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Sleep Disorders

I cannot hear anything!

09/25/2007

Question:

I am 28 years old and I still have to have my mother call me to wake me and my children up to get ready for school. My husband resets the alarms after he leaves for work. I can lay beside an alarm clock that has been going off for hours and NEVER move a muscle. I have awaken to see that I have missed 30!!! phone calls from my mom! This is really becoming a problem for me because unless my mom comes TO MY HOUSE and I hear her tell me to wake up, I will not wake up! My children & I are always late and everyone gets so frustrated with me but I cannot help this at all. I do not have trouble going to sleep, just hearing things to wake me up! Please help me!!! It is also causing me to have stressfull days because we always get started on the wrong foot by being late everywhere we go!!! I am willing to try ANY suggestions. Do you think that a sleep study would benefit me? Thank You!!

Answer:

Trouble awakening in the morning is not uncommon and can be very troublesome when it conflicts with your daily schedule. There are many possible reasons why you may have trouble awakening in the morning and further information would be required to definitively answer why waking up is such a problem for you. Information about your usual sleep hours, sleep duration, sleep habits and if you have any sleep-related symptoms during the daytime are all important to help sort this out.

Individuals may have trouble awakening in the morning if they have a delayed sleep phase. These individuals like to stay up late at night (also known as night owls) and need to be able to sleep-in late in order to get enough sleep. However, when they are required to awaken early for school or work, they tend to not get enough sleep and thus have trouble awakening. This type of sleep pattern fits the diagnosis of delayed sleep phase syndrome and is quite common in adolescents (about 10 times more common than in middle-aged adults) and young adults. The lack of sleep that results may contribute to daytime sleepiness and poor performance at school or work.

Of course a chronic lack of sleep could also lead to trouble awakening in the morning. This seems to be becoming more common in modern society as studies have suggested that more and more Americans are sleeping less, on average, per night. Aside from difficulty awakening, this trend may be leading to numerous bad consequences, such as weight gain and increased risk of developing hypertension.

If you are getting adequate sleep, but your sleep is of poor quality, frequently interrupted, or highly fragmented, then this could lead to trouble awakening in the morning. Primary sleep disorders, such as sleep apnea or periodic limb movement disorder, as well as other factors such as the environment you sleep in (i.e. too warm, too loud), medical problems (i.e. heartburn or breathing problems) or the medications you take, can all impact the quality of your sleep.

It’s also possible that what you are describing is a case of “Sleep Inertia”. Sleep inertia is the term used for extreme difficulty with arousing or awakening from sleep and is often seen in younger adults. Our sleep transitions through several distinct sleep stages that recur throughout the night. Depending on the stage of sleep that an individual is in, there are differences in the level of stimulus, such as noise, needed to awaken them. Typically, one is slower to arouse with a longer reaction time and less recollection if aroused from a stage of sleep called slow wave sleep. Slow wave sleep, also known as deep sleep, is concentrated in the first portion of the night, and decreases with subsequent sleep cycles until it is usually not present by the morning time. Arousal from other stages of sleep typically occurs quicker and the person achieves a functional degree of alertness and attention faster than when awakened from slow wave sleep. Sleep inertia describes the slower transition from slow wave sleep to full alertness. In some people, this inertia may be severe and may have additional manifestations.

It would probably be a good idea to talk to your primary care physician about your problem. It is likely that referral to a Sleep Specialist will be needed for further evaluation, which may or may not include a sleep study, depending on specific factors in your history.

If you would like further information about sleep disorders or sleep itself, I recommend the American Academy of Sleep Medicine website. 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.

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University