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Sleep Disorders

My Wife Sometimes Has Difficulty Waking Up

10/19/2009

Question:

Over recent years my wife has had a recurring problem waking up. This mostly happens in bed, but on a few occasions it has occurred after she has dosed off watching television. She becomes quite agitated in her sleep and mumbles my name and sometimes says "Help". I speak to her and gently massage her shoulders and neck until she eventualy regains consciousness. Last night it took me at least two minutes to bring her around. When she does awaken she is still in a slightly distressed state for a few minutes but soon settles down and suffers no long lasting effects. Is this sort of behaviour likely to indicate any underlying problem and if so what should we do about it?

Answer:

Your description of your wife’s condition nicely correlates with what is called “sleep inertia” or “sleep drunkenness”. This refers to a period of confusion while awakening from regular sleep or from a nap. This impairment may be severe, lasting from minutes to hours, and usually occurs when someone is woken up from the deep stages of sleep (also known as slow wave or delta sleep).

While 10-25% of people experience sleep inertia in the morning, waking up from naps is not well studied. Since most deep sleep is early in the night, sleep inertia is usually not seen with normal morning awakening unless the individual has a late distribution of their deep sleep. With napping, it’s possible to go into slow wave sleep, especially if the nap is more than 45 minutes in duration. This could result in sleep inertia when awakening from a nap.

Usually, sleepiness associated with worsening of sleep inertia can be blamed one or more of the following causes:

It’s not clear from your description if the sleep talking that is associated with your wife’s sleep is related to dreaming. While the phenomenon of sleep talking is not unusual, frequent dream enactment (acting out one’s actions in a dream, while asleep) can be associated with some neurological disorders.

For general sleep hygiene measures, I recommend adequate sleep duration (at least 7 hours per night); avoidance of sedatives and stimulants; and a cool, dark and quiet sleep environment.

If these problems are not explained or resolved after following the above recommendations, then you should consider having your wife speak with her doctor. An evaluation by a Sleep Specialist may be necessary. For additional information visit the American Academy of Sleep Medicine website. This website contains a list of Sleep Centers across the country so you can locate one near you.

I wish your wife and yourself most restful sleep.

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Response by:

Ziad  Shaman, MD Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University