Feeling sleepy after eating a big meal or after an early morning is normal. While excessive sleepiness does raise alarm, the key to avoid it to understand what is triggering it.

Our bodies have an internal clock, called the circadian rhythm, that controls when we feel sleepy or awake. According to National Institute of General Medical Sciences (NIGMS), these rhythms include physical and mental changes an organism experiences over 24-hour cycle.

According to John Hopkins Medicine this clock makes us naturally feel a bit sleepy in the early afternoon, usually around 1:00 or 3:00 PM. It's like a built-in dip in our energy levels. Scientists have studied this, and they've found that we're usually most alert in the morning and early evening, with a little dip in between. In some countries, people used to take a short nap in the afternoon to deal with this. It's just a normal part of how our bodies work, but we can learn how to manage it.

Ways You Can Avoid The Afternoon Crash

Everyone gets sleepy in the afternoon sometimes. It's a normal part of life. But you don't have to let it ruin your day. Sometimes, feeling really sleepy during the day can be a sign of a medical problem. If you have a condition like sleep apnea or narcolepsy, or if you take medicine that makes you sleepy, you might feel extra tired in the afternoon. The natural dip in alertness makes it even worse for you. If you're feeling excessively sleepy during the day, it's important to talk to your doctor. They can help you figure out what's going on and find ways to feel more awake and alert. By taking care of your sleep habits, you can make it easier to get through the day without feeling tired all the time. Here are some ways you can avoid the afternoon crash.

Prioritize Sleep

Quality sleep is crucial. Aim for consistent bedtime routines and sufficient hours of rest. Sleep deprivation amplifies afternoon fatigue. A well-rested body manages energy dips more effectively, reducing the severity of the midday slump.

Increase Physical Activity

Even brief movement combats sleepiness. Stand up, stretch, or take a short walk. Physical activity boosts blood flow and oxygen to the brain, enhancing alertness. Regular, light activity throughout the day helps maintain energy levels.

Lighter Lunch Choices

Heavy, carb-loaded lunches divert energy to digestion, inducing sleepiness. Opt for balanced meals with lean protein and vegetables. Lighter meals prevent excessive energy shifts, helping you stay alert and focused in the afternoon.

Caffeine or Hydration

Moderate caffeine intake can temporarily increase alertness. However, avoid excessive amounts, especially later in the day. Hydration is vital; water improves circulation and cognitive function. Choose refreshing drinks to stay hydrated and energized.

Vitamin C Supplementation

Vitamin C's antioxidant properties may reduce fatigue. It combats oxidative stress, a contributor to tiredness. Consider a supplement or vitamin C-rich foods. Remember, individual responses vary, and it's best to consult a healthcare professional.

Shift Mental Focus

When feeling sleepy, change your mental environment. Focus on completed tasks or engage in enjoyable activities. Distraction can redirect your mind, temporarily alleviating the feeling of sleepiness. A brief mental break can provide a needed reset.

Power Naps

Short naps (20-30 minutes) can rejuvenate, but avoid longer naps. They can lead to grogginess. Napping too close to bedtime disrupts nighttime sleep. A brief nap during the early afternoon can restore alertness and improve productivity.

Arthritis can affect people at different stages of life, limiting their ability to walk, climb stairs or carry out everyday activities with ease. While treatment largely depends on the extent of joint damage and the patient's condition, treatment approaches ranging from joint-preserving surgery to knee and hip replacement can help restore mobility. Rehabilitation still remains an essential part of recovery.

On World Arthritis Day, doctors explain how arthritis is treated and managed at different ages using real-life cases and highlighting how they assess joint damage, choose strategies and use physiotherapy to help patients return to their routines.

Knee Preservation Before Replacement

A 42-year-old man with grade 3 osteoarthritis in his right knee had been experiencing pain and locking. His symptoms began after a knee injury six years earlier and worsened with time. X-rays revealed marked varus alignment, cartilage and meniscus damage. Earlier consultations had suggested knee replacement, but given his age, doctors opted for knee preservation surgery.

Dr. Tapish Ravindra Shukla, Consultant Orthopaedics and Sports Medicine, Fortis Escorts Hospital, Amritsar, told HealthandMe that he performed three procedures in a single sitting: high tibial osteotomy to correct alignment and shift weight away from the damaged inner compartment, bone marrow aspirate concentrate (BMAC) to treat the cartilage defect, and meniscus repair.

The patient walked with a walker for approximately three weeks, began jogging at six weeks and was running by three months.

The case brings us to an important point, i.e., assessing whether a damaged joint can be preserved, especially in younger patients who may otherwise face joint replacement early in life.

Also read: Arthritis Day: Stanford Researchers Explore Possibility To Treat Osteoarthritis Without Knee Replacement Surgery

When Hip Replacement Becomes Necessary?

In another case, a patient developed pain in both hips after recovering from a major head injury. During prolonged rehabilitation, he had received steroids and anti-epileptic medication for an extended period. He was subsequently diagnosed with bilateral avascular necrosis, a condition in which compromised blood supply damages bone and can lead to joint destruction.

Initially, doctors performed core decompression to relieve pressure within the affected bone and attempt to preserve the joints. The patient experienced relief and continued his routine activities for nearly two years.

However, following a minor slip and fall, the pain returned. Further evaluation and X-rays showed significant progression of arthritis, prompting a recommendation for total hip replacement.

Dr. P Keerthivasan, Senior Consultant and Spine Surgeon, Kauvery Hospital, Alwarpet, Chennai, explained to us the importance of understanding the condition, accepting when treatment needs to change and planning for recovery. Following hip replacement, the patient began mobilising the next day and progressed well during the immediate recovery period.

The case illustrates that joint-preserving procedures may provide relief in selected patients, but progressive joint damage can make replacement necessary.

Also read: Joint Pain In Your 30s And 40s: When Should You Worry?

Knee Replacement To Improve Quality Of Life

A 65-year-old woman with osteoarthritis in both knees had severe pain and difficulty walking, climbing stairs and performing daily activities. She had become dependent on painkillers, raising concerns about potential kidney damage with prolonged use. Doctors recommended total knee replacement.

Dr. Rishabh Tiwari, Consultant (JR), Orthopaedics, and Dr. Vivek Allahbadia, Consultant, Orthopaedic Surgery, P.D. Hinduja Hospital & Medical Research Centre, Khar, treated the patient using a minimally invasive technique in which the tendon was lifted rather than cut. The posterior cruciate ligament (PCL) was also preserved.

According to the doctors, these approaches can help reduce postoperative pain, limit bone loss and provide a more natural feel to the replaced knee.

The patient could lift her leg on the night of surgery. The following day, she was walking with full weight-bearing, bending and straightening her knee, and using the washroom independently. Training to climb stairs began on the second day, and she was discharged that day.

At one-and-a-half months, she could perform daily activities without pain and travel independently to nearby friends and relatives. The case stresses upon how surgical technique and early mobilisation can contribute to a patient's return to everyday activities.

In another case of knee replacement, a 62-year-old woman with severe osteoarthritis in both knees had spent nearly four years avoiding stairs, temples and long walks with her grandchildren. Pain, stiffness and fear of falling had increasingly restricted her activities. “She stopped joining family outings because I couldn’t keep up,” she told her doctor.

Dr. Bhushan Shitole, Consultant Orthopaedic Surgeon and Director at Vencer Hospital, told us that he recommended robotic-assisted total knee replacement using an imageless robotic system. The technology creates a three-dimensional plan of the joint before surgery and helps the surgeon plan implant positioning according to the patient's anatomy.

“Robotic planning lets us match the implant to the patient’s unique anatomy so the first steps after surgery are already better aligned,” Dr. Shitole said. “That first confident walk is often the real turning point.”

Following surgery, the patient began walking with minimal support within days. Structured physiotherapy focused on strength, balance and gait training. By the end of the first month, she was moving independently at home. Three months later, she boarded a cruise she had postponed.

“The robot didn’t just replace my knee. It gave her back the confidence to live the life she wanted,” Dr. Shitole said.

The case highlights that recovery involves more than replacing the damaged joint. Regaining balance, strength and confidence is also central to returning to normal activities.

Severe Arthritis In Children

Arthritis and joint destruction are not restricted to older adults. A 15-year-old boy with Morquio syndrome, a rare genetic disorder affecting skeletal development, developed severe arthritis in both hips. Pain and complex hip deformities made walking and everyday activities difficult.

Because of his small skeletal anatomy and the complexity of the deformities, doctors opted for staged bilateral hip replacements. The surgical team used CT scans to create a three-dimensional printed model of the pelvis and specialised R.I Hip software to simulate the procedures virtually. This helped them select correct sized implants, plan positioning and anticipate physiological challenges.

The two hip replacements were performed three days apart. The boy was able to stand and walk with support the day after each procedure.

The treating doctor, Dr. Vaibhav Bagaria, Director, Orthopaedics- Sir HN Reliance Foundation Hospital, Mumbai, told us that rehabilitation played a huge role.

“A successful joint replacement restores the mechanics of movement, but rehabilitation helps restore the confidence to move. Both are equally important for meaningful recovery, ” he said.

Physiotherapy focused on progressive walking, muscle strengthening, balance and functional independence, with the programme tailored to the boy's underlying skeletal condition.

The case also highlights the additional considerations involved in treating young patients, including implant longevity and the possibility of revision surgery in the future.

Across these cases, treatment ranged from procedures intended to preserve a joint to partial or total replacement of severely damaged joints. The choice depended on the patient's age, the extent of joint destruction, associated conditions and the likelihood of preserving function.

Rehabilitation was central to each case. Early mobilisation helped patients use their joints after surgery, while physiotherapy helped with strength, balance, walking and daily independence.

With flu season setting in across countries, including the US and the UK, doctors are urging people to get their annual flu shots. October offers an opportunity to build protection before winter flu activity increases.

The UK Health Security Agency (UKHSA) reported above-average flu activity and urged at-risk groups to get vaccinated. England's flu vaccination program last winter is estimated to have prevented about 100,000 hospital admissions and 7,000 deaths.

The US Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone aged six months and older. The seasonal vaccine targets influenza A(H1N1), A(H3N2) and B/Victoria viruses.

In September, the Indian Medical Association (IMA) also highlighted annual influenza vaccination and gaps in adult immunization.

Why Is October A Good Time To Get Vaccinated?

Also read: Flu Activity Rises Early In US, UK And Japan: Why Experts Urge Vaccination Before Winter

The flu vaccine takes about two weeks to build protection, making October a good time to get vaccinated before winter, Dr. Bhawna Malik, Senior Consultant-Neonatologist and Pediatric Intensivist at Motherhood Hospitals, Greater Noida, told HealthandMe.

In India, flu activity can increase between January and March. Vaccination in October allows time for immunity to develop before this period.

However, October is not the only option. Dr. Vikas Maurya, Senior Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh, told HealthandMe that vaccination can also be taken between April and mid-June, ahead of another period of flu activity from July to September.

He said one dose annually is generally sufficient, with timing depending on local flu patterns and the vaccine used.

Who Should Get The Flu Vaccine?

Healthy adults and children, as well as people with underlying conditions, can benefit from flu vaccination. Influenza can cause pneumonia, hospitalization and other severe complications.

Older adults, particularly those aged 65 and above, and people with diabetes, heart disease, kidney or liver disease, asthma or chronic obstructive pulmonary disease (COPD) face a higher risk of complications.

“Flu vaccination doesn't protect just yourself against the risk of having influenza but it also prevents transmission of infection to other vulnerable people around ourselves like little ones, elderly family members and people with medical conditions,” Dr. Malik said.

Dr. Mohit Bhardhwaj, Consultant, Pulmonology, PB Health, Gurugram, told HealthandMe that annual vaccination helps protect individuals and reduce transmission, as flu viruses change and vaccine protection can decrease over time.

Flu Vaccine Schedule For Children And Adults

Read More: Flu 2026: Symptoms To Watch For As New Season Begins

The vaccine can be administered from six months of age. The schedule depends on age and previous vaccination history.

• Children aged six months to eight years: Some children receiving the vaccine for the first time need two doses at least four weeks apart.
• Children aged nine and above: Annual vaccination is generally recommended.
• Adults: One dose each flu season is generally recommended.
• Infants younger than six months: Cannot be vaccinated directly.

Dr. Malik recommends vaccination for parents, siblings and caregivers to help reduce the risk of transmitting influenza to infants who are too young to receive the vaccine.

Are There Any Side Effects?

Most flu vaccine side effects are mild and may include injection-site pain, redness or swelling, fever, headache, body aches and tiredness. These generally settle within a few days, Dr. Bhardhwaj said.

A cooling pack or an ice pack wrapped in cloth may help relieve injection-site discomfort. Nasal vaccines may cause a stuffy nose, cough or headache, Dr. Maurya noted.

The injected flu vaccine cannot cause influenza. Anyone experiencing persistent fever, breathing difficulty or unusual symptoms should seek medical advice. Those with a history of serious allergic reactions to a previous flu vaccine should consult their doctor before vaccination.

A migraine attack is characterised by nausea, vomiting and sensitivity to light and sound. But early symptoms may surface long before the headache itself. Signs like fatigue, mood changes, food cravings and difficulty focusing may appear hours or even days before the pain.

The symptoms that occur during the attack reflect a complex neurological process that involves several interconnected brain networks, rather than just a headache.

A new Lancet Seminar review, looks deeper into how migraine develops, why its symptoms extend beyond head pain and how the better understanding of its biology are affecting treatment.

The study authors describe migraine as a chronic neurovascular disorder shaped by genetic susceptibility and interactions between the brain’s sensory networks, nerves, and blood vessels.

What Happens In The Brain During A Migraine Attack?

Also read: These Yoga Asanas Could Cure Your Migraine

Migraine is the result of the interaction of multiple systems responsible for processing sensory information and transmitting pain. Researchers are focusing more on other factors that drive migraine rather than just blood vessel narrowing or widening.

An important concept is the trigeminovascular system, which is a network involving the trigeminal nerve, tissues sensitive to pain that surrounds the brain and blood vessels. When this system gets activated, the patient experiences the peculiar head ache.

Chemical messengers called neuropeptides also play a key role. One of the most important is calcitonin gene-related peptide (CGRP), which participates in pain signalling in migraine. Treatments that target CGRP is an important development in migraine treatment and management.

The condition also involves changes in how the brain processes sensory information. This explains why light, sounds or smells can become intolerable during an migraine attack, and why some patients experience nausea, dizziness or difficulty concentrating along with severe headache.

Not an isolated abnormality triggering every symptom, migraine involves interactive neurological and vascular processes whose contributions can vary between individuals and across different phases of an attack.

Symptoms May Begin Before The Headache

Also read: Saba Ali Khan Opens Up About Brain Tumour: Can It Go Unnoticed If You Walk, Talk And Work Normally?

Migraine attacks typically occurs through several phases mostly:

1. Prodrome: Hours or days before the pain

The earliest phase can involve fatigue, yawning, mood changes, food cravings, neck stiffness and difficulty concentrating. The involvement of brain regions linked with homeostasis, including the hypothalamus, may help explain why an approaching attack can affect sleep, appetite, mood and other bodily functions.

2. Aura: Temporary neurological symptoms

Some people experience an aura before or during the headache. This can include flashing lights, zigzag patterns, blind spots, tingling or temporary difficulties with speech. Aura is associated with a phenomenon called cortical spreading depression, a wave of changing electrical activity that moves across the brain’s cortex.

3. Headache: Pain and sensory sensitivity

During the headache phase, activation of the trigeminovascular system contributes to pain signalling. Patients may experience moderate-to-severe, often throbbing pain, alongside nausea, vomiting and sensitivity to light, sound or smells.

Movement can aggravate the pain, making routine activities difficult. The headache phase can last several hours to as long as 72 hours.

4. Postdrome: After the pain subsides

The end of an attack does not necessarily mean the attack is over. Some people experience exhaustion, dizziness, body aches and difficulty concentrating for hours or days afterwards. These phases can overlap, and their timing and severity differ from person to person.

The Lancet review also highlights the role of genetic and epigenetic factors that contribute to migraine risk. They interact with complex neurological networks, helping explain why some people experience occasional attacks while others develop frequent or chronic migraine.

Episodic migraine is characterised by fewer than 15 headache days per month. Chronic migraine involves headaches on at least 15 days per month for more than three months, including migraine features on at least eight days each month.