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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 42. This is the beginning of the thread.
Posted by Regis Harold on October 15, 2005, at 15:46:45
For the past few years, I have been dealing with a case of dysthymia, a lack of motivation and energy. Despite regular exercise, I would experience severe tiredness regularly, and found it difficult to do something as simple as reading a book or talking with friends.
Over the past three and half weeks, I have been taking 400 mg of SAM-e twice a day, and 600 mg of Adrafinil. I have been noticing a gradual, yet steady improvement in my focus, motivation and energy. For instance, I actually have the energy to write this post. I am cautiously optimistic about what the current regimen (along with multivitamins and fish oil) will do for my mood. I feel a lot better now than before, but I am still curious about one thing that has been plaguing me over the past few years.
I experience a noticeably dip in my mood anywhere from 20 minutes to an hour after eating. I feel fatigued, unfocused, irritable and so sleepy that I feel an incredible urge to nap, yet feel very little benefit after I wake up. The fatigue lasts through the early evening, and usually doesn’t lift until a few hours before I go to bed. Although it is not as bad as it used to be, it is still bothersome.
This is something that has been perplexing me for quite some time now. I’m not hypogylemic. I had a 5 hour blood glucose response test done, and I’m pretty normal in that department. I thought for a while that I might be experiencing food allergies, but after going through the rigamarole skin tests and food elimination tests, I have come to the conclusion that food allergies are not the issue either. I get tired after eating just steak, or just salad, or just chicken, or just wheat (you get the picture).
Has anyone ever experienced, or heard of this? I have talked to a couple of pdocs about it, but not surprisingly, none of them have answers. It’s frustrating, because I love to eat. But then eating leaves me tired, sleepy and grumpy for hours. The fact that SAM-e and Adrafinil have reduced the severity of the fatigue even after eating leads me to believe that this may have something to do with the postprandial balance of neurotransmitters in my system or the balance of hormones that influence the sensitivity of the receptors in my brain cells. But then again, I’m open to any ideas that people might have about this.
Regis
Posted by Declan on October 15, 2005, at 16:03:49
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
So you've already thought of food allegies. Does your pulse rate go up after eating? That's supposed to be a sign. I imagine you've looked at that. The skin prick tests are supposed to be a bit dodgy or something, aren't they?
Declan
Posted by Glydin on October 15, 2005, at 18:01:57
In reply to Re: Fatigue after eating?, posted by Declan on October 15, 2005, at 16:03:49
Circulatory changes after a meal can lead to feeling sleepy and fatigued. Whether this could explain all you symptoms, I'm not sure. It's a simple action of blood volume being shunted to the gut and away from other areas to include cerebral circulation.
That why you never want to be a conference speaker after the lunch break. Your audience nodding off doesn't do much for your public speaking self esteem.
Posted by Glydin on October 15, 2005, at 18:03:30
In reply to Re: Fatigue after eating? » Declan, posted by Glydin on October 15, 2005, at 18:01:57
not directed or commenting on your post.
Sorry...
Posted by tecknohed on October 15, 2005, at 19:51:54
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
Hi.
Post-mealtime tiredness can be caused by a high carbohydrate diet and/or not enough protein. If you're sensitive to the effects of serotonin (SE) then you might benefit from increasing your protein intake at breakfast and lunch. A protein/carb ratio of 1:1 is ideal. Evening meal is less relevant.
Carbohydrates increase insulin release which not only controls blood sugar but has an effect on amino acid ratio too. It basically lowers the blood levels of certain aminos (including precursors to NA (noradrenalin) and DA (dopamine)) that share the 'transport vehicle' with SE through the blood-brain barrier. This means more SE can get through which can cause tiredness in susceptible people.
Increasing protein will help prevent this happening. It will help steady the sensitivity by allowing a more steady serotonin turn-over and a better balance with NA and DA.Its worth pointing out that carb 'highs' are more to do with blood sugar than it is amino ratio, hence the 'slump' experienced afterwards from the excess insulin and low blood sugar.
I'm not saying this is definitely the cause, but its something you can easily try yourself for a week or so.
I too hate feeling tired during the day and I wish you luck in finding a solution.
Regards,
Teck.
Posted by Declan on October 15, 2005, at 20:03:12
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
I had a 3 hour glucose tolerance test done and I think it was about half way through I fell asleep, which may have been a reflection of an insulin spike. Also the presence of stress hormones, I forget which, could be inferred.
Declan
Posted by tecknohed on October 15, 2005, at 20:05:28
In reply to Re: Fatigue after eating? » Regis Harold, posted by tecknohed on October 15, 2005, at 19:51:54
> Carbohydrates increase insulin release which not only controls blood sugar but has an effect on amino acid ratio too. It basically lowers the blood levels of certain aminos (including precursors to NA (noradrenalin) and DA (dopamine)) that share the 'transport vehicle' with SE through the blood-brain barrier. This means more SE can get through which can cause tiredness in susceptible people.
Sorry, a correction on the above paragraph:
Its TRYPTOPHAN that is involved in the blood-brain cross-over, not SE. But as tryptophan is the precursor for SE everything else still applies.
Sorry for any confusion.
Teck.
Posted by Mistermindmasta on October 15, 2005, at 22:00:24
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
It's important to realise that most people with symptoms of hypoglycemia are most likely oversensitive to the effects of lowER blood sugar. They don't actually have low blood sugar.
Also, people who are diabetic who have low blood sugar sometimes don't even realise it. Everyone seems to vary in their physical and mental response to a slight decrease in blood sugar.
It's possible that your blood sugar never actually gets very low, just that you really FEEL when your blood sugar gets a little low. This is very true for me. My blood sugar is always fairly stable, but with a gigantic carb meal, I feel very sleepy, sometimes with anxiety and shakiness and the whole 9 yards.
Food "allergies", as a food allergy is normally defined , will almost never cause fatigue. However, delayed allergic-like reactions mediated by a different part of the immune system than normal allergies can cause fatigue. As I have said to many people that post here, I am extremely sensitive to gluten and dairy. The reaction to these, however, is not acute. On the other hand, I am acutely sensitive to yeast and rice. I get heart palpitations and fagigue.
Hope this info helps you a little.
Posted by UgottaHaveHope on October 15, 2005, at 23:42:54
In reply to Re: Fatigue after eating?, posted by Mistermindmasta on October 15, 2005, at 22:00:24
everyone gets a little tired after eating. everyone. you know what i'm talking about, about an hour after lunch when you start yawning a little bit at work. then you go to the soda machine and load up on caffeine to make it to the 5 o'clock bell.
i have found the only way to minimize this fatigue after eating ... is to eat healthier. when you eat a lot or certain foods, your body uses most available energy for digestion, hence the fatigue.
probably the best remedy not eating three big meals per day, but 6-8 small meals over the day. light meals. it is supposed to also help you lose weight, as your metabolism is steadied throughout the day.
Posted by Jakeman on October 16, 2005, at 14:30:08
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
Regis,
You sound just like me. Most times after I eat a substantial meal, especially lunch, shortly after I'll get hit by depression, anxiety, brain-fog. At times it feels like an invisible hand pushing me down to the ground. On a few occasions I've actually had to leave work and go home.
I've explained this to a few doctors, none thought a glucose tolerance test was needed. Their attitude seemed to be that this happens to everyone.
One day last week I didn't have time to eat lunch. Instead I made a protein shake with whey and orange juice. It gave me enough energy to get through the afternoon and I didn't experience the rapid downward mood-energy shift.
I may need switch to having very light meals, and then maybe a protein drink as a lunch substitute or to help out between meals.
warm regards ~Jake
Posted by Regis Harold on October 16, 2005, at 16:00:50
In reply to Re: Fatigue after eating?, posted by Jakeman on October 16, 2005, at 14:30:08
Thanks everyone for your responses.
Teck, I remember reading about how insulin can influence amino acid ratios, causing tryptophan to enter the brain more easily, which is then metabolized to serotonin. I think this is an interesting perspective, because it explains why I have a reaction after eating so many different types of food. While suspecting that I might have a food allergy, I got to the point where I was thinking that I must be allergic to everything under the sun because I kept reacting negatively to each of them. After a certain point, it became clear that food allergies couldn’t appropriately address my reaction.
UgottaHaveHope, thanks for your input re: Fatigue after eating is HUMAN NATURE. As having lived with humans my whole life, I am quite familiar with human nature. I understand that everyone experiences some sort of lull after eating – this is something that I have understood for a long time. It isn’t until recently, within the past year or two, that I have realized that my postprandial fatigue is worse than the common drowsiness as experienced by others.
Firstly, the drowsiness that people usually deal with lasts only for a a couple hours, not the whole day. Once I eat during the day, I don’t recover until the evening, if at all that day. This has caused me to eat my first meal later and later in the day. I find the symptoms I experience from low blood sugar in the afternoon outweigh the symptoms I experience if I breakfast.
Secondly, the fatigue I experience seems to be of a more profound nature than what others usually experience. Not only do I get sleepy, but I become socially withdrawn, nervous, and confused. I can’t focus on anything, nor do I have the motivation to do anything – even things that I normally enjoy doing.
This morning, I decided to start upping my protein intake. In fact, the only thing I ate this morning were eggs. Interestingly, not only did I not get fatigued, but I also accomplished a lot today – stuff that I have been putting off for weeks, stuff that I put off as recently as yesterday because I just felt a little too tired and unmotivated.
Perhaps I am one of those that is really sensitive to changes in blood sugar/insulin/blood tryptophan levels. I am not sure yet. I like to be cautious about these sorts of things, because I don't like to get my hopes up to find out that what I was feeling was a placebo effect. If upping my protein intake relative to my carbohydrate intake helps me out, then that is really what matters to me. I'll try this out and I’ll keep you guys updated as to how things are working out for me in this department.
Regis Harold
Posted by Regis Harold on October 16, 2005, at 16:11:08
In reply to Re: Fatigue after eating?, posted by Jakeman on October 16, 2005, at 14:30:08
Jake,
Yup. What you're describing sounds very familiar to me. Hopefully the reason for this happening to you is more easily determined than what is happening to me.
It might be a good idea to get a blood glucose tolerance test, even if your doctor(s) doesn't think it's necessary. As you are try to determine what the cause of your issues is, it helps to eliminate as many possible causes as possible. And who knows, you might in fact be hypoglycemic.
I have also gotten a couple sleep studies done. Turns out that I don't have sleep apnea, which is a fairly common cause of daytime sleepiness. Although it turns out that I don't have sleep apnea, I'm glad I had the sleep studies done so I don't have to worry about going down that path and can focus my time and energies on other more probably causes of my condition.
Jake, have you tried anything specifically figure out/cure your condition? Have you taken any tests, or tried any remedies?
Regis
> Regis,
>
> You sound just like me. Most times after I eat a substantial meal, especially lunch, shortly after I'll get hit by depression, anxiety, brain-fog. At times it feels like an invisible hand pushing me down to the ground. On a few occasions I've actually had to leave work and go home.
>
> I've explained this to a few doctors, none thought a glucose tolerance test was needed. Their attitude seemed to be that this happens to everyone.
>
> One day last week I didn't have time to eat lunch. Instead I made a protein shake with whey and orange juice. It gave me enough energy to get through the afternoon and I didn't experience the rapid downward mood-energy shift.
>
> I may need switch to having very light meals, and then maybe a protein drink as a lunch substitute or to help out between meals.
>
> warm regards ~Jake
Posted by Declan on October 16, 2005, at 16:23:46
In reply to Re: Fatigue after eating?, posted by Regis Harold on October 16, 2005, at 16:11:08
A few years ago I reduced and rearranged my carb intake (no sugar, lower glycemic carbs)and upped my protein intake. Every time I saw my Dr he would say that my creatine/urea ratio (I think) suggested I should be eating more protein. So I did and drank protein shakes as well. This stabilized my energy levels throughout the day. I hoped for more of course (like feeling OK or normal), but I lost weight as well so it's been worth it.
Declan
Posted by UgottaHaveHope on October 17, 2005, at 0:15:49
In reply to Re: Fatigue after eating?, posted by Declan on October 16, 2005, at 16:23:46
protein-only sounds like the way to go for you. best of luck.
and if i dont get caffeine in the afternoon, im tired the rest of the day.
sometimes, i think sleepiness can be a state of mind.
i'm never sleepy when i am around a beautiful woman!
Posted by shasling on October 17, 2005, at 9:52:08
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
I had the same thing for years. Also had an undiagnosed corticol insufficiency. I take low dose Cortef now and the fatigue after eating is gone.
Posted by Regis Harold on October 17, 2005, at 12:00:33
In reply to Re: Fatigue after eating? What it was for me, posted by shasling on October 17, 2005, at 9:52:08
shasling - How did you end up getting diagnosed? Were there any specific tests you took to determine that you had adrenal insufficiency? How did you end up getting prescribed hyrdrocortisone?
I have considered adrenal insufficiency being a possible cause. I took a product by Enzymatic Therapy that contained adrenal extract, but it didn't appear to be doing a lot of good after a bottle of that stuff.
Posted by Sarah T. on October 17, 2005, at 22:13:03
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
Hi Regis.
I have the same problem. It started about a year and half or two years ago. I've experimented with different foods, and that doesn't seem to help. Until this problem began, I used to eat mostly protein-based meals during the day, and I'd reserve the bulk of my carbohydrates for the night-time, when I want to be tired and groggy anyway. That helped until about two years ago.
The only thing that helps a little bit is to eat five or six tiny meals a day rather than several medium-sized or large ones. The trouble is, the meals have to be really tiny. For example, I can eat one protein bar or a container of yogurt or a small serving of cottage cheese or meat. This is so inconvenient. I love eating sandwiches for lunch, but if I ate a whole sandwich now, I'd be incapacitated for the rest of the day.
I've discussed this problem with several doctors, and they haven't been of much help. I'm uncertain whether cortisol is the problem. I actually have high urinary cortisol, not low cortisol. I will continue to try to figure out what's causing this. If I ever get to the bottom of this, I'll let you know.
Sarah
Posted by Regis Harold on October 18, 2005, at 5:36:33
In reply to Re: Fatigue after eating? » Regis Harold, posted by Sarah T. on October 17, 2005, at 22:13:03
Sarah - I'm sorry to hear that you are having similar difficulties.
Now that I recall, I did get some blood work done and it appears that my blood cortisol is fairly normal (actually smack dab in the middle of the reference range). That is one of the reasons why I discounted hypoadrenia.
Right now I am looking into controlling amino acid ratios in the blood as Teck mentioned. I have done a small amount of research in the past about the interaction between eating and blood hormone levels. There have been a few articles regarding CCK that have piqued my interest, but it doesn't appear that there has been enough research done on it to construct a model that is helpful just yet. I think a lot more research has been done on the relationship between insulin release and amino acid ratios.
The past couple days I have eaten mainly proteinaceous diets during the day. I have felt somewhat better. I am going to continue eating protein-rich diets during the day, and perhaps add tyrosine to my morning meals as it is a precusor to dopamine (and norepinephrine), competes with tryptophan for the same transport protein, and is an amino acid that is cleared from the blood during rises in insuline levels.
If it is the case that I am sensitive to the effects of insulin to amino acid ratios, then adding tyrosine should be of added benefit. That's the assumption at least. I'll let you know how I progress.
Thanks,
Regis> Hi Regis.
>
> I have the same problem. It started about a year and half or two years ago. I've experimented with different foods, and that doesn't seem to help. Until this problem began, I used to eat mostly protein-based meals during the day, and I'd reserve the bulk of my carbohydrates for the night-time, when I want to be tired and groggy anyway. That helped until about two years ago.
>
> The only thing that helps a little bit is to eat five or six tiny meals a day rather than several medium-sized or large ones. The trouble is, the meals have to be really tiny. For example, I can eat one protein bar or a container of yogurt or a small serving of cottage cheese or meat. This is so inconvenient. I love eating sandwiches for lunch, but if I ate a whole sandwich now, I'd be incapacitated for the rest of the day.
>
> I've discussed this problem with several doctors, and they haven't been of much help. I'm uncertain whether cortisol is the problem. I actually have high urinary cortisol, not low cortisol. I will continue to try to figure out what's causing this. If I ever get to the bottom of this, I'll let you know.
>
> Sarah
Posted by Sarah T. on October 19, 2005, at 1:14:03
In reply to Re: Fatigue after eating?, posted by Regis Harold on October 18, 2005, at 5:36:33
> Sarah - I'm sorry to hear that you are having similar difficulties.> Now that I recall, I did get some blood work done and it appears that my blood cortisol is fairly normal (actually smack dab in the middle of the reference range). That is one of the reasons why I discounted hypoadrenia.>>
Hi Regis,
According to one of my doctors, the blood test for cortisol is probably the least useful of the various cortisol tests. Do you remember what time of day you had that blood test? The problem with a single blood test for cortisol is that it will tell you what the cortisol is only at the moment the blood was drawn. If you have the 24-hour urinary cortisol, that will indicate whether your total daily amount is normal or not. Another test that is more definitive is the salivary cortisol test, which is usually done late at night, around 11 p.m. Cortisol is supposed to be lower then. Have you seen an endocrinologist about the problem with fatigue after eating?Thanks for mentioning the amino acid ratios. I want to read up on that. I think I have to be very meticulous about what I eat now. Today I was so hungry in the late afternoon. I really wanted to eat a normal-sized dinner, but I knew if I did, I'd have to lie down for several hours, and I wouldn't get anything done. I've wondered whether this might be some pre-diabetic state. My blood sugar has been normal in blood tests, and I did buy some Clinistix, which I use once or twice a month, just to be sure everything is OK. Actually, I have to use them for my cat, too!
Do you know of any good websites for a discussion of the amino acid ratios?
Thanks.
Sarah
Posted by Ryan2828 on October 19, 2005, at 6:28:27
In reply to Re: Fatigue after eating? What it was for me, posted by shasling on October 17, 2005, at 9:52:08
I have the same exact problem that the thread starter has, but I have always blamed it on the Effexor which I have been on for 4 years so drowsiness after meals would seem strange. My solution to this problem I encounter on a daily basis is to boost myself up on coffee. The feeling I get after I eat food at my lunch break is NO Motivation at all to do anything. I am constantly scratching my eyes and rubbing them wondering why I feel so foggy, lethargic, and lazy. Soon to realize that I am now getting addicted to more and more caffiene in order to cope, but in the end that is making it worse
Can someone please explain how to get hypoglycemic testing done and what tests do you go through? How do you get thryoid testing done?? and blood work??
Posted by Regis Harold on October 19, 2005, at 9:05:15
In reply to Re: Fatigue after eating? What it was for me, posted by Ryan2828 on October 19, 2005, at 6:28:27
Hey all,
I have to run off to work soon, so I'll post more later.
Ryan I just wanted to say that you should talk to your primary care physician about your concerns and have him do a blood glucose tolerance test (it should be done over the cours of several hours. you drink a sweet beverage after fasting overnight, then your blood is drawn every hour over the next few hours). Also, ask for tests for an underactive thyroid, and a coritsol test (the kind that Sarah recommended).
Sarah, I had a one blood cortisol test in the middle of the day. I'll look into getting the saliva cortisol test you mentioned. I have a book on adrenal fatigue that suggests this - thank you very much for reminding me. I haven't worked with an endocrinologist yet. I am working it though. Hopefully I will be talking to one soon.
Yesterday was a hard day for me. Things were good in the morning. I ate a breakfast solely of eggs. Then I ate lunch, which was my downfall. I hate roast chicken (that's it!). And I had a good amount of it. I was knocked out for the entire day, literally. Today I am going to try to eat in little itty bitty tiny portions (like a strip of chicken hour or so), and we'll see how that goes.
Regis
> I have the same exact problem that the thread starter has, but I have always blamed it on the Effexor which I have been on for 4 years so drowsiness after meals would seem strange. My solution to this problem I encounter on a daily basis is to boost myself up on coffee. The feeling I get after I eat food at my lunch break is NO Motivation at all to do anything. I am constantly scratching my eyes and rubbing them wondering why I feel so foggy, lethargic, and lazy. Soon to realize that I am now getting addicted to more and more caffiene in order to cope, but in the end that is making it worse
>
>
> Can someone please explain how to get hypoglycemic testing done and what tests do you go through? How do you get thryoid testing done?? and blood work??> I have the same exact problem that the thread starter has, but I have always blamed it on the Effexor which I have been on for 4 years so drowsiness after meals would seem strange. My solution to this problem I encounter on a daily basis is to boost myself up on coffee. The feeling I get after I eat food at my lunch break is NO Motivation at all to do anything. I am constantly scratching my eyes and rubbing them wondering why I feel so foggy, lethargic, and lazy. Soon to realize that I am now getting addicted to more and more caffiene in order to cope, but in the end that is making it worse
>
>
> Can someone please explain how to get hypoglycemic testing done and what tests do you go through? How do you get thryoid testing done?? and blood work??
Posted by Jakeman on October 20, 2005, at 21:32:42
In reply to Re: Fatigue after eating?, posted by Regis Harold on October 16, 2005, at 16:11:08
> Jake,
>
> Yup. What you're describing sounds very familiar to me. Hopefully the reason for this happening to you is more easily determined than what is happening to me.
>
> It might be a good idea to get a blood glucose tolerance test, even if your doctor(s) doesn't think it's necessary. As you are try to determine what the cause of your issues is, it helps to eliminate as many possible causes as possible. And who knows, you might in fact be hypoglycemic.
>
> I have also gotten a couple sleep studies done. Turns out that I don't have sleep apnea, which is a fairly common cause of daytime sleepiness. Although it turns out that I don't have sleep apnea, I'm glad I had the sleep studies done so I don't have to worry about going down that path and can focus my time and energies on other more probably causes of my condition.
>
> Jake, have you tried anything specifically figure out/cure your condition? Have you taken any tests, or tried any remedies?
>
> Regis
>Regis,
I've had a number of tests, but not the fasting blood glucose test; I probably should get it done as well. I've had thyroid and other hormones tested (I'm on the low end for HGH). I've had a battery of allergy tests, all negative. I've had a sleep study and was diagnosed with mild sleep apnea. I tried a cpap machine for a while and couldn't sleep with it. Since then I've learned to sleep on my side. While my poor quality sleep certainly contributes to my problem, I feel there are other bio-chemical factors involved. With me it's not so much the desire to sleep after eating, but a rapid decline into foggy thinking and depression.
For the time being I'm tired (and broke) of seeing doctors so I'm just watching my diet and living with it.
warm regards ~Jake
Posted by GlennInMinneapolis on December 30, 2006, at 11:39:44
In reply to Re: Fatigue after eating?, posted by Regis Harold on October 16, 2005, at 16:00:50
I have been taking an antacid medication for GERD for a number of years, and started experiencing the exact thing that Regis has described: drowsy, foggy fatigue after eating in the moring, lasting until evening before bed.
Also, I would get light headed exercising, which would get worse right when I stopped exercising, such as waiting for a streetlight to cross a stredet while brisk walking.
Well, stopping the Prevacid cleared this up. I tried it 2 times, an each time, after restarting the Prevacid, the fatigue and lightheadedness problems returned soon.
It happened with both Prevacid and Prilosec for me.
Posted by FredPotter on January 2, 2007, at 17:07:59
In reply to Fatigue after eating?, posted by Regis Harold on October 15, 2005, at 15:46:45
I had this too. It was accompanied by inner restlessness. When I gave up drinking beer all the time, it diminished considerably
Posted by yxibow on January 7, 2007, at 0:21:05
In reply to Re: Fatigue after eating is HUMAN NATURE, posted by UgottaHaveHope on October 15, 2005, at 23:42:54
> everyone gets a little tired after eating. everyone. you know what i'm talking about, about an hour after lunch when you start yawning a little bit at work. then you go to the soda machine and load up on caffeine to make it to the 5 o'clock bell.
>
> i have found the only way to minimize this fatigue after eating ... is to eat healthier. when you eat a lot or certain foods, your body uses most available energy for digestion, hence the fatigue.
>
> probably the best remedy not eating three big meals per day, but 6-8 small meals over the day. light meals. it is supposed to also help you lose weight, as your metabolism is steadied throughout the day.
I missed the first post because PB seems to have eaten it, but at least "ordinary tiredness" is normal after eating. Some stores in Spain and Italy and Mexico take siesta breaks and open later in the day.Digestion is a natural sleep inducer, as blood is utilized in the process and pulled away from the brain, causing drowsiness.
http://www.parenthood.com/articles.html?article_id=7801
-- Jay
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