Sleep And Irritation: Why Do I Feel This Way?

Feeling sleepy all day and irritated could be a sign of hypersomnia, a condition where people fall asleep repeatedly during the day. Hypersomnia can be caused by a variety of factors, including inadequate sleep, sleep disorders, medications, and medical or psychiatric illnesses. Other causes include environmental factors, such as a noisy neighbour or an uncomfortable mattress, shift work, mental states like anxiety and depression, and changes in time zones. Hypersomnia can be treated with medication and lifestyle changes, such as maintaining a regular sleeping schedule, avoiding caffeine and alcohol, and creating a peaceful sleeping environment.

Sleep disorders like sleep apnea, restless legs syndrome, and insomnia

Sleep Apnea

Sleep apnea is a disorder that causes you to stop breathing while asleep. Your brain tries to protect you by waking you up just enough to breathe, but this prevents you from getting restful and healthy sleep. This can cause serious complications if left untreated over time. Sleep apnea can cause daytime sleepiness, drowsiness, and even lead to dangerous accidents while driving or operating machinery. It can also result in mood changes, such as depression and anxiety, as well as disruptions in brain function, including memory loss and trouble concentrating.

Restless Legs Syndrome

Restless legs syndrome (RLS) is characterised by sensations of cramps or irritation in the legs, especially the calves. This compulsion to move the legs can disrupt sleep and lead to daytime sleepiness and fatigue. While the exact cause of RLS is unknown, it is believed to be related to dopamine, a chemical messenger in the brain that helps control body movements.

Insomnia

Insomnia is a common sleep disorder that affects an individual's ability to fall asleep or maintain restful sleep. It can be acute (short-term) or chronic (long-term), with the latter being referred to as insomnia disorder. Insomnia can lead to feeling tired, unwell, and sleepy during the day. It can also cause delayed responses, trouble remembering things, confusion, and irritability. In severe or long-lasting cases, insomnia can result in sleep deprivation, increasing the risk of high blood pressure, obstructive sleep apnea, and conditions involving psychosis.

If you suspect that you are suffering from any of these sleep disorders, it is important to consult a healthcare professional for proper diagnosis and treatment.

Underlying conditions like thyroid disorder, cancer, epilepsy, or Parkinson's disease

Underlying conditions: Thyroid disorder

If your thyroid makes too much or too little of certain hormones, your body chemistry can get out of balance. That can affect your circadian rhythm – the internal body clock that’s responsible for your sleep-wake cycle.

If your thyroid makes too much hormone, it’s a condition called hyperthyroidism. You might wake up often feeling nervous or cranky, have night sweats, or have to pee often.

If your thyroid makes too little hormone, it’s a more common condition called hypothyroidism. You might have trouble falling asleep or not be able to stay asleep long enough to feel fully rested. Hypothyroidism also can affect your sleep by making you feel too cold or causing joint or muscle pain. Some people with hypothyroidism also feel extremely sleepy in the daytime, to the point that it’s hard to stay awake.

Underlying conditions: Cancer

Fatigue is a major complaint among cancer patients, and it is unknown whether cancer-related fatigue experienced during the day is related to sleep/wake cycles or the quality and quantity of sleep obtained at night. Sleep disruption is also a very common complaint in patients with cancer. It is unknown whether fatigue has any relationship to the quality or quantity of sleep, or to the sleep/wake cycle.

Underlying conditions: Epilepsy

The effect of epilepsy on sleep can be related to the same pathophysiological mechanism causing epilepsy, the effect of seizures, the effect of antiepileptic therapy, or a combination of these factors. An increase in sleep onset latency, an increase in the wake time after sleep onset, increased instability of sleep stages, and an increase in light sleep have all been reported in patients with epilepsy. Many patients note postictal hypersomnolence following a seizure, which may last for more than a day at times. Seizures can cause sleep disruption by decreasing sleep efficiency, increasing sleep stage shifts, and increasing periods of wakefulness in patients with primary generalised seizures or complex partial seizures compared with normal controls.

Underlying conditions: Parkinson's disease

Parkinson’s disease and sleep are closely connected. Most people with Parkinson’s have sleep problems at times. The disease itself may cause some issues, such as REM sleep disorder. You might also have insomnia or feel overly tired during the day.

Mental health issues like anxiety, depression, bipolar disorder, or seasonal depression

Mental health issues, such as anxiety, depression, bipolar disorder, or seasonal depression (also known as Seasonal Affective Disorder (SAD)), can be both a cause and an effect of sleeping all day and feeling irritated.

Anxiety can cause racing or repetitive thoughts and worries that keep you awake at night. It can also increase agitation and arousal, making it difficult to fall asleep. On the other hand, lack of sleep can make it harder to cope with stress and regulate emotions, leading to increased anxiety and distress levels.

Depression is often associated with sleeping more, including staying in bed for longer or sleeping at times when one should be awake. It can also cause insomnia, making it difficult to fall or stay asleep. The link between depression and abnormal sleep patterns has been well-established in studies.

Bipolar disorder, particularly during a manic phase, can cause increased energy and elation, leading to insomnia or disrupted sleep patterns.

Seasonal affective disorder (SAD) is a type of depression that typically occurs during the fall and winter months when there is less natural sunlight exposure. It can lead to oversleeping, or hypersomnia, and increased feelings of depression or anxiety.

If you are experiencing mental health issues and sleeping difficulties, it is important to seek professional help. A doctor or mental health specialist can provide guidance, support, and treatment options to improve your sleep and overall well-being.

Lifestyle factors like diet, exercise, and substance use

Diet:

The foods and drinks you consume can affect your sleep in various ways. Consuming a healthy, balanced diet can improve your overall health and reduce the risk of health conditions that may disrupt your sleep. For example, a diet rich in calcium, magnesium, and vitamins A, C, D, and E may enhance sleep quality.

On the other hand, a diet too high in calories or fat may make it harder to get a good night's sleep. Consuming caffeine, especially close to bedtime, can also disrupt your sleep by making it difficult to fall asleep. Similarly, eating too close to bedtime can lead to sleep disruptions, as your body may still be digesting the food when you try to sleep.

Exercise:

Regular exercise is a cornerstone of health and can improve sleep quality and duration. Both aerobic exercises, like cardio and running, and resistance exercises, like weightlifting, can help you sleep better. Any amount of movement during the day can be beneficial, but younger people may require more exercise than older individuals to see similar benefits.

Exercising outdoors can be especially beneficial, as exposure to natural light during the day can help keep your body's internal clock, or circadian rhythm, in sync. However, it's important to avoid exercising too close to bedtime, as it may make it challenging to fall asleep due to increased alertness.

Substance Use:

The use of certain substances, including alcohol and prescription medications, can lead to oversleeping or disrupted sleep patterns. Alcohol, for instance, is a depressant that can make you sleepy, but if consumed in large quantities, you may build a tolerance, leading to potential alcohol use disorder (AUD). Even without AUD, alcohol can affect sleep quality as you are likely to wake up as the drug wears off, and it can cause breathing difficulties due to muscle relaxation.

Other substances that can disrupt sleep include illegal drugs like amphetamines, cocaine, and heroin, as well as certain prescription and over-the-counter medications. These substances can lead to insomnia, nighttime wakefulness, reduced overall sleep time, and strong daytime sleepiness.

Additionally, withdrawing from certain substances, such as prescription drugs, alcohol, opioids, and even marijuana, can also cause sleep problems, including insomnia, broken sleep, and restless leg syndrome.

In summary, paying attention to your diet, exercise routine, and substance use can have a significant impact on your sleep. Making positive changes in these areas can improve your sleep quality and duration, contributing to better overall health and well-being.

Sleep inertia or idiopathic hypersomnia

Sleep inertia is a temporary state of disorientation and reduced performance that occurs after waking up from a long sleep or a nap. It is characterised by grogginess, impaired cognitive ability, poor short-term memory, slower reaction times, and slower speed of thought, reasoning, remembering, and learning. Sleep inertia usually lasts for 15 to 60 minutes but can continue for up to two hours, especially if the person is sleep-deprived.

Idiopathic hypersomnia, on the other hand, is a chronic sleep disorder characterised by excessive daytime sleepiness. People with idiopathic hypersomnia may spend most of their day sleeping or thinking about, craving, or fighting the urge to sleep, which can severely impact their quality of life. They may need to sleep for longer than average (more than 9 hours a night) and often experience unrefreshing sleep. Other symptoms include brain fog, severe sleep inertia, difficulty waking up, poor coordination, and sleep attacks. The exact cause of idiopathic hypersomnia is unknown, but it may have a genetic link as a family history is present in up to 39% of cases.

Both sleep inertia and idiopathic hypersomnia can result in feelings of disorientation, confusion, and irritability. However, sleep inertia is a temporary state that typically lasts for less than an hour after waking up, while idiopathic hypersomnia is a chronic condition that affects a person's overall sleep patterns and quality of life.

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