Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Patients often come to me with symptoms they describe as "fatigue" or "tiredness." The first task is to tease out exactly what they mean. To a sleep doctor, fatigue and tiredness usually mean the body needs or wants to rest, whereas "sleepiness" suggests that the mind wants to rest.

Patients with any pain syndrome often come in complaining of fatigue or tiredness. Their bodies have trouble falling and staying asleep. Sleep and pain are both ultimately controlled by the central nervous system. Poor sleep and pain form a vicious cycle - uncontrolled pain makes sleep difficult (if not impossible) and, in turn, the resulting poor sleep makes it more difficult to adequately control the pain.

Most physicians know very well that poorly controlled pain will cause difficulty sleeping. But they often don’t think about the patient having a separate sleep disorder that may be fueling the pain.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

We all know the symptoms. Your eyelids droop and your vision becomes blurry. Your head feels so heavy that you can’t hold it up and so your chin keeps falling toward your chest. You can’t stop yawning. Diagnosis is clear to most of us: You’re sleepy.

I know what it feels like and looks like and so do you. So why do many surveys show that most of us have driven while drowsy and many of us do so on a regular basis?

Well, for one thing, we are not a culture that takes sleep seriously. We think that when our lives become so busy that we don’t see how we can fit everything into a 24-hour day, that we can find extra hours by carving it out of our sleep time.
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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

The autumn equinox has come and gone, but many of us here in the Midwest have continued to fool ourselves that it is really just late summer.

But the game is over once we turn the clocks back and we start driving home from work in the dark. The clock change that is mandated by the end of daylight saving time is really the marker for many people that a change in seasons has happened.

For people who live in the Northern Hemisphere, the change in autumn means more hours of darkness and colder weather, which keeps many people indoors. As a result, many feel more depressed and have more sleep disturbance as well as daytime sleepiness and fatigue.

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Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

I want to follow up on a piece I wrote two weeks ago about getting kids back on a good sleep schedule.

School was just starting and each year most children need to get out of the summer mode and back to a sleep/wake cycle that allows them to thrive during the school year. Now that most kids and teens are back to school, I would like to address another important topic that I wish educators would give some attention: School start times.
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