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Feeling Unwell?
Sleep & Travel
Sleeping difficulties

Temporary sleeplessness can have a significant impact on our health and general wellbeing. Sleep has a 'restorative' effect on the human body and mind. It is not just a matter of duration, the quality of sleep is also important. Rapid eye movement (REM) sleep - this is the time we dream - is essential and must be balanced. Lack of it produces an unsatisfying sleep which leaves you feeling tired. Excess alcohol can reduce the amount of REM sleep and so should be avoided.

Sleeplessness can be caused by stress, problems or jet lag. A number or bodily functions including body temperature regulation, hormone secretion and sleep operate rhythmically following an individual's 'body clock'. The hormone, melatonin, secreted during the hours of darkness, serves as the body's night-time indicator, helping to regulate these rhythmic functions. The body-clock rhythm, melatonin secretion, body temperature and sleep are all interdependent. Any change in one factor will upset the overall balance.; thus shift work and travel across time zones de-synchronize the body clock, so disrupting normal sleep.

 
Condition Insomnia
Symptoms Difficulty in falling asleep; frequent awakenings; early awakenings
OTC Treatment - Sedatives e.g. antihistamines such as diphenhydramine and promethazine
NB: Antihistamines such as diphenhydramine should be avoided by people with conditions such as asthma, narrow angle glaucoma, prostatic hypertrophy (enlarged prostate), bladder obstruction, pyloroduodenal obstruction (blockage of the gut) or stenosing peptic ulcer (stomach or duodenal ulcers).
For OTC products, read Sleeping Aids
Other self-help

A number of simple self-help measures can help you to manage your insomnia:
- Give yourself a  relaxing bedtime routine (bath, milky drink)
- Stop smoking – or at least cut down
- Find a way to reduce your stress levels e.g. take a yoga class
- Avoiding daytime sleeping
- Avoiding exercise just before bedtime (but do some regular exercise)
- Avoiding drinking tea, coffee and fizzy drinks from early evening onwards
- Not working or watching television in bed
- Making sure your bed and bedroom is comfortable
- Not going to bed unless you feel tired.

Some herbal remedies are also regarded as useful for insomnia due to their calming sedative effects (see www.hsis.org).

Other information The causes of  temporary insomnia are:
- Stress/anxiety
- Illness e.g. depression, thyroid problems, menopausal symptoms, night-time cough, pain
- Lifestyle e.g. shift work; jet-lag; over-tiredness; in-take of stimulants, including caffeine, alcohol and nicotine; exercising close to bedtime; daytime sleeping; an uncomfortable, noisy or unfamiliar environment. After travel across time zones, or changes in working hours, it can take the body clock a few days to two weeks to become resynchronised. A number of OTC sleep-aid products i.e. those with promethazine hydrochloride or diphenhydramine as their active ingredient, are sedative antihistamines. These OTC drugs are also:
- Available as tablets or liquid- Intended for short-term use in the relief of temporary sleeplessness
- For adult use only (not for use in children under 16 years)
- Generally well tolerated
- Not to be taken with other sedatives, alcohol or certain prescription drugs for depression
- Non-habit forming
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Travel (motion) sickness

Travel sickness affects many people of all ages, but younger people seem to be more prone to its effects. It affects many people of varying degrees when they are subject to swaying or pitching movements. Sufferers can experience motion sickness in cars, on planes and on ships - especially when conditions are undulating or rough!

The main organs of balance or equilibrium are located in the inner ear. Each consists of three fluid-filled canals, which contain tiny hairs. These respond to the changes in the position of the head and transmit this information to the brain where it is processed. Motion sickness occurs when there is excessive stimulation of the semi-circular canals; as a result the brain detects major changes in the position of the head, yet sensory input from the eyes seems out of step. This confusion in sensations is thought to cause motion sickness.

The eyes and certain sensory cells in the skin and internal tissues also help to maintain normal balance by transmitting information to the brain on the body's position relative to its external environment. Together, sensory input from the semi-circular canals, eyes and other sites control the body's balance.

 
Condition Travel (Motion) Sickness
Symptoms

Mild:
- Can be slight nausea
Severe:
- Vomiting
- Dizziness
- Sweating
- Unsteady gait
- Loss of balance
- Loss of co-ordination

OTC Treatment

Two main groups of OTC drugs can be used to treat motion sickness:
Anticholinergics: These are thought to prevent motion sickness by controlling vomiting. These drugs can cause dry mouth, blurred vision, dizziness, constipation and urinary retention. They are unsuitable for use in people who have glaucoma, urinary problems, high blood pressure or heart disease.
Antihistamines: Many antihistamines have anti-nausea properties and proven effectiveness in the treatment of motion sickness and the dizziness/nausea associated with disorders of equilibrium.
Antihistamines available OTC for travel sickness include promethazine, dimenhydrinate, meclozine and cinnarizine.
These antihistamines can make you drowsy. Children can take these drugs at half the adult dose or less.
For OTC products, read Travel Sickness

Other self-help

The following measures can help reduce symptoms:
Road travel: ride in the centre of a moving vehicle; look out of a window (especially children); avoid reading and open the window for fresh air
Air travel: sit over the wings of an aeroplane. Avoid alcohol.
Sea travel: ride in the centre of the vessel, fixing the eyes on the horizon.
‘Travel bands’ are a non-drug option that can be worn around the wrist and relieve pressure by use of acupressure.
NB: Anyone prone to motion sickness should try to take a remedy before leaving home as some are ineffective once an attack has begun.

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Loss of appetite
 
Condition Loss of appetite
Symptoms A lack of feeling hungry. NOTE - If a person is losing weight for no apparent  reason then they should seek medical advice.
OTC Treatment

Vitamin and mineral supplements sold individually or as tonics.
OTC tonics contain various combinations of the following ingredients:
Caffeine: included to promote well-being; it increases cardiovascular function, stimulates the central nervous system, stimulates the action of the heart and lungs, promotes urine formation and can aid digestion.
Alcohol: Useful in small amounts to stimulate gastric juices and stimulate appetite
Vitamins: A, B1 (thiamine), B3 (niacin), D/D2
Minerals: including calcium/manganese/potassium/sodium glycerophosphate, copper sulphate, ferric ammonium citrate, manganese sulphate monohydrate, iron.
Some OTC tonics are not suitable for use in children, while others can be recommended for children. Tonics containing alcohol should not be used in combination with other central nervous system depressants. Caffeine-containing products should not be used where caffeine-sensitivity is suspected. Side effects of caffeine include nausea, headache and insomnia.
For OTC products, read Calming/Tension/Stress

Other information

Illness or surgical operations can often leave you feeling in need of a boost to help you recover and gain strength.
It can be difficult to eat healthy, nutritious food when you have little appetite. And even if you do feel like eating, the recovery process can be helped by supplementing the diet with additional vitamins and minerals.
Vitamins and minerals are included in tonics because:
- Vitamins enhance the metabolism of proteins, carbohydrates and fats; without these vitamins the breakdown and assimilation of foods couldn’t occur. Certain vitamins participate in the formation of blood cells, hormones and nervous system chemicals.
- Minerals help the structural composition of hard and soft body tissues; they also participate in the action of enzyme systems, the contraction of muscles, nerve reactions and blood clotting.
Most people will get enough vitamins if they eat a health diet. See www.hsis.org for more information on supplements and who can benefit from taking them.

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Stimulants and Tonics
These are used as pick-me-ups or appetite promoters in those who are ill or convalescing. They can help rebuild strength and aid a speedy recovery. Stimulants contain some similar ingredients to tonics but are more specifically aimed at relieving fatigue and improving alertness.
 
Condition Fatigue and listlessness
Symptoms Feeling more tired than usual; lacking energy
OTC Treatment

Stimulants contain the following ingredients in various combinations:
Caffeine:  promotes well being; increases cardiovascular function, stimulates the central nervous system, stimulates the action of the heart and lungs, promotes urine formation and can aid digestion. This should not be used long term not least because you can build up a dependence and tolerance to caffeine.
Vitamins: B1 (thiamine), B2, and B3 (niacin) enhance the metabolism of proteins, carbohydrates and fats. Most people will get enough vitamins if they eat a healthy diet.
Glucose monohydrate: Boosts energy levels.
NB: Stimulants are not to be used by children.
For OTC products, read Tonics and Stimulants

Other information

Any stimulant drug acts to excite the central nervous system, increase alertness and lower fatigue. Stimulants can be recommended to help overcome feelings of tiredness resulting from illness, overwork, stress or where you simply feel the need for a boost of energy.
Caffeine, the most commonly used stimulant, is present naturally in coffee, tea and some fizzy drinks. Anyone taking an OTC stimulant shouldn’t drink excess amounts of these as high doses of caffeine can induce tremors and severe agitation.

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