Are you running
on empty?
If you're reading this, there's a good chance you're tired. Not just tired — but running on empty.
A Note From Dr. Puryear
My first child was born right in the middle of my fellowship as an interventional radiologist in Miami. We were up every two hours. I would bounce her in the dark at 2am, then walk into the hospital a few hours later and try to look like a functioning human being. At the time, I thought I was managing. I really did.
I wasn't. My patience disappeared faster than it should have. My mood changed. Small mistakes started showing up, the kind I normally would have caught. And for a while, I blamed everything else. The schedule. The stress. The newborn stage. The demands of training.
Sleep barely crossed my mind. That is often how poor sleep works. It does not always announce itself as the problem. It shows up somewhere else first.
A shorter fuse. More mistakes. A body that feels older than it should. Brain fog you keep trying to push through. That was me. It might be you.
— Jerome Puryear, MD
This checkup will not diagnose you. It is not meant to. But it can help you pause long enough to see whether poor sleep has become a pattern.
And that is a good place to start.
Sleep Warning Sign Checklist
Read through these and notice what lands.
What Your Score Means
Your score reflects the number of sleep-related patterns you identified. This is not medical advice statement (or diagnosis)
Basic Maintenance
A few small sleep problems, repeated night after night, can still wear on you. Start with the things that are easiest to miss. A steadier bedtime. Less caffeine after noon. A darker room. Less noise. Fewer screens close to bed. Nothing flashy. But those small changes, if you actually keep them up, can compound.
Your Body Is Paying a Price
You may be getting through the day, but not at your best. This is where a lot of people start explaining things away. They blame age. Stress. Hormones. Work. Discipline. A busy season. And to be fair, sometimes those things do play a role. But sometimes sleep is underneath all of it. You may not be far off. Something is just getting in the way.
Worth Taking Seriously
A higher score can point to insomnia, sleep apnea, circadian disruption, stress overload, medication effects, or something that has been quietly building for a while. That does not mean you are broken. It means your body has been sending signals worth listening to.
Now look back at what landed. Your pattern may be one of these:
If your score was 10 or higher, do not panic. It does not automatically mean something is seriously wrong. It means there may be more to the story. That is one reason I wrote The Up & Die Series Sleep Deprivation. Many people spend years managing symptoms without ever figuring out what is actually disrupting their sleep. They treat the exhaustion. The caffeine dependence. The 3am waking. The irritability. The fog. But they never get to the cause.
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Awareness
Poor sleep is rarely just about being tired. It is information. The body is telling you something before the problem gets louder.
Action
Pick one thing from the Sleep Reset below. Do it tonight. Not five things. Not a complete life overhaul. One thing you can actually keep. That is how this changes.
Protection
Better sleep touches nearly every system in your body. Heart. Hormones. Immune function. Cognition. Mood. None of them work as well as they should when sleep keeps getting shortchanged.
Sleep Reset Plan
Do not try to fix everything tonight. That is how people quit by Wednesday. Just fix the conditions.
Pick a real bedtime
Not the aspirational version. The real one. The one you can actually keep. Your body runs on rhythm. Give it one.
Set an alarm on your phone with a time-sensitive reminder to stick to the plan.
Cut caffeine 6+ hours before bed
Coffee, energy drinks, some teas, sodas, and even chocolate all count here. Choose a cutoff today.
Protect the last 30 minutes
No email. No news. No phone scrolling. Give your nervous system a little time to come down. Pick one thing:
Make the room easier to sleep in
That is the whole assignment. Simple, yes. But many bedrooms are missing at least one of those.
Stop negotiating with the clock
If you wake up at 3am, try not to start doing the math. Your job is not to force sleep. Your job is to give your body the conditions that let sleep return on its own.
When to Get Help
A better routine can help a lot. But not every sleep problem is a routine problem. Talk with a healthcare provider or sleep specialist if you:
Do not guess at this for years. Get the right information.
Start With Tonight
Pick one reset step from this guide and do it before bed. Over the next few days, I'll send you the 5-Day Sleep Reset by email. Five short emails. One idea each day. One practical thing to try that night. Nothing overwhelming. Nothing complicated for the sake of sounding smart.
If this checkup felt familiar, pay attention to that.
Your body may have been asking for better sleep for a long time.
Get the 5-Day Sleep Reset Email Series.
Five short emails. One practical change each day. Starting tonight.
The Up & Die Series Sleep Deprivation
The Science and Survival Guide to Better Sleep
If you recognized yourself anywhere in this checkup, don't stop here. The checklist tells you that something may be off. The book helps you understand why — and what to do next.
Wishing you deep rest and renewed strength,
Jerome Puryear, MD
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