Daytime Sleepiness: Is It Normal To Want To Snooze?

Feeling sleepy all day can be a symptom of hypersomnia, a condition characterised by excessive sleepiness. People with hypersomnia may sleep for long hours at night but still feel the need to nap during the day. Other symptoms include difficulty thinking and making decisions, memory and concentration difficulties, and an increased risk of accidents. Hypersomnia can be caused by a variety of factors, including inadequate sleep, sleep disorders, medications, and medical or psychiatric illnesses. If you are experiencing hypersomnia, it is recommended that you consult a healthcare professional for advice and treatment.

Hypersomnia

The symptoms of hypersomnia include constant, recurrent episodes of extreme sleepiness during the day, sleeping longer than average (10 or more hours) but still feeling sleepy, difficulty waking up in the morning or after naps, daytime naps that don't lead to improved alertness, anxiety, irritability, slow thinking, slow speech, inability to focus or concentrate, and memory problems.

The cause of most cases of hypersomnia is unknown, but researchers have investigated the potential roles of neurotransmitters in the brain and cerebrospinal fluid, including hypocretin/orexin, dopamine, histamine, serotonin, and gamma-aminobutyric acid (GABA). There may also be a genetic link, as a family history is present in up to 39% of people with idiopathic hypersomnia.

Treatment for hypersomnia depends on the underlying cause and can include medication and lifestyle changes. Medications used to promote wakefulness include modafinil, armodafinil, pitolisant, solriamfetol, amphetamine, and methylphenidate. Lifestyle changes that may help improve sleep quality include maintaining a regular sleeping schedule, avoiding caffeine and alcohol, establishing a relaxing routine before bedtime, and exercising regularly.

Sleep Disorders

There are over 80 known sleep disorders, and they can significantly impact your quality of life. Here are some of the most common sleep disorders:

• Insomnia: This is the most common sleep disorder, where people are unable to fall asleep or stay asleep.
• Sleep apnea: This condition causes people to stop breathing during sleep, leading to fragmented sleep.
• Restless legs syndrome (RLS) or Willis-Ekbom disease: This disorder causes an overwhelming urge to move the legs, which can disrupt sleep. It is related to unusual sensations in the legs when trying to sleep.
• Hypersomnia: With this condition, people fall asleep repeatedly during the day despite getting adequate or excessive sleep at night. It can affect work life, social life, and home life, and increase the risk of accidents. Hypersomnia can be primary (its own condition) or secondary (caused by another condition).
• Circadian rhythm disorders: These conditions disrupt the body's internal clock, causing misalignments between sleep-wake cycles and light-darkness cycles. Delayed sleep phase syndrome is an example of this type of disorder.
• Parasomnia: People with this condition engage in unusual behaviours during sleep, such as sleepwalking or sleep talking.
• Narcolepsy: This is a rare sleep disorder characterised by involuntary napping, sleep paralysis, vivid hallucinations before falling asleep, and muscle weakness during periods of strong emotion (cataplexy). There are two types of narcolepsy: type 1, which includes cataplexy, and type 2, which does not.
• Idiopathic hypersomnia: This sleep disorder is characterised by excessive nighttime sleeping and the need for daytime naps. It is different from narcolepsy in that it doesn't include cataplexy or sleep paralysis.

If you suspect you may have a sleep disorder, it is important to consult a healthcare professional for diagnosis and treatment. They may refer you to a sleep specialist or a sleep disorders clinic, and recommend lifestyle changes or medications to improve your sleep.

Physical and Mental Health Conditions

There are several physical and mental health conditions that can cause excessive sleepiness and a desire to sleep all day. These include:

• Chronic pain
• Diabetes
• Fibromyalgia
• Hypothyroidism
• Depression
• Anxiety
• Seasonal allergies
• Chronic fatigue syndrome
• Thyroid conditions
• Iron deficiency anemia
• Heart disease
• Pregnancy
• Premenstrual syndrome
• Vitamin B12 deficiency
• Stress
• Bipolar disorder
• Attention deficit hyperactivity disorder (ADHD)

If you are experiencing excessive sleepiness, it is important to consult a healthcare professional to determine the underlying cause and receive appropriate treatment.

In addition to physical and mental health conditions, other factors such as drug and alcohol use, environmental factors, and sleep disorders can also contribute to a desire to sleep all day.

Drug and Alcohol Use

Excessive sleepiness can be caused by a wide range of factors, including sleep disorders, medications, and medical or psychiatric illnesses. Sleep problems have been associated with medication use, drug abuse, and withdrawal from drugs. Alcohol is often thought of as a sedative or calming drug, and while it may induce sleep, the quality of sleep is often fragmented during the second half of the sleep period. Alcohol increases the number of times you awaken in the later half of the night, preventing you from getting the deep sleep and REM sleep you need. With continued consumption just before bedtime, alcohol's sleep-inducing effect may decrease as its disruptive effects continue or increase. The sleep disruption resulting from alcohol use may lead to daytime fatigue and sleepiness. The elderly are at particular risk for alcohol-related sleep disorders, as they achieve higher levels of alcohol in the blood and brain than younger adults after consuming an equivalent dose.

Many prescription and non-prescription drugs can cause sleep problems. Prescription drugs that may cause sleep problems include high blood pressure drugs like beta-blockers, hormones such as oral contraceptives, steroids, inhaled respiratory drugs, attention deficit hyperactivity disorder stimulant medications, and some antidepressants. Non-prescription drugs that can cause sleep problems include pseudoephedrine, medications with caffeine, illegal drugs such as cocaine, amphetamines, and methamphetamines, and nicotine.

Sleep problems are commonly associated with drug and alcohol use. Nearly 70% of patients admitted for detoxification report sleep problems prior to admission, and 80% of those who report sleep problems relate them to their substance use. The association between substance use and sleep problems appears to be bidirectional, with sleep problems increasing the risk for developing substance use disorders, and acute and chronic substance use leading to acute and chronic problems with sleep. Evidence also indicates that long-term abstinence from chronic substance use can reverse some sleep problems.

Environmental Factors

There are a number of environmental factors that can cause a person to feel sleepy during the day or to nap frequently. These factors can include:

• Shift work that goes against the typical sleep-wake body cycle, or circadian rhythm. This is especially true for night shifts.
• 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.
• A snoring partner, a baby that wakes up during the night, noisy neighbours, uncomfortable temperatures, or sleeping on a mattress that is uncomfortable.
• Jet lag, which can affect the internal biological clock that regulates sleep.
• The side effects of certain medications, such as alcohol, caffeinated drinks, tranquillisers, sleeping pills, and antihistamines.

Frequently asked questions