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Sleep Disorders

Trouble Waking Up

12/12/2008

Question:

I`m 18, in my last year of highschool, and having the worst time waking up in the mornings. I just can`t wake up for anything. I set two alarms, but they`re useless because I don`t hear them until it`s way, way too late. I usually have to have someone physically wake me, but often that doesn`t even work. I`ve missed half of the semester because of this problem and face not graduating if I can`t fix it soon. Naturally, I will fall asleep around 1 or 2am, but when I force myself to get the 7-8 hours of sleep, that seems to make it worse. I`ve found that it`s easier to wake up when I go to sleep around 4 or even 5. But I can`t run on sleep like that for very long. I`ve always been one to take a few minutes to get up and going, I have never been a morning person, but this is way beyond that. It seems impossible for me to wake up in the morning, I just don`t know what to do.

Answer:

You sound like your having a lot of trouble related to this and it’s good to look into it. As you may know, difficulty arising early in the morning is quite common amongst those your age. 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.

Those in your age group often stay up late and sleep in, especially on the weekends. When this becomes their regular sleep habit every night of the week, they may run into 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 develop problems with not getting enough sleep (most in your age group need at least 8-10 hours per night to feel rested). This type of sleep pattern, known as delayed sleep phase, 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 (when the symptoms occur, it becomes known as delayed sleep phase syndrome). 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, which help determine when an individual becomes sleepy. Treatments that can influence the internal clock usually include appropriate timing of light exposure and, in certain cases, the use of melatonin or similar types of agents. Despite fairly effective therapies, some individuals have a hard time adjusting their internal clocks and have to adjust their work or school schedule to match their sleep schedule (i.e. only taking afternoon and evening classes).

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), narcolepsy, idiopathic hypersomnolence, and depression, to name a few. If you find that once you get enough sleep on a regular basis but still having problems, then you may need to be checked for one of these sleep disorders.

To find out how best to approach and treat your problem, you should discuss the problem with your doctor. Your doctor will ask 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 history.

If you would like further information about sleep and sleep disorders, 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. The website Sleep Education.com also provides plenty of good consumer friendly information. Good Luck!

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Response by:

James   Knepler, MD James Knepler, MD
Formerly, Assistant Professor
College of Medicine
University of Cincinnati