Daytime Sleep: Normal Or A Health Concern?

Sleep is a complex and mysterious process that occupies about a third of our lives. While getting enough sleep is essential for maintaining optimal health, too much sleep can also be problematic. Oversleeping, or long sleeping, is associated with various health risks and may indicate an underlying condition. Hypersomnia, a condition characterized by excessive daytime sleepiness, can lead to unintended lapses into drowsiness or sleep and an increased risk of accidents. Sleep needs vary across ages and lifestyles, but adults generally require 7-9 hours of sleep per night. If you regularly sleep more than 8-9 hours and still feel tired, it's recommended to consult a healthcare professional to rule out sleep disorders or underlying medical conditions.

Sleep disorders and medical conditions

There are over 80 different types of sleep disorders, and they can affect your mental and physical health. Sleep disorders can be a symptom of other medical or mental health conditions, or they can be the cause of them.

Insomnia

Insomnia is the most common sleep disorder. It involves difficulty falling and staying asleep. To be diagnosed with insomnia, a person must experience sleep difficulties at least three nights a week for at least three months, causing distress or problems at work, school, or other important areas of daily functioning.

Sleep-related breathing disorders

Sleep apnea is a common sleep-related breathing disorder. It involves interruptions in breathing during sleep, causing snoring, snorting, gasping, or pauses in breathing. This interrupted sleep leads to daytime sleepiness and fatigue. Obstructive sleep apnea is the most common type, often caused by obesity, a family history of sleep apnea, menopause, or certain genetic or endocrine disorders. Central sleep apnea is rare and usually occurs in older adults or people with heart disorders, strokes, or opioid use.

Central disorders of hypersomnolence

People with central disorders of hypersomnolence have trouble staying alert during the day. Narcolepsy is a type of hypersomnolence disorder characterised by extreme daytime sleepiness and episodes of cataplexy, a brief sudden loss of muscle tone triggered by laughter or joking.

Circadian rhythm sleep-wake disorders

These disorders occur when a person's internal clock is misaligned with the external light-darkness cycle, causing significant sleep problems and extreme sleepiness during the day. This can be caused by internal factors, such as a person's body clock differing from the light-dark cycle, or external factors like shift work or jet lag.

Parasomnias

Parasomnias involve physical actions or verbal expressions during sleep, such as walking, talking, or eating. Examples include sleepwalking, night terrors, nightmares, and REM sleep behaviour disorder.

Sleep-related movement disorders

These disorders involve physical movements or the urge to move, making it difficult to fall asleep or stay asleep. Restless leg syndrome is a common sleep-related movement disorder, causing an urge to move the legs, usually accompanied by uncomfortable sensations.

Other medical conditions

Sleep difficulties can also be a symptom of other medical conditions, such as heart disease, asthma, pain, nerve conditions, depression, anxiety, or genetic factors.

Lifestyle factors

Mental health issues, such as anxiety and depression, can also impact sleep. Anxiety can keep a person awake at night, leading to daytime sleepiness, while depression can sap energy levels, making it difficult to stay awake during the day. Additionally, certain medications and substances, including alcohol, caffeinated drinks, tranquillisers, sleeping pills, and antihistamines, can disrupt sleeping patterns and contribute to daytime sleepiness.

To improve sleep quality and reduce daytime sleepiness, it is recommended to make lifestyle adjustments, such as maintaining a consistent sleep schedule, exercising regularly, avoiding electronic devices, bright lights, and caffeine and alcohol before bed, and creating a peaceful and comfortable sleeping environment. These adjustments can improve sleep quality and reduce the need for daytime naps.

It is worth noting that while napping is common and can be beneficial in some cases, it can also have drawbacks. Long naps or napping too frequently can affect the quality of nighttime sleep and may be a sign of underlying sleep deprivation or a sleep disorder. Therefore, it is generally recommended to limit naps and focus on improving nighttime sleep quality.

Sleep quality

Poor sleep quality can have several negative consequences, including:

• Increased risk of accidents: Sleep deprivation can impair judgement and reaction time, increasing the likelihood of motor vehicle accidents and work-related injuries.
• Mood disturbances: Insufficient or disrupted sleep can lead to irritability, depression, and anxiety.
• Cognitive impairments: Lack of quality sleep can cause difficulties with concentration, memory, and decision-making.
• Health risks: Chronic sleep loss has been linked to an elevated risk of diabetes, heart disease, high blood pressure, obesity, and depression.

To improve sleep quality, the following strategies can be implemented:

• Maintain a consistent sleep schedule: Go to bed and wake up at the same time each day, even on weekends.
• Create a bedtime routine: Engage in relaxing activities before bed to signal to your brain that it's time to wind down.
• Optimise your bedroom environment: Make your bedroom a peaceful and technology-free space, maintaining a cool, dark, and quiet environment.
• Avoid stimulants and heavy meals close to bedtime: Caffeine, alcohol, and large meals too close to bedtime can disrupt sleep.
• Engage in regular physical activity: Exercise during the day can promote better sleep at night.
• Address underlying health issues: If sleep issues persist despite your best efforts, consult a healthcare professional to rule out any underlying sleep disorders or medical conditions.

Sleep duration

Excessive daytime sleepiness, or hypersomnia, is characterised by regular napping and long sleep durations at night. This can be caused by underlying health conditions such as sleep apnea, circadian rhythm sleep-wake disorders, narcolepsy, or psychiatric disorders. Additionally, lifestyle factors such as shift work can contribute to insufficient sleep and excessive daytime sleepiness.

Chronic sleep loss and sleep disorders can elevate the risk of various health issues, including diabetes, heart disease, high blood pressure, obesity, and depression. Addressing sleep issues is crucial, as it can impact overall health and well-being.

To improve sleep quality, it is recommended to maintain a consistent sleep schedule, engage in regular physical activity, avoid caffeine and alcohol close to bedtime, and create a peaceful sleeping environment. If excessive sleepiness persists, it is advisable to consult a healthcare professional for further evaluation and guidance.

Treatment options

Medication

Wakefulness-promoting agents like modafinil (Provigil), armodafinil (Nuvigil), and pitolisant (Wakix) are usually tried first. Psychostimulants such as amphetamine, methylphenidate (Ritalin, Daytrana, Methylin, Concerta), or dextroamphetamine (Procentra, Dexedrine, Zenzedi) are also an option but have more abuse potential and side effects. Other drug options include sodium oxybate (Xyrem or Xywav), flumazenil (Romazicon), and clarithromycin (Biaxin).

Lifestyle Changes

Making some lifestyle changes can help improve sleep quality and overall well-being. This includes maintaining good sleep habits, such as establishing a regular sleeping schedule, having a sleep-conducive environment, and limiting caffeine and exercise before bedtime. Creating a bedtime routine that includes calming activities like meditation, reading, or a warm bath can also be beneficial.

Therapy

Cognitive behavioural therapy (CBT) is often the first treatment approach for insomnia and can help improve sleep quality. Behavioural therapy is also used to manage narcolepsy, along with timed short naps and proper sleep hygiene.

Medical Interventions

Sleep disorders may require medical interventions such as positive airway pressure (PAP) therapy for sleep apnea. This can be administered through a continuous positive airway pressure (CPAP) machine or a bilevel positive airway pressure (BiPAP or BPAP) machine. For restless leg syndrome, pneumatic pressure therapy and regular exercise may help relieve symptoms.

Supplements

While supplements like chamomile, lavender, and kava are sometimes used to aid sleep, there is limited research on their effectiveness. Melatonin supplements can be beneficial for those with circadian rhythm disorders, helping them fall asleep and wake up on time. However, it is generally better to focus on improving sleep quality and quantity through lifestyle changes rather than relying on supplements.

Frequently asked questions