The Mystery Of Sleeping Beauty Syndrome

Feeling sleepy all day can be a symptom of hypersomnia, a condition where people fall asleep repeatedly during the day despite getting adequate sleep at night. Hypersomnia can be caused by a variety of factors, including sleep disorders, medications, medical or psychiatric illnesses, and lifestyle habits such as working night shifts or long hours. It is important to consult a healthcare professional to determine the underlying cause of excessive sleepiness, as it can impact one's quality of life and ability to function in daily activities.

Hypersomnia and its causes

Hypersomnia is a condition characterised by excessive daytime sleepiness and a strong desire to sleep at inappropriate times, such as during work or school, or in the middle of a conversation. People with hypersomnia often struggle to stay awake during the day, which can significantly impact their daily life and overall well-being. Hypersomnia can affect a person's ability to function at work and socially, and it can also increase the risk of accidents, especially motor vehicle accidents.

The causes of hypersomnia can vary from person to person and remain unknown in most cases. However, some potential causes include:

• Underlying medical conditions: Hypersomnia can be caused by various medical conditions, including epilepsy, hypothyroidism, encephalitis, multiple sclerosis, Parkinson's disease, obesity, obstructive sleep apnea, delayed sleep phase syndrome, multiple system atrophy, myotonic dystrophy, and other genetic disorders. It can also be a result of head trauma, tumours, and central nervous system diseases.
• Medications and substance use: Certain medications, such as sedatives, benzodiazepines, barbiturates, melatonin, sleeping aids, anti-hypertensive drugs, anti-epileptic drugs, and antipsychotics, can contribute to hypersomnia. Additionally, excessive alcohol consumption, narcotic drug use, and withdrawal from stimulant drugs can also play a role.
• Sleep disorders: Hypersomnia is often associated with other sleep disorders, including insomnia, obstructive sleep apnea, narcolepsy, idiopathic hypersomnia, and restless legs syndrome.
• Lifestyle factors: Factors such as shift work, family demands, long working hours, environmental disturbances (e.g., noise, temperature), and poor sleep habits can contribute to hypersomnia.
• Mental health issues: Mood disorders, such as depression, bipolar disorder, and seasonal affective disorder, can lead to hypersomnia. Additionally, anxiety can keep people awake at night, making them prone to sleepiness during the day.
• Genetic factors: There may be a genetic link to hypersomnia, as a family history is present in up to 39% of people with idiopathic hypersomnia. Researchers are exploring the role of certain genes in the circadian rhythm that may be different in people with this condition.

Sleep disorders

There are several sleep disorders that can cause excessive sleepiness, including:

• Sleep apnea – This occurs when the upper airway collapses multiple times during sleep, interrupting breathing and causing fragmented sleep. Obstructive sleep apnea is caused by a blockage in the airway, while central sleep apnea occurs when the brain fails to send the correct signals to the muscles that control breathing.
• Restless legs syndrome – This causes an uncomfortable urge to move the legs, which can be soothed by getting up and walking around. It can be caused by low iron levels and may affect up to 10% of adults in the US.
• Narcolepsy – A rare sleep disorder that causes excessive daytime sleepiness and can include vivid hallucinations, sleep paralysis, and cataplexy (sudden muscle weakness triggered by emotions).
• Insomnia – This is very common and can be caused by an irregular sleep schedule, caffeine, nicotine, alcohol, medication, or other sleep disorders.
• Idiopathic hypersomnia – This is characterised by excessive night-time sleeping and the need for daytime naps, without a known cause.
• Circadian rhythm sleep disorders – These are caused by problems with the body's internal "clock", causing difficulty falling asleep or waking up at the right times, or trouble adjusting to a sleep schedule.
• Periodic limb movement disorder – This rare disorder causes the legs, feet, and sometimes arms to jerk or twitch during sleep.

If you suspect you have a sleep disorder, it's important to seek advice from a healthcare professional. They can help determine the underlying cause of your excessive sleepiness and recommend appropriate treatment options.

Lifestyle factors

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

• Shift work: Working night shifts or long hours can disrupt your sleep schedule and make it difficult to get adequate rest.
• Family demands: Responsibilities such as caring for a new baby can interfere with your sleep.
• Study or social life: A busy social life or studying can lead to insufficient or inadequate sleep.
• Environmental factors: Factors such as a snoring partner, a noisy baby, loud neighbours, temperature fluctuations, or an uncomfortable mattress can cause broken sleep.
• Mental states: Anxiety or depression can impact your sleep. Anxiety can keep you awake at night, leading to daytime sleepiness, while depression can sap your energy and affect your sleep patterns.
• Substance use: Alcohol, caffeine, and nicotine use can disrupt your sleep. Additionally, certain medications, such as tranquilizers, sleeping pills, and antihistamines, can also affect your sleep patterns.
• Diet and exercise: A poor diet and lack of exercise can contribute to excessive sleepiness.
• Time zone changes: Jet lag can disrupt your internal biological clock, affecting your sleep patterns.

Making adjustments to your lifestyle habits, such as improving sleep hygiene, maintaining a healthy diet and exercise routine, and reducing substance use, can help improve excessive daytime sleepiness.

Medical conditions

There are several medical conditions that can cause excessive sleepiness. These include:

• Sleep apnea: This occurs when the upper airway collapses during sleep, interrupting breathing and causing sleepiness during the day.
• Restless legs syndrome (RLS): RLS causes an uncomfortable urge to move the legs and can lead to leg jerks throughout the night, interrupting sleep.
• Narcolepsy: A sleep disorder that causes excessive daytime sleepiness and can include "sleep attacks" and sudden muscle weakness.
• Depression: Sleep changes can be an early sign of depression, and vice versa.
• Idiopathic hypersomnia: When a healthcare professional cannot determine a clear cause of excessive sleepiness, they may diagnose this chronic sleep disorder.
• Vitamin deficiencies: Low levels of certain vitamins and minerals, such as vitamin D, vitamin B12, iron, and vitamin B complex, have been linked to excessive sleepiness.
• Other medical conditions: Hypothyroidism, oesophageal reflux, nocturnal asthma, chronic pain, epilepsy, Parkinson's disease, multiple sclerosis, and cancer can also disrupt sleep.

Mental health

There is a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health. Poor sleep can lead to worrying, and worrying can lead to poor sleep, creating a vicious cycle.

People with depression often experience sleep issues, such as insomnia, hypersomnia, and obstructive sleep apnea. Sleep issues may influence the function of the neurotransmitter serotonin, which can contribute to the development of depression. Sleep disruptions can also affect the body's stress system, disrupting circadian rhythms and increasing vulnerability to depression.

Depression and anxiety can also cause excessive daytime sleepiness. A study published in Sleep Medicine in November 2021 found that nearly 20% of participants met the criteria for insomnia disorder, and sleep disturbances were linked to higher levels of psychological distress.

Anxiety can keep a person awake at night, making them prone to sleepiness during the day. Depression saps energy, making it difficult to stay awake and alert.

If you are experiencing problems with sleep, it is important to seek help from a healthcare professional. They can help identify the cause of your sleep issues and suggest treatment options, such as cognitive behavioural therapy or medication.

• Establish a relaxing bedtime routine.
• Exercise regularly, but avoid excessive exercise close to bedtime.
• Maintain a normal weight and a well-balanced diet.
• Avoid cigarettes, alcohol, and caffeinated drinks near bedtime.
• Keep your bedroom well-ventilated, cool, dark, quiet, and comfortable.
• Stick to a regular sleeping schedule.

Frequently asked questions