Daytime Sleep: Why Can't I Stay Awake?

Feeling sleepy during the day can be a symptom of hypersomnia, a condition that makes it hard to stay awake during the day. People with hypersomnia may fall asleep at any time, even while performing important tasks such as working or driving. This condition can be caused by various factors, including sleep deprivation, sleep disorders, medications, and medical or psychiatric illnesses. It is important to note that hypersomnia is different from simply feeling tired all the time. If you are experiencing symptoms of hypersomnia, it is recommended to consult a healthcare professional for proper diagnosis and treatment.

Hypersomnia, a condition causing extreme sleepiness during the day

Hypersomnia is a condition that causes extreme sleepiness during the day. People with hypersomnia may nap or fall asleep during the day, and still sleep for long hours at night. They may experience low mood, irritability, and a lack of energy, and have trouble thinking clearly. Hypersomnia can affect a person's ability to function at work and socially, and can increase the risk of accidents, particularly while driving.

There are two main types of hypersomnia: secondary hypersomnia and primary hypersomnia. Secondary hypersomnia is caused by another condition, such as a physical or mental health problem, a genetic disorder, or substance use. Conditions that can cause secondary hypersomnia include:

• Parkinson's disease
• Obstructive sleep apnea
• Vitamin deficiencies
• Multiple system atrophy
• Mood disorders such as depression
• Head injury or neurological disease (e.g. multiple sclerosis, Parkinson's disease)

Primary hypersomnia, on the other hand, is its own condition and is not caused by another medical condition or symptom. The four types of primary hypersomnia are:

• Narcolepsy type 1: caused by low levels of hypocretin (orexin), a chemical in the brain and cerebrospinal fluid that regulates sleep and wakefulness. It is also called narcolepsy with cataplexy, as it can cause sudden muscle weakness triggered by emotions.
• Narcolepsy type 2: similar to type 1, but with milder symptoms and normal levels of hypocretin. It does not include cataplexy.
• Kleine-Levin syndrome: a rare condition that occurs mostly in male teenagers, causing extreme bouts of hypersomnia. Those affected may sleep up to 20 hours a day, with episodes lasting from a few days to a few weeks.
• Idiopathic hypersomnia: there is no known cause for this type of hypersomnia, and those affected sleep for long periods and wake up feeling confused, irritable, and unrefreshed.

Treatment for hypersomnia depends on the underlying cause and may include medication to promote wakefulness, as well as lifestyle changes such as maintaining a regular sleep schedule, avoiding caffeine and alcohol, and creating a peaceful sleeping environment.

Sleep deprivation, which can be caused by long working hours or overtime

Understanding Sleep Deprivation

Sleep deprivation occurs when an individual fails to get sufficient sleep, either in quantity or quality. This can be a short-term issue, lasting just a night or two, or it can become a chronic condition persisting for weeks, months, or even years. It is a very common problem, affecting millions of adults in the US alone.

Impact on Health and Daily Life

Sleep deprivation can have far-reaching consequences for your health and daily functioning. Here are some of the key areas it can affect:

• Brain and Cognitive Function: Sleep deprivation impairs your ability to think clearly, focus, and remember things. It slows down your mental processes and can lead to "brain fog." Even short-term sleep loss can affect these functions.
• Physical Health: Lack of sleep can increase your risk of developing serious health conditions, including obesity, heart disease, Type 2 diabetes, high blood pressure, and high cholesterol. It also negatively impacts your immune system, making it harder for your body to fight off infections.
• Mental Health: Sleep deprivation is closely linked to mental health. It can make it harder to manage and process emotions, and people who are sleep-deprived are more likely to experience symptoms of anxiety and depression. It can also contribute to the development of more severe mental health conditions.
• Daily Performance: Sleep loss affects your ability to perform daily tasks and can reduce your productivity. It impairs your reaction times and increases the likelihood of errors and accidents. This is particularly important for jobs requiring quick reactions, such as driving or operating heavy machinery.
• Behaviour and Social Life: Sleep deprivation can alter your mood and make you more irritable, angry, and vulnerable to stress. It can also impact your social life and relationships as you may become less motivated to socialise or engage in activities.

Causes of Sleep Deprivation

There are various factors that can contribute to sleep deprivation, including:

• Work-Related Factors: Long working hours, shift work (especially overnight shifts), and working from home can disrupt your sleep. The stress associated with work can also impact your sleep quality.
• Lifestyle Choices: Using electronic devices late at night, consuming caffeine or alcohol before bed, and inconsistent sleep habits can all contribute to sleep deprivation.
• Sleep Disorders: Conditions such as insomnia, sleep apnea, restless leg syndrome, and bruxism (teeth grinding) can disrupt sleep quality and duration.
• Medical Conditions: Chronic pain, mental health disorders, diabetes, and other chronic illnesses can interfere with sleep.
• Environmental Factors: An uncomfortable sleeping environment, such as extreme temperatures or noise, can impact your sleep quality.

Addressing Sleep Deprivation

If you are experiencing sleep deprivation, there are several steps you can take to improve your sleep:

• Prioritise Sleep: Make sure you are allowing enough time for sleep and maintain a consistent sleep schedule, even on weekends.
• Improve Sleep Hygiene: Create a quiet, comfortable, and dark sleeping environment. Limit the use of electronic devices before bed, and avoid consuming caffeine or alcohol close to bedtime.
• Seek Professional Help: If your work schedule is affecting your sleep, discuss this with your supervisor or HR department. Consider seeking advice from a doctor or sleep specialist, who can help create a plan to improve your sleep and manage work-related fatigue.

It is important to take sleep deprivation seriously and make the necessary changes to prioritise your sleep. Doing so will have a positive impact on your overall health and daily functioning.

Environmental factors, such as a snoring partner or noisy neighbours

Environmental factors can play a significant role in disrupting sleep and contributing to hypersomnia. One common environmental factor is a snoring partner. Snoring can cause broken sleep for the other person, leading to daytime sleepiness. Additionally, noisy neighbours can also impact sleep quality. Other environmental factors include an uncomfortable mattress, temperature fluctuations, and the presence of a baby or pet that wakes you up during the night.

To mitigate the impact of environmental factors on your sleep, consider the following strategies:

• If your partner's snoring is affecting your sleep, suggest that they see a doctor to rule out any underlying sleep disorders or respiratory issues. In the meantime, consider using earplugs or a white noise machine to block out the sound of snoring.
• If noisy neighbours are the issue, try using earplugs or noise-cancelling headphones to reduce the amount of noise that reaches you while you sleep. You could also consider soundproofing your bedroom or even moving to a quieter location if the problem persists.
• Invest in a high-quality mattress that provides adequate support and comfort for your body.
• Ensure your bedroom is well-ventilated and maintained at a comfortable temperature.
• If you have a baby or pet that frequently wakes you up, establish a consistent sleep schedule for them and create a soothing sleep environment to promote longer stretches of sleep.

Remember, hypersomnia can significantly impact your daily functioning and increase your risk of accidents. If you suspect that environmental factors are contributing to your sleep issues, addressing them can be an important step towards improving your sleep quality and overall well-being.

Shift work, especially night shifts, which disrupt the body's internal clock

Shift work, especially night shifts, can be extremely disruptive to the body's internal clock. The human body's circadian rhythm has evolved to align with the light/dark cycle of the earth's rotation. When a person works night shifts, their sleep/wake and light/dark cycles shift too quickly for their internal clock to keep up. This results in a misalignment between their behaviour and their internal clock, which can lead to issues with their health, performance, and safety.

Shift work affects almost every biological system in the body. Research has shown that it can lead to an increased risk of accidents, errors, absenteeism, high employee turnover, lost productivity, weakened immune function, long-term health implications, and poor quality of life.

The impact of shift work on the body's internal clock can be mitigated by managing exposure to light. Light is the most important time cue for resetting the circadian clock, so managing when to see light and when to avoid it is critical to reducing the negative effects of shift work. Melatonin supplements can also help speed up adaptation to shift work by helping the body manage sleep during transitions between work shifts.

Mental states, such as anxiety or depression, which can impact sleep

Mental states such as anxiety and depression can have a significant impact on sleep quality and duration. People with anxiety or depression may experience insomnia, hypersomnia, or obstructive sleep apnea. It is believed that about 20% of people with depression have obstructive sleep apnea, and about 15% have hypersomnia. Those with depression may alternate between insomnia and hypersomnia during a single depressive episode.

Anxiety and depression can also lead to persistent sad, low, or irritable moods; feelings of hopelessness, worthlessness, or guilt; a loss of interest or pleasure in activities; decreased energy and fatigue; and difficulty concentrating. These symptoms can further contribute to sleep disturbances. Additionally, sleep problems can increase the risk of developing depression and can increase the risk of relapse in individuals who have been successfully treated for depression.

The relationship between sleep and mental health is complex and bidirectional. Poor sleep quality can contribute to the development of anxiety and depression, and having these mental disorders makes an individual more likely to experience sleep troubles. This complex interplay can make it challenging to determine whether sleep issues or the mental disorder came first.

Frequently asked questions