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826 Original Article Postprandial Somnolence and Its Awareness Bangladesh Journal of Medical Science Vol. 20 No. 04 October’21 Original article Postprandial Somnolence and its awareness among the Medical Undergraduate Students: A cross- sectional study Abhishek Chaturvedi1, Anitha Guru2, Naveen Kumar3, Ling Yi Lin4, Daniel YeapTze Wei5, Lai Kah Sheng6, Leow Hjun Yee7 Abstract Introduction: Postprandial somnolence or commonly referred to as food coma is generally experienced after the ingestion of afternoon meals. The performance of an individual gets affected after the ingestion of a heavy meal and this is more pertinent in a college setup where students have to attend a lecture right after the meal. The objective of this study was to assess the awareness of medical students about the factors responsible for postprandial somnolence, to identify the methods used to counteract it and to ascertain lecturers’ perception on responsiveness and participation of the students in a post lunch lecture. Methods: Total 330 students (first year to third year MBBS students) aged between 18-21 years and 40 lecturers teaching first and second year MBBS students were involved in this study. Two separate questionnaires (Part A: students’ perception, and B: lecturers’ perception) were prepared, peer-reviewed, validated and administered to the respective participants. All the responses were compiled and expressed in frequency percentage. Statistical analysis was performed using Statistical Package for Social Sciences, version 15.0 for a level of statistical significance of 5%. Pearson correlation was used to get the association between the variables. Results: About 55.75% students were aware about the role of serotonin and melatonin in drowsiness but 45.75% students did not know that food rich in tryptophan relaxes the brain and results in sleepiness. Students agree that heaviness of their meal might cause drowsiness and indigestion or bloating, which can also result in lethargy and can affect their performance. Majority of the lecturers opined that students disturb the harmony of the class and are less responsive and participative in post lunch break lectures. Conclusion: Thus, the present study provided scope for conducting awareness talks regarding the strategies to counteract postprandial somnolence among medical students which can help improve their concentration during post-lunch lectures. Keywords: Postprandial somnolence, Food coma, Heavy meals, Drowsiness, Students’ performance, Power nap Bangladesh Journal of Medical Science Vol. 20 No. 04 October’21. Page : 826-832 DOI: https://doi.org/10.3329/bjms.v20i4.54141 INTRODUCTION gets affected after the ingestion of a heavy meal and Postprandial somnolence or commonly referred to as this is more so in a college setup where students have food coma is generally experienced after the ingestion to attend a lecture right after the meal. of afternoon meals1. The performance of an individual Food consumption is thought to induce sleepiness. 1. Abhishek Chaturvedi, Senior Grade Lecturer, Department of Biochemistry, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India 2. Anitha Guru, MAHE FAIMER International Institute for Leadership in Interprofessional Education (M-FIILIPE), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. 3. Naveen Kumar, Associate Professor, Department of Anatomy, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. 4. Ling Yi Lin, MBBS students, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. 5. Daniel YeapTze Wei, MBBS students, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. 6. Lai Kah Sheng, MBBS students, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. 7. Leow Hjun Yee, MBBS students, Melaka Manipal Medical College (Manipal campus), Manipal Academy of Higher Education, Manipal-576104, Karnataka, India. Correspondence to: Dr. Naveen Kumar, PhD Associate Professor of Anatomy Melaka Manipal Medical Col- lege (Manipal Campus) Manipal Academy of Higher Education Manipal-576104 Udupi, Karnataka, India Email- [email protected] Telephone no. +919880548636 826 Postprandial Somnolence and its awareness among the Medical Undergraduate Students: A cross-sectional study The after-meal-tiredness (postprandial somnolence they would want to work on. This study was carried or commonly known as food coma) does not entirely out from August 2018 to January 2019. The study depend on how heavy the meal that was taken. questionnaire comprises two parts; part-A and part-B. Furthermore, it is hypothesized that release of gut- The questionnaire was validated by two independent brain hormones and activation of vagal afferents, may senior faculty members. Part A was a self-structured play a role in postprandial somnolence through the and self-administered questionnaire consisting 2 modulation of sleep centers such as hypothalamus . of 18 close ended and 01 open ended questions. It High carbohydrate and fatty food are the major agent was structured, peer-reviewed, validated and pilot which contributes to the general feeling of tiredness tested. The questionnaire was distributed to all the and inefficiency after meals. Besides that, increased participating students’ after the class and collected insulin secretion after meals results in absorption of on the following day. Closed ended questions in the most amino acids including tryptophan; this will then questionnaire were related to the awareness about the become preferentially available to be transported postprandial somnolence, students’ opinion about the across the blood brain barrier, which leads to methods suggested by the investigators to overcome ingression of tryptophan into the brain. Tryptophan postprandial somnolence, and their perception on the will then get converted into serotonin followed by factors that exacerbate postprandial somnolence (e.g. conversion into melatonin and these neurochemicals stress, rushing through the meal, indigestion and are liable for causing dizziness and the urge to sleep 3. heaviness of the meal). The open ended question was Similarly, while eating, there is simultaneous release “What do you usually do after lunch and before the of one paramount hormone that gives a feeling next class?”. It was asked to ascertain the methods of satiety to the body – Cholecystokinin (CCK). used by the students to counteract the somnolence Alternatively, CCK has another action, that is, it will after a meal. Part B was a questionnaire for the activate the areas in the brain associated with sleep, lecturers. In order to find out the responsiveness and leading to postprandial somnolence4. participation of the students in a lecture after lunch In a nutshell, the common feeling of lethargy break, a self-structured and self-administered survey felt after meals is a predicament faced by most consisting of 14 questions (10 close ended, 04 open individuals, especially students, ultimately leading ended) was prepared, peer-reviewed, validated, to their inability to concentrate in an ongoing lecture. pilot tested and administered to 40 lecturers. The object of this study was to assess the awareness The questionnaire was distributed to the faculty in medical students about the factors responsible for members in-person and appointment was taken for postprandial somnolence, to identify the methods the following day to collect the filled questionnaire. used to counteract it and to ascertain lecturers’ In the questionnaire the close ended questions were perception on responsiveness and participation of related to lecturers’ perception on responsiveness and the students in a post lunch lecture. Therefore, this participation of students in a post lunch lecture (Table study is imperative in understanding the need to 5). The open ended questions were asked to ascertain educate the students regarding the awareness of the observation of lecturers in a post lunch lecture postprandial somnolence and what impact it has on related to behavior and body language of the students, one’s performance. reason for such behavior, methods employed by them MATERIALS AND METHODS for better engagement and suggestion to students to mitigate the somnolence. The present cross-sectional study involves 330 students (first year to third year MBBS students) Ethical clearance: Institutional ethics committee aged between 18-21 years of Melaka Manipal (IEC) permission was obtained and participation was Medical College, Manipal Campus, India. It is a kept voluntary. Participant’s information sheet was twinning program in which Malaysian students distributed to all participants and informed consent spend the first 30 months in India and remaining was obtained prior to the study. 30 months in Malaysia. This study was a part of The response rate was 100% percent. All the Mentored Student Project (MSP) in which a group responses were compiled and presented in the form of students (4 or 5 students) work on a project which of a table. Responses for the closed ended questions 827 Abhishek Chaturvedi, Anitha Guru, Naveen Kumar, et al. were compiled in 2-point scale as agree or disagree to Table 2: Students’ opinion on the activities the statement. Strongly agree and agree is compiled suggested by the investigators to counteract together and presented as agree, similarly
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