Have you ever been so tired that the moment you hit the bed, you feel like you are sinking in your mattress? Or did you ever feel your leg twitch in middle of your sleep? Did you feel like you moved your leg to prevent yourself from falling down? If yes, then you are in for a great read!

Why does this happen?

You are not alone, this happens to around 70% of the total population in some way or another. Although these are signs of sleep disorders, it can also happen to people who are otherwise healthy. Sleep disorder specialists believe that there are certain common triggers that leads to such a sensation.

Our brain is exceptional and sometimes when we dream, it makes us believe that we our part of the dream. And if you are falling from somewhere in your dream, chances are, you would feel like you are falling in real life. This experience is known as hypnic jerk, the movement of your muscle that helps you be safe from that fall, or the imaginary one.

What causes it? When we sleep, our bodies become paralyzed, but that does not mean that our muscle control is not totally off. Rather, a slow, dimmer switch. When the dim switch randomly is turned on, we get jerky movements in our sleep.

This involuntary muscle movement is also called myoclonus or hypnic myoclonus, that transitions as you shift from one sleep phase into another.

ALSO SEE: What is sleep paralysis?

What Could Cause It?

There are many theories on what might be causing it. One of them is that when you are at this stage of sleep, you are still not in deep sleep and your brain misinterprets it as wakefulness, however, at the same time your brain does not recognize your muscles to be moving. This is what leads your brain to send a message to your muscles to check-in. It is a way your brain tries to protect you.

Another theory is of course that of stress. When you are stressed, your mind might be racing, while your body is in stationary. This can also affect your sleep cycle and your sleep can be disrupted.

If you are on stimulant drugs or alcohol, it too can prevent you from achieving a good night sleep. If you have consumed too much caffeine then too your muscles can twitch to make you stay awake.

Furthermore, lack of sleep could also be the reason why your mind is used to staying awake even if your body really needs the rest.

Periodic Limb Movement Disorder

While the falling sensation in sleep is quite common, and happens to healthy people, a severe form is the Periodic Limb Movement Disorder (PLMD). PLMD is a repetitive cramping or jerking of legs during sleep. It is a movement disorder that happens only during sleep. It is called "periodic" because the movements are repetitive and rhythmic, which means it occurs in every 20 to 40 seconds. It is also often linked with restless legs syndrome, however, the two are not the same thing.

Restless leg syndrome on the other hand is a condition that involves strange sensations in the legs and arms while awake and an irresistible urge to move the limbs to relive the sensations.

What causes PLMD may be more severe things, including diabetes, iron deficiency, spinal cord tumor, spinal cord injury, sleep apnea, uremia, anemia, narcolepsy, or certain medications.

Not every medicine carries the same level of risk. Some drugs can trigger reactions that are severe or even life-threatening. When that possibility exists, the manufacturer is required to place a special notice inside the prescribing information. This highlighted section is known as a black box warning.

A black box warning is meant to draw clear attention to the most serious dangers linked to a drug. Many medicines fall under this category. Still, having the warning in place does not automatically make the treatment unsafe. When a drug is used correctly and monitored by a trained professional, the benefits may outweigh the risks.

The sections below outline what an FDA black box warning means, why a medicine might receive one, and how it may influence your treatment plan.

What Is An FDA Black Box Warning And What Does It Signify?

A black box warning is the strongest caution that the FDA can attach to a prescription drug. You might also see it described as a boxed warning.

The presence of this warning does not mean a person should never take the medication. Instead, it alerts doctors and patients to serious potential harm. This information helps clinicians decide who is an appropriate candidate and under what circumstances the drug should be used.

Many medicines with boxed warnings remain the best or only option for certain conditions.

How Serious Is A Black Box Warning?

A drug receives this type of label when it has been linked to outcomes such as permanent injury, hospitalisation, or death. These warnings should be read carefully, and patients should discuss them openly with their healthcare provider.

Doctors follow specific precautions when prescribing drugs that carry this label to minimize unnecessary risk.

Where Can I Find A Drug’s Black Box Warning?

The warning sits at the very top of the medication’s official package insert. Its placement is deliberate so it stands out immediately. The text is printed inside a bold black border, which is how the term “black box” took hold.

You may not always receive the full package insert from the pharmacy. However, you might receive a medication guide if the drug is considered high-risk. These guides describe proper use and highlight major side effects. You can also look up medication guides online.

Information about boxed warnings is available from multiple sources. The FDA website, the drug manufacturer’s website, and medical reference sites used by clinicians all include these details.

How Does A Drug End Up With A Black Box Warning?

Every prescription drug must go through extensive testing before it reaches the market. During this process, researchers aim to uncover risks that could require a boxed warning from the start. Even so, some side effects only appear once large numbers of people begin using the drug in everyday settings.

Because of this, most black box warnings are added after a medicine has already been approved. The FDA continues to monitor safety reports through MedWatch, a program where patients, physicians, and companies can report problems.

These reports are gathered in a database called the FDA Adverse Event Reporting System. When the agency notices a pattern of serious reactions, they investigate. If needed, they update the prescribing information and add a boxed warning so that future users are clearly informed.

People assigned female at birth live with hormone shifts throughout their lives. These chemical messengers guide nearly every system in the body. The swings linked to periods, pregnancy or menopause are easy to recognise, but many other factors can unsettle hormone levels.

The body produces more than fifty hormones through the endocrine system, and changes in any of them can signal a deeper health concern. Low insulin may point toward diabetes. Excess cortisol can influence weight gain. Other hormones, like melatonin, rise and fall through the day as part of normal rhythm. And the gradual drop in estrogen and progesterone as women approach menopause is also expected.

What Causes Hormonal Imbalance?

Puberty, pregnancy and menopause naturally reshape hormone activity. Beyond these, several conditions can disrupt normal patterns. Problems with the adrenal gland, thyroid disorders, eating disorders, congenital adrenal hyperplasia, Cushing’s syndrome, diabetes or PCOS can all change your hormone levels. Changes may also stem from stress, certain medicines, tumours, cysts or environmental chemicals.

Interest in hormones has grown recently. Earlier this month, the Food and Drug Administration agreed to remove the boxed warning on menopause hormone therapy after reviewing the evidence. The decision prompted fresh discussion among women considering treatment. Clinicians say many patients are reaching out with new questions, especially in an era filled with quick tests and supplements marketed as hormone balancers. It can be difficult to tell when testing is truly needed.

Warning Signs Of Hormonal Imbalance

As each hormone plays a different role, symptoms vary widely. These are some of the more frequent changes seen in people, as per UCLA Health.

1. Menstrual changes: Shifts in estrogen and related hormones can alter the monthly cycle. Periods may become heavier, lighter, irregular or go missing. Stress, diet and exercise can contribute as well, but hormonal swings remain a leading cause.

2. Hair changes: Hair often reacts quickly to hormonal shifts. Pregnancy can bring thicker strands, while imbalances may trigger hair thinning or hair growth in unexpected places. Excessive facial hair may suggest elevated androgens. Hair loss can point toward a thyroid concern.

3. Skin Changes: Hormonal shifts can influence skin colour, texture and oil production. Acne may flare during pregnancy due to rising progesterone. Darkened patches of skin may appear on areas like the neck, groin or beneath the breasts when estrogen or progesterone levels change.

4. Sexual and vaginal symptoms: Lower estrogen levels, especially with age, can reduce libido and cause vaginal dryness or pain during intercourse. Some women may experience vaginal atrophy when estrogen remains low for long periods.

5. Weight changes: Sudden weight gain or weight loss can reflect a hormonal issue. Many women notice weight gain after menopause. Thyroid disorders, PCOS and Cushing’s syndrome are also linked to changes in body weight.

6. Mood and sleep difficulties: Falling estrogen levels influence serotonin, a chemical important for stable mood. Low serotonin can contribute to anxiety, irritability or low mood. These disruptions often spill into sleep. Some women also report night sweats or trouble staying asleep.

7. Digestive issues: Estrogen and progesterone affect digestion. When these hormones shift, the gut may respond with bloating, constipation or diarrhoea. Some research has linked hormonal changes in people AFAB to irritable bowel syndrome. Many notice digestive changes around their menstrual cycle.

What To Do If You Suspect A Hormonal Imbalance

There is no single test that measures every hormone, and at-home kits only cover a few markers. The safest first step is to speak with your primary care doctor. They can look at your overall health and decide what evaluations are appropriate.

Diagnosis may include:

• A physical exam and review of your medical history
• Checking prescriptions or supplements that may influence hormones
• Blood, urine or saliva tests to measure specific hormone levels
• A pelvic exam to check for cysts or growths
• An ultrasound to look at the ovaries, uterus, thyroid or pituitary gland

As bird flu continues to trouble several countries, health officials in the United States have reported the first known human case of the H5N5 subtype of avian influenza. The Washington State Department of Health announced on November 14, 2025, that the virus was found in a resident of Grays Harbor County.

The patient, an older adult with existing medical issues, is currently in the hospital. Authorities noted that the individual kept poultry at home that had contact with wild birds, which is believed to be the likely source of the infection, though the investigation is still underway. Since H5N5 is newly identified in humans, many are asking whether it differs from the earlier H5N1 strain.

What Is the H5N1 Strain?

H5N1 is a highly pathogenic form of avian influenza that mainly affects birds but can also infect mammals, including humans. It can lead to severe illness in people and has a high fatality rate, though it rarely spreads from one person to another, as per the World Health Organization. The virus has moved across continents in wild and farmed birds and has recently been found in dairy cattle and several other mammals.

What Is The New H5N5 Strain?

The “new” H5N1 strain refers to the 2.3.4.4b clade of highly pathogenic avian influenza (HPAI), which has caused a widespread animal outbreak since appearing in 2020. This version is a newer genetic branch of H5N1 and has swept through wild birds, poultry farms and an increasing range of mammals, including dairy herds in the United States. At present, the patient infected in the U.S. has been diagnosed with the newer H5N5 subtype.

How Is H5N5 Different From H5N1?

According to the CDC, both H5N5 and H5N1 fall under the avian influenza family, with the main distinction being the type of neuraminidase (N) protein on the virus surface. H5N5 contains the N5 protein, while H5N1 carries the N1 protein. Although this genetic change can influence viral features, their overall pattern of illness and symptoms is expected to be much the same, particularly in birds and livestock.

The genetic structure is the only difference, with H5N1 strain containing a subtype of influenza A with a segmented genome while the other has a new reassortant virus formed from several subtypes, possibly including H5N1, as per National Institute of Health.

Is A Vaccine Available For The H5N1 Bird Flu Strain?

Vaccines for bird flu do exist, but they are not intended for general public use and are not easily available for everyday protection. Some vaccines have been created and stored for possible deployment in people at higher risk, such as poultry workers and farm staff, and they are also used in animals like chickens to help manage outbreaks. The United States and several other countries have stockpiled H5N1-specific vaccines that could be rolled out if the threat to humans grows. A few nations, including Finland, are already offering them to certain high-risk groups. At the moment, there is no advice for the wider public to take a bird flu vaccine, as there is no sustained human-to-human spread and no mass-market human vaccine in use.