Understanding Sleep Disturbance

When Alarm Clocks Don’t Work
There are people who have an extremely hard time waking up in the morning. Are they just lazy? Do they simply
need a louder alarm clock? Or perhaps they might have a real disorder that affects one’s ability to wake up in the morning.It might surprise you that there are numerous possible causes of morning sleepiness. Here is a partial list and brief explanation of some of the possible causes.

Insufficient Sleep – This is the most obvious culprit. If you are not getting enough sleep your body might not want you to wake up until it has received the sleep that it needs. 

Poor Sleep Hygiene – Sleep hygiene is a variety of different practices and habits that are necessary to have quality  sleep. This includes limiting daytime sleep, avoiding stimulants such as caffeine, proper exercise (but not in the  hours preceding sleep), and refraining from eating foods near bedtime that affect sleep. If someone has poor sleep  hygiene then their sleep might not be restful which can lead to morning sleepiness.

Circadian Rhythm Sleep Disorder (CRSD) – The circadian rhythm is our “body clock” that controls many  physical functions including our sleep timing. People with CRSD have a sleep cycle that is timed differently than  most people. These individuals could sleep well if they would able to sleep according to their individual sleep  cycle. But if they want to wake up at a “normal hour” then this condition can be a real impediment. 

Sleep Apnea – Sleep apnea is a condition when one’s breathing becomes very shallow or even stops briefly during  sleep. The most common form is obstructive sleep apnea (OSA) that is caused by complete or partial obstructions  of the upper airway. The episodes of limited breathing can last as long as 40 seconds. The individual with OSA is  often completely oblivious of the condition and is often alerted to it by family members or roommates since people  with OSA often experience snoring during sleep. OSA severely disrupts the sleep cycle and therefore can cause  morning sleepiness.

Periodic Limb Movement Disorder (PLMD) – PLMD is a disorder where one’s limbs jerkor twitch involuntarily  during sleep. This can disrupt one’s sleep and lead to excessive sleepiness in the morning. The person with PLMD  is frequently unaware of his own condition and is often first noticed by family members or roommates who observe  the abnormal movements of the limbs during sleep.

Restless Leg Syndrome (RLS) – RLS is a disorder where one feels an acutely unpleasant feeling in one’s legs  when trying to rest which compels the person to move his legs in order to “shake off” the feeling. This often occurs  when one is trying to go to sleep which can obviously lead to insufficient sleep. This is a very different disorder  than PLMD, since one with PLMD is usually unaware that he has the condition, whereas RLS occurs when one is  awake and one would therefore be aware that he has the condition.

Medications – Many medications can cause a disruption of the sleep cycle which can lead to difficulty getting out  of bed in the morning.  

Depression – Depression can affect one’s sleep in a variety of ways. This includes difficulty falling asleep (sleep  onset insomnia), difficulty staying asleep (sleep maintenance insomnia), and non-refreshing sleep. Sleep that is not  refreshing can easily lead to morning sleepiness even if one sleeps a sufficient number of hours. Depression and  sleep can be tricky since the same way depression can disrupt one’s sleep, insufficient sleep can also lead to  depression! Furthermore, the relationship between depression and sleep disorders can lead to a downward spiral  where depression leads to a sleep disorder which then exacerbates the depression which then further intensifies the  depression. 

The treatment for a sleep disorder is very much determined by its cause. A physical exam by a physician, a sleep  study done by a sleep specialist, and a psychological evaluation might all be necessary in order to properly diagnose  the cause of the excessive sleepiness.