early today and avoid napping before that.
04/02/2023, 1:13 pm - Patient Advocate:
2pm-3:30pm
Woke up at 2pm
Got fresh
Sunlight (20mins)
Breakfast (Paratha with scrambled egg)
Namaz
3:30pm-7pm
Birthday celebration of a friend
Namaz
Skincare routine
Namaz
7:30pm-9pm
Study
9pm-10pm
Meal (Rice with aaloo palak)
10pm-12am
Study
12am-2:30am
Random work
Break
2:30am-4am
Study
Slept around 4:30am
Water Intake = 1.5L
4rth Feb Friday
04/02/2023, 1:56 pm - PaJR PHR Moderator: What is the study that your patient does?
04/02/2023, 3:39 pm - Patient Advocate: Study regarding the world of psychology, neurology, religion, and philosophy. It includes video lectures, short courses, articles, research papers recommended by others, books, talking with other patients, and wherever stuff I can find on the internet to clear my concepts.
04/02/2023, 4:07 pm - PaJR PHR Moderator: 👏👏
06/02/2023, 3:15 pm - Patient Advocate: Unable to update about Saturday as there was a severe body ache coz I slept under the fan. The whole day I rested and just read a book and took a work call.
06/02/2023, 3:19 pm - Patient Advocate:
Woke up at 1pm
2pm-3pm
Got fresh
Room organize
Had Breakfast (1 Paratha with scrambled egg)
Took Calcium med
Namaz
Self-care
3pm-4pm
Study
Had 1 Orange
5pm-11:30pm
Went to Super Mart
Had Russian salad at 7:30pm
Went to Relative's home
{
Had a Meal around 9pm (1 plate of chicken biryani)
Had 2pieces of pizza at 10:30pm
Had Half a cup of tea
}
12am-1am
Did Housework
Had Chocolate (32g)
Water Intake = 700ml
6th Feb Sunday
06/02/2023, 3:49 pm - PaJR PHR Moderator: What work call for a 16F?
07/02/2023, 2:39 pm - Patient Advocate: Study call. 🙂
07/02/2023, 2:37 pm - Patient Advocate:
Woke up at 2pm
2pm-4pm
Got fresh
Room organized
Had Chocolate 32gm
Namaz
Self-care
4pm-5:30pm
Study
5:30pm-7:30pm
Namaz
Call
{
Lunch (Chicken biryani)
Calcium med
Namaz
}
7:30pm-8:30pm
Study
9pm-12:30am
Too drowsy the whole day- Tried to study by taking frequent breaks coz slept at 8:30am last night.
1piece veg roll
1piece non-veg samosa
1packet chips (45gm)
Slept at 12:30am
Water Intake = 1.3L
5th Feb Monday
09/02/2023, 4:23 pm - Patient Advocate:
Woke up at 2pm
2pm-5pm
Got fresh
Room organized
Self-care
Breakfast (1 paratha with scrambled egg)
Vitamin D3 med
Random work
Call
Had 1 piece of chocolate nut cake
5pm-9pm
Study
9pm-10pm
Lunch (1paratha with mutton stew)
Calcium med
10pm-1am
Break/Random stuff
Had half a chicken roll and 1 piece peri bites
1am-3:30am
Study
Water Intake = 1.3L
Slept around 4:30 am
8th Feb Wednesday
10/02/2023, 9:48 pm - Patient Advocate:
Woke up at 2pm
2pm-4:30pm
Got fresh
Room organized
Breakfast (1paratha with scrambled egg with mixed veggies)
Took Calcium med
Housework
Had 1 Orange
Self-care
4:30pm-5:15pm
Study
Took nap
5:15pm-8pm
Call
{
Exercise (15mins)
Random work
Meal (2 packets noodles with minced meat in it)
}
8pm-11:30pm
Slept
Random work
1 mayo garlic roll
11:30pm-4:30am
Study
1 piece chocolate cake
Half chicken burger
Slept around 5am
Water Intake 1.8L
9th Feb Thursday
10/02/2023, 9:48 pm - Patient Advocate: (file attached)
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11/02/2023, 7:22 am - PaJR PHR Moderator: Very interesting routine especially with regard to the timeline.
We have one 29M admitted with us right now who has the exact same routine.
11/02/2023, 7:26 am - Patient Advocate: Admitted for which problem?
11/02/2023, 8:04 am - PaJR PHR Moderator: There is a separate PaJR group and case report on him
12/02/2023, 2:55 pm - Patient Advocate: Ok ok.
25/02/2023, 10:22 am - Patient Advocate:
Woke up at 5:30am
6am-7am
Prayer
Got fresh
Self-care
Exercise (Treadmill 15mins)
Had one biscuit
7am-2pm
Study
2pm-3:30pm
Nap
Meal (1paratha with tea)
Prayer
3:30pm-9:30pm
Calls
Music
Ate 2 samosas
Housework
Meal (Rice with kabab)
9:30-12:00
Study
Slept around 12:30am
23rd Feb
25/02/2023, 10:25 am - Patient Advocate:
Woke up at 5:30am
6am-7am
Got fresh
Self-care
Exercise (15mins)
Ate a biscuit
7am-8am
Study
8am-9am
Slept
9am-1:30pm
Study
1:30pm-3:30pm
Slept
3:30pm-10:30pm
Meal (1paratha with potato sabzi)
Calls
Meal (Noodles at 6pm)
Housework
Did some Writing
Slept around 10:30pm while meditating
24th Feb
26/02/2023, 4:30 pm - Patient Advocate:
Woke up at 6:30am
6:30am-7am
Got fresh
Ate biscuit
Self-care
7am-8am
Study
8am-9:30am
Writing
9:30am-10:30am
Break
10:30am-12:30pm
Study
Breakfast (1paratha with potato sabzi around 11:30am)
1pm-3:30pm
Slept
4pm-8:30pm
Had two kharboza
Lil bit fried chicken
Calls
Housework
Meal (Rice with meat daal gravy)
8:30pm-9:30pm
Study
9:30pm-12am
2piece non-veg pizza
Music
Housework
12am-3am
Tried to sleep but can’t
3am-4am
Random work
Ate 1 piece of non-veg pizza + drink
4am-7am
Study
7am-8am
Exercise (30mins)
Got fresh
Self-care
Had one omeprazole med
8am-9am
Study
Slept around 9:30am
26/02/2023, 4:57 pm - PaJR PHR Moderator: Biscuits, pizza, drink sugary? All red flag bearers for metabolic syndrome
27/02/2023, 8:38 am - Patient Advocate: Dara dya 😭😭😭😭😭😭
27/02/2023, 8:40 am - Patient Advocate:
Continue
Woke up at 2pm
2:30pm-5pm
Meal(1 Paratha n potato sabzi)
Random stuff
5:30pm-10pm
Housework
Meal (Half plate Chicken biryani around 6pm)
Calls
Rest
Housework
Study an hour
Slept until around 10:30pm
01/03/2023, 5:49 pm - Patient Advocate:
Woke up at 6am
6am-7am
Got fresh
Prayer
Exercise (15mins)
Self-care
1 biscuit (only 3 pieces)
7am-8am
Study
8am-12:30pm
Slept
12:30pm-5pm
Study
Meal (1 paratha with veg at 3pm)
Prayer
Study
5pm-12:30am
Prayer
Calls
Meal (non veg biryani)
Prayer
Housework
Had chocolate shake
Had a piece of sandwich
Watched a web series for an hour.
Slept around 1:30am
01/03/2023, 7:04 pm - PaJR PHR Moderator: Wow! Your patient appears to have turned over a new leaf!
Was thinking of changing this group title to Altered sleep rhythm but now I am wondering what else would be better.
01/03/2023, 7:19 pm - PaJR PHR Moderator: Just as you have been a successful patient advocate for this patient with throat pain that recovered, would you like to help this 14F with currently similar symptoms 👇
01/03/2023, 9:26 pm - Patient Advocate: Yeyeyeyeyeye thank you 🙈🙈🙈
01/03/2023, 9:28 pm - Patient Advocate: Yes Doctor I would love to help. I joined 👍
[02/03/2023, 3:56:32 PM] - Patient Advocate:
Woke up at 6am
6am-7am
Got fresh
Prayer
Self-care
Exercise (15mins)
Ate a piece of sandwich
7am-12:30pm
Study
Had half plate of biryani
12:30pm-3:30pm
Slept
3:30pm-10:30pm
Prayer
Calls
Prayer
Housework
Prayer
Housework
Ate 4 chocolate pancakes (cooked by me) around 7:30pm.
Few sips of a cold soft drink
Music
Random stuff
Slept around 12am
[02/03/2023, 3:57:03 PM] - Patient Advocate: Ok 🙃🙃
[02/03/2023, 4:00:11 PM] - PaJR PHR Moderator: Great 👍
Managing to wake up at the right time. Why not ask your patient to convert her 2-hour afternoon nap into a 15-minute power nap and then have an early dinner and retire at 10: 00 PM?
[02/03/2023, 4:12:46 PM] - Patient Advocate: Ok I will ask my patient to do that. Might be possible some of the issues a patient is facing regarding tiredness will eventually sort out.
[04/03/2023, 3:12:14 PM] - Patient Advocate:
Yesterday woke up at 6am
6am-7am
Got fresh
Prayer
Self-care stuff
Exercise (15mins)
After 7am
Actually did random house stuff yesterday, calls and prayers, nothing much.
Meal 1: Onion paratha at 1pm
Meal 2: non-veg Biryani and a few sips of cold soft drink at 4:30pm
Meal 3: 2 chocolate pancakes around 8pm
Went to bed at 10:30pm but cannot sleep till 1am so watched youtube videos.
Woke up again at 2am due to acid reflux in my throat.
Cannot sleep till 4am so did some online shopping.
Again woke up at 6am due to acid reflux in my throat and Took omeprazole.
6am-7am
Got fresh
Prayer
Self-care
Exercise (15mins)
7am-8am
Study
8am-1pm
Slept
1pm-3pm
Room organized
Prayer
Meal (1 paratha and non-veg stue)
01/05/24
PA: Woke up at 11:30am.
Left the bed 12:30pm.
Freshen up.
Prayer.
Cooked breakfast.
Ate breakfast at 1:40pm
Took last dose of iberet folic supplement.
Washed utensils.
Tried to study.
PaJR PHR Moderator: From 1:40 PM hourly till now?
02/05/24
PA: Yes. I was bit distracted and tired so everything was slow.
PA: 4pm - 5pm : studied
5pm - 5:45pm : slept
6pm - 8pm :
Prayer
walking/talking
Kitchen work
8:30pm : Ate meal
Walk again
Music
12am : freshen up
12:30am : on bed
Water intake : 3L
Walked a lot.
Very tired so did a lot less work, trying to get it better.
PaJR PHR Moderator: 👍
PA: Slept at 3am.
12pm = woke up
12-1 = freshen up
1-1:30 = cooked & ate meal#01
Meal#01
1 medium sized roti
Scrambled egg (salt+black pepper)
Meat Stue
PaJR PHR Moderator: Are we updating all this in her advocate's portfolio?
Narmeen Shah: Yes sir, I will update the recent ones by tonight.
Participant 1: Nice
Good to see patient have started updating regularly
PA: 2pm - 5:30pm :
prayer
Study
30mins break
Study
5:30pm - 7:30pm
Prayer
Kitchen work
Ate snack at 6:30pm
Walk
Prayer
7:30pm - 9pm
nap
Journaling
Snack
5 fried Chicken pieces
1 cucumber
03/05/24
9:30pm-12am
Study
Meal # 02 at 11:20pm
Meal#02
Rice, Lentil with Bottle gourd
05/05/24
3:30am slept
12:30pm woke up
12:30pm-3pm
Freshen up
Kitchen work
Meal#01
Prayer
3pm-5:30pm
Study
5:30pm-9pm
Prayer
Kitchen work
Prayer
Meal#02
Walk 45 mins
Meal#01
1 boiled egg (salt + black pepper)
Half mug doodh patti (2cardamom + 2Cloves + cinnamon + 1/4tsp sugar included)
Time : 2pm
Meal#02
1 large sized chapati
Butter Cream chicken (this portion × 2)
Time : 7pm
PaJR PHR Moderator: 👍
Participant 2: Add more greens/veggies
06/05/24
PA: 9:30pm - 11:30pm
Study
11:30pm-12:30am
Music/walk/Random surfing on internet
Water Intake : 2.2L
Note: Too much distracted but reducing the distraction day by day.
07/05/24
Slept at 4am
Woke up at 12pm
12:30pm-2pm
Freshen up
Meal#01
2:30pm - 5:30pm
Study
Prayer
Study
5:30-8:30pm
Kitchen work
Prayer
Snack
Prayer
Meal#02
9pm-10pm
Study
10pm-11pm
Walk
11pm-2am
Study
Water Intake : 2.2L
Meal#01
1 medium sized roti with butter cream chicken + 1 cucumber.
1 Ice cream as well.
Time : 2pm
Snack
5 piece fried pappar
Time : 6pm
Meal#02
Saada pulao with dahi ka raita and cucumber
Time : 8pm
Note :
Productivity was good (in terms of study) along with the energy.
Study keeps the mind stimulated. As the productivity gets better so as the energy
Attention was better as well.
08/05/24
Slept at 4am
Woke up at 12:30pm
12:30pm-2pm
Freshen up
Meal#01
Prayer
2:30pm-5:30pm
Study
5:30pm-7:30pm
Kitchen work
Prayer
Snack
Prayer
7:30pm-9:30pm
Study with walk
9:30pm-12:30am
Meal#02
Music/webseries
Water Intake : 2.2L
Meal#01
Pulao rice with dahi ka raita
Time : 1:30pm
Snack
3 piece fried chicken fries
Time : 7pm
Meal#02
Pulao rice with dahi ka raita & cucumber
Time : 9:30pm
Note:
Due to extreme heat wave, do not feel like eating heavy meals. So switched to light meals.
Walking regularly as it makes me feel less tired/lethargic/heavy.
PA: Slept 3am
Woke up at 12:30pm
12:30pm-2pm
Freshen up
Meal#01
2:15pm-5:30pm
Study
Fruit
Prayer
5:30pm-6:30pm
Snack
Prayer
Meal#01
1 medium sized roti
With yogurt
Time : 2pm
Fruit : Melon
Time : 3pm
Snack
4 pieces fried chicken fries
Time : 6pm
PaJR PHR Moderator: 👍
Participant 3: What are the highs (high noon) and lows (night) temperatures.
PA: Today
High : 35 feels like 39 as humidity was around 50%
Low : 27 predicted with humidity above 70%
Participant 3: Thank you.
PA: My pleasure.
09/05/24
6:30pm -9pm
Kitchen work
Prayer
Rest
Web series
Meal 2
10:30pm-11:30pm
Walk
Water Intake : 2L
Small glass Falooda
Had only 20% of it.
Time : 9:15pm
MEAL 2
2 piece chicken club sandwich with fries
Time : 9:30pm
10/05/24
Slept around 12:30am
Woke up at 5:30am
Study
Slept again at 7:30am
Woke up at around 12pm
Meal 1
2pm-3pm
Prayer
Study
3pm-6:30pm
Fruit
House work
Prayer
6:30pm-7:30pm
Rest
Prayer
Meal 2
Post 7:30pm
Rest
On bed at 12am
Slept at 2am
Note:
Post 7pm
I had stomach cramps and bloating.
I neglectfully ate fruit on an empty stomach that triggered my stomach cramps.
Managed by taking omeprazole.
Cramps were mild in intensity.
Didn't eat anything after that.
Got completely better at today's noon 11am.
MEAL 1
2 chicken sandwiches only
Time : 1pm
Fruit: 1 Peach
Time : 4:30pm
MEAL 2
Daal, chawal, loki
Time : 7pm
OBSERVATION
Wednesday:
- Yogurt contains sugar.
- Melon contains sugar.
- Falooda, although I consumed 20% of it but it contains sugar.
- 2 sandwiches composed of white bread (maida).
Thursday:
- Sandwiches (maida) again on empty stomach.
- Peach contains sugar
> 2 days continuous intake of foods high in sugar and maida.
> Especially consumed on an empty stomach.
11/05/24
PaJR PHR Moderator: Yes this patient needs to cut down on maida and added sugars as in faloodaa but natural fruits should be fine
12/05/24
PA: Ok. Thank you 🙏
25/10/24
PA: Sleep cycle is very bad since 2 months. Can’t sleep on time. Sometimes patient is able to sleep only 6 hrs in 72hours.
Participant 2: Can your patient advocate share answers for these?
https://drive.google.com/file/d/1-A4-rOInlMMpQaPtVjJBronMilpl8tZH/view?usp=drive_link
PA: Yes
Participant 2: There are 2 more short self reported questionnaires here.Ask pt advocate to fill those too..Fatigue severity scale and Epworth sleepiness scale.
https://drive.google.com/file/d/1mLUiQ_Ra_Bw4D8Sq2VKXPo_4g5gQnuVu/view?usp=drive_link
PA: Ok
https://drive.google.com/file/d/1-A4-rOInlMMpQaPtVjJBronMilpl8tZH/view?usp=drive_link
I haven’t filled ESS as for me the answers are different for everyday depending upon the amount of work I have done that day.
26/10/24
PA: 11pm - Slept
Friday 25-10-2024
2am - Woke up
Tried to sleep but can’t sleep
5am - Got up
Freshen up
Namaz
Household work
Breakfast (1 roti with omlette)
7am - Slept
1:30pm - Woke up
Had 1 mug -> Coffee
Household work
3pm - Namaz
Study -> 1hr
4:30pm - Lunch (1/2 roti with 2pcs chicken Qorma)
Namaz
Study -> 1hr
Namaz
6:30pm - Household work
7:30pm to 10:30pm - Studied
Dinner (1 tandoori roti with 3 pcs chicken Qorma)
Updated Diary
12am - Walk for 40mins
1am - Slept
PA: Saturday 26-10-2024
3am - Woke up
Tried to sleep again but can’t
5:30am - Got up
Freshen up
Namaz
PaJR PHR Moderator: Was there a similar walk at 11:30AM on the 24th?
PaJR PHR Moderator: 3AM to 5:30AM patient was lying in bed in the first stage of sleep?
@Meta AI what are the stages of sleep? Which stage of sleep would you call it when a person is lying in bed trying to sleep? What happens to the body in this initial stage of sleep? Is it as beneficial as the deeper planes of sleep?
Meta AI: The stages of sleep are divided into two main categories: Non-Rapid Eye Movement (NREM) sleep and Rapid Eye Movement (REM) sleep. Here's a breakdown of the stages:
NREM Sleep Stages:
1. Stage 1 (N1): Transition to Sleep (what you're referring to)
- Lasts 5-10 minutes
- Easy to wake up
- Brain waves slow down
- Muscle tone decreases
- Heart rate and blood pressure decrease
2. Stage 2 (N2): Light Sleep
- Lasts 20-40 minutes
- Body temperature cools
- Heart rate and blood pressure decrease further
3. Stage 3 (N3): Deep Sleep
- Lasts 20-30 minutes
- Slow-wave sleep (delta waves)
- Difficult to wake up
- Body repairs and regenerates tissues
REM Sleep Stage:
1. Stage 4 (R): Dreaming Sleep
- Lasts 10-15 minutes
- Brain activity similar to being awake
- Vivid dreams occur
- Muscle paralysis to prevent acting out dreams
When a person is lying in bed trying to sleep, they are likely in Stage 1 (N1) or what's also known as the "transition to sleep" stage. This stage is characterized by:
- Decreased brain activity
- Relaxation of muscles
- Slower heart rate and breathing
- Decreased body temperature
While Stage 1 sleep is essential for transitioning into deeper sleep stages, it's not as beneficial as the deeper stages (Stages 2, 3, and REM) for physical restoration, memory consolidation, and mental rejuvenation.
However, Stage 1 sleep still plays a crucial role in:
- Relaxing the body and mind
- Preparing the body for deeper sleep
- Helping to consolidate memories
Keep in mind that Stage 1 sleep can be easily disrupted, and it's common to experience multiple transitions between wakefulness and Stage 1 sleep throughout the night.
Regarding the time frame you mentioned (3 AM to 5:30 AM), it's possible the patient was in different stages of sleep during that period, as sleep cycles typically last around 90-120 minutes and repeat throughout the night.
Would you like more information on sleep or specific aspects of sleep stages?
PA: No… on 24th I slept at 11pm followed by reading something.
PaJR PHR Moderator: That's a significant difference walking can make!👏👏
27/10/24
PA: 7:45am to 11:00am - Study
11:30am to 2pm - Slept
Household work
Namaz
Meal (1 roti with 1 kabab)
1 mug green tea with cinnamon
4pm - Had a long convo with family
Two Namaz
Meal 2 (1/2 plate chicken biryani)
6:45pm to 11pm - Study
Meal 3 (1/4 chicken biryani + 1pack chips)
11:30pm - 1hr walk
12:30 am - Updated diary
PaJR PHR Moderator: Can you elaborate on household work?
During study for three hours in the morning what was the posture of the patient? Was she lying in bed or sitting in a sofa?
PA: Yesterday’s household work involves the kitchen work washing utensils.
She was sitting on the sofa, reading a course book.
PaJR PHR Moderator: Duration of washing utensils? The patient has clubbed all in one larger time duration I guess.
Washing utensils in standing posture?
Can the patient's advocate share some line graphs of her 24 hourly activities by providing the time in hourly slots in the X axis and hourly activity events in the y axis?
PaJR PHR Moderator: Was just going through this patient's case report i found it was last updated on Feb 2023 and i quote below:
"
PaJR PHR Moderator: Great 👍
Managing to wake up at the right time. Why not ask your patient to convert her 2-hour afternoon nap into a 15-minute power nap and then have an early dinner and retire at 10: 00 PM?
[02/03/2023, 4:12:46 PM] - Patient Advocate: Ok I will ask my patient to do that. Might be possible some of the issues a patient is facing regarding tiredness will eventually sort out.
https://narmeenshah.blogspot.com/2023/03/22012023-700pm-dr.html?m=1
"
PaJR PHR Moderator: 👆Would you like to update the case report till today?@PA
PA: I guess 30 mins in standing posture.
Ok she will separate it with hours from the next time.
I will try to make it in graph.
29/10/24
PA: 1am - slept
Sunday 26-10-2024
3am - woke up
Tried to sleep again
5:30 am - Got up
Freshen up
6am - Namaz
6:30am to 7:30am - Study
Lost is thoughts I guess for 1 hour
8:30 to 9am - study
9am to 1:30pm - Slept
Study for 30mins
2pm - House work (organized room + prepared meal : Half paratha & Scrambled egg)
3pm - Namaz
Updated diary
Sit for a while
4pm to 5:10pm - Study
Snack (2 Bananas)
Namaz
6pm - Namaz
6:20 to 8pm - Study
9pm to 2am - Watched online Movie with a friend
3:30am - slept
PA: Monday 28-10-2024
8am - Woke up (sleep interrupted multiple times)
8:45am to 11am - study course book
Extremely irritable, frustrated due to quality of sleep was worse.
Freshen up
12:30pm - Prepared meal
1pm to 3pm - slept again
Meal # 01 ( 1roti with Scr.egg)
3pm to 6:15pm - House work (Cleaning of room)
6:30pm to 8pm - Kitchen work (Prepared meal)
8pm - Meal#02 (4pcs fried chicken only)
8 to 9pm - 1 hour walk
9pm to 10pm - Rested for 1 hour
11pm to 12am - Study
Music
Tried to sleep but can't
Stomach disturb/nausea
Tuesday 27-10-2024
5am to 6:30am - Got up
Updated Diary
Freshen up
Namaz
Had a biscuit
6:30 to 7am - Study
7am - Put up headphone and listened to rain sound
7am to 1pm - Finally had a good sleep 😌😌 (Feeling good)
PaJR PHR Moderator: Pre sleep walk: good sleep
Pre sleep online movie: bad sleep
Pre sleep rain sounds on headphone: good sleep
@Narmeen Shah would you like to update all this data in her case report and submit the url to a suitable LLM for a detailed thematic analysis?
Narmeen Shah: Yes sir... 👍
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