Narcolepsy, post-meal sleepiness, and what to eat to stay alert

For years, I’ve struggled with a strange problem: eating in the morning makes me really tired.  Tired as in I might just have to go back to sleep tired.

Version 1 goes like this: I wake up after my eight or so hours of sleep feeling okay but not as refreshed as a “normal” person.  I drag myself out of bed, take my medicine and am awake and ready to start the day. 

I eat something, ANYTHING, and WHAM, maybe 10 or 20 minutes later I AM IRRESTIBLY TIRED.  I do my best to resist the sudden (and continuing) urge to return to bed, but I often lose the battle and go back to bed.

(Just to clarify, because if you tell someone about this they often will go on to ask: yes, ANYTHING includes a healthy breakfast like oatmeal with nuts.  It also includes the “low carb” breakfast.)

Version 2 is a bit better, but still not great: I wake up and get ready but leave without eating anything.  I eat breakfast or something wherever I am, and sometimes I feel about the same afterwards or only slightly tired.  (For some reason, I sometimes can eat and be okay when I eat somewhere other than at home.) 

However, other times I will feel very tired and if I’m in a situation where I am unable to take a short nap, I might struggle to stay awake, kind of half asleep and half awake.  (I suspect that this second situation generally happens when I eat and then do a non-stimulating and sedentary activity, such listening to a lecture in school).

For years this half asleep, half awake version used to happen to me in 1st period classes, regardless of how much I used to struggle, and I never knew what was going on.

Unfortunately, my problem was so strange that it took me over 10 years to figure out that I even had it.  I just never quite made the definite connection between the food and the sleepiness. 

I suppose I must have thought I just had a problem with wanting to sleep shortly after getting up…

It was only in my last years of college that I finally realized what was going on.  But I never understood why this happened to me – or how to stop it (other than skipping breakfast, which is hard when you wake up hungry).

Five or so years later, I still don’t understand it completely, but a few days ago I found an explanation while doing Internet research for this article.   

It turns out, my experience is a documented medical phenomenon (!) – not for Narcoleptics – but for people in general.

I suspect that I may just be more sensitive to it than your average person because of Narcolepsy, although I still don’t understand why this happens to me in the morning.

My experience is called Postprandial somnolence, which is a fancy term for a state of drowsiness or fatigue following a meal.   

Basically, postprandial somnolence has two components, both of which causes one to feel sleepy after a meal.  First, there is a general state of low energy and a desire to be at rest related to the activation of one part of the nervous system (and decrease in activity of another part) in response to the arrival of food in the stomach and small intestine. 

And second, there is the sleepiness “caused by hormonal and neurochemical changes related to the rate at which glucose enters the bloodstream and its downstream effects on amino acid transport in the central nervous system.”  As Wikipedia explains, when you eat foods with a high Glycemic index, this ultimately results in increased brain serotonin and melatonin levels, which makes you feel sleepy.

What can you do if you want to stay awake but don’t want to starve yourself all day?  Well, some of the research I found was a bit conflicted, but I’ll share with you what seemed to me the best answer.

Apparently, what is important when it comes to staying awake after a meal is not how much you eat but what you eat.  Although eating almost anything can cause this sleepiness, the worst things to eat are simple carbs, food high in tryptophan, and high fat foods. 

The nutritionist in the video above suggested eating foods high in tyrosine when you need to stay alert, with her ideal meal being a low to moderate amount of lean protein, a half cup of veggies, and a half cup of rice (to give some carbs to “keep the brain happy”).

I also read a few places that supposedly staying active after eating (as opposed to lounging on the couch) and drinking water can help to prevent this sleepiness, although there seems to be a lot of conflicting advice surrounding how to deal with this (for instance, some people say it matters how much you eat, others say the opposite).

Perhaps the staying active advice explains why sometimes I do okay when I do something stimulating immediately after eating.

Here are two excerpts from another source that had good advice:

“Two factors influence whether the brain perks up or slows down following a meal: the ratio of protein to carbohydrate, and the ratio of the amino acids tryptophan and tyrosine. High protein, low carbohydrate, high tyrosine foods that are likely to jumpstart the brain are seafood, soy, meat, eggs, and dairy. High carbohydrate, low protein, high tryptophan foods that are likely to relax the brain include: chocolate, pastries and desserts, bean burritos, nuts and seeds (e.g., almonds, filberts, sunflower and sesame seeds), and legumes.”

“Brain performance following a meal is also affected by the carbohydrates consumed with the protein. Carbohydrates stimulate the release of insulin, which helps more tryptophan to enter the brain where it makes more serotonin. The more simple sugars in the meal, the more serotonin is produced, and the more the brain is sedated. Complex carbohydrates - slower insulin-release sugars - on the other hand, will cause less drastic serotonin production. … So, to perk up the brain, eat a meal that is:

• High in tyrosine-containing proteins.
• Moderate in the amount of sugars, containing mainly complex carbohydrates.“

Although I still don’t understand why this happens to me mainly in the morning, I will have to try this advice and see if it works.  I don’t know how much of this can be attributed to Narcolepsy, but perhaps I am  just unusually sensitive to the changes in the body caused by food. 

Considering how sensitive I am to food in the morning, I think I will have to try eating food with a very low Glycemic index or high in tryosine, while at the same time staying active and drinking water.  I know I previously have tried eating a low carb breakfast without noticing any benefits, but I am going to try to reserve judgment and hope for the best.

What do you think?  Do you get post-meal sleepiness, and if so, do you find that anything helps?  I’m curious to see if this happens to many other Narcoleptics…