Why Do I Feel Tired In the Morning - While Waking Up ?

Econet, 8th May 2021.

WHY DO I FEEL TIRED IN THE MORNING - WHILE WAKING UP ?

It’s not unusual to wake up feeling a bit groggy. For many people, it’s nothing a cup of coffee or shower can’t fix.

Occasionally waking up tired is not usually a cause for concern. However, frequently waking up tired can be a symptom of an underlying sleep habit or health condition. This may be especially likely if a person continues to feel tired throughout the day.

But if you regularly wake up tired, especially if you continue to feel fatigued throughout the day, there may be something else going on.

Here’s a look at some common causes of waking up tired.

1. Sleep inertia 

The term sleep inertia refers to the normal cognitive and sensory-motor impairments that occur immediately after waking.

Sleep inertia occurs when a person wakes suddenly from deep, or slow-wave, sleep. As a result, certain parts of their brain are not fully awake.

The brain stem, which controls basic functions, activates immediately after waking. The prefrontal cortex, which is involved in decision making and self-control, can take up to 30 minutes to catch up.

Sleep inertia can also be worsened by shift work sleep disorder, obstructive sleep apnea, and certain types of circadian rhythm sleep disorder. 

Some symptoms of sleep inertia include:

• drowsiness or disorientation
• difficulty concentrating
• poor decision making
• difficulty performing fine motor tasks

Solution :

What you can do, Sleep inertia is a natural part of waking up, but you can limit its effects by:

• regularly getting a full night’s sleep

• limiting naps to less than 30 minutes

• drinking coffee or another caffeinated beverage when you get up

If your symptoms persist, visit your primary healthcare provider. They can rule out an underlying sleep disorder.

2. Blue light exposure

Screen time, especially at night, is linked to poor sleep. The blue light from electronic devices messes with your circadian rhythm, or sleep cycle. It signals your brain to wake up when it should be winding down. In one study, as little as 2 hours of exposure to blue light at night slowed or stopped release of the sleep hormone melatonin. Powering down your digital devices at least 3 hours before bedtime can help.

Nighttime exposure to blue light was linked to depressive symptoms in animal studies. But exposure to blue light during the day may have the opposite effect. It’s been used to treat seasonal effective disorder, or SAD. That’s a form of depression related to the changing of the seasons. Research shows 20 minutes of blue light exposure in the morning helps ease SAD symptoms. 

Blue light from electronics is linked to problems like blurry vision, eyestrain, dry eye, macular degeneration, and cataracts. Some people have sleep issues.

Some symptoms of sleep inertia include:

Solution :

What you can do, To reduce the impact of blue light on your sleep:

• Avoid screen time for two or three hours before you go to bed.
• Use dim red lights at night, which don’t have as powerful of a melatonin-suppressing effect on your circadian rhythm.
• Expose yourself to a lot of bright light during the day.
• Use blue-blocking glasses at night or an app that filters blue light if you have to use electronics at night.

3. Poor sleep environment
A poor sleep environment can have a big impact on the quality of your sleep. 

Environmental conditions, such as temperature, noise, light, bed comfort and electronic distractions, play a significant role in one's ability to get proper sleep—and, subsequently, in overall sleep-related wellness.

If your morning fatigue is accompanied by stiffness or aching body parts, your mattress could be to blame.

Solution :

What you can do,

Make your bed an inviting place to be. Buy comfortable bedding, including pillows, sheets, and comforters or other coverings.

Turn out the lights. Tell your body it’s time to sleep by darkening your room. Eliminate as much light as possible, blocking sunlight with curtains or shades.

Turn off the TV. Keep all electronics—from televisions to computers to cell phones—out of your bedroom.

Turn down the volume. Make sure sound levels during the night are significantly lower than during the day. Block out distracting sounds by turning off any electronics, such as televisions or radios, closing the bedroom door, and using heavy curtains if traffic noise or other outside noise is a problem.

Adjust the thermostat. Find the temperature at which you are most comfortable sleeping.

Protect your bed. Use your bed only for sleep and sex—and not as an office or family recreation space.

4. Eating and drinking habits

What you consume before bed can keep you up at night and make you feel tired in the morning. Too much eating and drinking before the bedtime can disturb in your sleep. 

Too much caffeine, Caffeine is a natural stimulant that promotes alertness. Having too much caffeine during the day or having it too close to bedtime can:

• make it harder to fall asleep

• make it harder to stay asleep

• increase the number of times you go to the bathroom overnight

Coffee, chocolate, and certain teas and soft drinks all contain caffeine. Caffeine can also be found in certain medications, including some prescription and over-the-counter pain-relieving medications.

Drinking alcohol, Alcohol has been shown to have a sedative effect and make you sleepy, but it doesn’t lead to a good sleep. According to the Cleveland Clinic, alcohol increases the number of times you wake up once the relaxing effect wears off and prevents you from getting deep sleep.

The more alcohol you consume before bed, the more it disrupts your sleep, increasing your likelihood of waking up tired.

Frequent urination, Drinking too much of anything too close to bedtime can make you frequently get up to urinate throughout the night. This can also happen in certain situations if you’re retaining a lot of fluid.

Excessive urination at night, also called nocturia, may also be a sign of an underlying medical condition. If you continue to wake up two or more times per night to urinate after limiting how much you drink before bed, speak to your doctor.

Solution :

What you can do, 

• Avoid having caffeine three to seven hours before bed.
• Limit your intake of coffee or other caffeinated beverages to one or two servings a day.
• Check medications for caffeine content.
• avoiding drinking alcohol in the evening
• limiting your alcohol consumption to no more than one drink a day for women and two drinks for men
• avoiding drinking liquids for at least two hours before bedtime
• cutting back on caffeine and alcohol-containing beverages
• wearing compression socks during the day if you have swollen ankles and legs or certain states of water retention

5. Sleep disorders

Common sleep disorders like insomnia, restless legs syndrome, narcolepsy and sleep apnea can affect every aspect of your life including your safety, relationships, school and work performance, thinking, mental health, weight and the development of diabetes and heart disease. Not getting enough quality sleep can hurt your quality of life.

There are four common types of sleep disorders, 

• Insomnia.
• Sleep apnea.
• Restless legs syndrome.
• Narcolepsy.

What causes sleep disorders?  Sleep problems can be caused by various factors. Although causes might differ, the end result of all sleep disorders is that the body's natural cycle of slumber and daytime wakefulness is disrupted or exaggerated. Eight factors include:

Physical (such as ulcers).

Medical (such as asthma).

Psychiatric (such as depression and anxiety disorders).

Environmental (such as alcohol).

Working the night shift (this work schedule messes up “biological clocks.”)

Genetics (narcolepsy is genetic).

Medications (some interfere with sleep).

Aging (about half of all adults over the age of 65 have some sort of sleep disorder. It is not clear if it is a normal part of aging or a result of medicines that older people commonly use)

Insomnia, 

Insomnia is a sleep disorder where people have difficulty falling or staying asleep. People with insomnia have one or more of the following symptoms:

• Difficulty falling asleep.
• Waking up often during the night and having trouble going back to sleep.
• Waking up too early in the morning.
• Having unrefreshing sleep.
• Having at least one daytime problem such as fatigue, sleepiness, problems with mood, concentration, accidents at work or while driving, etc. due to poor sleep.

Sleep apnea, 

Sleep apnea is a potentially serious sleep disorder that occurs when a person's breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep.

There are two types of sleep apnea: obstructive and central.

Obstructive sleep apnea (OSA) is the more common of the two. It is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep. Symptoms of OSA may include snoring, daytime sleepiness, fatigue, restlessness during sleep, gasping for air while sleeping and trouble concentrating.

In central sleep apnea (CSA), the airway is not blocked, but the brain fails to tell the body to breathe. This type is called central apnea because it is related to the function of the central nervous system. People with CSA may gasp for air but mostly report recurrent awakenings during night.

Restless legs syndrome, 

Restless legs syndrome (RLS) is a sleep disorder that causes an intense, often irresistible urge to move the legs. This sensation is brought on by resting such as lying down in bed, sitting for prolonged periods such as while driving or at a theater. RLS typically occurs in the evening, making it difficult to fall asleep and stay asleep. It can be associated with problems with daytime sleepiness, irritability and concentration. Often, people with RLS want to walk around and shake their legs to help relieve the uncomfortable sensation

Narcolepsy

Narcolepsy is a neurological disorder of sleep regulation that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day. Some patients with narcolepsy experience sudden muscle weakness with laughter or other emotions.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

Solution :

What you can do, 

There are a variety of treatments recommended by healthcare providers:

• Counseling: Some sleep specialists recommend cognitive behavior therapy. Such counseling helps you “recognize, challenge and change stress-inducing thoughts” that can keep you awake at night.
• Medications and/or supplements.
• Practice sleep hygiene such as keeping a regular sleep schedule.
• Get regular exercise.
• Minimize noise.
• Minimize light.
• Manage the temperature so that you’re comfortable

Here are some tips for getting a good night's sleep? 

• Create an optimal sleep environment by making sure that your bedroom is comfortable, cool, quiet and dark. If noise keeps you awake, try using background sounds like "white noise" or earplugs. If light interferes with your sleep, try a sleep mask or blackout curtains.
• Think positive. Avoid going to bed with a negative mind set, such as "If I don't get enough sleep tonight, how will I ever get through the day tomorrow?"
• Avoid using your bed for anything other than sleep and intimate relations. Do not watch television, eat, work, or use computers in your bedroom.
• Try to clear your mind before bed time by writing things down or making a to-do list earlier in the evening. This is helpful if you tend to worry and think too much in bed at night.
• Establish a regular bedtime and a relaxing routine each night by taking a warm bath, listening to soothing music, or reading. Try relaxation exercises, meditation, biofeedback, or hypnosis. Wake up at the same time each morning, including days off and vacations.
• Stop clock watching. Turn the clock around and use only the alarm for waking up. Leave your bedroom if you cannot fall asleep in 20 minutes. Read or engage in a relaxing activity in another room.
• Avoid naps. If you are extremely sleepy, take a nap. But limit naps to less than 30 minutes and no later than 3 p.m.
• Avoid stimulants (coffee, tea, soda/cola, cocoa and chocolate) and heavy meals for at least four hours before bedtime. Light carbohydrate snacks such as milk, yogurt, or crackers may help you fall asleep easier.
• Avoid alcohol and tobacco for at least four hours before bedtime and during the night.
• Exercise regularly, but not within four hours of bedtime if you have trouble sleeping.