Dealing with sleep inertia

Dr. Oz is writing for the general public. My doctor is one of the leading sleep disorder specialists in the region, and has written papers on the (relatively rare) condition I have.

However, I appreciate you bringing this issue to light. Although I’d prefer to see more information before making a judgment, it very well may be that what my doctor has prescribed for my condition would be inappropriate for anyone not under a doctor’s care (despite what the herbal supplement companies are pushing). I should have taken more care to explain that my situation is clinically different than most when I responded to your post.

I have a lot of first-hand experience with sleep inertia because of my job. My schedule varies drastically throughout the week, and ends with two 8 hour shifts (early/overnight) in a 24 hour period. I’ve also been through some sleep seminars that were mandatory for my line of work.

Things I have found through experience:

  • Do not use the snooze button on your alarm. Move it out of reach from your bed if you have to.
  • Get a coffee pot with a timed-brew feature. They can be as cheap as $20-$30. Get it set before you go to sleep. Having the fresh coffee brewing as soon as the alarm goes off makes it easier to wake up (instead of having to go through the motions of manually doing it while a sleep-zombie).
  • Jump in the shower ASAP. Leaving a nice warm bed is part of what makes getting up so difficult sometimes. Going right to a hot shower helps tremendously.
  • Consider natural sleep aids. There’s tons if these out there, but I’ve found any type of “sleepy time” tea or magnesium (ex: “Natural Calm” brand) helps for restful, fulfilling sleep.
  • Avoid caffeine later in the day and don’t drink alcohol right before bedtime. This is a big recommendation in every sleep seminar I’ve attended.

Mileage varies. I used to take 10mg melatonin daily in a single dose for several weeks, a few months ago. I would take it around 8 pm. I swear it did absolutely nothing for me.

I have experienced instances when I would awaken very early (usually around 4 am) feeling I am done sleeping. I begin my usual morning routines, but sleep eventually intervenes. Apparently it was a false start. The mind was not yet ready to give up sleeping.

WAG: sometimes the brain wants a break from sleep itself, just as it desires a break from a tedious mental or physical activity. The brain wakes, spends a little time looking around, and goes back to sleep again, as if sleep itself were a tiresome activity.

That said, such instances for me are few and far between.

Melatonin becomes almost immediately ineffective if you overdose on it. Overdosing can cause irritability and anxiety and lead to a hangover effect the next morning. These are all inversely correlated with sleep quantity and quality. I have been down that road. I started with 5mg a night and it didn’t do anything. Switched to a much smaller dose after doing online research, and it’s as effective as diphenhydramine without the hangover now.

Keep in mind that melatonin is a hormone. More is not always better, you want to achieve a balance. Since it’s been several weeks, you might try again with a dose of 1/3 (one-third of a) mg a night.

I’m not being glib, I really am glad if it works for you. But it’s not good general advice. There are a lot of people out there who try taking 3mg-10mg doses and wonder why melatonin doesn’t work. It’s because they’re taking way too much!

I do wonder if your doctor started you on a lower dose and worked up to the 3mg. Because if so, then I suppose it could actually be the therapeutic level for you. That would be highly unusual, as the body only produces about 1/3 mg a day, although not impossible. But if he/she just started you on 3mg from the outset, it was likely **much **more than you needed.

This sounds very similar to the way I have felt in the past and, if you’re fairly certain you don’t have some other sleeping disorder like sleep apnea, I think it’s mostly a sleeping habit thing. For me, I had almost identical symptoms for years, and changing my habits was difficult, but it made a significant difference.

For falling asleep, a big thing was trying to be more consistent about when I go to sleep. If it’s all over the place, then I’ll have a harder time falling asleep on some of the earlier nights. More importantly, having some kind of pre-bed ritual to winddown helps. That means, not being on the compute rand immediately jumping in bed, but trying to avoid that sort of stuff.

The biggest helping factor, for me personally, was meditation, which helped me learn to calm my racing mind, which otherwise can easily keep me up. If you’re not into that, or have difficulty with it, anything you can do that will help with that will make a difference. That could mean some light reading or soft music, or other relaxation techniques like focusing on your breath or whatever.

For waking up, it’s probably a bit more difficult because it requires some presence of mind, but the most effective thing is just to get the hell out of bed. In the OP, you say you plop back into bed promising yourself 5 more minutes. Don’t do that. If you have to, put your alarm across the room, and once you get out of bed, no matter how much you want to lay back down, don’t. Each time you lay back down, you basically reset your wake-up, but it’s not like that extra 5, 10, 20 minutes is meaningful restful sleep. And it also helps to do something to reinforce waking up, like when you get out of bed, jump in the shower as quickly as possible. Not only will it help you wake up, but it makes it more or less impossible to just shower and lay back down.

Another thing, try to wake up at the same time every day, even on days off, as much as possible. Getting your body into that routine will help with the chemical side. When I had issues waking up, I was waking up at different times throughout the week. Waking up at more consistent times, even on weekends, not only would I start to wake up naturally about the time my alarm would go off, but even when I wasn’t, I was in the natural process of it, so it was easier.
And some more general things, if you’re not getting regular exercise, do it. I have an intense and consistent regimen, and I can even feel a difference in how quickly I fall alseep and the quality of sleep I get on days I work out and days I take off. When I take a longer break, like on a vacation, I can definitely feel that quality drop a lot. Personally, I also found that caffeine, while it might help you wake up, ultimately made it more difficult for me, and I mostly eliminated it. If you are going to drink it, make sure you avoid it for several hours before bed. For that matter, diet can make a noticable difference. Besides just eating better in general, I find avoiding heavy meals late, but usually eating something light and with some decent protein not too long before bed helps give me that energy in the morning I wouldn’t otherwise have until at least sometime after eating breakfast.

I will certainly try a micro dose of Melatonin and see if it helps. Thanks for this valuable piece of information!

I also struggle with sleep inertia and waking up in the morning. I recently found out I have sleep apnea, and I’m currently in the process of getting a c-pap.

Pretty much all my life I’ve struggled with waking up in the morning. Using the snooze button on the alarm clock for hours, or even turning of the alarm without remembering it because I’m so groggy and then going back to sleep. Using different alarms. Putting the alarm on the other side of the room. Going to bed at the same time and waking up at the same time helps a little bit, but not very much. Lots of different strategies.

Regarding the issue of sleep cycles mentioned by others, for about a year now I’ve been using an alarm clock app on my iPhone that tracks your sleep cycle. You turn the alarm on and place the phone on the bed next to your pillow, and the accelerometer in the phone tracks your movements so it can tell when you’ve in light sleep vs. deep sleep. You set a time to wake up, and the app will turn on the alarm within a 30 minute window before that time. So if you set it for 6am, it will wake you up between 5:30 and 6, whenever you are in a lighter stage of sleep. Even with the sleep cycle alarm clock I still oversleep sometimes, especially when I don’t get enough sleep, and because I have a very erratic work schedule. But it works better than any other alarm clock I’ve used before. There’s a few different sleep cycle alarm clocks in the iPhone app store - I’m not sure how they differ but the one I have is free.

My brother uses a Jawbone Up, which is a bracelet that you wear all the time to track your physical activity, but it also functions as a sleep cycle alarm clock, and he says that he loves it and it really works well for him.

I thought of another thing that worked for me: instead of hitting the snooze button, I would promise myself to take a nap later. I almost never did, but knowing I had the option made the morning less painful.

For help getting out of bed, also try turning on as many lights as you can and immediately get moving. Do everything you can to tell your body that it needs to be awake. Make that a habit, and it should help.

At least, that’s the type of stuff I’m seeing lately, as I’ve been dealing with some insomnia and am trying an at-home version of CBT-I.

I don’t have any suggestions for your sleep disorder, but I do have for your alarm.

Buy the loudest alarm you can find (difficult to let the store try it out) and place it across the room. This way you HAVE to get out of bed to turn it off and it’s loud enough, you’ll want to turn it off and once you are up, there is no sense going back to bed (in theory). NEVER use the snooze button.

I did this most of my working live and never had a problem (not that it’ll necessarily work for you).

Bob

Interesting article on unexpected sleep disturbers: 10 Unexpected Things That Can Ruin Your Sleep | HuffPost Life

I have tried it. Having to crawl across the room to turn off a loud alarm needs you to be awake - for a few seconds. Sleep inertia is a powerful thing. It can persist for a long time for me (a couple of hours is a long time!). This is not a problem that will go away with any amount of willpower and determination. In any case, I cannot pull off such a feat.

I have been through this. I get it very rarely now. Here is what I did. It does require some willpower.

  1. Go to bed early enough that you can get the ideal amount of sleep for you. I need 7-8 hours to feel refreshed. (I’m not counting the fact that I get up to go to the bathroom once in there.) No matter what I think I need to do, I put it down and go to bed so I can get 7-8 hours before I need to get up the next morning. I am more productive if I am well-rested, so I find it is not a problem to get everything I need to do finished.

  2. Practice sleep hygiene.

  3. Do not block all natural light from your bedroom. I use sheer curtains so that starting around 6 am, I am gradually awakened by the sun coming into the room.

  4. If I feel like I am entering/in a sleep inertia pattern, I force myself to sit up. I force myself to blink, and try to keep my eyes open. I swing my legs off the bed. Sometimes I will even force myself to get up and walk around the bedroom even though I still feel “asleep.” If I do this, I feel awake/normal within a couple of minutes.

Also, I recommend getting checked for diabetes/blood sugar problems. My sleep inertia problems were at their worst when I was pre-diabetic and not being treated. Morning blood sugars are usually very high in people with Type 2, and it made it really hard for me to wake up and get out of bed, because a symptom of high blood sugar is sleepiness. The following things I did are specific to managing those issues:

  1. Eat a small snack before bed. If you are worried about gaining weight, plan for it in your diet. I eat a banana, because after trial and error, this is what works best for me. This prevents long periods of fasting, which in turn keeps my morning blood sugars lower, which in turn means I am less sleepy in the morning as I try to wake up.

Lots of these are things I don’t want to do. I don’t enjoy them. I would like to stay up late playing on my computer. I would like not to have the sun in my eyes early in the morning. I definitely hate the feeling of forcing myself up, when I need to. But overall, my life is much better if I do these things.