Deep Slumber: Won't Wake Up From Sleep

Sleep is essential for health, and deep sleep is critical for feeling rested. However, some people struggle with waking up from sleep, experiencing conditions like sleep inertia, sleep drunkenness, or sleep paralysis. Sleep inertia refers to the transition from sleep to wakefulness, marked by performance impairments and sleepiness. Sleep drunkenness, commonly associated with idiopathic hypersomnia, manifests as confusion, slowness, and a tendency to return to sleep. Meanwhile, sleep paralysis involves being conscious yet unable to move or speak, often accompanied by hallucinations and a sense of pressure or choking. Understanding and addressing these conditions can help improve sleep quality and morning alertness.

Characteristics of 'Won't wake up from sleep'

Sleep drunkenness

People experiencing sleep drunkenness may act on automatic behaviors instead of rational thoughts. They may also exhibit unusual behaviors, such as appearing to be drunk without having consumed alcohol. Episodes typically last for 5–15 minutes, but some may endure for up to 40 minutes or even an hour.

The causes of sleep drunkenness are varied and often unclear. However, certain factors can increase the likelihood of experiencing it. These include poor sleep quality or insufficient sleep, certain medications, sleep disorders like sleep apnea or restless leg syndrome, alcohol consumption, irregular sleep schedules due to shift work, and mental health conditions like panic disorder or PTSD.

If you suspect you are experiencing sleep drunkenness, it is advisable to consult a doctor, especially if it occurs frequently or leads to dangerous situations. Diagnosis is often a multi-step process, and treatment options are typically focused on lifestyle changes.

While not a specific cure, improving sleep quality and addressing any underlying sleep disorders can help reduce the occurrence of sleep drunkenness. This can be achieved through measures such as avoiding alcoholic and caffeinated beverages, particularly close to bedtime, and maintaining a dark, quiet, and cool sleeping environment.

Sleep paralysis

During an episode of sleep paralysis, you may be aware of your surroundings but unable to move or speak. You may also experience hallucinations, such as the presence of a dangerous figure in the room, or feel a sense of suffocation. Other symptoms include pressure on the chest, daytime sleepiness, and a sense of moving out of your body. Episodes can last from a few seconds to up to 20 minutes, but usually only last a couple of minutes.

The exact cause of sleep paralysis is unknown, but it is believed to be linked to a disturbed rapid eye movement (REM) sleep cycle. Sleep paralysis happens as people are falling into or coming out of REM sleep, and studies have shown that people who experience it have shorter REM sleep latencies and shorter NREM and REM sleep cycles. Sleep paralysis may also be linked to other sleep disorders, such as narcolepsy, or mental health conditions such as anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), or panic disorder.

There is no treatment available to stop a sleep paralysis episode once it has started, but treatments are available to reduce the frequency of episodes. These include sleep hygiene, cognitive behavioural therapy, and antidepressants. It may also be helpful to identify and address the underlying causes of sleep paralysis, such as sleep deprivation or irregular sleep schedules.

Sleep inertia

The duration of sleep inertia varies, but it usually lasts from 15 to 60 minutes after waking and can potentially extend for several hours. The symptoms are expressed with the greatest intensity immediately after waking and gradually dissipate with extended wakefulness. The exact cause of sleep inertia is unknown, but researchers have proposed several theories to explain this phenomenon.

One theory suggests that sleep inertia is caused by high levels of adenosine, a nucleic acid compound found in the brain, upon waking. Adenosine levels progressively increase with sleep deprivation and typically return to normal during sleep. However, if an individual wakes up while still sleep-deprived, the high levels of adenosine bound to receptors in the brain can slow down neural activity, resulting in feelings of tiredness and impaired cognitive and physical performance.

Another theory suggests that sleep inertia may be a protective mechanism that helps maintain sleep during moments of unwanted wakings. Additionally, prior sleep deprivation has been found to increase the likelihood of experiencing sleep inertia, as it increases the percentage of time spent in slow-wave sleep (SWS). Abrupt awakenings during this deep sleep stage can lead to more significant sleep inertia.

The effects of sleep inertia can be mitigated through various strategies. Consuming caffeine, which blocks adenosine receptors in the brain, can help reduce the symptoms of sleep inertia. Taking caffeine before a short nap or upon awakening can be particularly effective. Additionally, consistent wake-up times, exposure to natural light, and the use of gentle alarms can also help reduce morning sleep inertia.

Sleep disorders

• Insomnia: Insomnia is a sleep disorder in which a person is unable to fall asleep and stay asleep. It is the most common sleep disorder.
• Sleep apnea: Sleep apnea is a breathing disorder characterised by periods of stopped breathing during sleep, lasting 10 seconds or more. Sleep apnea often goes undiagnosed, but it is important to seek medical advice if you suspect you have this condition.
• Restless leg syndrome (RLS): RLS is characterised by a tingling or prickly sensation in the legs, along with a powerful urge to move them.
• Hypersomnia: People with hypersomnia struggle to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
• Circadian rhythm disorders: These are problems with the sleep-wake cycle, making it difficult to fall asleep and wake up at the right times.
• Parasomnia: People with parasomnia act in unusual ways while falling asleep, sleeping, or waking up, such as walking, talking, or eating.

The causes of sleep disorders vary and can include other medical conditions, mental illnesses, ageing, or unknown factors. Some signs that you may have a sleep disorder include regularly taking more than 30 minutes to fall asleep, frequently waking up during the night, and feeling sleepy during the day. If you are concerned that you may have a sleep disorder, it is important to consult a doctor or a sleep specialist, who can help identify the cause and provide appropriate treatment.

Treatments for sleep disorders depend on the specific disorder and can include lifestyle changes, such as improving sleep habits, exercising, and eating a healthy diet. Other treatments may involve cognitive behavioural therapy, relaxation techniques, medication, or the use of a CPAP machine for sleep apnea.

Training yourself to wake up

It is possible to train yourself to wake up on time in the morning. A few changes to your routine can help get rid of your morning fatigue so you can be bright and early. Here are some tips to train yourself to wake up early:

• Stick to a sleep schedule: Try to stick to your sleep schedule every day, even on your days off. Your body will naturally begin to wake up at this time. Avoid sleep fragmentation, which is when you fall back asleep after waking up. According to a small 2022 study, sleep fragmentation can increase subjective fatigue and decrease inhibition.
• Get enough sleep: Make sure you are getting at least seven hours of sleep per night. Aim to get to bed early enough so that you wake up feeling refreshed.
• Exercise regularly: A 2021 review of studies found that regular moderate exercise can improve sleep quality in adults.
• Eat healthily: Focus on eating whole foods in their most natural form. A healthy diet can improve your sleep quality.
• Expose yourself to light: According to sleep specialist Dr. Afifa Shamim-Uzzaman, exposing yourself to light in the morning can help to regulate your internal clock and make you feel more alert. If you live somewhere dark in the mornings, consider using a broad-spectrum light box to simulate sunlight.
• Create a morning routine: Establish a morning routine that includes activities you enjoy and look forward to, such as exercise, personal writing, or a hot cup of coffee. This can give you an incentive to get out of bed in the morning.
• Reflect and adjust: Take notes each morning on what worked and what didn't. This will help you identify the habits that are helping you wake up early and those that are not.

Frequently asked questions