Dear Dr. Roach: In one of your columns, someone asked if it was helpful to just rest during the night, and how did that compare to sleeping if one is unable to sleep.
You said just resting was not that helpful, that one really needed sleep. I wanted to ask about “restless” minutes as recorded by a fitness watch. Restless minutes are separated from awake minutes, so I am referring only to the times when I’m moving but still asleep. Why are these subtracted from actual sleep time? I usually have no trouble sleeping and wake up on my own within six hours, but I’m always surprised because my fitness watch subtracts these restless minutes from the time slept. They often add up to around 30-45 minutes.
“Restless sleep” isn’t a term used by sleep experts, and I am not sure what your sleep device is registering. It could be that you are indeed asleep and moving around — this might be normal but could also be a manifestation of restless leg syndrome. You may also be awake, or nearly awake, for a short time and not remember it — this can be an issue in people with obstructive sleep apnea.
I don’t want to leave you with the idea that you have abnormal sleep. Consumer sleep monitors are not perfect, and the device could be misreading what is happening. If you feel like you sleep well, and you aren’t sleepy during the day, even when doing something uninteresting for a prolonged period, odds are that you are sleeping just fine. I have had many patients get so worried about what their sleep monitor says that it has adversely affected their sleep!
Dear Dr. Roach: I’m a healthy 32-year-old woman. I went into the emergency room last week with a 103.1 fever caused by a urinary tract infection. The doctor took a CT scan of my abdomen and found fecaliths. I have some constipation, but nothing to the extreme. I was drinking prune juice to hopefully make it pass. I don’t know what else to do, and I don’t want this to lead into something bigger.
“Fecalith” comes from Latin and Greek roots meaning hardened or stone-like feces. These occur in people with slower-than-normal stool passage time. The cause could be intestinal disease, but it’s also seen in people who don’t get a lot of fibre or who are chronically dehydrated.
The major symptom of a slow intestinal transit time is constipation, which is the passage of hard, dry stools. This is often associated with a few bowel movements, such as three per week or fewer. Low thyroid hormone is a potential cause of slow intestinal movement. A fecalith can block the appendix, leading to acute appendicitis.
Since these were found incidentally, and you are reporting no symptoms from them, it’s not necessarily something you need to worry about. However, you can help keep your intestines healthy by exercising, getting plenty of fibre (from vegetables and whole grains or from supplements), and drinking plenty of water. Fibre can cause bloating in people with slow transit time, so you need to make dietary changes gradually. Prunes are a good choice because they contain not only fiber but also naturally occurring substances that help to promote intestinal movement.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu