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You Don’t Want Diabetes, This is Why.

You Don’t Want Diabetes, This is Why.


Ever wondered why people refer to diabetes as ‘sugar’? Some even assume that diabetes is caused by sugar. There’s a connection for sure, but diabetes is a much more complex health condition. 

What’s more alarming is how common diabetes is.  

It doubles the risk of death. And every 20 seconds one person loses their leg somewhere in the world due to diabetes. 

Globally, more than 530 million people are affected by it, and this is expected to reach a half billion by the end of this decade. Recently, the World Bank reported that in Sri Lanka, 11.3% of the adult population (between the ages of 20 and 79) have diabetes. That’s quite a significant number and shouldn’t be taken lightly.

Therefore, you should know a few very important things about diabetes.

Diabetes in Simple Terms

Your body transforms a lot of the food you eat into sugar (glucose) and releases it into your bloodstream. When your blood sugar increases, it signals the pancreas to create insulin. Insulin is used to convert blood sugar into energy.

With diabetes, your body doesn’t make enough insulin or can’t use it that well. This leads to having too much blood sugar in your bloodstream. When this builds up, this can lead to many serious health problems like heart disease, vision loss and kidney failure. 

The poor health condition due to the high blood sugar level is called Diabetes.

The Types of Diabetes and its Causes

You might be curious what causes this, let’s cover that one type at a time. 

Type 1 Diabetes

This results from the failure of pancreas to create enough insulin. Only around 5-10% of those who have diabetes are affected by this type. 

Cause: It’s still not clearly known. Even though some believe it to be the body attacking itself.

Type 2 Diabetes

This occurs when your body doesn’t use insulin well and struggles to maintain healthy blood sugar levels. Around 90-95% of the people have type 2 diabetes. 

Cause: Obesity, poor physical activity and genetics have a part to play. 

Did you know? A survey reported that around 30% of the Sri Lankan population didn’t engage in recommended moderate-intensity physical activities. And Females were considered more inactive than males. 

Gestational Diabetes

This happens in pregnancy and often can be harmful for the baby. 

Cause: Mostly unknown but it’s believed that the pregnancy hormones get in the way of the mother’s insulin creation. 

There’s no cure for diabetes of any form. Having said that, with early diagnosis and proper care, all of the above conditions can be managed very well.

Signs of Diabetes

Start by being aware of the symptoms of diabetes. 

  • Weight gain or loss while always feeling hungry 
  • Always thirsty
  • Wanting to urinate all the time
  • Feeling too tired around the clock
  • Blurry vision
  • Frequent genital or skin infections 
  • Cuts and bruises take forever to heal
  • Tingling sensation or numbness in the hands or feet
  • Trouble of getting or maintaining an erection

With diabetes type 2, a majority show no symptoms until it’s too late. This is why regular check-ups are key!

signs of diabetes

Diabetes Diagnosis in Sri Lanka

If you feel the above symptoms are too familiar, head to your nearest hospital or if you’re unsure, you can always call a doctor via oDoc. 

Here are a few tests that your doctor may carry out to diagnose. 

  1. Fasting Blood Sugar: 

You will have to fast for 8 hours without eating or drinking except water.

  1. Random Blood Sugar:
  2. HbA1C:

You don’t have to fast for these tests and it can be carried at any time of the day. 

  1. Oral Glucose Tolerance Test:

You will fast for 8 hours and after that you’ll be given a glucose drink. Two hours later, your blood sample will be taken.

Treating and Preventing Diabetes

If you’re diagnosed with diabetes, it’s not the end of the world. It’s a new beginning to refresh your lifestyle. 


Your doctor will prescribe oral medications and insulin doses depending on the type of diabetes and the severity of it. 

Other than that, lifestyle changes and regular monitoring makes up a great proportion of it. Interestingly, these are also the two things that are important to prevent diabetes.


  1. Eat healthy. Choose foods that are rich in nutrients and fiber instead of calories and fat. Get the help of a nutritionist if needed; there are plenty of recognised professionals on ODoc. 
  2. Get moving. Allocate a minimum of 30 minutes daily to improve your physical activity. 
  3. Take regular tests. ODoc app connects you with the country’s leading practitioners in seconds. This way, you can find out if you’re eligible for any of the tests in the most convenient way!
preventing diabetes

You don’t always show symptoms so, every 3 years, approach your doctor to learn if you need any. 

However, if you relate to any of the below, you may need to get checked every 12 months.

  • Overweight 
  •  Sedentary lifestyle
  • අධි රුධිර පීඩනය
  • High cholesterol and lipids
  • Slightly high blood sugar
  • Polycystic Ovary Syndrome (PCOS)
  • Family history of diabetes
  • Dark, thick and velvety skin over neck and armpits. 

Although there’s no complete cure, diabetes is a completely manageable condition. If you have more questions, speak to an endocrinologist from the safety and comfort of your home via oDoc today!


  • WHO
  • CDC
  • World Bank
  • SLDF

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Are you part of the Vitamin D Deficiency club?

Are you part of the Vitamin D Deficiency club?


Do you always get sick? muscles and joints hurt out of nowhere? Uncontrollable hair loss?  Get tired easily?

You might have Vitamin D Deficiency. 

The Ministry of Health says that 50% of Sri Lanka’s population suffers from vitamin D deficiency. Around 1 billion people worldwide have a vitamin D deficiency, and it’s a global public health concern. 

So, what is it? Should you be worried? Let us break it down for you. 

What is Vitamin D? 

Prepare to be surprised. Vitamin D is not technically a “vitamin”, it’s a prohormone—which means, it’s converted into a hormone by our body. Hormones generally carry out key bodily functions. 

Vitamin D is divided into 5 different substances, out of which, the below two are the most important to us.

Vitamin D2: This comes from plants. 

Vitamin D3: This comes from animal sources, or our body can produce it when exposed to sunlight. D3 is supposed to be the most impactful one of all the Vitamin D siblings.

Note to reader: Try not to worry about the differences between these two. The point is that you need them both and let’s explore along those lines. 

Why do we need Vitamin D? 

Vitamin D helps the body absorb and retain calcium and phosphorus—both are needed for bone development and maintenance. 

It  also affects many other body organs like lungs, skin, cardiovascular system and more. Therefore, it impacts our disease-fighting ability, mood, weight loss journey, etc.

In summary, Vitamin D is essential to function normally as a human being. Having low levels of this nutrient causes Vitamin D Deficiency and it can lead to trouble. 

You usually know things are not going well when you start to show the following symptoms.

Vitamin D Deficiency Symptoms

If you relate to any of the below symptoms, we would like to interrupt your intention to self-diagnose and urge you to use this article as a guide and consult a doctor. Hint: With the oDoc app, your doctor is only a few taps away. 

Frequent illnesses: Vitamin D plays a huge role in determining how your body handles any form of threats such as viruses. 

Unable to sleep well: There are parts in your brain that require Vitamin D to create Melatonin (the ‘sleep hormone’) needed for a good night’s sleep. 

Bone and joint aches: Joint pain can lead to so many inconveniences like issues such as rheumatoid arthritis. 

Hair loss: Vitamin D is used in the skin by keratinocytes—cells that process keratin, a protein found in your hair, nails and skin. When the body doesn’t have enough vitamin D, keratinocytes in hair follicles have trouble doing their job, which includes hair growth.

Depression or feelings of sadness: There are several findings that link depression and Vitamin D Deficiency under different conditions. 

Fatigue: Deficiency of Vitamin D can cause bone and muscle weakness, which can lead to being tired all the time. 

Loss of appetite: This is an early sign of vitamin D deficiency.

Slow wound healing: The vitamin D plays a key role in wound healing as it controls growth factors and others that form new tissues.

Fractures: If someone has a fracture, the doctor might test their vitamin D level to cure, depending on the person’s age and health history. 


What Causes the Deficiency of Vitamin D? 

Like our elders says, ‘you should always ask why?’, The answer to this question varies from person to person but here are a few common reasons:  

  1. Not enough vitamin D in your diet and/or through sunlight.
  2. Your body isn’t absorbing vitamin D effectively. 
  3. Certain medical conditions such as obesity, kidney diseases and cystic fibrosis. 
  4. Weight-loss surgeries can reduce the size of your stomach and make it difficult for your body to absorb enough amounts of certain vitamins, minerals and nutrients. 
  5. Specific medications like laxatives, steroids, some cholesterol-reducing and weight loss drugs

Pro-tip: Always ask your healthcare provider the side effects of what’s been prescribed. 


Did you know some are naturally more at risk for Vitamin D Deficiency? 

If you didn’t, it’s okay. Remember the below list doesn’t confirm anything. Be aware, you could prevent the symptoms by taking good care of yourself.

  1. Age: Our skin’s ability to produce vitamin D reduces as we age, so people over the age of 65 are asked to watch out. Infants, especially those who are breastfed are also at risk, as breastmilk only has a small amount of vitamin D.
  2. Skin colour: Those with darker skin produce less vitamin D compared to the ones with lighter skin. Therefore, they are prone to vitamin D deficiency.
  3. Lifestyle: Those who work from home or stay indoors mostly can be at risk for Vitamin D deficiency as they don’t get much sunlight. 

Now, if you connect with any causes or symptoms of Vitamin D Deficiency, we suggest you consult a doctor at your earliest. Via oDoc, it only takes a few seconds to download the app and get in touch with a professional. 

Meanwhile, incorporate healthy habits in your day-to-day life to recover or prevent Vitamin D deficiency, look below for an exhaustive list of tips.

How to get Vitamin D naturally

  1. Spending time under the sun: 

This might be interesting to hear after everyone around us seems to not like direct sunlight. Having said that, the sun is the best source of vitamin D3.

To do it right, get 10–30 minutes of midday sunlight every day. If you have darker skin, you may need a little more than that, but it depends on your skin sensitivity.

2. Making changes to your diet:

You could incorporate the following to enhance the level of vitamin D in your body. 

  • Fatty fish and seafood such as tuna, mackerel, oysters, shrimp, sardines and anchovies. The vitamin D content changes according to the type of seafood. Bonus points: These are also rich in heart-healthy omega-3 fatty acids. 
  • Mushrooms are a vegetarian option. They can make their own vitamin D when exposed to sunlight. So, it’s wise to purchase the mushrooms from vendors who treat them with UV light and sell them in the safest way possible. 
  • Have egg yolks as part of your diet. Free-range and pastured eggs are better ways to get vitamin D as chicken raised under sunlight produce more vitamin D in their eggs. 
  • Consume fortified goods that are treated with a high level of Vitamin D in a process called fortification. Some common examples are cow’s milk, plant-based milk options, cereals, orange juice, tofu and yogurt. This depends on the brands so always check the ingredient list. 

3. Get a UV lamp: 

These emit UV-B radiation to elevate your vitamin D levels. However, for safety reasons, they shouldn’t be used for more than 15 minutes at a time.


Finally, watch out for this one: 

Just like that, you can also have too much vitamin D, which is also a bad thing. 

Vitamin D toxicity may never happen from sunlight. It’s usually caused by taking too many supplements. It’s rare but it can occur with the following troubling symptoms: 

  • Nausea
  • Increased thirst and urination 
  • Poor appetite
  • Constipation
  • Weakness
  • Confusion
  • Ataxia (impaired balance or coordination)
  • Dysarthria (unclear speech)


The final piece of wisdom is to clear everything with your doctor, never take extra supplements, clarify any lifestyle/diet changes to make sure it doesn’t affect your other health conditions.

oDoc easily allows you to cross-check and consult with the country’s top healthcare professionals with the highest convenience. Download oDoc today!



  • Healthline (2022)
  • WebMD (2022)

Dengue - the whats, whys and hows.


Dengue seemed to have taken a back seat in the news the last year but it is fast becoming  a household concern, yet again. With  9,669* dengue patients being reported in Sri Lanka so far in 2021, it is safe to say that dengue ‘is back’ (not like it ever went away though). So we at oDoc are breaking it down for you. We go into detail about the causes, treatment and prevention of dengue, so keep reading!

What is dengue and how is it caused?

Dengue is a mosquito-borne disease. Dengue viruses spread among  people through the bite of an infected Aedes species mosquito. These are the same types of mosquitoes that spread Zika and chikungunya viruses. These mosquitoes breed and lay eggs in still water (in buckets and pots in your garden which has collected water). These eggs can even survive up to 1 year and can withstand dry conditions till they are in water again.

Is dengue contagious?

Dengue is not contagious so you cannot catch the virus via contact with an infected person. However, an infected mother can pass the virus to her fetus during pregnancy or around the time of birth. In the case of infected breastfeeding mothers, it is encouraged that they continue breastfeeding their infant due to the benefits of breastfeeding. So far, there has only been 1 case of the virus passing to the infant via breast milk.

What are the symptoms of dengue?

It is said that 1 out of 4 people who are infected with the dengue virus will get sick and can show mild to severe symptoms.

Mild symptoms include high fever along with a combination of aches and pain in muscles and joints, rashes and nausea. Symptoms last about 2–7 days. Most people will recover after about a week.

Severe cases of dengue usually require hospitalisation. Symptoms and warning signs include:

  • Belly pain, tenderness
  • Vomiting (at least 3 times in 24 hours)
  • Bleeding from the nose or gums
  • Vomiting blood, or blood in the stool
  • Feeling tired, restless, or irritable

If you are showing any of these symptoms or warning signs, seek medical attention immediately. It is also important to note that these warning signs usually begin 24–48 hours after your fever has gone away.

What’s the treatment for dengue?

Unfortunately, there is still no specific treatment to cure dengue. However, it is vital that you rest as much as possible and keep yourself hydrated by taking a lot of fluids if you are diagnosed with dengue. You can also take paracetamol (do not take aspirin or ibuprofen) to help with the fever and body aches and pains.

It is advised to seek medical advice rather than self-diagnosing and opting for self-treatment.

What can you do to prevent dengue?

  • Keep neighborhoods clean and free of still water 
  • Frequently clean garden, pots, vases and balconies
  • Wear clothes that cover the body and minimize exposure to mosquito bites
  • Always use mosquito repellents
  • Use mosquito nets
  • Installing net screens on doors and windows.

In these difficult times, it is vital we look after ourselves and our loved ones. If you or anyone you know is suffering from any of the above-mentioned symptoms you can speak to an on-demand doctor on oDoc from the comfort of your home. 

Stay indoors. Stay safe.


  1. Epidemiology Unit – Ministry of Health (2021, July 13). 
  2. Centers for Disease Control and Prevention (2021, June 28). 
  3. Dunkin, M. A., Dengue Fever, WebMD (2010, July 26). 
  4. Preventing Dengue in Sri Lanka, World Health Organization (2019, July 8).  

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Let’s talk flu, its prevention and home remedies.

Let’s talk flu, its prevention and home remedies.


Boo-ger season is here! Let’s begin by defining flu (short term for influenza) because it’s usually misunderstood as fever or cold. Flu is a common respiratory infection caused by the influenza virus and is usually a very mild illness. Having said that, influenza can be a serious threat, especially for new babies, people who are over 65, and those with chronic illnesses. A weak or under-developed immune system is a common reason why flu can cause complications to some.

Understanding this moderately-complicated sickness means knowing it’s seasonal and in Sri Lanka, it peaks between April-June and November-January. Not to be a bummer, these are the months we celebrate New Year, Diwali, Thanksgiving, Christmas and Vesak—a time when people mostly gather, and flu is highly contagious. Uh-oh. 

Fret not, the good news is that you can prevent and prepare so keep reading as we are about to share the symptoms, preventions and natural home remedies.

person sick with flu
symptoms of flu

Influenza symptoms

  • Fever or having chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (feeling very tired)
  • Some people may also have vomiting and diarrhoea. (This is common in children)

Also, there are ways to tell if you are affected by flu or just having a common cold. You always know when you’re about to catch a cold as it affects you quite gradually. On the other hand, flu catches you off guard by showing up on a random day. Also, fever, aches and fatigue are usually more common for influenza than cold. Flu can lead to serious health problems and cold doesn’t, so by being aware allows you to take care of yourself and others better. 

Prevention is better than panicking – remedies for flu

While it is an instinct to not want an infected person next to you, demonizing them isn’t the answer. It’s only going to make things worse as people may try not to reveal their sickness. It’s a crazy world out there so simply the following preventive steps: 

  1. Avoid close contact with an infected person. Wear your mask, avoid physical contact  and sanitize regularly. If you are infected, stay indoors as much as possible and be responsible. 
  2. Cover your mouth and nose. Flu viruses spread mainly by droplets when those infected cough, sneeze or talk. Use a tissue to cover your mouth and nose  (or just wear a mask!) when talking or sneezing. Make sure to toss the tissue in a bin after using it.
  3. Wash your hands regularly! This goes without saying but it’s too crucial to not emphasize. Carefully wash your hands with soap and water by scrubbing for at least 20 seconds. If you’re out and can’t find a sink next to you, use a sanitizer after using door handles, railings, etc.
  4. Avoid touching your eyes, nose and mouth. Infections enter your body through this.
  5. Clean and disinfect surfaces and objects that might be contaminated.
  6. Check with your doctor if you could take the flu shot.
  7. Take care of yourself with enough rest, nutritious food, physical activity and plenty of fluids. They support your immune system and are a good force against the virus.

Before you start making notes, remember the first step is always to consult a doctor.The home remedies are simply an aid to sail smoothly in your recovery process and it’s never the sole answer. 

So you got the flu? Avoiding the flu is quite a task so try not to be hard on yourself. Usually, mild flu symptoms disappear on their own and prescribed medication go a long way. Meanwhile, trying proven home remedies can make you feel better and help speed up the recovery process. Here are some suggestions.


Rest more: Your immune system has extra work to do while you are sick. By sleeping more than usual, you save energy for your immune system to do its job.

Have faith in fluids: A fever can dry you out and the moisture inside your lungs will evaporate fast when your body temperature is high. Therefore, help yourself with hydration.

Get some fresh air: Spending time outdoors helps to soothe your breathing. Make sure to do this in your garden or in isolated open areas for others’ safety. 

preventing flu

Take zinc and vitamin C supplements: They help with strengthening your immune system and make you feel better soon.

Take probiotics: It’s a natural bacterium that supplements your microbiome and stimulates your immune response. You can consume them in the form of cultured or fermented foods like yogurt, kombucha and pickles. 

Gargle with salt water: This helps to soothe a sore throat by pulling water from surrounding tissues to decrease inflammation, wash out mucous and bring moisture.

Slurp into a bowl of soup: Broth contains electrolytes that balances your body. The steam from heated soup helps to soothe your dry nose and throat. Surround yourself with essential oils: Oils made with tea tree leaves, lemon and eucalyptus can help unblock nasal passages. 

Use tea to fight it: Green tea, ginseng tea and hibiscus tea are known to have effects against influenza. Honey is an effective cough reliever, so maybe you could use that to sweeten the tea. 


Time to see the doctor

If you are an adult with flu symptoms, speak to a doctor, if the fever lasts longer than  3 days  or the cough lasts longer than 2 weeks. Anyone having trouble breathing should get treatment right away! Aside from that, adults shouldn’t overlook chest pain and children be taken to the emergency room if they are having problems passing urine, fever higher than 104 degrees or if they are overly sleepy.

 If you are experiencing any of the symptoms or would like more information on how to prevent or treat the flu, speak to a GP from the safety and comfort of your home at any time via oDoc. Stay safe! 



  • Healthy Habits to Help Protect Against Flu, CDC (2022)
  • Epidemiology Unit, Ministry of Health (2022)

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Migraines 101: Symptoms, Causes and Treatments

Migraines 101: Symptoms, Causes and Treatments


If you are one of the 1 billion people with migraines, you may know how uncomfortable a migraine attack can be. If you are not, how does it feel to be one of God’s favourites?! 

Keep reading to find out the answer to that 😉

Here's what a migraine feels like:

Most people describe it as a pulsating, pounding, dull ache that spreads across their forehead. You can feel the pain on one side of your head or both sides. Sometimes you can even feel it shift. 

What causes a migraine attack?

The direct causes of migraines have still not been identified. However, researchers believe that ‘abnormal’ brain activity affecting nerve signalling, blood vessels and chemicals are the root cause of migraines. Researchers have identified the following as significant triggers for migraines:

  • Severe heat
  • Dehydration
  • Bright lights
  • Unusual smells
  • Hormonal changes in women (oestrogen and progesterone fluctuations) during menstruation, pregnancy or menopause
  • Changes in sleep pattern

Hereditary history of migraines and being a female are some risk factors for developing migraine conditions.

causes of migraine attacks

How does a migraine attack arise?

Stages of migraine

Let’s learn about the process of how a migraine attack occurs and its respective symptoms.

  1. Prodrome Phase

This is the initial stage of a migraine. Usually occurring around 1-2 days before the migraine attack or any other headaches related to it, here are some prodrome symptoms:

  • Food cravings
  • Neck stiffness
  • මානසික පීඩනය
  • Fatigue
  1. Attack Phase

It is during this phase that people have reported extremely uncomfortable sensations. The pain typically begins above your eyes and might spread over to one side of your head, your entire head or shift from side to side. Throbbing in the head may worsen if you exert yourself or move.

Other notable symptoms to look out for during the migraine attack phase include:

  • Increased sensitivity to light and sound
  • Nausea
  • Feeling faint

The symptoms of a migraine attack could last between several hours to two days, depending on the patient.

  1. Postdrome Phase

The migraine attack is followed by the postdrome phase. You may feel sick for up to a day. You may also experience:

  • Extreme tiredness
  • Pain in the head  that increases when you move too quickly or lean over
  • Confusion

You must gain sufficient rest after experiencing a migraine attack to recover effectively.

Now that we have broken down each stage of a migraine, did you also know there are different types of migraines, each with varied symptoms? Keep scrolling to find out more

Different types of migraines that exist

There are two common types of migraines: 

  • Migraine with aura
  • Migraine without aura

Along with the previously mentioned symptoms of a migraine, a person might experience either a migraine with an aura or a migraine without an aura.

Aura? What’s that?

It may sound like a pretty word but, it’s not a comfortable sensation. Aura is a condition that involves minor impairments to your vision, senses and speech for a period of time. Common signs involve blurry vision, coloured spots, neck stiffness, inability to hold your balance, difficulty speaking or forming words.

1. Migraine with aura (Brainstem Aura)

A person who experiences a migraine with brainstem aura would experience pain at the back of the head on both sides. They would face the following symptoms before the main migraine attack happens.

                                        Aura symptoms

  • An aura with visual problems
  • Numbness of body, face and tongue
  • Speech problems
  • Problems with moving

                                     Brainstem symptoms

  • Difficulty talking (unclear speech)
  • Vertigo (a spinning feeling)
  • Ringing in the ears
  • Eye problems in one eye (blind spots, flashes of light, temporary blindness, etc.)

2. Migraine without aura

Although, others may not experience an aura before their migraine attack or headaches. The following are some symptoms of a migraine without aura.

  • Migraine occurs only on one side of the head 
  • Throbbing/pulsating pain in the head
  • Pain gets more intense as you move (Eg: Walking)
  • Becoming sensitive to light
  • Becoming sensitive to sound
  • Nausea with or without vomiting

Treatment and tips for managing migraines

But wait! There’s some good news. Although migraine is not something that can be cured, you can still manage and control migraines from occurring through the following methods. As a result, it may lead to fewer attacks.

  • Adjustments to your lifestyle

You must ensure that you minimise or avoid any migraine triggers mentioned above. Along with this, managing your stress would also help you reduce the intensity of migraines.

  • Keep a journal

Maintaining a journal to list the instances you face migraine symptoms and attacks will help identify your triggers. This will allow you to avoid events and circumstances that trigger these symptoms.

  • Apply a cold compress on your forehead

This method slows down the nerve signals involved with migraine pain and generates a soothing, cool feeling that can help reduce the severe headache.

  • OTC pain or migraine medications

These medications include Nonsteroidal anti-inflammatory drugs (NSAIDs), Paracetamol, etc. These would reduce the intensity of migraine headaches and attacks. It is advisable to consult a doctor and receive a prescription before taking these medications.

  • Stay hydrated

Often when we are out in an environment with severe heat, we may forget to keep ourselves hydrated. Dehydration is a main trigger of migraine attacks. Therefore, ensuring an adequate intake of fluids will rule out the possibility of dizziness and headaches associated with dehydration.

Did any of the above symptoms and triggers sound familiar to you?  Feel like you’ve experienced them? If you have, it is possible that the ‘really bad headache’  you experienced was actually a migraine attack. Consulting a doctor about these symptoms may help diagnosis and treatment of your ailment. .

Consult a GP via the oDoc app to receive expert medical advice on reducing the highly uncomfortable symptoms of migraines and improving your well-being.


  1. Everything You Want To Know About Migraine, Healthline (2021)
  2. Migraine with brainstem aura, Genetic and Rare Diseases Information Center (2022)

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Sleep: How To Do It Right?

Sleep: How to do it right

Written by Dr. Ruwanthi Jayasekara

Consultant Respiratory Physician (MBBS, MD Medicine, MRCP UK, ESRS/ Expert Somnologist)

We wake up in the morning, go through the daily routine and finally, sleep at night. This happens day in and day out throughout our lives. We spend about one-third of our lives sleeping. If you consider a person who has lived up to a ripe age of 90, he or she would have spent about 30 years sleeping. 

Why has nature allocated such a considerable amount of time to spend in sleep during the evolutionary process? Surely there must be some great importance.

Keep reading to find out what sleep is, what happens in our body during the long hours we spend in sleep, how many hours and why we should sleep, and how to sleep right and improve the quality of our sleep. Click here to read my other article on sleep disorders regarding how to investigate them, what tests to do and what treatment is available for them.

So, let’s start with the basics - What is sleep ?

Sleep is not one static state. When we sleep, we go through 5-6 sleep cycles every night. Each sleep cycle has several stages as the brain’s EEG or electric current waves change.

stages of sleep

We go to bed and close our eyes. Initially, we drift in and out of sleep during light sleep, and this is stage N1 in sleep. Gradually we enter deeper sleep stages called N2 and N3. These three stages are called NREM sleep, which is Non-Rapid Eye Movement sleep. As we enter deeper sleep stages, the brain EEG waves progressively slow down. Furthermore, the time we spend in N3 is more significant during the night’s first half and reduces in duration as we get closer to the wake-up time.

After the stages of wake, N1, N2 and N3, we enter REM sleep, which is called dreaming sleep. In this stage, our brain waves, again, look very active. However, our body becomes atonic or almost paralysed. In this stage of sleep, we start dreaming, and we remember our dreams only if we are awakened from this stage of sleep.

What is a body clock?

The amount of dreaming sleep increases as the night goes on. As we spend less time in deep sleep towards the early hours of the morning, we also tend to have episodes of waking up in the morning. 

Our body clocks run this pattern of waking up in the morning and sleeping at night, called the circadian rhythm. The central body clock is situated in the brain in the small but essential organ known as the hypothalamus. There is an area with packed neurons called the suprachiasmatic nucleus, which plays a vital role in setting the body clock so that we wake up in the morning and sleep at night. The sun also plays a massive role in maintaining the sleep-wake cycles.  

Many complex neuronal signalling and hormonal interplay go on in the body, especially in the brain, so this cycle happens smoothly. As the sun goes down in the evening and dusk sets in, there is another small organ in the back of the brain called the pineal gland, which secretes a hormone called melatonin. Melatonin is essential in making us feel sleepy. People who take over-the-counter melatonin tablets for sleeping without proper medical advice may have worse sleep patterns than they bargained for due to improper timing or wrong dose.

circadian rhythm and sleep

How much sleep do we need?

how much of sleep do we need?

The amount of sleep we get varies with age, and most young adults report 7-8 hours of sleep. Restricting sleep to 4-6 hours per night negatively impacts our mental and physical skills and performance.

A baby will sleep about 12-16 hours most of the day, and as time goes on, the amount of sleep lessens gradually. A 10–12-year-old child will need about 9 to 10 hours of sleep, and a teen would require 8-10 hours. 

A healthy young adult will need about 7-9 hours of sleep. However, this is a population average. The amount of sleep each person needs is highly individualistic. 

It is essential you find out how many hours of sleep your body needs.  How can you do this? On a holiday,  go to sleep when you feel sleepy and let yourself sleep until you wake up in the morning without an alarm clock. Continue this for several days and calculate how many hours of sleep you need. It may be within the population average of 7-9 hours.

Occasionally, it may also be less than that. Certain people sleep less or more, which may not impact their daytime functioning. If you find out your natural sleep requirement, you must ensure you get this amount of sleep every night of the week.

As ageing sets in, the sleep requirement reduces. An elderly person’s sleep can vary from 5-6 hours of sleep to 7-9 hours. The amount of time spent in deep sleep reduces with age as well. Also, the amount of fragmented sleep tends to increase, especially in the early hours of the morning.

Is it normal to wake up several times during sleep?

Yes! It is normal to wake up several times during any of these stages. We may keep tossing and turning around and go back to sleep. Sometimes, we may remember waking up at night, while other times, we may have no recollection of this. So, if someone thinks that once you fall asleep in the night, you must sleep without any wake periods, that is a myth.

why is sleep so important?

Why do we sleep? Why is it so important?

‘A good laugh and a long sleep are the best cures in a doctor’s book’. Many studies have been done to understand the importance of sleep.

  • Sleep is essential to rest the brain.

Studies have shown that the brain clears unwanted material called neurotoxins from the brain during the sleeping process.

  • Improved physical health

There is also a clear link between good sleep and improved physical health.

  • Helps maintain a balanced mind

Sleep is vital for maintaining a balanced mind. Otherwise, you become angry, irritable, and depressed.

  • Memory consolidation

There are many harmful consequences of inadequate sleep. Increased risk of cancers, infections, increased forgetfulness, poor decision-making power, increased body pains, increased risk of dying early and increased risk of road traffic accidents are some of the negative impacts of poor sleep.

Tips for better sleep

To achieve the best of sleep amidst our busy schedules, we must know how to sleep right. Following are guiding steps to observe, fall asleep quickly and sleep well.

  • Maintain a regular sleep routine – Depending on your work and family schedule, decide what your regular wake-up and bedtime are. Maintain this routine throughout the week. Strictly abiding by a sleep routine can reduce sleep deprivation.
  • Avoid stimulants such as tea, coffee, cola and chocolates about five hours before bedtime
  • Stop smoking
  • Avoid exercise close to bedtime – It will have a stimulating effect on the brain even though you may think that it causes the body to be tired.
  • The last mealtime before bedtime should be 2-3 hours before
  • Utilise between 30 minutes to 1 hour to wind down, take a wash, change into pyjamas, and spend time on self-grooming in preparation for sleep.
  • It would be best if you stopped using devices such as phones, laptops, and iPad at least an hour before bedtime. 
  • The bedroom must be a quiet, dark environment. 
  • It is essential to avoid napping in the daytime. Instead, opt for short, power naps of less than an hour during the daytime.
  • Engage in exercise
  • Maintain a healthy diet 

If you regularly follow these simple but essential steps, good quality sleep can be ensured. However, if you still have difficulty sleeping, have doubts about your sleep hygiene, or want to find out whether you have a sleep disorder, it is best to consult your respiratory consultant. You can consult SLMC registered sleep consultants or respiratory consultants via oDoc, who can assist you towards a healthier sleep routine.

Dr Ruwanthi Jayasekara

SLMC 25147

Chest Physician