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Thursday, April 24, 2014
I Sleep Way too Deeply
I slept through a bear knocking in the side panel door and a gun being shoot off at the bear. I have always slept extremely deeply and my parents say that I sometimes talk in my sleep. Also if I go to anyone`s house I have been told that I swear in my sleep at people. I have also slept through a fire alarm going off and I am always tired in the morning. There is a long family history of depression in my dad`s side of the family.
You are really describing 3 issues related to your sleep that may or may not be related: extremely deep sleep, unrefreshing sleep and sleep talking. We’ll address these one at a time.
The extremely deep sleep you are describing is probably the extreme end of a normal phenomenon, and may not be abnormal, although several details are needed before this can be concluded. Normal sleep consists of 2 stages of sleep; NREM (which has 4 stages known as Stages 1 to 4) REM sleep (also known as dream sleep). Stages 3 and 4, also known as slow wave sleep (SWS), are the deepest sleep, and it is difficult to arouse from these two stages. Awakening from other stages of sleep is typically easier than awakening from Stages 3 and 4. SWS occurs most commonly in the first portion of the night and recurs in smaller portions in the second half of the night. Therefore, it is common that a person is more difficult to arouse early in the night.
Younger individuals tend to have an increased percentage of SWS and tend to manifest more difficulty awakening from sleep. Without knowing your age, it’s impossible to state whether or not your deep sleep may just reflect that you are in SWS and that that is the main explanation for your problem. Other factors, such as menstrual period, physical activity, fever, and medications, may contribute to changes in sleep architecture, including increasing the amount of SWS you have on any given night. Many individuals who obtain less than the adequate sleep (about 7-8 hours) may suffer from a degree of sleep deprivation and sleep debt that often results in a rebound in SWS on many nights. They would therefore be more difficult to arouse on the nights they obtain their “makeup” sleep. An irregular sleep wake schedule and disruption of sleep can also cause changes in the normal sleep architecture leading to increased SWS on some nights or SWS late in the night.
Not feeling rested after a night of adequate sleep can be frustrating. There are a number of potential factors that can make an adequate night’s sleep feel unrefreshing, many of which have to do with factors or conditions that may interrupt or fragment sleep. Some possible causes of nonrestorative sleep include:
- a poor sleep environment (too loud, too brightly lit)
- anxiety or stress
- sleep apnea (a condition where individuals struggle to breath in their sleep)
- periodic limb movement disorder (frequent leg twitches in sleep)
- painful conditions
- certain medical conditions such as heartburn
- asthma or heart disease, certain medications
- excessive use of stimulants such as caffeine and nicotine
- chronic insufficient sleep
As you can see this can be a complicated problem. Determining how best to treat this really depends on obtaining more information so that appropriate treatments can be recommended. All of these conditions can be treated if they are properly diagnosed.
Sleep-talking or somniloquy is an extremely common sleep behavior. It is different from other common forms of sleep behaviors such as sleep walking and night terrors, in several ways. Sleep talking is common in all age groups, and has been reported in all sleep stages. It is reported more often in females than males. It can be related to dream content in some cases, although it may not necessarily have full concordance with the dream. That is an individual who has a dream of persecution may recall screaming for help during the nightmare, but may be heard vocalizing a different statement that may still be consistent with persecution theme of the dream. Generally, this is a benign form of sleep-related behavior that is in the category of parasomnias. Sleep talking has not been associated with injury, and rarely is persistent enough to disturb the bed partner.
Individuals who do not have a regular bed or room partner may never become aware of the presence of occasional periods of sleep talking. Therefore, like other manifestations of sleep, normal or abnormal, sleep talking may have been present for a long time before it was brought to your attention. Sleep talking can be a manifestation of a disturbance in your sleep pattern. This may be caused by medication, sleep deprivation, depression, stress, medical illness, or pain. Absent any indication of one of these abnormalities, I usually assure my patients and emphasize general good sleep hygiene.
I strongly recommend that you follow proper sleep hygiene recommendation; avoid alcohol before bedtime; and stay regular in your sleep wake schedule. You also need to avoid sleep deprivation and sleep restriction. Being sleepy in the morning may be a sign of inadequate sleep time, or another sleep disorder. Sleep talking alone is not typically a cause of sleep disruption or daytime sleepiness.
A detailed sleep history will help to determine if what you are experiencing is just a part of normal sleep phenomenon or if there could be other explanations for your symptoms. I recommend you talk to your doctor about your problems and they can then determine if referral to a Sleep Specialist is needed.
Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University