Sleeping Beauty Syndrome: Days Of Unconscious Slumber

Sleep is an essential part of our daily routine, but what happens when we sleep too much? Oversleeping, or long sleeping, is when someone regularly sleeps for more than 9 hours in a 24-hour period. This can be a sign of hypersomnia, a condition characterized by extreme sleepiness during the day, sleeping for up to 18 hours a day, and multiple sleep sessions per day. Hypersomnia can be caused by a variety of factors, including insufficient sleep, sleep disorders, medications, and medical or psychiatric illnesses. It can also be a symptom of other underlying health conditions, such as epilepsy, hypothyroidism, depression, or Parkinson's disease. Apart from health issues, lifestyle factors like shift work, family demands, and social life can also contribute to hypersomnia.

While the exact cause of hypersomnia remains unknown in many cases, researchers are exploring the potential roles of neurotransmitters and genetic links. Treatments for hypersomnia include medications, non-drug options, and lifestyle changes to improve sleep quality. However, it's important to consult a healthcare professional to properly diagnose and address the issue.

Hypersomnia

The characteristics and symptoms of hypersomnia vary from person to person, depending on age, lifestyle, and underlying causes. However, common symptoms include:

• Regular napping and sleeping during the day
• Sleeping for long hours at night (up to 18 hours)
• Feeling unrefreshed and sleepy after waking up or napping
• Difficulty thinking, making decisions, memory problems, and "brain fog"
• Slow thinking, slow speech, and inability to focus or concentrate
• Anxiety, irritability, and mood swings
• Increased risk of accidents, especially motor vehicle accidents
• Inadequate or insufficient sleep due to long working hours, shift work, family demands, or social life
• Environmental factors such as noise, light, or an uncomfortable mattress
• Mental states like anxiety and depression
• Medications and substances, including alcohol, caffeine, tranquilisers, sleeping pills, and antihistamines
• Medical conditions such as hypothyroidism, oesophageal reflux, nocturnal asthma, chronic pain, epilepsy, multiple sclerosis, Parkinson's disease, and more
• Changes in time zones, resulting in jet lag
• Other sleep disorders, including sleep apnoea, restless legs syndrome, sleepwalking, narcolepsy, and insomnia

The treatment for hypersomnia depends on the underlying cause. It may include medications such as wakefulness-promoting agents or psychostimulants, as well as lifestyle changes to improve sleep quality and "sleep hygiene". These changes can include maintaining a regular sleeping schedule, creating a comfortable and peaceful sleeping environment, avoiding substances that disrupt sleep, and establishing a bedtime routine.

Sleep disorders

There are several sleep disorders that can cause someone to sleep for days. These include:

• Hypersomnia, a condition characterised by excessive sleepiness during the day. People with hypersomnia may sleep for 12 hours or more at night but still feel the need to nap during the day. The symptoms of hypersomnia include feeling unusually tired all the time, needing daytime naps, feeling drowsy despite sleeping, difficulty thinking and making decisions, and memory problems. The cause of most cases of hypersomnia is unknown, but it is more common in females than males and is usually diagnosed in adolescence or young adulthood.
• Insomnia, a condition that makes it hard to fall asleep or stay asleep. Insomnia is often related to other sleep problems that cause excessive sleepiness, such as hypersomnia.
• Obstructive sleep apnea, a breathing disorder characterised by brief pauses in breathing during the night, resulting in fragmented sleep that causes daytime drowsiness.
• Restless legs syndrome, a condition that causes a strong sensation of needing to move one's legs. It can interrupt sleep and lead to sleepiness when one needs to be awake.
• Narcolepsy, a neurological condition in which the brain cannot properly regulate the sleep-wake cycle, making people prone to falling asleep rapidly at inopportune times.
• Circadian rhythm sleep-wake disorders, which occur when a person's sleep schedule is misaligned with their local day-night cycle, resulting in short and fragmented sleep. Examples include jet lag and sleep problems among shift workers.
• Kleine-Levin syndrome, a condition that consists of recurring episodes of extreme hypersomnia, usually occurring with mental, behavioural, and sometimes psychiatric disturbances. Each episode can last about 10 days, with some lasting several weeks or months and recurring several times a year.
• Idiopathic hypersomnia, a type of hypersomnia with no known cause, meaning people feel extremely sleepy for unknown reasons even after sleeping for 9 to 10 hours.

If you suspect you may have a sleep disorder, it is important to consult a healthcare professional for a proper diagnosis and treatment plan.

Depression

People with depression may find it difficult to fall asleep and stay asleep at night, or they may experience periods of excessive daytime sleepiness. This can manifest as sleeping throughout the day, using sleep to pass the time, or choosing sleep over other daily activities. Depression can make individuals feel fatigued, both physically and mentally, to the point where even small tasks can feel exhausting or difficult.

The relationship between depression and sleep is bidirectional, meaning that poor sleep can contribute to the development of depression, and having depression makes a person more likely to experience sleep troubles. Sleep issues may influence the function of neurotransmitters such as serotonin, which can contribute to the development of depression. Additionally, sleep disruptions can affect the body's stress system, disrupting circadian rhythms and increasing vulnerability to depression.

Treating sleep problems can help alleviate depressive symptoms. Cognitive behavioural therapy for insomnia (CBT-I), along with depression treatment, has been shown to improve sleep in people with depression and may increase the chances of remission. Other treatments for depression include selective serotonin reuptake inhibitors and other medications, as well as brain stimulation therapies such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS).

It is important to note that while oversleeping can be a symptom of depression, it is not a cause. However, it can exacerbate and worsen depression symptoms. If you or someone you know is experiencing symptoms of depression, it is important to seek professional help and treatment.

Medication

Common culprits that cause sleepiness include:

• Antidepressants
• Antihistamines, found in sleep aids or medicines that treat allergies
• Antiemetics, which are used to control nausea and vomiting
• Antipsychotics and anticonvulsants, which can be used to treat seizures or depression
• Drugs to treat high blood pressure, including alpha and beta-blockers
• Benzodiazepines and other sedatives, commonly used for anxiety or insomnia
• Drugs for Parkinson's disease
• Muscle relaxants
• Opioids and other prescription pain medications
• Over-the-counter medicines for insomnia, allergies, nausea, vomiting, or diarrhea

Prescription sleep medications can also cause excessive sleepiness. These include:

• Benzodiazepines, such as Dalmane, Halcion, and Restoril
• GABA medications, such as Lunesta, Ambien, and Sonata
• Rozerem, a melatonin receptor agonist
• Belsomra and Quviviq, which affect the brain chemical orexin
• Silenor, a low-dose form of the antidepressant doxepin

Over-the-counter sleep medications can also cause excessive sleepiness. These include:

• Antihistamines, such as Benadryl, Nytol, Sominex, and Unisom
• Melatonin supplements
• Valerian supplements

It is important to note that mixing sleep medications with alcohol or other drugs that affect the central nervous system can increase the risk of side effects and lead to dangerous interactions. Older adults are also more susceptible to the side effects of sleep medications, which can last longer in their system and increase the risk of falls and accidents.

If you are experiencing excessive sleepiness due to medication, it is important to consult your doctor or pharmacist. They may recommend adjusting the dose, changing the medication, or taking the medication at a different time of day. Maintaining healthy sleep habits and avoiding substances that can cause tiredness, such as alcohol, may also help reduce excessive sleepiness.

Lifestyle factors

• Sleep Habits: Maintaining a consistent sleep schedule, including going to bed and waking up at the same time each day, is crucial for regulating your body's sleep-wake cycle. This helps to establish a routine that promotes better sleep quality.
• Exercise: Regular physical activity, such as getting at least 30 minutes of exercise most days of the week, can improve sleep. However, it is important to avoid exercising close to bedtime, as this may interfere with falling asleep.
• Substance Use: Caffeine, alcohol, and nicotine consumption can disrupt sleep. Avoiding these substances, especially close to bedtime, may improve sleep quality and reduce excessive sleepiness.
• Diet: A well-balanced and nutritious diet is essential for overall health and can impact sleep quality. Avoiding stimulants like caffeine and certain foods before bed can promote better sleep.
• Relaxation: Incorporating relaxing activities into your bedtime routine, such as reading or taking a warm bath, can help reduce anxiety and promote better sleep.
• Environment: Creating a sleep-conducive environment involves making your bedroom comfortable, dark, quiet, and free from distractions like electronic devices. This can help you fall asleep more easily and improve sleep quality.
• Power Naps: While daytime napping is generally not recommended, brief 'power naps' can be beneficial in specific situations, such as when concentration and alertness are required for tasks like driving or studying.
• Avoiding Shift Work: Working night shifts or irregular hours can disrupt your body's natural circadian rhythm, making it challenging to fall asleep at the desired time and leading to excessive sleepiness during the day.
• Managing Stress: Stress and anxiety can keep you awake at night, leading to daytime sleepiness. Finding healthy ways to manage stress, such as through relaxation techniques or cognitive behavioural therapy, can improve sleep quality.

Frequently asked questions