Why Do Some People Sleep 22 Hours A Day?

While it is normal for newborn babies to sleep up to 18-22 hours a day, it is uncommon for adults to sleep this much. Oversleeping in adults can be a symptom of underlying conditions like depression, illness, or a sleep disorder. Beth Goodier, a 20-year-old from England, suffers from Kleine-Levin Syndrome, also known as Sleeping Beauty Syndrome, which causes her to sleep up to 22 hours a day.

Sleep disorders

Sleep is a complex biological process that is critical to both physical and mental health. While sleeping, the body and brain remain active, performing important jobs that help us stay healthy and function at our best. Sleep disorders are conditions that disturb these normal sleep patterns, resulting in daytime distress and impaired functioning. There are over 80 types of sleep disorders, with insomnia being the most common.

Insomnia

Insomnia is a sleep disorder characterised by difficulties in falling and staying asleep. It affects about one-third of adults, with 4-22% meeting the criteria for insomnia disorder. To be diagnosed with insomnia disorder, sleep difficulties must occur at least three nights a week for a minimum of three months, causing significant distress or problems at work, school, or other daily activities.

Sleep Apnea

Obstructive sleep apnea (OSA) is a sleep-related condition where people experience interruptions in their breathing while asleep, leading to issues like snoring, snorting, gasping, or breathing pauses. This interrupted sleep results in daytime sleepiness and fatigue. Sleep apnea is more prevalent among men, certain racial and ethnic groups, and individuals who are obese, have a family history of sleep apnea, or are going through menopause.

Restless Leg Syndrome (RLS)

RLS is a disorder characterised by an urge to move one's legs, usually accompanied by uncomfortable and unpleasant sensations such as tingling, creeping, burning, or itching. These symptoms occur at least three times a week and continue for at least three months, causing significant distress or problems in daily functioning. RLS can make it difficult to fall asleep and can lead to frequent awakenings during sleep, resulting in daytime sleepiness.

Hypersomnia

Hypersomnia is a condition where individuals experience excessive sleepiness and tend to sleep for longer periods, often sleeping more than nine hours per day and not feeling rested. This disorder can cause difficulty in waking up and being fully alert, leading to issues with concentration and memory.

Circadian Rhythm Sleep-Wake Disorders

These disorders occur when an individual's sleep-wake rhythms (body clock) become misaligned with the external light-dark cycle. This misalignment results in significant sleep problems and extreme sleepiness during the day, causing distress and functional problems. Circadian rhythm disorders can be caused by internal factors, such as a person's unique body clock, or external factors like shift work or jet lag.

Kleine-Levin Syndrome (KLS)

KLS, also known as Sleeping Beauty syndrome, is a rare condition that affects about 40 people in the UK, mostly boys. It can cause individuals to sleep up to 22 hours a day, leaving them awake for only two hours. KLS also induces behavioural changes, including binge eating and dream-like feelings. There is currently no known cure for this mysterious condition.

Environmental factors

There are several environmental factors that can contribute to oversleeping. These include:

• Shift work that goes against the typical sleep-wake body cycle, or circadian rhythm.
• Having limited time for sleep due to the nature of certain jobs, such as being a caregiver.
• Not leaving adequate time in schedules to sleep.
• Illness: it is normal to sleep longer than usual when sick, although the sleep may not be restful.
• Sleep debt: oversleeping can be the result of making up for lost sleep due to a hectic period.

In addition, certain medications can cause oversleeping due to their sedating effects or drowsiness. These include:

• Certain types of painkillers
• Some medications that treat mental health disorders

It is important to note that while these factors can contribute to oversleeping, there may be other underlying causes such as sleep disorders, mental health disorders, or other health issues. If you are concerned about your sleep habits, it is recommended to consult a healthcare provider.

Physical and mental health conditions

Sleeping for 22 hours a day can be a symptom of a physical or mental health condition. Oversleeping, or long sleeping, is defined as sleeping for more than nine hours in a 24-hour period. It is often associated with underlying health issues, including:

• Sleep disorders, such as insomnia, narcolepsy, and sleep apnea
• Mental health disorders, particularly depression and anxiety
• Obesity
• Cardiovascular disease
• Chronic pain
• Respiratory infections
• Diabetes
• Fibromyalgia
• Hypothyroidism

In some cases, oversleeping may be a result of taking certain medications or recovering from an illness. For instance, people with respiratory infections like the flu, a cold, or COVID tend to sleep for longer periods, although the sleep is not always restful.

It is important to note that sleeping for 22 hours a day is not typical and could indicate a more serious health condition. If you or someone you know is consistently sleeping for this long, it is advisable to consult a healthcare professional for further evaluation and guidance.

Drug and alcohol use

Alcohol can act as a sedative and can help people fall asleep. However, it can also disrupt sleep, especially during the second half of the night. Alcohol abuse and dependence are associated with chronic sleep disturbances, lower slow-wave sleep, and more rapid eye movement sleep than normal.

Alcohol can suppress REM sleep, with a longer latency to REM sleep and decreased REM sleep in the first half of the night or across the whole night. In the second half of the night, sleep is disrupted, with increased wakefulness and/or stage 1 sleep. This pattern of initial sleep augmentation followed by a period of poor-quality sleep can lead to a downward spiral, with insomnia being self-treated with alcohol to produce rapid sleep onset, subsequent poor sleep then leading to daytime sleepiness that is self-treated with caffeine, which exacerbates insomnia, requiring more alcohol to fall asleep, etc.

Alcohol is used by more than one in ten individuals as a hypnotic agent to self-medicate sleep problems.

People can rapidly develop tolerance to the sedative effects of alcohol.

Alcohol's effects on sleep can be bidirectional in that nocturnal sleep quantity and continuity and subsequent levels of daytime sleepiness also influence alcohol's sedative and performance-impairing effects. Sleep quality and daytime sleepiness may also relate to rates of alcohol drinking and become a gateway to excessive alcohol use.

Sleep problems are a risk factor for the development of psychiatric disorders, including depression, anxiety, and alcohol abuse.

Sleep problems may predispose some people to developing alcohol problems.

Sleep problems may increase the risk of relapse among abstinent alcoholics.

Sleep disturbances at the time of treatment are risk factors for relapse to drinking.

Lifestyle factors

Shift Work and Circadian Rhythm Disruption: Working shifts that go against the typical sleep-wake body cycle, known as the circadian rhythm, can contribute to oversleeping. This disruption can lead to not getting enough sleep during the regular sleep-wake hours.

Time Management and Sleep Scheduling: Not leaving adequate time in one's schedule for sleep can result in sleep deprivation and subsequent oversleeping. Proper time management and maintaining a consistent sleep schedule are essential for healthy sleep habits.

Sick Days and Recovery: It is common to sleep longer than usual when feeling unwell or recovering from an illness. Research has shown that people with respiratory infections, such as the flu, a cold, or COVID-19, tend to sleep for longer periods, although the quality of sleep may not always be restful.

Medications and Substances: Certain medications and substances can induce drowsiness and contribute to oversleeping. This includes specific painkillers, medications for mental health disorders, and alcohol consumption, which has sedating effects.

Physical and Mental Health: Physical and mental health conditions can impact sleep duration. For example, chronic pain, diabetes, fibromyalgia, and hypothyroidism may make it challenging to stay awake for extended periods. Additionally, depression and anxiety have been linked to both oversleeping and difficulty sleeping.

Sleep Disorders: Various sleep disorders can lead to excessive sleepiness and longer sleep durations. These include circadian rhythm sleep-wake disorders, hypersomnia or hypersomnolence disorder, narcolepsy, obstructive sleep apnea (OSA), and restless leg syndrome (RLS).

Frequently asked questions