Struggling with Sleep: Why Am I Exhausted Yet Can't Sleep?

Q: Struggling with Sleep: Why Am I Exhausted Yet Can't Sleep?

Hello, Xu： It seems that your main issue is difficulty falling asleep, while excessive sleepiness may be a result of this difficulty, leading to accumulated fatigue. <br>The symptoms you mentioned, such as nausea, eye pain, eye twitching, and difficulty concentrating, may also be

I have two conflicting issues that occur alternately: (1) After work, I feel physically and mentally exhausted but still can't fall asleep, lying in bed for a long time without being able to sleep; (2) Even if I go to bed early, I often end up sleeping for more than 12 hours?

The first issue is that I am so exhausted that I can't sleep.
Currently, aside from academic pressure, I only have work-related stress.
However, I usually have a positive outlook, so I try to manage my stress.
Despite this, I often find myself completely worn out after a busy day, with my body aching all over.
After taking a shower and lying in bed, I still can't fall asleep, and I don't even use my phone.
At its worst, I have stayed awake until dawn and then forced myself to get through the next day.
There was one particularly severe instance where I went three days without sleep, and in the end, I only managed to get a few hours of hasty sleep before getting up.
The second issue is that I sometimes sleep for more than 12 hours, or even longer.
This usually occurs a day or two after the first issue.
I have tried going to bed early, but even when I successfully fall asleep early, I still wake up in the afternoon.
The most recent time, I went to bed around 10 PM and set numerous alarms, but I ended up waking up at 5:30 PM, which has significantly impacted my daily life and work.
I can't seem to control my sleep schedule; I want to sleep but can't, and when I do sleep, I sleep too long.
This leads to feelings of nausea and eye pain.
Sometimes, my eyes feel like they are vibrating rapidly, and I can't describe it well.
I also struggle to concentrate and suspect there might be an issue within my body.
I want to seek medical advice but don't know which department to consult.
I searched online but couldn't find answers, so I'm here seeking help.
Please evaluate my situation; I really don't know what to do.
Thank you.
🙏

Hsu Cheng-Wei, 10~19 year old female. Ask Date: 2022/10/17

Dr. Lin Mianzhang reply Psychiatry

Hello, Xu: It seems that your main issue is difficulty falling asleep, while excessive sleepiness may be a result of this difficulty, leading to accumulated fatigue.
The symptoms you mentioned, such as nausea, eye pain, eye twitching, and difficulty concentrating, may also be related to irregular sleep patterns.
There are many potential causes for difficulty falling asleep, including excessive consumption of tea or coffee, prolonged napping, use of electronic devices before bedtime, high psychological stress, hyperthyroidism, depression, and anxiety disorders.
I recommend that you consult a mental health professional for a comprehensive evaluation, so that appropriate treatment recommendations can be made based on your specific situation.
Wishing you peace and good health.

Reply Date: 2022/10/17

More Info

It sounds like you're experiencing significant sleep disturbances that are affecting your daily life and overall well-being. Based on your description, you may be dealing with a combination of insomnia and hypersomnia, which can be quite frustrating and exhausting. Let's break down your symptoms and explore potential causes and solutions.

Understanding Your Symptoms
1. Inability to Sleep Despite Exhaustion: You mentioned that after a long day of work and physical fatigue, you find it difficult to fall asleep. This phenomenon can occur due to several factors, including anxiety, racing thoughts, or an overactive mind that prevents relaxation. Even if you feel tired, your body may be in a heightened state of alertness, making it hard to transition into sleep.

2. Oversleeping: On the other hand, you also experience episodes where you sleep excessively, sometimes for more than 12 hours. This could be a sign of a sleep disorder, such as hypersomnia, or it may be a response to accumulated sleep debt from previous nights of poor sleep. Oversleeping can lead to feelings of grogginess and disorientation upon waking, which you described as feeling nauseous or having eye discomfort.

3. Physical Symptoms: The physical sensations you mentioned, such as body aches, eye pain, and difficulty concentrating, can be linked to both sleep deprivation and oversleeping. Chronic sleep issues can lead to a range of physical symptoms, including headaches, fatigue, and cognitive difficulties.

Potential Causes
Several factors could be contributing to your sleep issues:
- Sleep Disorders: Conditions like insomnia, sleep apnea, or restless leg syndrome can disrupt your sleep cycle. Insomnia can manifest as difficulty falling asleep or staying asleep, while sleep apnea can cause interruptions in breathing during sleep, leading to poor sleep quality.

- Circadian Rhythm Disruption: Your body has a natural circadian rhythm that regulates sleep-wake cycles. If your sleep schedule is inconsistent, it can confuse your internal clock, leading to difficulties in falling asleep or waking up.

- Stress and Anxiety: Even if you feel you are managing stress well, underlying anxiety can still affect your ability to relax and sleep. It's essential to consider whether there are any unresolved stressors in your life.

- Lifestyle Factors: Caffeine consumption, irregular sleep schedules, and lack of physical activity can all impact sleep quality. Even if you are not using electronic devices before bed, other lifestyle habits may still be influencing your sleep.

Recommendations
1. Sleep Hygiene: Establish a consistent sleep routine by going to bed and waking up at the same time every day, even on weekends. Create a relaxing bedtime routine that signals to your body that it's time to wind down. This could include activities like reading, taking a warm bath, or practicing relaxation techniques.

2. Limit Naps: If you find yourself sleeping excessively during the day, try to limit naps to 20-30 minutes and avoid napping late in the day.

3. Physical Activity: Regular exercise can help regulate your sleep patterns. Aim for at least 30 minutes of moderate exercise most days, but try to avoid vigorous workouts close to bedtime.

4. Mindfulness and Relaxation Techniques: Consider incorporating mindfulness practices, such as meditation or deep breathing exercises, to help calm your mind before bed.

5. Consult a Specialist: Given the complexity of your symptoms, it may be beneficial to consult a sleep specialist or a healthcare provider. They can conduct a thorough evaluation, which may include a sleep study, to diagnose any underlying sleep disorders.

6. Consider Professional Help: If your symptoms persist, it may be helpful to speak with a mental health professional. They can help address any underlying anxiety or stress that may be contributing to your sleep difficulties.

Conclusion
Your sleep struggles are valid and deserve attention. By implementing some of these strategies and seeking professional guidance, you can work towards improving your sleep quality and overall health. Remember, sleep is a crucial component of well-being, and addressing these issues can lead to significant improvements in your daily life.

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