Weakness in the body. Reasons for women aged 30-50 years, symptoms of diseases, loss of strength, want to sleep. What to do

Constant lethargy and drowsiness in a person during an active working day is a widespread problem of modern civilization and developed society. Most often, residents of large cities suffer from such symptoms.

In the vast majority of cases, the provoking factors of regular drowsiness are external factors (or a combination of them). Only after they have been excluded can we talk about a possible pathology or disease that requires complex diagnosis and appropriate treatment from a specialized specialist.

The problem may become the butt of jokes

With rare exceptions, watching day after day a lethargic and apathetic person constantly trying to “take a nap”, someone seriously thinks that he is not healthy. Colleagues get used to it, perceive it as indifference and indifference, and consider these manifestations more of a character trait than a pathological condition. Sometimes constant drowsiness and apathy generally become the subject of jokes and all sorts of jokes.

Medicine “thinks” differently. She calls excessive sleep duration hypersomnia, and names its variants depending on the disorder, because constant sleepiness during the day does not always mean a full night's rest, even if a lot of time has been spent in bed.

From the point of view of specialists, such a condition requires research, because daytime drowsiness, which occurs in a person who seems to have slept sufficiently at night, may be a symptom of a pathological condition that is not perceived by ordinary people as a disease. And how can one evaluate such behavior if a person does not complain, says that nothing hurts him, he sleeps well and, in principle, is healthy - just for some reason he is constantly drawn to sleep.

Outsiders here, of course, are unlikely to help; you need to delve into yourself and try to find the reason, and, perhaps, contact a specialist.

Signs of drowsiness are not difficult to detect in yourself; they are quite “eloquent”:

• Fatigue, lethargy, loss of strength and constant obsessive yawning - these signs of poor health, when nothing hurts, prevent you from plunging headlong into work;
• Consciousness is somewhat dulled, surrounding events are not particularly exciting;
• The mucous membranes become dry;
• The sensitivity of peripheral analyzers decreases;
• Heart rate decreases.

We should not forget that the sleep norm of 8 hours is not suitable for all age categories. For a child under six months of age, constant sleep is considered normal.
However, as he grows and gains strength, his priorities change, he wants to play more and more, to explore the world, so he has less and less time to sleep during the day. For older people, on the contrary, the older a person is, the more he needs to not go far from the sofa.

Useful video

You can familiarize yourself with a simple but effective technique that will help restore vitality quickly in the video below:

Loss of energy is an unpleasant condition that you always want to get rid of as quickly as possible. By identifying exactly the root cause that provokes this condition, eliminating it and adjusting your life, you can forever forget about the unpleasant symptoms of “internal burnout.”

Read the continuation of the article:

Chronic fatigue syndrome - what to do about it and how to avoid it?

Still fixable

The modern rhythm of life predisposes to neuropsychic overloads, which, to a greater extent than physical ones, can lead to sleep disorders. Temporary fatigue, although manifested by drowsiness (which is also temporary), quickly passes when the body rests, and then sleep is restored. We can say that in many cases people themselves are to blame for overloading their body.

When does daytime sleepiness not cause concern for your health? The reasons may be different, but, as a rule, these are transient personal problems, periodic emergency situations at work, a cold, or rare exposure to fresh air. Here are a few examples when the desire to organize a “quiet hour” is not considered a symptom of a serious illness:

• Lack of night sleep due to banal reasons: personal experiences, stress, caring for a newborn, a student session, an annual report, that is, circumstances to which a person devotes a lot of effort and time to the detriment of rest.
• Chronic fatigue, which the patient himself talks about, implying constant work (mental and physical), endless household chores, lack of time for hobbies, sports, walks in the fresh air and entertainment. In a word, the person got caught up in the routine, he missed the moment when the body recovered in a couple of days, with chronic fatigue, when everything has gone so far, perhaps, in addition to rest, long-term treatment will also be needed.
• Fatigue makes itself felt more quickly when there is insufficient oxygen supply to the body, causing the brain to begin to experience starvation (hypoxia). This happens if a person works for a long time in unventilated rooms and spends little time in the fresh air in his free time. What if he also smokes?
• Lack of sunlight. It's no secret that cloudy weather, the monotonous tapping of raindrops on the glass, the rustling of leaves outside the window greatly contribute to daytime drowsiness, which is difficult to cope with.
• Lethargy, loss of strength and the need for longer sleep appear when “the fields are compressed, the groves are bare,” and nature itself is about to plunge into sleep for a long time - late autumn, winter (it gets dark early, the sun rises late).
• After a hearty lunch, there is a desire to lay your head on something soft and cool. This is all the blood circulating through our vessels - it strives for the digestive organs - there is a lot of work there, and at this time less blood flows to the brain and, along with it, oxygen. So it turns out that when the stomach is full, the brain is starving. Fortunately, this doesn't last long, so the afternoon nap passes quickly.
• Fatigue and drowsiness during the day can appear as a protective reaction of the body during psycho-emotional stress, stress, and prolonged anxiety.
• Taking medications, primarily tranquilizers, antidepressants, antipsychotics, sleeping pills, and certain antihistamines that have lethargy and drowsiness as a direct effect or side effects, can cause similar symptoms.
• A mild cold, which in most cases is carried on the legs, without sick leave or drug treatment (the body copes on its own), is manifested by rapid fatigue, so during the working day it tends to fall asleep.

• Pregnancy itself, of course, is a physiological condition, but one cannot ignore the changes occurring in a woman’s body, primarily related to the ratio of hormones, which are accompanied by sleep disturbances (it’s hard to sleep at night, and during the day it’s not always possible).
• Hypothermia is a decrease in body temperature as a result of hypothermia. From time immemorial, people have known that when they find themselves in unfavorable conditions (blizzard, frost), the main thing is not to succumb to the temptation to rest and sleep, but they are incredibly prone to sleep from fatigue in the cold: a feeling of warmth often appears, a person begins to feel that he is in good health. a heated room and a warm bed. This is a very dangerous symptom.

However, there are conditions that are often included in the concept of “syndrome”. How should we perceive them? In order for the presence of such a disease to be confirmed, you need not only to undergo some tests and go to some kind of fashionable examination. A person, first of all, must identify his problems and make specific complaints, but, unfortunately, in most cases, people consider themselves healthy, and doctors, to be honest, often talk about the sick to their health.

Stress and emotional stress

If you have no strength and energy, and constantly want to sleep, then you cannot discount emotional overstrain. Stress causes a very real physical response in the body. Nervous stress causes fluctuations in the levels of certain hormones, which affects all organ systems, including the immune system.

It's no secret that under stress, the body becomes more susceptible to infections and recovers more slowly from illness. Unfortunately, it is not always possible to avoid conflict or emergency situations. Therefore, you need to learn to cope with stress. As reviews indicate, breathing exercises, yoga, morning jogging, as well as any other activities that allow you to distract yourself, throw out emotions and calm down, work well for this.

Disease or normal?

Lethargy, drowsiness, and daytime fatigue can result from various pathological conditions, even if we do not consider them as such:

1. Apathy and lethargy, as well as the desire to sleep at inappropriate times, appear in neurotic disorders and depressive states, which are within the competence of psychotherapists; it is better for amateurs not to meddle in such subtle matters.
2. Weakness and drowsiness, irritability and weakness, loss of strength and decreased ability to work are often noted in their complaints by people suffering from sleep apnea (problems with breathing during sleep).
3. Loss of strength, apathy, weakness and drowsiness are symptoms of chronic fatigue syndrome, which in modern times is often repeated by both doctors and patients, but few have seen it written down as a diagnosis.
4. Often, lethargy and a desire to sleep during the day are noted by patients whose outpatient records include a “semi-diagnosis” such as vegetative-vascular dystonia or neurocirculatory dystonia, or whatever else such a condition is called.
5. an infection - acute or have it in a chronic form - want to stay longer in bed, sleep both at night and during the day . The immune system, trying to restore its defenses, requires rest from other systems. During sleep, the body inspects the condition of the internal organs after the illness (what damage has been caused by it?) in order to correct everything if possible.
6. It prevents you from sleeping at night and leads to sleepiness during the day, “restless legs syndrome . Doctors do not find any specific pathology in such patients, and night rest turns into a big problem.
7. Fibromyalgia. Due to what reasons and circumstances this disease appears, science does not know for sure, since, apart from excruciating pain throughout the body, disturbing peace and sleep, doctors do not find any pathology in the suffering person.
8. Alcoholism, drug addiction and other abuses in the status of “former” - in such patients, sleep is often disrupted forever, not to mention conditions after abstinence and “withdrawal”.

The already long list of causes of daytime sleepiness that occurs in people who are considered practically healthy and able to work could be continued, which we will do in the next section, identifying as causes conditions that are officially recognized as pathological.

When taking certain medications

A side effect of taking some groups of medications is drowsiness at any time of the day. In addition to psychotropic drugs (neuroleptics, antidepressants, tranquilizers), some antihistamines, sedatives, hypnotics, motion sickness medications, painkillers, and antivirals have this property.

If you have a persistent desire to sleep associated with taking the drug, you should consult a specialist and replace the drug with another.

The cause is sleep disorders or somnological syndromes

The functions and tasks of sleep are programmed by human nature and consist of restoring the body’s strength spent during daytime activities. As a rule, active life takes 2/3 of the day, approximately 8 hours are allocated for sleep. For a healthy body, in which everything is safe and calm, life support systems are working normally, this time is more than enough - a person wakes up cheerful and rested, goes to work, and in the evening returns to a warm, soft bed.

Meanwhile, the order established since the origin of life on Earth can be destroyed by problems invisible at first glance, which do not allow a person to sleep at night and force him to fall asleep on the move during the day:

• Insomnia (insomnia) at night very quickly forms signs indicating that a person is not doing well: nervousness, fatigue, impaired memory and attention, depression, loss of interest in life and, of course, lethargy and constant sleepiness during the day.
• Sleeping beauty syndrome (Kleine-Levin), the cause of which is still unclear. Almost no one considers this syndrome a disease, because during the intervals between attacks, patients are no different from other people and do not resemble patients. This pathology is characterized by periodically occurring (intervals from 3 months to six months) episodes of long sleep (on average, 2/3 days, although sometimes a day or two, or even longer). The most interesting thing is that people wake up to go to the toilet and eat. In addition to prolonged sleep during exacerbations, other oddities are noticed in patients: they eat a lot without controlling this process, some (males) exhibit hypersexuality, become aggressive towards others if they try to stop gluttony or hibernation.
• Idiopathic hypersomnia. This disease can plague people up to 30 years of age, so it is often mistaken for the healthy sleep of young people. It is characterized by daytime drowsiness, which occurs even in situations that require high activity (study, for example). Despite a long and full night's rest, awakening is difficult, a bad mood and anger do not leave the person who “got up so early” for a long time.
• Narcolepsy is a fairly severe sleep disorder that is difficult to treat. It is almost impossible to get rid of drowsiness forever if you have such a pathology; after symptomatic treatment, it will manifest itself again. Surely, most people have never even heard the term narcolepsy, but sleep specialists consider this disorder to be one of the worst variants of hypersomnia. The thing is that it often does not give rest either during the day, causing an irresistible desire to fall asleep right at the workplace, or at night, creating obstacles to uninterrupted sleep (inexplicable anxiety, hallucinations when falling asleep, which wake up, frighten, provide a bad mood and loss of strength during the coming day).

• Pickwick's syndrome (experts also call it obese hypoventilation syndrome). The description of Pickwickian syndrome, oddly enough, belongs to the famous English writer Charles Dickens (“Posthumous Papers of the Pickwick Club”). Some authors argue that it was the syndrome described by Charles Dickens that became the founder of a new science - somnology. Thus, having nothing to do with medicine, the writer unwittingly contributed to its development. Pickwickian syndrome is predominantly observed in people with significant weight (4th degree of obesity), which puts a huge strain on the heart, puts pressure on the diaphragm, complicates breathing movements, resulting in blood thickening (polycythemia) and hypoxia. Patients with Pickwick's syndrome, as a rule, already suffer from sleep apnea, their rest looks like a series of episodes of stopping and resumption of respiratory activity (the starving brain, when it becomes completely unbearable, forces breathing, interrupting sleep). Of course, during the day - fatigue, weakness and an obsessive desire to sleep. By the way, Pickwick's syndrome is sometimes observed in patients with less than fourth degree obesity. The origin of this disease is not clear, perhaps a genetic factor plays a role in its development, but the fact that all sorts of extreme situations for the body (traumatic brain injury, stress, pregnancy, childbirth) can become an impetus for sleep disorders, in general , proven.

A mysterious disease that also comes from a sleep disorder - hysterical lethargy (lethargic hibernation) is nothing more than a protective reaction of the body in response to severe shock and stress. Of course, drowsiness, lethargy, and slowness can be mistaken for a mild course of a mysterious illness, manifested by periodic and short-term attacks that can occur in the daytime anywhere. Lethargic sleep, which inhibits all physiological processes and lasts for decades, certainly does not fit into the category we are describing (daytime sleepiness).

Is drowsiness a sign of a serious illness?

A problem such as constant drowsiness accompanies many pathological conditions, so there is no need to put it off for later; perhaps it will turn out to be the symptom that will help find the true cause of the ailment, namely a specific disease. Complaints of weakness and drowsiness, loss of strength and bad mood may give reason to suspect:

1. IDA (iron deficiency anemia) is a decrease in iron content in the body, which leads to a drop in the level of hemoglobin, a protein that delivers oxygen to cells for respiration. Lack of oxygen leads to hypoxia (oxygen starvation), which is manifested by the above symptoms. Diet, fresh air and iron supplements help get rid of this kind of drowsiness.
2. B12-deficiency anemia, hemolytic anemia, some forms of leukemia - in general, conditions in which cells do not receive the amount of oxygen necessary for full functioning (mainly, red blood cells, for some reason, cannot carry it to their destination).
3. A decrease in blood pressure below normal values ​​(usually blood pressure is taken as normal - 120/80 mmHg). Slow blood flow through dilated vessels also does not contribute to the enrichment of tissues with oxygen and nutrients. Especially under such circumstances, the brain suffers. Patients with low blood pressure often experience dizziness, they cannot tolerate attractions such as swings and carousels, and they get carsick. Blood pressure in hypotensive people decreases after intellectual, physical and psycho-emotional stress, intoxication, and lack of vitamins in the body. Hypotension often accompanies iron deficiency and other anemias, but people suffering from autonomic dysfunction (hypotonic VSD) are most prone to it.
4. Diseases of the thyroid gland with a decrease in its functional abilities (hypothyroidism). Insufficiency of thyroid function naturally leads to a drop in the level of thyroid-stimulating hormones, which gives a rather varied clinical picture, including: fatigue even after minor physical exertion, memory impairment, absent-mindedness, lethargy, slowness, drowsiness, chilliness, bradycardia or tachycardia, hypotension or arterial hypertension, anemia, damage to the digestive organs, gynecological problems and much more. In general, a lack of thyroid hormones makes these people quite sick, so you can hardly expect them to be highly active in life; they, as a rule, always complain about loss of strength and a constant desire to sleep.
5. Pathology of the cervical spine (osteochondrosis, hernia), which leads to compression of the vessels supplying the brain.
6. Various lesions of the hypothalamus, since it contains areas involved in regulating the rhythms of sleep and wakefulness;
7. Respiratory failure with hypoxemia (decreased oxygen levels in the blood) and hypercapnia (saturation of the blood with carbon dioxide) is a direct path to hypoxia and, accordingly, its manifestations.

Possible complications

If a condition such as general malaise is ignored, various types of complications may arise. It all depends on whether general weakness is an independent disease or a secondary form of the underlying disease. In the first case, the outcome is positive. In the second case, it will lead to progression of the underlying disease.

Weakness in the body is more common in women than in men. This is due to physiological blood loss, unstable hormonal levels, hence emotional stress, sudden changes in blood pressure.

For such reasons, the female body’s inadequate response to the environment expends more energy than the body of a healthy person and is subject to rapid energy depletion. Consultation with your doctor, an active lifestyle and elimination of the irritating factor will improve the overall clinical picture.

When the reason is already known

In most cases, chronic patients are well aware of their pathology and know why symptoms that are not directly related to a specific disease periodically arise or are constantly accompanied by:

• Chronic heart failure, which disrupts many processes in the body: the respiratory system, kidneys, and brain suffer, resulting in a lack of oxygen and tissue hypoxia.
• Diseases of the excretory system (nephritis, chronic renal failure) create conditions for the accumulation of substances in the blood that are toxic to the brain;
• Chronic diseases of the gastrointestinal tract, dehydration due to acute digestive disorders (vomiting, diarrhea) characteristic of gastrointestinal pathology;
• Chronic infections (viral, bacterial, fungal), localized in various organs, and neuroinfections affecting brain tissue.
• Diabetes. Glucose is a source of energy for the body, but without insulin it will not enter the cells (hyperglycemia). It will not be supplied in the required quantity even with normal insulin production but low sugar consumption (hypoglycemia). Both high and low glucose levels for the body threaten starvation, and, therefore, poor health, loss of strength and the desire to sleep more than expected.
• Rheumatism, if glucocorticoids are used for its treatment, they reduce the activity of the adrenal glands, which cease to ensure the patient’s high vital activity.
• Condition after an epileptic seizure (epilepsy) the patient usually falls asleep, wakes up, notes lethargy, weakness, loss of strength, but absolutely does not remember what happened to him.
• Intoxication. Stunning of consciousness, loss of strength, weakness and drowsiness are often among the symptoms of exogenous (food poisoning, poisoning with toxic substances and, most often, alcohol and its surrogates) and endogenous (cirrhosis of the liver, acute renal and hepatic failure) intoxication.

Any pathological process localized in the brain can lead to impaired cerebral circulation and oxygen starvation of its tissues, and, therefore, to the desire to sleep during the day (which is why they say that such patients often confuse day with night). Diseases such as atherosclerosis of the head vessels, hydrocephalus, traumatic brain injury, discirculatory encephalopathy, brain tumor and many other diseases, which, along with their symptoms, are already described on our website, impede blood flow in the brain, leading it to a state of hypoxia.

Diagnostics

The primary examination is carried out by a general practitioner. The initial diagnostic stage consists of a detailed collection of all complaints, a history of the development of the disease, on the basis of which the presence of a certain pathology or risk factor is assumed. Then, based on the complaints, special laboratory and instrumental methods are prescribed that make it possible to confirm the probable causes of weakness. The most informative ones are:

• Neurological examination
  . To study the functioning of the nervous system, cognitive functions are examined, and the time of occurrence of dermographism is measured. Specific tests (orthostatic and Danini-Aschner) reveal discoordination of sympathetic and parasympathetic regulation. The functional activity of the brain is clarified using EEG.
• Blood tests
  . A general blood test determines leukocytosis, hemoglobin and red blood cell levels. A biochemical study is carried out to assess liver function, detect signs of inflammation or residual electrolyte disturbances. The content of free T3 and T4 in the blood must be taken into account, and a fasting glucose test is done.
• Coprogram
  . If weakness occurs after symptoms of poisoning, it is necessary to do a microscopic examination of the stool and culture the material on nutrient media to detect pathogenic microorganisms. In case of prolonged dyspepsia for no apparent reason and malabsorption syndrome, stool is examined for the level of fecal elastase and specific antigen H. pylori.
• Ultrasound examination
  . If there are complaints from the digestive system, a survey ultrasound of the abdominal organs and retroperitoneal space is performed. In women, the pelvic organs are additionally visualized. If there are signs of a pathological process, more informative examinations are recommended - endoscopy, radiography of the intestine using a contrast agent.
• ECG
  . In middle-aged and elderly patients, an electrocardiogram must be recorded in standard leads and with a load. For a detailed examination of the heart, 24-hour Holter monitoring is effective. To examine the anatomical features of the heart and identify signs of valve damage, echocardiography with vascular Dopplerography is performed.
• Additional methods
  . To study the respiratory system, a chest x-ray is taken. Spirography helps to assess the function of external respiration. If weakness is caused by a lack of thyroid hormones, scintigraphy of the thyroid gland with iodine is indicated to diagnose organic damage. MRI and CT scan of the brain will help rule out inflammation and degenerative changes.

Drowsiness in a child

Many of the conditions listed above can cause weakness and drowsiness in a child, but newborns, infants up to one year old and older children cannot be compared.

Almost round-the-clock hibernation (with breaks only for feeding) in babies up to one year old is happiness for parents if the baby is healthy. During sleep, it gains strength for growth, forms a full-fledged brain and other systems that have not yet completed their development until the moment of birth.

After six months, the duration of sleep in an infant is reduced to 15-16 hours, the baby begins to be interested in the events happening around him, shows a desire to play, so the daily need for rest will decrease with each month, reaching 11-13 hours by the year.

Drowsiness in a small child can be considered abnormal if there are signs of illness:

• Loose stools or prolonged absence;
• Dry diapers or diapers for a long time (the child has stopped urinating);
• Lethargy and desire to sleep after a head injury;
• Pale (or even bluish) skin;
• Fever;
• Loss of interest in the voices of loved ones, lack of response to affection and stroking;
• Prolonged reluctance to eat.

The appearance of one of the listed symptoms should alert parents and force them to call an ambulance without hesitation - something must have happened to the child.

In an older child, drowsiness is considered an unnatural phenomenon, if he sleeps normally at night and, as it seems at first glance, is not sick. Meanwhile, children's bodies better sense the influence of invisible unfavorable factors and respond accordingly. Weakness and drowsiness, loss of activity, indifference, loss of strength, along with “adult diseases” can cause:

• Worm infestations;
• Traumatic brain injury (concussion), which the child chose to remain silent about;
• Poisoning;
• Astheno-neurotic syndrome;
• Pathology of the blood system (anemia - deficiency and hemolytic, some forms of leukemia);
• Diseases of the digestive, respiratory, circulatory system, pathology of the endocrine system, occurring latently, without obvious clinical manifestations;
• Lack of microelements (iron, in particular) and vitamins in food products;
• Constant and prolonged stay in unventilated areas (tissue hypoxia).

Any decrease in daily activity, lethargy and drowsiness in children are signs of ill health that should be noticed by adults and become a reason to consult a doctor, especially if the child, due to his youth, cannot yet correctly formulate his complaints. You may just have to enrich your diet with vitamins, spend more time in the fresh air, or “poison” the worms. But it’s still better to be safe than sorry, isn’t it?

Treatment of drowsiness

Treatment for drowsiness? It may be there, but in each specific case it is separate, in general, this is the treatment of a disease that makes a person struggle with sleep during the day.

Considering the long list of causes of daytime drowsiness, it is impossible to give any universal recipe for how to get rid of drowsiness. Perhaps a person just needs to open the windows more often to let in fresh air or walk outside in the evenings and spend weekends in nature. Maybe it's time to reconsider your attitude towards alcohol and smoking.

It is possible that you will need to streamline your work and rest schedule, switch to a healthy diet, take vitamins, or undergo ferrotherapy. And finally, get tested and undergo an examination.

In any case, you don’t need to rely too much on medications, but it’s human nature to look for the easiest and shortest ways to solve all issues. It’s the same with daytime sleepiness, because it’s better to buy some medicine, take it when your eyes start to stick together, and everything will go away. However, here are a few examples:

• Let’s say that drowsiness is caused by low blood pressure (hypotension), that is, a person knows exactly the reason for his constant falling asleep. Such people, undoubtedly, can afford to love coffee or strong tea more than others, which, in general, is what hypotensive people do. I drank coffee and felt more energetic and had a desire to work, but the main thing was not to overdo it. Even for patients with low blood pressure, excessive doses of these drinks and taking them in the evening may not have a very good effect. In addition, people suffering from hypotension can turn to pharmaceutical herbal remedies. These are tinctures of eleutherococcus, zamanikha, and ginseng. They increase blood pressure and performance, give a surge of vitality and relieve daytime sleepiness.
• Another common cause of drowsiness is low hemoglobin. In this case, we can advise you to buy only a vitamin complex at the pharmacy, and the doctor will prescribe iron, if it turns out that iron deficiency anemia actually occurs. But first you will have to undergo an examination and establish the specific reason for the decrease in hemoglobin levels.
• Or, let's say, hypoxia. What kind of treatment can be prescribed to a person if his body requires a medicine called “oxygen” ? Of course, it happens that professional activity and leisure time are somehow structured in such a way that a person spends little time in the fresh air and is overcome by drowsiness during the day. The only advice is to take care of the nutrition of your brain yourself. In connection with hypoxia, one cannot ignore such a bad habit as smoking. And what can be recommended in this case? Of course, if you quit smoking, you will probably feel less sleepy during the daytime.

It is difficult to give one universally satisfying recipe for combating daytime sleepiness to people who have completely different problems: thyroid disease, cardiovascular pathology, respiratory or digestive diseases. It will also not be possible to prescribe the same treatment to those suffering from depression, sleep apnea or chronic fatigue syndrome. Everyone has their own problems, and, accordingly, their own therapy, so it’s clearly impossible to do without an examination and a doctor.

Video: tips - how to overcome drowsiness