Daytime Sleepers: The Mystery Of Prolonged Slumber

Sleep is a necessity, but when it starts to interfere with your daily life, it may be a sign of something more serious. Excessive daytime sleepiness, or hypersomnia, is characterised by a strong urge to sleep during the day, napping frequently, and sleeping for long hours at night. This condition can affect your work, school, and relationships, leaving you feeling confused and distracted.

There are many potential causes of hypersomnia, including sleep disorders such as sleep apnea, restless legs syndrome, and narcolepsy, as well as lifestyle factors like shift work, family demands, and social life. It can also be a side effect of certain medications or a symptom of an underlying medical or psychiatric condition.

If you are experiencing excessive daytime sleepiness, it is important to consult a healthcare professional to determine the underlying cause and explore treatment options, which may include lifestyle changes, medication, or both.

Sleep disorders

Insomnia

Insomnia is a common sleep disorder that involves problems with falling and staying asleep. It can be episodic, persistent, or recurrent, and is often caused by specific life events or situations. 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 in daily functioning.

Sleep apnea

Sleep apnea is a breathing disorder characterised by interruptions in breathing during sleep, which can last for 10 seconds or longer. It can be caused by a blockage in the airway (obstructive sleep apnea) or when the brain fails to send signals to the muscles that control breathing (central sleep apnea). Sleep apnea can cause snoring, gasping for air, and increased heart rate, and it often leads to excessive daytime sleepiness.

Restless leg syndrome (RLS)

RLS causes an uncomfortable urge to move the legs, usually accompanied by unpleasant sensations such as throbbing or itching. It can be relieved by moving the legs or getting up and walking. RLS can make it difficult to fall and stay asleep, leading to excessive sleepiness during the day.

Hypersomnia

Hypersomnia is a condition where individuals experience excessive sleepiness and an inability to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness. Hypersomnia can be caused by various factors, including inadequate sleep, sleep disorders, medications, and medical or psychiatric illnesses.

Circadian rhythm disorders

Circadian rhythm disorders are problems with the sleep-wake cycle, making it difficult for individuals to sleep and wake at the right times. This misalignment between an individual's sleep-wake rhythms and the external light-darkness cycle can cause significant sleep problems and extreme daytime sleepiness.

Parasomnia

Parasomnia involves acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating. This can include sleepwalking, sleep terrors, nightmare disorder, and rapid eye movement sleep behaviour disorder. These disorders can cause distress and problems with functioning, and in some cases, lead to social isolation or work-related issues.

Depression

The link between depression and sleep problems is bidirectional, meaning that sleep issues can contribute to depression, and depression can cause sleep disturbances. Certain sleep disorders, such as insomnia, obstructive sleep apnea, and restless legs syndrome, are commonly associated with depression. People with insomnia, for example, are ten times more likely to experience depression. Additionally, changes in sleeping habits can sometimes be an early sign of depression, while in other cases, they may occur after other depressive symptoms have already manifested.

It is important to note that depression is not a normal part of aging, but older adults may be particularly susceptible to the side effects of certain medications, including those for depression, which can cause excessive sleepiness. If you or someone you know is experiencing symptoms of depression, it is crucial to seek professional help. Treatment can help manage symptoms and improve overall well-being.

Medication side effects

There are many reasons why someone might sleep all day. While it could be a symptom of a sleep disorder, it could also be the side effect of a medication.

Medications that can cause drowsiness and excessive sleepiness include:

• Antihistamines, which are used to treat nasal congestion
• Antiemetics, which are used to treat nausea and vomiting
• Alcohol, drugs, and cigarettes can also cause excessive sleepiness
• Prescription drugs for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson's disease, nausea, and allergies
• Atypical (second-generation) antipsychotics, which are hard on elderly patients, especially those with dementia
• Antidepressants, which can be prescribed for depression

If you think your medication is making you sleepy, talk to your doctor. Do not stop taking any medication without your doctor's supervision. They may suggest tapering off, changing the dosage, or switching to a different brand.

Older individuals metabolize medications differently than younger people, making them more susceptible to adverse effects like drowsiness and dizziness. Polypharmacy, or taking multiple drugs, can also cause interactions that magnify side effects.

Excessive sleepiness can also be a symptom of certain medical conditions, like fibromyalgia, low thyroid function, mononucleosis, narcolepsy, sleep apnea, or obesity.

Age-related sleep problems

Older adults may also have insufficient exposure to daylight, which is a crucial cue for maintaining circadian rhythms. Additionally, hormonal changes, such as decreased melatonin production, can contribute to disrupted sleep.

Several health conditions common in older adults can interfere with sleep. These include depression, anxiety, heart disease, diabetes, and arthritis. The use of multiple medications for managing these conditions can also affect sleep. Lifestyle changes that come with ageing, such as retirement and social isolation, can further impact sleep patterns.

Research suggests that older adults experience a shifting sleep schedule, often feeling tired earlier in the day and waking up earlier in the morning. They spend more time in the lighter stages of sleep and frequently wake up during the night, resulting in fragmented sleep.

To address age-related sleep problems, experts recommend improving sleep hygiene and developing healthy habits. This includes regular exercise, reducing distractions in the bedroom, avoiding substances that disrupt sleep, maintaining a regular sleep schedule, and establishing a relaxing bedtime routine.

Lifestyle factors

There are several lifestyle factors that can contribute to excessive daytime sleepiness. These include:

• Work patterns: Working night shifts or long hours can disrupt the sleep-wake cycle and lead to excessive sleepiness during the day. This is especially true for those working in shift work, such as night shifts, as it can be difficult to get good sleep while working outside of the standard daytime schedule.
• Social life and family demands: Social activities or family commitments, such as caring for a new baby, can interfere with sleep schedules and lead to sleep deprivation, resulting in daytime sleepiness.
• Environmental factors: Noisy or uncomfortable sleeping environments can cause broken sleep. This includes factors such as a snoring partner, a baby that wakes up frequently, noisy neighbours, temperature fluctuations, or an uncomfortable mattress.
• Mental health: Mental states such as anxiety and depression can impact sleep. Anxiety can keep a person awake at night, making them prone to sleepiness during the day, while depression is often associated with changes in sleep patterns and low energy levels.
• Substance use: The use of certain substances, including alcohol, cigarettes, and caffeinated drinks, can disrupt sleep patterns and contribute to daytime sleepiness. It is recommended to avoid these substances close to bedtime to improve sleep quality.
• Physical activity and weight: Lack of physical activity and obesity have been linked to excessive sleepiness. Engaging in regular exercise and maintaining a healthy weight can help improve sleep quality and reduce daytime sleepiness.
• Diet: Nutritional deficiencies, such as low levels of iron and vitamin B complex, have been associated with excessive sleepiness. Adhering to a well-balanced and nutrient-rich diet can help improve energy levels and reduce sleepiness.
• Age: Age-related changes in sleep patterns are common, with older adults experiencing lighter sleep and more frequent awakenings during the night. This can lead to compensatory napping during the day, which may become problematic if it interferes with regular activities.
• Medications: Certain medications can cause drowsiness and excessive sleepiness as side effects. These include treatments for nasal congestion (antihistamines), nausea and vomiting (antiemetics), and other conditions. It is important to discuss any concerns about medication side effects with a healthcare professional.

Frequently asked questions