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Wednesday, August 27, 2014
Trouble waking up
My teenage son insists that he is not aware in the morning when I am trying to wake him up. He will talk to me, say he is getting up, and eventually when we are running late he will get up and wonder why no one woke him earlier. He turns off alarms and doesn`t remember turning them off. Is there a condition that could cause this or is he pulling the wool over my eyes? Is there any hope for waking a person up like this? He says that he is aware at times that it is time to get up but that he has no control over his body.
Difficulty arising early in the morning is not uncommon amongst teenagers. There are several potential reasons for this that can range from normal variations in sleep schedule to more serious sleep conditions that require specific treatment.
Children typically experience a fair amount of deep sleep (also known as slow wave sleep or delta sleep), and this type of sleep gradually decreases in amount as they mature into adulthood. During deep sleep, an individual can be very difficult to awaken and may have no recall of being woke up. Usually deep sleep occurs in the first half of sleep, but in younger individuals it may be spread out throughout the sleep episode and can occur even after several hours of sleep.
In addition, if an individual is awoken for school or work after only a few hours of sleep, they may still be experiencing deep sleep and thus be difficult to awaken. Adolescents often like to stay up late and sleep in, especially on the weekends. When this becomes their regular sleep habit every night of the week, they may develop problems. Individuals who like to stay up late at night, also known as night owls, need to be able to sleep late in order to get enough sleep. However, when they are required to awaken early for school or work, they tend to run into problems with not getting enough sleep. This type of sleep pattern, known as delayed sleep phase syndrome, is quite common in adolescents (about 10 times more common than in middle-aged adults). The lack of sleep that results may contribute to daytime sleepiness and poor performance at school or work. This problem is being increasingly recognized in society, and some states are now experimenting with a later start time for high school students to see if this will impact behavior and performance. If present, delayed sleep phase syndrome can usually be treated with behavioral modification and measures to help change the circadian rhythms, also known as biorhythms, that help determine when an individual becomes sleepy.
Other sleep conditions may make it difficult to awaken in the morning and usually require specific evaluation and treatment. This list includes problems such as sleep disordered breathing, factors that may fragment or interrupt sleep (such as a poor or noisy sleep environment, pain, heartburn), idiopathic hypersomnolence, and depression, to name a few.
To find out if your child is suffering from one of these conditions, you should have him discuss the problem with his doctor. His doctor will ask him additional questions that will help to determine if further evaluation or referral to a Sleep Specialist is indicated. A specific treatment plan may also be recommended, depending on further details of your son's history.
If you would like further information about sleep and sleep disorders, I recommend the American Academy of Sleep Medicine website (http://www.aasmnet.org/). In addition to information about sleep medicine, the website also contains a list of accredited Sleep Centers and may help you to locate one nearest you. Good Luck!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University