WHAT
IS PROBLEM SLEEPINESS?
Everyone
feels sleepy at times. However, when sleepiness interferes
with daily routines and activities, or reduces the
ability to function, it is called “problem sleepiness.”
A person can be sleepy without realizing it. For example,
a person may not feel sleepy during activities such
as talking and listening to music at a party, but
the same person can fall asleep while driving home
afterward. You may have problem sleepiness if you:
* consistently do not get enough sleep, or get poor
quality sleep;
*
fall asleep while driving;
* struggle to stay awake when inactive, such as when
watching television or reading;
* have difficulty paying attention or concentrating
at work, school, or home;
* have performance problems at work or school;
* are often told by others that you are sleepy;
* have difficulty remembering;
*
have slowed responses;
* have difficulty controlling your emotions; or
* must take naps on most days.
Sleepiness can be due to the body’s natural
daily sleep-wake cycles, inadequate sleep, sleep disorders,
or certain drugs. Sleep-Wake Cycle Each day there
are two periods when the body experiences a natural
tendency toward sleepiness: during the late night
hours (generally between midnight and 7 a.m.) and
again during the midafternoon (generally between 1
p.m. and 4 p.m.). If people are awake during these
times, they have a higher risk of falling asleep unintentionally,
especially if they haven’t been getting enough
sleep.
Inadequate
Sleep
The
amount of sleep needed each night varies among people.
Each person needs a
particular amount of sleep in order to be fully alert
throughout the day. Research
has shown that when healthy adults are allowed to
sleep unrestricted, the average
time slept is 8 to 8.5 hours. Some people need more
than that to avoid problem
sleepiness; others need less. If a person does not
get enough sleep, even on one night, a “sleep
debt” begins to build and increases until enough
sleep is obtained. Problem sleepiness occurs as the
debt accumulates. Many people do not get enough sleep
during the work week and then sleep longer on the
weekends or days off to reduce their sleep debt. If
too much sleep has been lost, sleeping in on the weekend
may not completely reverse the effects of not getting
enough sleep during the week.
Sleep
Disorders
Sleep disorders such as sleep apnea, narcolepsy, restless
legs syndrome, and insomnia can cause problem sleepiness.
Sleep apnea is a serious disorder in which a person’s
breathing is interrupted during sleep, causing the
individual to awaken many times during the night and
experience problem sleepiness during the day. People
with narcolepsy have excessive sleepiness during the
day, even after sleeping enough at night. They may
fall asleep at inappropriate times and places. Restless
legs syndrome (RLS) causes a person to experience
unpleasant sensations in the legs, often described
as creeping, crawling, pulling, or painful. These
sensations frequently occur in the evening, making
it difficult for people with RLS to fall asleep, leading
to problem sleepiness during the day. Insomnia is
the perception of poor-quality sleep due to difficulty
falling asleep, waking up during the night with difficulty
returning to sleep, waking up too early in the morning,
or unrefreshing sleep. Any of these sleep disorders
can cause problem sleepiness. Medical Conditions/Drugs
Certain medical conditions and drugs, including prescription
medications, can also disrupt sleep and cause problem
sleepiness. Examples include:
* Chronic illnesses such as asthma, congestive heart
failure, rheumatoid arthritis, or any other chronically
painful disorder;
* Some medications to treat high blood pressure, some
heart medications,
and asthma medications such as theophylline;
*Alcohol—Although some people use alcohol to
help themselves fall asleep, it causes sleep disruption
during the night, which can lead to problem sleepiness
during the day. Alcohol is also a sedating drug that
can, even in small amounts, make a sleepy person much
more sleepy and at greater risk for car crashes and
performance problems;
*Caffeine—Whether
consumed in coffee, tea, soft drinks, or medications,
caffeine makes it harder for many people to fall asleep
and stay asleep. Caffeine stays in the body for about
3 to 7 hours, so even when taken earlier in the day
it can cause problems with sleep at night; and
*Nicotine
from cigarettes or a skin patch is a stimulant and
makes it harder to fall asleep and stay asleep.
PROBLEM SLEEPINESS AND ADOLESCENTS
Many U.S. high school and college students have signs
of problem sleepiness, such as:
*
difficulty getting up for school;
*
falling asleep at school; and/or n struggling to stay
awake while doing homework.
The
need for sleep may be 9 hours or more per night as
a person goes through adolescence. At the same time,
many teens begin to show a preference for a later
bed time, which may be due to a biological change.
Teens tend to stay up later but have to get up early
for school, resulting in their getting much less sleep
than they need. Many factors contribute to problem
sleepiness in teens and young adults, but the main
causes are not getting enough sleep and irregular
sleep schedules. Some of the factors that influence
adolescent sleep include:
* social activities with peers that lead to later
bedtimes;
*
homework to be done in the evenings;
* early wake-up times due to early school start times;
* parents being less involved in setting and enforcing
bedtimes; and
* employment, sports, or other extracurricular activities
that decrease the time available for sleep.
Teens
and young adults who do not get enough sleep are at
risk for problems such as:
* automobile crashes;
* poor performance in school and
poor grades;
* depressed moods; and
* problems with peer and adult relationships.
Many adolescents have part-time jobs in addition to
their classes and other activities. High school students
who work more than 20 hours per week have more problem
sleepiness and may use more caffeine, nicotine, and
alcohol than those
who work less than 20 hours per week or not at all.
