The Sleepyheads: Understanding The Lives Of Those Who Sleep All Day

Someone who sleeps all day may be experiencing hypersomnia, a condition characterised by excessive sleepiness. This can be caused by a variety of factors, including sleep disorders, medications, and medical or psychiatric illnesses. Hypersomnia is particularly common in people with dementia, especially in the later stages of the disease. Those with hypersomnia may feel the need to nap during the day, even after sleeping soundly at night, and may experience difficulty thinking, making decisions, and concentrating. While hypersomnia can be concerning, it is important to note that in many cases, it can be managed or cured with adjustments to lifestyle habits and improvements in sleep hygiene.

Hypersomnia

The characteristics of hypersomnia vary from person to person, depending on age, lifestyle, and underlying causes. Some common symptoms of hypersomnia include regularly napping during the day, feeling drowsy and confused upon waking, and experiencing difficulty with thinking, memory, and concentration. People with hypersomnia may also have an increased risk of accidents, especially those involving motor vehicles.

There are several factors that can contribute to hypersomnia, including insufficient or inadequate sleep, environmental factors such as noise or an uncomfortable mattress, shift work, mental states like anxiety and depression, medications, and medical conditions. Sleep disorders such as sleep apnoea, insomnia, restless legs syndrome, sleep walking, narcolepsy, and idiopathic hypersomnia can also lead to hypersomnia.

To diagnose hypersomnia, a doctor may investigate lifestyle habits, medications, physical health, and emotional state. Treatment options depend on the underlying cause and may include lifestyle adjustments, such as improving sleep hygiene, or medication to help stay awake.

Sleep disorders

Sleep is a complex biological process that is critical to both physical and mental health. While you are sleeping, your brain and body functions are still active, performing important jobs that help you stay healthy and function at your best. Sleep disorders are conditions that disturb your normal sleep patterns, and there are more than 80 different types. Sleep-wake disorders often occur alongside medical conditions or other mental health conditions such as depression, anxiety, or cognitive disorders.

Insomnia

Insomnia is the most common sleep disorder, affecting about one-third of adults. It involves problems with falling and staying asleep. To be diagnosed with insomnia disorder, sleep difficulties must occur at least three nights a week for at least three months and cause significant distress or problems with daily functioning.

Sleep Apnea

Sleep apnea is a breathing disorder characterised by interruptions in breathing during sleep, which can last for 10 seconds or more. This interrupted sleep leads to daytime sleepiness and fatigue. Sleep apnea can be treated with lifestyle changes, such as weight loss or sleeping on your side, and in some cases, a custom-fit plastic mouthpiece may be used to keep airways open.

Restless Leg Syndrome (RLS)

RLS involves a tingling or prickly sensation in the legs, along with a powerful urge to move them. The symptoms occur at least three times a week and continue for at least three months, causing significant distress or problems in daily functioning.

Hypersomnia

Hypersomnia is excessive sleepiness and can include narcolepsy, which causes extreme daytime sleepiness. Those with hypersomnia may sleep for 12 hours or more at night but still feel the need to nap during the day. It can be caused by various factors, including insufficient sleep, environmental factors, shift work, mental states, medications, and medical conditions.

Circadian Rhythm Disorders

These disorders involve problems with the sleep-wake cycle, making it difficult to sleep and wake at the right times. They can be caused by internal factors, where a person's body clock differs from the light-dark cycle, or external factors such as shift work or jet lag.

Parasomnia

Parasomnia involves acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating.

Mental states

The relationship between mental states and sleep is bidirectional, meaning that just as mental states can influence sleep, the quality and quantity of sleep can also affect mental health. For instance, individuals with insomnia may experience difficulty falling or staying asleep, which can subsequently contribute to feelings of anxiety or depression. Furthermore, sleep disorders or disturbances can exacerbate existing mental health conditions.

It is important to recognize that mental states and sleep are intricately linked. Changes in sleep patterns can be an early indicator of underlying mental health issues. Therefore, addressing sleep problems and maintaining healthy sleep habits are crucial for overall well-being and mental health. Seeking professional help for sleep disorders or persistent sleep difficulties is essential, as proper diagnosis and treatment can improve both sleep quality and mental state.

Additionally, certain medications used to treat mental health conditions can have an impact on sleep. For example, antipsychotics, antidepressants, antihistamines, and sleeping pills may contribute to sleepiness during the day. Therefore, it is important to be aware of the potential side effects of any medications and consult with a healthcare professional if sleep disturbances occur.

Dementia

People with dementia tend to sleep a lot during the day and night, and time spent sleeping typically increases as dementia progresses. This can be distressing for the person with dementia and their loved ones, who may worry that something is wrong.

The brain of a person with dementia undergoes physical changes that can affect how much and how well they sleep. As the disease progresses, the damage to their brain becomes more extensive, and they gradually become weaker and frailer. As a result, they may find it exhausting to do simple tasks like communicating or eating, which can make them sleep more during the day as their symptoms worsen.

Additionally, people with dementia may experience:

• Medicine side effects: Some medications for dementia or other conditions may cause drowsiness or insomnia. These include antipsychotics, antidepressants, and antihistamines.
• Fatigue: Dementia can be physically exhausting for the body to cope with, and sleep is an important part of the healing process.
• Melatonin depletion: As dementia progresses, the brain may produce less melatonin, a hormone that regulates sleep/wake cycles.
• Low sleep pressure: Those with dementia may experience long periods of low activity or boredom during the day, which can affect their sleep/wake cycles.
• Sundowning: This is when confusion and other symptoms worsen at night, making it difficult to maintain a regular sleep schedule.

Disrupted sleep patterns in people with dementia can cause:

• Increased irritability throughout the day
• Decreased attention and focus
• Reduced cognitive performance
• Increased psychiatric symptoms
• Heightened risk of falls

How to help manage sleep patterns:

Even though increased sleep is considered a normal side effect of dementia, trouble sleeping and excessive sleep have been tied to issues like depression, anxiety, and apathy. Here are some ways to help manage sleep patterns:

• Create a daily routine: Keep your loved one engaged and active during daylight hours. When their days are full of planned activities, a nighttime sleep schedule is easier to follow.
• Avoid caffeine and heavy meals: Plan dinnertime several hours before going to bed, and reduce caffeine intake later in the day.
• Establish a bedtime routine: Ensure your loved one is going to bed at the same time each night, and try to create a winding-down ritual like undressing and showering before bed.
• Avoid upsetting situations: Try not to bring up distressing topics or turn on disruptive television shows before bed.
• Keep a sleep diary: Track key pieces of information like bedtime, wake-up time, and nap durations.

Sleep hygiene

Optimise Your Sleep Schedule

• Maintain a fixed wake-up time: Stick to the same wake-up time every day, including weekends, to establish a consistent sleep rhythm.
• Prioritise sleep: Avoid sacrificing sleep for other activities like work, studies, socialising, or exercise. Calculate your target bedtime based on your wake-up time and prepare for bed accordingly.
• Make gradual adjustments: If you need to shift your sleep schedule, do so gradually, making small adjustments of up to an hour to avoid disrupting your sleep rhythm.
• Manage naps: While naps can boost energy during the day, they can also interfere with nighttime sleep. Keep naps short and limited to the early afternoon.

Establish a Nightly Routine

• Keep a consistent routine: Follow the same pre-sleep steps each night, such as putting on pajamas and brushing your teeth, to signal to your mind that it's bedtime.
• Wind down for 30 minutes: Engage in calming activities like soft music, light stretching, reading, or relaxation exercises before bed to ease yourself into sleep.
• Dim the lights: Avoid bright lights before bed as they can hinder melatonin production, a hormone that facilitates sleep.
• Unplug from electronics: Take a break from devices like phones, tablets, and laptops for 30-60 minutes before bed. These devices stimulate your mind and emit blue light, which can reduce melatonin production.
• Practice relaxation techniques: Instead of forcing yourself to fall asleep, focus on relaxation. Techniques like meditation, mindfulness, and paced breathing can prepare your mind and body for sleep.
• Avoid tossing and turning: If you can't fall asleep within 20 minutes, get out of bed and engage in a calming activity in low light before trying again.

Cultivate Healthy Daily Habits

• Get daylight exposure: Sunlight is a key driver of circadian rhythms, which promote quality sleep.
• Exercise regularly: Physical activity improves sleep quality and offers additional health benefits.
• Avoid smoking: Nicotine stimulates the body and disrupts sleep.
• Reduce alcohol consumption: While alcohol may make it easier to fall asleep initially, it can disrupt sleep later in the night. Moderate your intake and avoid drinking close to bedtime.
• Limit caffeine intake: Caffeine is a stimulant that can keep you wired when you want to rest. Avoid consuming it in the afternoon and evening.
• Avoid late dinners: Eating a large, heavy, or spicy meal close to bedtime can disrupt sleep as your body is still digesting. Opt for lighter meals or snacks before bed.
• Restrict in-bed activities: To associate your bed with sleep, use it only for sleep and sexual activity.

Optimise Your Bedroom Environment

• Comfortable mattress and pillow: Choose a mattress and pillow that provide comfort and support for pain-free sleep.
• Use comfortable bedding: Ensure your sheets and blankets match your preferences for a pleasant sleep experience.
• Set a cool temperature: Keep your bedroom on the cooler side, around 65 degrees Fahrenheit, for optimal sleep.
• Block out light: Use heavy curtains or an eye mask to prevent light from interrupting your sleep.
• Drown out noise: Use earplugs, a white noise machine, or a fan to block out disruptive noises.
• Try calming scents: Light scents like lavender may promote relaxation and create a positive sleep environment.

Frequently asked questions