The Mystery Of Uneven Sleep Patterns And Their Causes

There are many reasons why you might sleep more on some days. Oversleeping, or long sleeping, is generally considered to be sleeping for more than nine hours in a 24-hour period. This could be caused by a number of factors, including environmental factors, drug and alcohol use, physical and mental health conditions, and sleep disorders. For example, you might be sleeping more because of a change in your environment, such as a new baby, or because of a sleep disorder like insomnia or sleep apnea. Oversleeping has been linked to a host of medical problems, including diabetes, obesity, heart disease, and increased risk of death, so it's important to identify the cause if you find yourself regularly sleeping too much.

Sleep disorders

Oversleeping, or "long sleeping", is when a person sleeps for more than nine hours in a 24-hour period. This can be caused by a number of factors, including underlying health conditions, medications, environmental factors, and sleep disorders.

• Circadian rhythm sleep-wake disorders: Disorders related to misalignments between sleep-wake cycles and light-darkness cycles.
• Hypersomnia: A condition characterised by excessive daytime sleepiness despite getting an adequate amount of nighttime sleep. People with hypersomnia may sleep for up to 18 hours a day and experience symptoms such as sleep drunkenness, anxiety, irritability, and memory problems.
• Narcolepsy: A sleep disorder characterised by involuntary napping, sleep paralysis, vivid hallucinations, and muscle weakness during periods of strong emotion.
• Obstructive sleep apnea (OSA): A sleep-related condition in which a person's breathing is interrupted during sleep, causing snoring or pauses in breathing.
• Restless leg syndrome (RLS): A disorder causing an urge to move the legs due to sensations such as tingling or burning in the legs.
• Idiopathic hypersomnia: A sleep disorder with no known cause, characterised by excessive nighttime sleeping and daytime napping.
• Insomnia: A common symptom rather than a disease, where a person has difficulty falling or staying asleep.
• Sleep walking: A common abnormal behaviour during sleep, more prevalent in children.

If you suspect you have a sleep disorder, it is important to seek advice from a healthcare professional or a sleep disorder clinic for diagnosis and treatment.

Health conditions

Oversleeping, or long sleeping, is defined as sleeping for more than nine hours in a 24-hour period. This can be a symptom of other underlying conditions, such as depression, illness, or a sleep disorder.

Sleep Disorders

Narcolepsy and other sleep disorders commonly cause hypersomnia, or excessive sleepiness. Sleep disorders that can cause hypersomnia include:

• Sleep apnea: A disorder that causes interruptions in breathing during sleep, resulting in snoring, choking, and sleepiness during the day.
• Restless leg syndrome: A disorder causing an urge to move the legs due to sensations such as cramps or irritation.
• Sleep walking: More common in children, this disorder involves walking around while still asleep.
• Idiopathic hypersomnia: A sleep disorder characterised by excessive night-time sleeping and daytime napping, without a known cause.
• Insomnia: A common symptom rather than a disease, where a person has difficulty falling or staying asleep.

Mental Health Disorders

People with depression and anxiety often struggle with sleep disorders or other health disorders that can cause oversleeping. Depression is linked to both insomnia and oversleeping, with around 15% of people with depression sleeping too much. This may, in turn, worsen their depression as regular sleep habits are important for recovery. People with anxiety can also experience sleepiness during the day due to being kept awake at night.

Other Health Issues

Other health issues that can cause oversleeping include:

• Obesity: People who sleep for nine or ten hours every night are more likely to become obese over time, even when food intake and exercise are taken into account.
• Chronic pain: Conditions that cause chronic pain can disrupt sleep.
• Cardiovascular disease: Longer sleep durations are associated with a higher risk of heart disease.
• Respiratory infections: People with respiratory infections such as the flu, a cold, or COVID tend to sleep for longer periods, though the sleep is not necessarily restful.
• Vitamin B12 deficiency: A lack of vitamin B12 can lead to fatigue and low energy, causing people to sleep more.

Medication

Antihistamines

Allergy medications, or antihistamines, are a common cause of drowsiness. Examples include brompheniramine, diphenhydramine, hydroxyzine, and meclizine. Some antihistamines are also present in sleeping pills.

Antidepressants

Tricyclic antidepressants, such as amitriptyline, doxepin, imipramine, and trimipramine, are known to cause sleepiness. Selective serotonin reuptake inhibitors (SSRIs) can also lead to insomnia, though the reason is not well understood.

Anxiety Medications

Benzodiazepines, a type of anxiety medication, can induce drowsiness. These include alprazolam, clonazepam, diazepam, and lorazepam.

Blood Pressure Medications

Beta-blockers, used to treat high blood pressure, can cause sleepiness by slowing down the heart rate. Examples include atenolol, metoprolol, and propranolol hydrochloride. Alpha-blockers, another type of blood pressure medication, can also disrupt sleep patterns and cause daytime sleepiness.

Cancer Treatment

Cancer treatments can cause fatigue by altering protein and hormone levels in the body.

Gut Medications

Drugs that control nausea, vomiting, or diarrhoea can lead to sleepiness.

Muscle Relaxants

Muscle relaxants work on the nerves in the brain and spine, and their effects on the nervous system can cause tiredness. Examples include carisoprodol and cyclobenzaprine.

Opioid Pain Medications

Opioids mimic the body's natural endorphins and are often associated with sleepiness. Common opioids that may cause this include fentanyl, oxycodone, morphine, and hydrocodone.

Seizure or Epilepsy Medications

Anticonvulsants, used to treat seizures or epilepsy, can cause drowsiness. Some of these drugs, such as benzodiazepines, are also used to treat anxiety. Other common seizure medications with this side effect include carbamazepine, phenobarbital, phenytoin, topiramate, and valproic acid.

Sleeping Pills

Sleeping pills are designed to induce sleep and are therefore a common cause of increased sleep on certain days. Both over-the-counter and prescription sleeping pills can lead to daytime drowsiness. Natural sleep aids, such as melatonin and valerian, can also cause side effects like daytime sleepiness and confusion.

Environmental factors

There are several environmental factors that can contribute to sleeping more on some days. These factors can be related to your lifestyle, work schedule, physical environment, and more. Here are some detailed examples:

• Shift work: Working outside the typical 9-to-5 schedule can disrupt your sleep patterns. This is especially true for night shifts, which go against your body's natural circadian rhythm or sleep-wake cycle.
• Limited time for sleep: Certain jobs or responsibilities may leave you with insufficient time for sleep. For example, caregivers or people with demanding careers might have irregular sleep schedules, leading to sleep debt.
• Inadequate sleep habits: Not leaving enough time in your schedule for sleep can contribute to oversleeping. This could be due to working long hours, studying, social activities, or other lifestyle factors.
• Physical environment: Factors in your physical environment, such as a snoring partner, a baby that wakes up frequently, noisy neighbours, temperature fluctuations, or an uncomfortable mattress, can interrupt your sleep and lead to oversleeping.
• Time zone changes: Travelling across time zones, known as jet lag, can disrupt your body's internal biological clock, leading to sleep disturbances.
• Social life: A busy social life can impact your sleep schedule and leave you with insufficient sleep. Social activities, especially those involving alcohol consumption, can disrupt your sleep patterns and contribute to oversleeping.
• Light exposure: Exposure to light, especially before bedtime, can affect your body's internal clock. This includes the use of electronic devices, which emit blue light, and can interfere with your sleep.
• Diet and substance use: Caffeine and alcohol consumption can impact your sleep. Caffeine is a stimulant that can keep you awake, while alcohol can disrupt your sleep patterns and cause drowsiness the next day. Additionally, certain prescription medications can cause drowsiness and contribute to oversleeping.

Lifestyle factors

• Shift work: Working shifts, especially night shifts, can disrupt the body's natural sleep-wake cycle, known as the circadian rhythm. This disruption can lead to broken sleep and make it challenging to get enough quality sleep.
• Family demands: Responsibilities such as caring for a new baby or elderly parents can cut into sleep time, leading to sleep deprivation and a greater need for sleep during the day.
• Study or social life: A busy social life or long study sessions can result in staying up late and not getting enough sleep. This can accumulate over time, leading to a sleep deficit that the body will eventually demand to be repaid.
• Environmental factors: Noisy neighbours, an uncomfortable mattress, or a snoring partner can all contribute to broken sleep, reducing the quality and quantity of sleep.
• Mental states: Anxiety and depression are mental states that can impact sleep. Anxiety can keep a person awake at night, leading to daytime sleepiness, while depression can sap energy and make it difficult to maintain a regular sleep schedule.
• Substance use: Alcohol, caffeine, and certain medications can disrupt sleep patterns. Alcohol, for example, can cause drowsiness and contribute to excessive daytime sleepiness (EDS), making it challenging to stay awake during the day.
• Lack of exercise: Regular exercise is essential for maintaining a healthy sleep schedule. A sedentary lifestyle can disrupt sleep patterns and contribute to overall fatigue.
• Nutrition: A well-balanced diet is crucial for optimal health and can impact sleep. Nutritional deficiencies can play a role in sleep disturbances and fatigue.
• Time zone changes: Jet lag, caused by travelling across multiple time zones, can disrupt the body's internal biological clock, leading to sleep disturbances and daytime sleepiness.

Addressing these lifestyle factors can help improve sleep quality and regulate sleep patterns. It's important to maintain a consistent sleep schedule, create a relaxing sleep environment, and seek professional help if sleep disturbances persist.

Frequently asked questions