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Sleep Disorders

Always Sleepy

03/03/2009

Question:

I am a 31 year old female and am always sleepy. I will admit I have an odd sleep pattern. I will work until 4am and get the kids up at 7am. Around 10 am I will go back to sleep until about 2 pm. About 8pm I am falling asleep with the kids. I will then get back up at 10 pm to work until 4. I have tried breaking this cycle but it is very hard. Should I be so tired even though I am getting sleep throughout the day? Does the required 8 hours of sleep need to be in 1 sleep session?

Answer:

Thank you for visiting NetWellness. On this site, we try to answer general questions about sleep disorders but can not diagnose or recommend treatment. You appear to have some specific questions about your sleeping pattern which can ultimately only be answered properly by a physician who is familiar with your history, physical exam, and test results.

It sounds like you have a very busy schedule and life. Trying to fit everything in and still get an adequate amount of good quality sleep can be difficult to do. Our body’s natural tendencies are to fall asleep in the evening after dark and wake in the morning when it is light. This schedule is maintained by our internal (circadian) clock which is typically reset by daylight each day. Shift work, as you are doing, can disrupt your circadian clock making it difficult to get adequate sleep. Further disrupting your sleep pattern by multiple sleep periods per 24 hour cycle can make obtaining good quality sleep even more difficult.

There are several different stages of sleep including both dream sleep and non-dream sleep. Both are important to feeling fully refreshed. Fragmented sleep can disrupt our sleep stages. Furthermore, waking from brief segments of sleep can cause sense of grogginess which occurs when waking from deep stages of sleep.

It can be difficult to change sleep patterns and alter your internal clock, but trying to get a more continuous block of sleep (or a more consolidated sleep period) will probably help you feel more refreshed. If it is possible, enlist some help from family or friends in getting your children up and ready for school in the morning so that you can consolidate your sleep time (4:30am-12:30pm). With your present schedule, this would probably be best as you would be rested when your children come home from school. If there is no way for you to accomplish this, then you may need to rethink the idea of doing night shift and whether you (and your family) might be better off is your worked a day shift..

If you plan to continue night time shift work, it is best to optimize your daytime sleep by adhering to the following rules.

1. Try to go to bed as soon as you get home after your shift ends.

2. Try to maintain your schedule 7 days a week. Changing your schedule on days off can make it more difficult to sleep.

3. Keep your bedroom comfortable, dark, cool, and quiet. Use room darkening shades on any windows in your bedroom if needed.

4. When you wake up, expose yourself to as much light as possible. Well lit work places can improve alertness.

5. Limited use of caffeine is acceptable but try to avoid it for 6 hours prior to your bedtime to prevent insomnia.

6. Maintain good sleep hygiene, such as keeping the television out of the bedroom, avoid going to bed hungry, have a bedtime routine and stick with it.

If you have continued problems, consultation with a Sleep Specialist may help. It is possible that you may have another underlying sleep disorder that may need to be addressed, though a thorough history and physical examination would be needed to help determine if this is the case. If it turns out that your shift work is the major issue, then in some cases melatonin and prescription stimulants can be used for shift workers with persistent problems.

If you would like further information about shift work, circadian rhythms, 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. The website SleepEducation.com also has plenty of consumer friendly information about sleep. Best of Luck!

Related Resources:

American Academy of Sleep Medicine

For more information:

Go to the Sleep Disorders health topic, where you can:

Response by:

Aneesa M Das, MD Aneesa M Das, MD
Assistant Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University