Always sleepy

Proven content

Insomnia is a lack of sleep. And the other way around? What if we want to sleep almost constantly and the time of our activity is dangerously shortening? Is such excessive sleepiness just exhaustion or is it a symptom of a disease?

Sleep is said to be good for everything. It relieves pain, refreshes the mind, calms emotions, regenerates the body. This is true, but to excess can be harmful. We are in the best position when drowsiness is caused by fatigue. Then the matter seems simple – we have to sleep off. In order to fall asleep, you have to go to bed, put your head against the pillow, wrap a blanket or duvet, close your eyes, stop thinking. This is how you fall into a healthy sleep. We react a bit differently when we are stressed – then the level of adrenaline rises, and overwork and crowds of thoughts make it difficult, prolonged or impossible to fall asleep peacefully. But when it comes to physical exhaustion, we can fall asleep suddenly – on the bus, at the wheel, at work, during a conversation. In addition, diseases affect the length and quality of sleep. So, at first glance, you can see that from a medical point of view, sleep is a more complicated phenomenon, and sleepiness can mean something else to everyone.

Individual standards

How many hours should a healthy sleep last? What is the norm and what is its exceeding? Unfortunately, it must be said right away that sleep, although one of the main processes in the body, has not been fully understood yet. It is known, however, that it is of great importance for the proper functioning of the nervous system. During sleep, those neurons (nerve cells) that were not working while awake are activated – so they do not disappear. Sleep is a “moment of respite” for the whole body, then the body temperature drops, which saves our internal energy, and our organs work slower and release less hormones.

It is also worth dealing with the myths about the correct length of sleep. The daily need for sleep is an individual feature – both in animals and in humans. Giraffes need two hours of sleep a day, and cats and bats need up to 20. In turn, penguins, seals and dolphins have their brains asleep alternately – when the left one sleeps, the right one is awake, and vice versa. This is easy to see, because the sleeping hemisphere then closes the eye lying on its side. Research has shown that people usually sleep 8–9 or 7–8 hours a day and they need less and less sleep with age. Newborns and small children sleep the longest – about 18 hours a day, but their sleep is divided into several parts interrupted by feeding and changing. In adults, sleep usually lasts uninterrupted between 22 p.m. – 23 p.m. and 6 – 7 a.m. So we spend 20 years sleeping in total throughout our lives.

In humans, the rhythm of falling asleep is regulated by the intensity of light, social stimuli, as well as a kind of natural “timer” located in the brain, which “dictates” to us when to fall asleep and when to wake up. Its existence was proved by scientific tests carried out on a group of people who were placed for long periods in rooms without windows, clocks, television, radio, telephones, and allowed to choose the time of sleep and wake. It turned out that our brain, even if it does not know whether it is night or day, functions in 24–25 hour cycles.

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A dream of a nap

It is known how easy this mechanism is to disrupt. It is said that we are a civilization of people who are constantly sleepy, but many patients complain to doctors about difficulties with leaving the bed in the morning, waking up when even coffee does not help. There are more and more situations when at work we “fall asleep over the desk” or dream about a short nap during the day. Then, after work, we neglect our home duties, we do not spend time with loved ones, we give up our hobby because we have no strength for anything, we limit our functioning to necessity – work, after which we can finally fall asleep.

What causes this behavior? There may be many reasons for this. Excessive sleepiness is most often a natural effect of too long wakefulness, fatigue, overwork of the body, and its exhaustion after an illness. It disappears when we get enough sleep. It is, among others, o the most famous and most experienced so-called exogenous sleep deficiency syndrome – a reaction to insufficient sleep on weekdays, resolving at weekends and holidays. The increased need for sleep is also common in pregnant women – it is a reaction to the “hormone revolution”. But excessive sleepiness can also be a medical condition (hypersomnia is one of the major sleep disorders), or it can be a symptom of a malfunction in certain organs or body systems.

You sleep because you are sick

It is estimated that excessive sleepiness occurs in about 5–15% of people. We deal with this disorder when night sleep (still prolonged) does not give a sense of regeneration, and sleepy episodes occur during the day and limit our activity. According to the International Classification of Sleep Disorders, the time criterion for the diagnosis of hypersomnia is at least three months, but excessive sleepiness, which has been going on for more than a month, should prompt us to see a doctor as soon as possible. The so-called polysomnographic tests, the patient also takes special tests. Helpful in determining the causes of chronic sleepiness may also be: medical history, visual inspection of the patient, blood pressure measurement, determination of blood sugar and thyroid hormones, and morphology.

The causes of excessive sleepiness may be unknown – the so-called idiopathic hypersomnia – or related to e.g. narcolepsy, Kleine-Levin syndrome and breathing disorders during sleep (snoring, sleep apnea).

Hypersomnia can be a sign of serious injury, damage to the central nervous system, and may appear up to several days after a head injury. Then it may be accompanied by: headache, nausea, vomiting, confusion, visual, behavioral and consciousness disturbances. Then immediate contact with a doctor is required. For this reason, rescuers ask victims of accidents if they are not drowsy and warn them to report to the emergency room with episodes of sleepiness. Similar “traumatic” signs – including an overwhelming desire to fall asleep – occur in brain tumors which, as they grow, constrict or destroy its structures, and in infectious diseases of the central nervous system (so-called neuroinfections – meningitis and encephalitis) with which they occur convulsions and high fever.

Drowsiness, as a result of the weakening of the body, occurs during viral and bacterial infections (together with fever, weakness, sweating or cough), as well as with mononucleosis, an infectious disease caused by the Epstein-Barr virus (EVB). The latter is called kissing disease because the EVB virus spreads easily through saliva. The virus itself is quite common – its carriers are about 80% of people over 40 years of age, but few of them can develop acute mononucleosis (with fever, sore throat, enlargement of sensitive, hardening lymph nodes) or chronic mononucleosis syndrome (difficulty concentrating, feeling constantly tired).

Excessive sleepiness is also a symptom of Reye’s syndrome – a disease of the brain and liver in children up to 16 years of age, which may develop several days after a viral infection treated with aspirin.

Diseases of the thyroid gland and diabetes

Most often, however, drowsiness is a symptom of two metabolic diseases – hypothyroidism (the organ produces too little hormones, and its additional symptoms are: increased feeling of cold, weight gain, dry skin, thin and brittle hair, constipation, slow heart rate), and diabetes (in diabetics it is a symptom of carbohydrate disorders). The third most common cause of weakness and drowsiness is hypotension (systolic less than 100 mm Hg). This, in turn, may result, for example, from hormonal disorders and the work of the cardiovascular or nervous system, or from improperly treated hypertension. It often occurs in people who are particularly sensitive to drops in atmospheric pressure (meteopaths).

Finally, the feeling of drowsiness and general weakness, pale skin and mucous membranes, shortness of breath with exertion and headaches, mouth corners, brittle hair and nails are also accompanied by anemia, i.e. anemia. The most common form of anemia is iron deficiency (about 80% of all illnesses) and mainly affects women. Other causes of anemia may include vitamin B12 deficiency, premature breakdown of blood cells (hemolysis), or gastrointestinal bleeding.

From awakening to depression

Sleepiness can also be caused by disturbances in certain sleep phases. Due to numerous awakenings (we do not remember most of them), it does not bring relaxation, so the body looks for an opportunity to regenerate during the day. And our sleep is very heterogeneous, although it consists of two main phases. The first is the so-called NOT REM sleep (NREM) – deep and slow-wave, during which the body calms down, calms down, muscles relax, breathing becomes deep and regular, and the brain still works, but uses energy more sparingly. It is during NREM that sleepwalking and sleeping speech can occur. The second phase is REM sleep (otherwise: shallow, paradoxical) – similar to waking. Its signs are, among others rapid eye movements under the eyelids, rapid breathing and an unstable heart rhythm. The REM phase seems restless, but it is during this period that the relevant brain centers organize the information acquired during the day and organize it into logical relationships.

Disturbances in this rhythm can be caused by various factors – related to physical fatigue, but also to the psyche (depression) or even alcohol addiction. We also rarely associate them with the use (or withdrawal) of certain medications (e.g. sleeping pills, which usually have a prolonged effect, lowering blood pressure, cough and cold) and psychoactive substances, which result in temporary changes in consciousness, behavior and mood. It is worth knowing that they are not only hard drugs (heroin, cocaine, amphetamines), but also our daily “boost” – coffee.

How to fight sleepiness?

However, if we have ruled out diseases and excessive sleepiness results from exhaustion or lack of sleep, we can try to deal with it with home remedies. First, let’s try… not to sleep too long. Let’s try to start the morning with a 15-minute light exercise or a cold shower – they accelerate circulation, have a positive effect on the secretion of hormones and tighten the muscles. Then eat a healthy breakfast containing carbohydrates and protein, but without simple sugars, because they increase insulin secretion, which in turn lowers blood glucose levels, which makes you nervous. During the day, let’s find an excuse to be active – let’s go up the stairs instead of taking the elevator and take care of light meals at noon and in the evening (at least 3 hours before bedtime). Remember that a hearty lunch and dinner will make you sleepy worse, so take a good 20-minute walk after eating to burn calories faster and not overburden your digestive system. In addition, enrich your meals with supplements – vitamins and nutrients – and drink 2-3 liters of fluid a day, as drowsiness can be a sign of dehydration. However, let’s limit coffee and energy drinks, because caffeine stimulates, but excessively causes mood swings.

Changing your lifestyle will also help you fight sleepiness – avoid stressful situations, stop smoking (smoke blocks the supply of oxygen to tissues, which causes fatigue), perform daily activities at different times (to avoid monotony), let’s find time to relax (sauna, massage, baths) with energy oils, listening to music, watching a comedy, reading a book), which improves your mood and energizes. We should also remember to let the sun and fresh air into the house. Let us also surround ourselves with bright or energetic colors – red stimulating or blue stimulating concentration.

However, if excessive sleepiness persists for more than a few days or is accompanied by the aforementioned ailments – contact a doctor.

Worth knowing

The theory of sleep

By definition, sleep is a functional state of the central nervous system that occurs and passes cyclically in the circadian rhythm, and is characterized by withdrawal of consciousness and immobility. This condition also disappears under the influence of external factors. The opposite of sleep is wakefulness. In humans, these states can be distinguished, but in some animals – for example turtles – the boundary between them is fluid. Sleep-like states in animals are the so-called winter sleep (hibernation) and summer sleep (aestivation – it is more difficult to obtain food and water during droughts).

In healthy people, night rest begins with NREM (deep sleep), after about 80–100 minutes the REM wave (light sleep) comes, which lasts about 15 minutes, and during the whole sleep this cycle repeats 4–5 times. The REM phase in newborns accounts for up to 50% of all sleep. As the years go by, the duration of REM REM sleep shortens, up to about 15% in adulthood.

Interestingly – during sleep, the frequencies of the waves sent by the brain change (faster alpha and beta rhythms disappear, and slower theta and delta rhythms appear). This means that some parts of our brain work more actively during sleep than when awake. Hence, among others came the saying: sleep on with this problem. Often, when we wake up, we feel that the solution to some embarrassing situation has come to us in a dream.

Test Check if you are excessively sleepy

The Epworth Sleepiness Scale (ESS) is one of the most commonly used tests in the diagnosis of excessive sleepiness. Assess – on a scale of 0 to 3 (zero, 1 – low, 2 – medium, 3 – high) the probability of falling asleep in eight situations (active and passive), typical of everyday life. Less than 10 points indicate no excessive sleepiness, and more than 14 points – pathological somnolence, which should be assessed by a physician.

Test situations:

1. sitting and reading
2. watching tv
3. while talking, sitting
4. passive sitting in public places (theater, meeting)
5. driving as a wage passenger for an hour, without rest
6. lying down and relaxing in the afternoon (if possible)
7. sitting quietly after lunch (no alcohol)
8. in the car (traffic jam, red light)

Total points

Text: Magdalena Gajda