Dr. Roach: I have just retired from working the graveyard shift for 40 years. I am hoping you can share some information on how to safely learn to sleep at night once again. -- E.H.
Answer: Changing your body's circadian rhythm isn't always easy, and after such a long time, it will take longer for you. But it shouldn't be as difficult as you might fear. When people fly to the other part of the world, they need to get accustomed to a new sleep schedule, and it usually doesn't take more than a week or two to become accustomed to the new schedule. For you, it will be difficult learning to be up during the day, which is more a behavioral issue than a circadian-rhythm issue.
The first advice I give in this situation is to push your internal time clock forward, not backward. Try to stay up two hours or so later each day until you get to a bedtime that works with your family (if appropriate) and your goals. Your body has an easier time moving forward than backward.
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Bright light can be your friend or your enemy. You want bright light when you wake up, not right before bed. Computers, phones and tablets all put out light that signals to your brain to wake up, so don't use those before bed. Making sure that your bedroom is dark when you want to sleep is something you probably have already done.
Caffeine is very helpful to a lot of people, so if you partake, do so when you awaken, not before bedtime. Some people metabolize caffeine slowly, so they shouldn't have any for at least 8 hours before planning to go to sleep.
Dr. Roach: Recently, I had COVID and was given Paxlovid. I am a 74-year-old woman with a 25-year history of a fibromyalgia-type disorder, along with rheumatoid arthritis and a few other problems. I was expecting to feel worse after taking Paxlovid, but I was quite surprised to feel much better. The COVID symptoms were gone in 24 hours, and for the first time in years, I had energy. The fibromyalgia symptoms were gone, too.
This lasted for four days, then it was back to reality. Once I stopped Paxlovid, the symptom relief halted as well. Have you ever heard of this? -- F.P.
Answer: Yes, this is well-reported among the fibromyalgia community. It's not at all dissimilar to what I have heard from some patients about feeling better after getting antibiotics for an unrelated condition.
As far as I know, nobody has a definitive answer for why this happens. I doubt very much that it is an effect of Paxlovid. Many people have tried using antivirals or antibiotics for fibromyalgia, and it does not seem to be helpful. Some authorities have speculated about it suppressing other viruses, but I do not think this is likely either. It seems that not only do people feel relatively better after being very sick with COVID, people report being able to do activities that they hadn't been able to do before.
I'm sorry, but I don't have an answer as to why this happens. A diligent search doesn't lead me to any great insight. Obviously, a better understanding of these types of conditions would be great if it could lead to more effective treatments.
Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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