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Having sleepless nights. Feeling groggy. What is the problem? Suggest some treatment

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Practicing since : 2003
Answered : 2190 Questions
I'm having strange problems with my sleep. I will fall asleep and wake a few times during the night before finally waking up and feeling "awake". However, I am still exhausted after I wake up. The problem is that if I fall back to sleep for even 10 minutes, when I wake up I will be groggy for the rest of the day (usually 12 hours or so) until I go to sleep that night. By groggy, I mean completely unable to function. I have to stay in bed the entire day. I am disoriented and feel absolutely horrible. Why does this happen? I can't take naps because of this, and it bothers me because I would love to be able to sleep a little to relieve the exhaustion when I don't get a good night's sleep. This is not a new development.
Posted Wed, 17 Oct 2012 in Sleep Disorders
Answered by Dr. Jonas Sundarakumar 2 hours later
Hi and welcome to Healthcare Magic. Thanks for your question...

From the description of your symptoms it appears that you are having a sleep disorder where the natural rythm of your sleep is affected. I think the basic problem is that you don't seem to be getting proper, continuous sleep in the night due to the frequent awakenings and this in turn alters your entire sleep-wake rythm.

Normally, when a person falls asleep, he goes through different stages of sleep (REM and NREM) which alternate in a specific, clyclical and balanced pattern. It is essential that sleep proceeds normally through these clycles in order to get a refreshing sleep. When this natural rythm is altered, the person feels unrefreshed and groggy, even though he / she may be spending several hours in bed. When you try to sleep later on during the day, the body will want to bring back this balance by attemting to re-establish the cylclical pattern. However, when you take only short naps, this becomes impossible and the sleep clycle again becomes erratic, leaving you unrefreshed and groggy.

So, in order to sort out your problem, you first need to have a normal, continuous sleep at night. In other words, we need to find out what is causing your frequent awakenings inbetween and this has to be stopped. There could be various reasons like sleep apnea, anxiety / depressive disorders, substance abuse, etc.

Sometimes, you may need medication for a short while to help you get back your natural sleep rythm. Following stict 'sleep hygiene' can also help your natural rythm to fall back in place, such as:
- following specific timings for going to bed and waking up
- avoiding 'snoozing' after the wake-up time
- avoiding daytime naps
- avoiding large meals, coffee, alcohol, etc. before going to bed
- arranging a sleep evironment that is dark, quiet and free of disturbance
- avoiding the use of your bed for any other activities like watching tv, reading, etc.
- having a daily exercise routine in the evenings
- avoiding psychological stress and trying relaxation techniques

In case, your problem persists despite trying these tips, then I think you should consult a psychiatrist for a detailed assessment and you may need medication.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
Follow-up: Having sleepless nights. Feeling groggy. What is the problem? Suggest some treatment 17 minutes later
Thank you. I am curious as to why I feel so intensely groggy after even a 10 minute nap, whereas friends can sleep like this during the day if they are tired and not have an issue. I am truly scared of falling asleep accidentally when watching a movie, or on a car trip, etc, because I will be unable to function and will be extremely sensitive to light, noise, etc for the rest of the day until I sleep a full night. It is very frustrating. Do you think I might have a chemical imbalance or something of that nature? Or maybe a hormone imbalance? Thanks for your detailed answer, I appreciate what you said about sleep hygeine and will try out your suggestions.
Answered by Dr. Jonas Sundarakumar 1 hour later
Hi again and thanks for writing in...

It is likely that since your sleep cycle has been disturbed and offset during the night, the effects of it are being carried over during the daytime also. When you fall asleep during the day, your body is still desparately trying to catch up with the lacking sleep and altered rythm and this would require a few hours of continuous sleep at least. But when you wake up after a few minutes, your sleep cycle gets broken again and though your body wants to continue in a state of sleep, you are forcefully awake. This may be causing you to feel sleepy, groggy and run down.

In other people who have already had a proper, continuous sleep rythm at night, the body is not going to be desparately attempting to catch up sleep during the day and so, a short nap would just include one short sleep cycle and then revert back to wakefulness.

It is possible that certain chemical imbalances, like altered levels of serotonin (the same neurochemical involved in anxiety / depressive disorders) or melatonin can predispose you to such problems. Hormonal imbalance resulting this type of problem (with no other physical symptoms indicative of it) is rare, but still possibe.

I would advise you to have a first have a "Sleep Study" - Polysomnogram done to find out what exactly is going wrong with your sleep rythm and why it is getting altered so much. Once we have an idea of this, futher evaluation or management can be planned accordingly. Please consult a local psychiatrist regarding this. Getting a proper assessment would be worthwhile not only because of the amount of distress this is causing you but also because continuous disturbance in sleep can also have adverse health effects, both physically and psychologically.

Wish you all the best. Kindly leave a review if you are satisfied with my answer.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
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