Struggling with Insomnia and Excessive Sleepiness: A Common Dilemma

Insomnia and hypersomnia???

I work in the service industry, where I have to talk and move around constantly.
After work, I often find that I still have a lot of energy until bedtime, and I end up falling asleep at least two hours later than my intended bedtime.
The next day, I set multiple alarms, but my sleep time rarely exceeds six hours.
However, on my days off, I tend to sleep for over twelve to fourteen hours or even more.
I have tried many methods over the years, but nothing seems to improve the situation.
I feel like I am reluctant to sleep because I have so many things I want to do, yet on my days off, I end up sleeping through the time I could be productive.
It's a complete contradiction, and I don't even know what kind of life I'm living.
My family and partner have given up on me; they can joke about the topic, but I am genuinely troubled by it.

Anqi, 40~49 year old female. Ask Date: 2022/09/29

Dr. Qiu Junda reply Psychiatry

Hello.
It is recommended that you take the time to visit a psychosomatic medicine clinic for consultation with a physician to discuss and address your concerns.

Reply Date: 2022/09/29

More Info

Struggling with insomnia and excessive sleepiness is indeed a common dilemma faced by many individuals, particularly those in demanding jobs like service industries. Your situation reflects a classic pattern of sleep disruption that can stem from various factors, including lifestyle, work demands, and psychological stressors.

From what you've described, it seems that your work environment requires constant interaction and physical activity, which can lead to a heightened state of alertness that persists even after your shift ends. This phenomenon is often referred to as "hyperarousal," where the body remains in a state of heightened alertness due to the demands of the job. Consequently, when you attempt to wind down for sleep, your mind and body may still be in an active state, making it difficult to fall asleep at your intended bedtime.

The fact that you find it challenging to sleep until at least two hours past your intended bedtime indicates a potential misalignment between your circadian rhythm and your lifestyle. The circadian rhythm is the body's internal clock that regulates sleep-wake cycles, and disruptions to this rhythm can lead to insomnia. Additionally, the excessive sleep you experience on your days off could be a compensatory mechanism for the sleep debt accumulated during your workdays. This pattern of sleeping excessively on days off is known as "social jetlag," where your sleep schedule shifts significantly between workdays and weekends.

Your feelings of being torn between wanting to accomplish tasks and the need for sleep are not uncommon. Many individuals experience a sense of guilt or anxiety about not utilizing their waking hours effectively, leading to a cycle of overexertion and subsequent exhaustion. This can create a paradox where you feel compelled to stay awake and productive, yet when you finally have the opportunity to rest, you end up oversleeping and feeling unproductive.

To address your insomnia and excessive sleepiness, consider the following strategies:
1. Sleep Hygiene: Establish a consistent sleep routine by going to bed and waking up at the same time every day, even on your days off. This helps regulate your circadian rhythm and can improve sleep quality over time.

2. Wind-Down Routine: Create a calming pre-sleep routine that signals to your body that it's time to relax. This could include activities such as reading, gentle stretching, or practicing mindfulness meditation.

3. Limit Stimulants: Be mindful of your caffeine and sugar intake, especially in the hours leading up to bedtime. These substances can interfere with your ability to fall asleep.

4. Physical Activity: Incorporate regular physical activity into your daily routine, but try to avoid vigorous exercise close to bedtime, as it can be stimulating.

5. Mindfulness and Relaxation Techniques: Explore relaxation techniques such as deep breathing exercises, progressive muscle relaxation, or guided imagery to help reduce anxiety and promote a sense of calm before bed.

6. Seek Professional Help: If your insomnia persists despite implementing these strategies, it may be beneficial to consult a healthcare professional or a sleep specialist. They can help identify any underlying issues contributing to your sleep difficulties and recommend appropriate treatments, which may include cognitive-behavioral therapy for insomnia (CBT-I) or medication if necessary.

7. Communicate with Family and Partners: It’s important to communicate your struggles with your family and partner. They may not fully understand the impact of your sleep issues on your daily life, and having their support can be invaluable.

In conclusion, your experience of insomnia and excessive sleepiness is a multifaceted issue that can be addressed through a combination of lifestyle changes, relaxation techniques, and professional support. By taking proactive steps to improve your sleep hygiene and seeking help when needed, you can work towards achieving a more balanced and restful sleep pattern. Remember, it's essential to prioritize your well-being and find a routine that works for you.

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