Brief Sleep, Frequent Wakefulness: Why It Happens

Sleep is a necessity for the human body, but it can often be disrupted by various factors. Many people experience difficulty sleeping or wake up feeling tired, which can be attributed to sleep disorders such as insomnia, sleep apnea, narcolepsy, or delayed sleep phase syndrome. Sleep disorders can be caused by stress, anxiety, depression, poor sleep habits, circadian rhythm imbalances, or even genetic factors. Understanding the causes of disrupted sleep is essential for managing sleep health and overall well-being. In this discussion, we will delve into the reasons why someone might sleep for only 10 minutes before waking up and explore strategies to improve sleep quality.

Delayed sleep phase syndrome (DSPS)

DSPS is more common among adolescents and teenagers due to changes in the body's natural circadian rhythm during puberty. It can also affect adults, particularly women between the ages of 40 and 60. The syndrome may be linked to a person's genetic makeup, as it tends to run in families and has been associated with the hPer3 (human period 3) gene and CRY1 gene. In most cases, however, the cause of the abnormality in the biological clocks of DSPS patients is unknown.

There are two types of DSPS, characterised by the timing of the sleep hormone melatonin, which signals the circadian rhythm:

• Circadian aligned: The melatonin onset is less than two hours before falling asleep.
• Circadian misaligned: The melatonin onset is more than two hours before or after falling asleep.

Treatment for DSPS aims to reset the internal clock. It is different from the treatment of insomnia, as it recognises the patient's ability to sleep well on their own schedule while addressing the timing problem. Treatment success may be partial, and consistency is paramount. Before starting treatment, patients are often asked to spend a week sleeping regularly, without napping, at the times when they are most comfortable.

Certain careers can be more DSPD-friendly, including security work, entertainment, hospitality, call centre work, manufacturing, healthcare, and freelance writing, as these jobs may accommodate later sleep schedules.

Sleep drunkenness

During an episode of sleep drunkenness, an individual may act on automatic behaviors rather than rational thoughts. They may appear to be drunk, even if they have not consumed alcohol. Sleep drunkenness is often associated with poor sleep quality, insufficient sleep, or sleep disorders such as sleep apnea. Other factors that can trigger sleep drunkenness include alcohol consumption, irregular sleep schedules, and certain medications.

The treatment for sleep drunkenness typically involves lifestyle changes. Recommendations include improving sleep hygiene by maintaining a dark, quiet, and cool bedroom environment, avoiding screens and caffeinated beverages before bed, and refraining from alcoholic drinks, especially close to bedtime. In some cases, medication may be necessary to reduce or eliminate the issue.

While there is no specific test to diagnose sleep drunkenness, a doctor may review an individual's medical records and risk factors, such as pre-existing medical conditions or medications. A sleep study may also be ordered to look for clues, such as a higher-than-normal heart rate during sleep. It is important to seek medical advice if sleep drunkenness is causing dangerous side effects or if it occurs frequently.

Sleep apnea

People with sleep apnea may experience repeated awakenings throughout the night, which prevent them from getting enough sleep and can lead to fatigue, mood swings, and other symptoms during the day. Sleep apnea can also cause unusual breathing patterns, such as fast breathing that gets deeper, then shallower again, until breathing stops before starting again. This can result in snoring, snorting, or gasping for air, which may be noticed by a bed partner.

The risk factors for sleep apnea include being overweight or obese, having a thick neck, and being male. Men are more likely to be diagnosed with sleep apnea than women, although the risk for women increases after menopause. Sleep apnea can often go undiagnosed, but it is estimated that about 1 billion people worldwide between the ages of 30 and 69 have obstructive sleep apnea.

If you suspect you may have sleep apnea, it is important to see a healthcare provider. They will ask about your symptoms and medical history and may recommend further testing, such as an overnight polysomnogram or a home sleep study, to confirm a diagnosis. Treatment options for sleep apnea include the use of a continuous positive airway pressure (CPAP) machine, weight loss, changing sleeping positions, and managing any underlying conditions.

Insomnia

Waking up after sleeping for only 10 minutes could be a sign of insomnia, a common sleep disorder that affects sleep patterns. Insomnia is characterised by difficulty falling asleep or staying asleep, resulting in a lack of sleep that causes distress or difficulty with daily activities. It can manifest in several ways: initial insomnia, which involves trouble falling asleep; middle insomnia, which causes waking up in the middle of the night but falling back asleep; and late insomnia, which means waking up too early in the morning and being unable to fall back asleep.

The causes of insomnia vary widely and can be acute (short-term) or chronic (long-term). Brain activity differences, such as increased brain activity or brain chemistry changes, can impact an individual's ability to sleep. Physical health conditions, including temporary illnesses, chronic conditions like acid reflux, and diseases affecting the brain and nerves, can also contribute to insomnia. Mental health conditions, particularly anxiety and depression, are often associated with insomnia. Stressful life circumstances, jet lag, sleeping in unfamiliar places, and adjusting to new work schedules, especially shift work, are other factors that can trigger insomnia.

Additionally, sleep apnea, a disorder characterised by disrupted breathing during sleep, can lead to insomnia. This condition causes individuals to wake up briefly multiple times a night without remembering it. Hormonal changes, especially in women during their periods, perimenopause, or menopause, can also disrupt sleep due to hot flashes and night sweats.

To manage insomnia, it is important to prioritise sleep and maintain a steady sleep-wake cycle. Practicing good sleep hygiene, such as spending time outdoors daily, exercising regularly, and following a relaxing bedtime routine, can be beneficial. It is recommended to avoid napping during the day, drinking alcohol before bed, and worrying about sleep loss, as these can exacerbate insomnia. If insomnia persists or significantly impacts daily life, seeking medical advice is essential.

Sleep inertia

The biological reason for sleep inertia is not yet fully understood, but researchers have put forward several theories. One theory suggests that sleep inertia is caused by high levels of adenosine, a nucleic acid compound found in the brain, which plays a pivotal role in sleep and wakefulness. Upon waking, adenosine levels should be low; however, sleep deprivation can cause a buildup of adenosine, resulting in feelings of tiredness and impaired neural activity. Another theory suggests that sleep inertia is a protective mechanism that helps maintain sleep during moments of unwanted wakings. From an evolutionary standpoint, this hypothesis is counterintuitive, as sudden transitions to wakefulness seem more adaptive. Nonetheless, sleep inertia may reflect the contradictory needs of maintaining sleep while allowing for behavioural responsiveness or the brain's need for a more gradual awakening process.

The duration of sleep inertia varies, typically lasting from 15 to 30 minutes after waking, but it can last up to 60 minutes or even a few hours in some cases. The effects of sleep inertia can be more pronounced if the person is sleep-deprived or has consumed alcoholic beverages the night before. To reduce the impact of sleep inertia, it is recommended to allow time for it to dissipate before performing critical tasks. Consistent wake-up times, natural light exposure, and gentle alarms can also help mitigate morning sleep inertia.

Additionally, caffeine has been found to reduce the duration of sleep inertia when consumed prior to a short nap or upon awakening. Caffeine blocks adenosine receptors in the brain, increasing alertness and counteracting the effects of adenosine buildup. However, individual consumption patterns and tolerance to caffeine may influence its effectiveness in reducing sleep inertia symptoms. Other suggested treatments for sleep inertia include washing with cold water and dosing with stimulant medication 30 minutes before the desired awakening time.

Frequently asked questions