The change of seasons brings pleasant variety to our lives. After sweltering summer days , the coolness is pleasant; the monotonous green of the leaves is replaced by a riot of colors. But when the leaves fall and the temperature is no longer comfortable, many feel like their battery is dead. A person is overcome by apathy and constant drowsiness . I want to eat a lot, my body requires sweets, fatty foods, fried foods, and not getting up from the couch. But no one canceled their studies or work. Constant absent-mindedness and weakness have a bad effect on work results and prevent you from studying well, making a career, or running a business. Some take vitamins or go to the doctor and get examined. It is useful to monitor your health and undergo an annual medical examination, but autumn drowsiness, if there are no other unpleasant symptoms, should not be a cause for concern. This is a natural reaction of the body to cold weather and reduced daylight hours .
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We often hear that social networks are to blame for everything: “Teenagers do not part with their phones, they sit on them day and night! And then they can’t wake up for school, they fall asleep in class, and because of this they study poorly. Then on weekends they sleep until noon, but the lessons won’t teach themselves. Okay, if they want to go to bed late, then let them read books, because it’s this blue light from the screens that keeps them awake for so long!”
Do you recognize the arguments? But some of them are myths, while the significance of others is exaggerated. In reality, why we sleep and how we do it at different times in our lives is a complex and contradictory story. Let's try to figure out why the sleep of teenagers and young adults is so different from the sleep of middle-aged people and children, why we don't get enough sleep all the time (even if we sleep for what seems like a sufficient amount of time), what role does the first class/first lesson at 8 play in this? :30 in the morning, and what - hanging out on social networks at night, looking at it, and let's talk about whether something can be done about all this.
Why is autumn drowsiness dangerous?
Drowsiness and weakness occur due to the approach of winter , but it can be the first sign of dangerous diseases: diabetes, heart failure, atherosclerosis, anemia, oncology. If there are other symptoms (increased sweating, palpitations, dry mouth, constantly thirsty, loss of appetite, weight loss, etc.), discuss the reasons for lethargy with your doctor.
Unless you have an underlying medical condition, drowsiness can also be life-threatening. Difficulty concentrating can be deadly for drivers and pedestrians, and for people who operate complex machinery and equipment. Absent-mindedness is not life-threatening, but it can create big problems for a student, accountant, or store clerk.
A perfect storm
The map for us will be the model of a “perfect storm” (a perfect storm, an English phraseological unit denoting an event in which a rare combination of circumstances sharply aggravates the events) (Fig. 1) [1], [2]. This is a model according to which, in adolescence, sleep is influenced by physiological and social factors: on the one hand, shifting it in time, on the other, reducing its duration. This subsequently affects well-being, mood, academic performance and can cause health problems.
Figure 1. The “perfect storm” model.
[2]
Physiological factors
With the onset of puberty, a biologically determined shift in the sleep-wake cycle occurs, with a tendency toward falling asleep later. This shift is mediated by at least two reasons.
Firstly, there is melatonin. It determines our bedtime, and its synthesis follows the circadian rhythm. As the child grows older, the peak of its secretion shifts to a later time, from approximately 10:00 pm to 1:00 am. In addition, the volume of its synthesis decreases significantly, and in girls these changes occur earlier than in young people, as does the onset of puberty [2], [3].
What circadian (aka circadian) rhythms are can be learned from the article “Biomolecules” about the Nobel Prize in Physiology or Medicine for 2022 [4].
In addition, it is melatonin that synchronizes our internal biological clock with the time of day: its secretion changes depending on the activity of the suprachiasmatic nucleus, which, receiving signals from the retina, responds to changes in ambient light. Sensitivity to evening light levels increases in early adolescence [5]. This leads to suppression of melatonin secretion and, as a consequence, a delay in falling asleep [6].
You can learn more about the work of the suprachiasmatic nucleus from the article “Biomolecules” : “Wake up!” - “Go to sleep...” - “Wake up!” - “Go to sleep...” - “Wake up!” [7].
The second reason is a delay in the phase of the sleep-wake cycle during adolescence. And this is not a disease of modern society and city residents. This phenomenon is noted regardless of the significant cultural differences in the habits of adolescents in different countries around the world [8]. In order to understand it, we first need to become familiar with the two-component model of sleep regulation (Figure 2). It is based on the interaction of two components—the circadian and homeostatic processes of sleep regulation [9], [10]. The circadian process (C-process) is rhythmic, its cycle is approximately 24 hours and is regulated by the level of light at different times of the day, the activity of the suprachiasmatic nucleus and melatonin. The homeostatic process (S-process) is associated with the accumulation of fatigue and drowsiness during wakefulness; it increases during the day and decreases during the night. Its marker is considered to be the delta index (also known as the SWA level, slow-wave activity on the electroencephalogram, EEG). In healthy people, it is maximally expressed during slow-wave sleep (NREM sleep), increases depending on the duration of previous wakefulness, and is extremely high during sleep deprivation.
Figure 2. Two-component model of sleep regulation.
[9], [10]
This “sleep pressure” (homeostatic S-process) accumulates more slowly in adolescence, which is associated, among other things, with a decrease in the peak level of melatonin and leads to a longer time to fall asleep, forcing one to stay awake at night (Fig. 3). At the same time, this “pressure” decreases in adolescents almost as slowly as in children. Thus, given the need to wake up early the next day, the 8–10 hours of sleep required for adolescents turns out to be an almost impossible condition in their usual reality [11]. It is worth noting that the listed processes increase with growing up and puberty, so high school and junior students experience the greatest difficulties with short and poor-quality sleep [12], [13].
Figure 3a. Levels and timing of melatonin secretion in adolescents at different stages of sexual development.
[12]
Figure 3b. “Childhood” and “teenage” patterns of the sleep-wake cycle. The red and blue lines are the upper and lower boundaries of the circadian process (C-process), which indicate the threshold for falling asleep and the threshold for waking up. The green line is the homeostatic process (S-process).
[13]
How exactly these features are programmed at the genetic level is still unknown, but there are studies on fruit flies. For example, the pdm3 gene was discovered, which is necessary for the formation of sleep regulation mechanisms in Drosophila. This gene encodes the protein PDM3, a transcription factor domain that coordinates the early brain development program and controls the communication of wakefulness-promoting dopaminergic neurons with the sleep-promoting region. When the pdm3 gene is knocked out, dopaminergic inhibition of the sleep center increases prematurely, its formation is disrupted, and young flies continue to stay awake when they should fall asleep, thereby not getting the required amount of sleep. There are a number of homologous genes in humans, one of them is POU6F2. In mammals, its products, the POU proteins, are associated with neurodevelopmental disorders such as autism spectrum disorder, which are often accompanied by comorbid sleep disorders, suggesting a potential role for these early life sleep regulators [14]. Thus, we have little evidence that the shift in the sleep-wake cycle is genetically determined and occurs with maturation and brain development.
You can learn about another “sleep gene” discovered in fruit flies from the 2008(!) news on Biomolecule [15].
We cannot influence all this biological machinery, but the second group - social factors, which are associated with most misconceptions and myths - is quite amenable to modification.
When does it occur
Frequent worries and stress at work and in the family lead to emotional exhaustion. At the same time, the person constantly wants to sleep, he does not have the energy to engage in even ordinary activities. Over time, a person's condition worsens, and fatigue becomes chronic. This is mixed with diseases of the heart, blood vessels, and digestive tract.
Lack of life goals
Constant fatigue and drowsiness occurs in those who are not satisfied with their life. This is what leads to a job you don’t like, when you force yourself to go to the office or enterprise every morning. Those who stop developing, not realizing their potential, become emotionally burnt out.
The same result awaits workers who devote all their strength to the work they love, but do not receive a final positive result. A reduced emotional background causes muscle weakness and irritability.
Nervous tension, shock
Everyone has enough troubles in life. When life goes through a dark period: a loved one dies, a divorce is coming, children bring grief - then the body cannot cope with the stress and fails. It is expressed by the appearance of drowsiness and fatigue. You give up, it seems that life is over. It is in this situation that depression develops.
It’s important to set yourself up for the fact that everything will pass. Problems will subside and life will return to normal.
No support
An adult’s psyche suffers when loved ones do not support him in difficult life situations. When faced with a choice, it is difficult to determine what the right thing to do is. And when there is no person nearby who can understand and forgive, then lethargy and apathy come. At the same time, they feel muscle weakness and a reluctance to think and reason. With a long-term condition, a feeling of anxiety, suspiciousness, and irritability is mixed in.
Weakness of character
Personality traits influence why fatigue occurs. For pampered people it is more difficult to deal with problems. Any deviation from everyday life in one direction or another causes panic. And decision making is difficult.
The weak-willed person always needs support like no one else. Without it, you give up, panic and stress begin. They are accompanied by irritability and anxiety in some, and lethargy and drowsiness in others.
Increased fatigue
Chronic fatigue syndrome is the scourge of modern people, especially residents of big cities. Excessive fatigue due to poor nutrition, prolonged exposure to high or low temperatures, diseases associated with metabolic disorders, major bleeding, and injuries can lead to weakness of the body.
Often, for six months, a state persists when you don’t want to do anything, just sleep. After all, at this time the level of melatonin in the blood is increased. Fatigue syndrome complicates life, lasting for a long time with varying severity of symptoms. Women between 20 and 40 years of age suffer from the pathology more often.
Stress
Everyone knows what it means to feel tired, exhausted, weak and depressed, and what suffering this brings. Everyday stress negatively affects the entire body:
- increased blood pressure;
- increased heart rate;
- suppression of the immune system.
The release of stress hormones leads to the fact that energy reserves are depleted, reducing the protective response. The supply of nutrients, B vitamins, antioxidants, zinc and other substances necessary for the functioning of the immune system is depleted. The body begins to age faster. It’s not for nothing that stress is called the silent killer. If you do not remove stress using reasonable methods, its consequences will negatively affect your health.
Social factors
As we have already figured out, from a physiological point of view, social networks and the cold light of screens associated with them are not the only culprits of late bedtime. Of course, an active social life attracts our attention to countless chats, but it is not entirely clear: this is the reason for going to bed late or a way to fill the time in which, on the one hand, you are no longer productive enough to study, and on the other, not yet so Do you want to sleep to put off all your work? In addition, there is no consensus in the scientific community about which element of sleep hygiene has the greatest impact, and therefore there are no direct recommendations from international sleep medicine and pediatric organizations regarding the use of gadgets before bed [16], [17].
Other social factors that influence teens' sleep include academic workload and peer pressure. For some, it may be the fear of failing an upcoming exam, forcing them to study all night long; for others, it may be difficult relationships with teachers or classmates that are disturbing and do not allow them to sleep. In both cases, a vicious circle is formed: problems at school can lead to anxiety, insomnia and lack of sleep, which, in turn, reduces cognitive function the next day, adds irritability and impulsivity, and therefore new problems appear that interfere with sleep.
Another factor (it can be called sociobiological) is the consumption of caffeine in general and coffee in particular. In the eyes of many teenagers, this is one of the ways to appear older by drinking a kind of “growing up drink.” But for teenagers, the daily caffeine intake is much lower than for adults; it is easy to exceed it, focusing on parents, and as a result - tachycardia, hand tremors and increased anxiety, which in no way contribute to healthy sleep [18].
Above we mainly talked about going to bed late. But its duration is limited by the time at which we need to wake up, and few of us do this without an alarm clock (and more often than not without several at intervals of “five more minutes”). The first and main requirement of society for teenagers - studying at school, college or university - is inextricably linked with the early time of waking up (at 6-7 in the morning) for the first lesson. This mismatch between the physiological need for a particular sleep-wake schedule and social demands is the cause of chronic sleep deprivation, the “perfect storm” that plagues adolescents every day and every night. In the evening, sleep is interrupted by minutes of delay in the phase of the sleep-wake cycle, a slow increase in sleep pressure, social and academic problems, and in the morning by the early start of classes, which makes healthy sleep (one of the basic human needs!) unattainable.
The graph shows a strict limitation of sleep time by social factors (Fig. 4) [19]. With the onset of adolescence, sleep time on Saturday and Sunday begins to differ significantly from that on weekdays: getting up and falling asleep later, sleeping longer on weekends is not a sign of laziness, but an attempt to enter a biologically necessary mode after lack of sleep during the work week. And this attempt is not very successful: two nights of full sleep are simply not enough for recovery. The study, conducted by researchers at the Center for Cognitive Neuroscience in Singapore, involved adolescents who slept 9 hours each in the first control week, 5 days of 5 hours each in the second test week, and then 2 days of 9 hours each, reproducing weekdays and weekends [ 20]. Over 5 “weekday” days, the delta index increased and did not return to its original level. As a result, with this regime, lack of sleep becomes chronic with all the ensuing consequences, which we will talk about later.
Figure 4. Average bedtime and wake-up times on weekdays and weekends by age. Adolescents and young adults make up for the sleep time strictly limited by social factors on weekdays on weekends.
[19]
Causes of fatigue
Fatigue can be divided into physiological (normal) and pathological.
With physiological fatigue of the body, the reasons are usually the following:
- Leisure
- Emotional outburst, overexcitement
- Sports training
- Hard work
- Biorhythm shift due to travel or flights
Pathological causes of fatigue:
- Mental and psychological problems: excessive mental stress, chronic stress, anxiety disorder, depression, alcohol or drug abuse
- Medicines: incorrect dosage, abrupt withdrawal and incorrect use of certain medications are a common reason why constant fatigue, weakness and loss of strength do not go away
- Insomnia: if a person does not get enough sleep, the body becomes exhausted and chronic fatigue sets in
- Vitamin deficiency: vitamins and minerals are involved in the activity of the nervous system and are responsible for mental work
- Chronic diseases: the presence of heart failure, arrhythmia, hepatitis, COPD, rheumatoid arthritis, hormonal imbalance, cancer, infectious and other diseases are common causes of weakness and fatigue
- Excess weight and eating disorders: the body is forced to experience increased stress on the cardiovascular, skeletal and other systems, prone to muscle and joint pain and the development of conditions such as diabetes or sleep apnea
- Chronic pain: such patients often wake up at night and are in a state of constant tension, which may be associated with constant fatigue
- Viral infections and the subsequent rehabilitation period
- Lack of physical activity
We should also talk about such a reason as chronic fatigue syndrome (CFS, myalgic encephalomyelitis). This is no longer just a symptom, but a separate disease, which is characterized by a high degree of fatigue without a corresponding somatic disorder. Such patients may wonder why they feel tired and apathetic all the time, almost constantly, since they are hypersensitive to even light stress.
Patients with chronic fatigue syndrome are able to carry out some relatively productive activity for only a few hours a day, or even less. We are not talking about difficult work, creative projects or intense workouts - such people are exhausted even by talking about abstract topics or going to the nearest store. They are forced to spend most of their time trying to rest and recover.
For persistent weakness and fatigue, causes in this case include viral infections, primarily the Epstein-Barr virus, and problems with the immune system. The etiology of this disease is still being studied. Risk factors include age over 40, female gender and stress.
The main symptom of CFS is extreme fatigue, which lasts for at least six months and is not relieved by rest. Characterized by post-exertional weakness, which persists for at least 24 hours.
Constant companions of chronic fatigue syndrome are various sleep disorders, cognitive disorders, muscle and joint pain, orthostatic hypotension, painful lymph nodes and frequent colds. With constant fatigue, the reasons for a decrease in the quality of life are not only in poor health, but in the fact that it becomes almost impossible to lead a full-fledged lifestyle: there is no strength for previous hobbies and even work, self-development and learning new things stops. It becomes difficult to maintain daily contact with people, to the point of social isolation.
Symptoms of the disorder may wax and wane, which can create a false sense of well-being. But, unfortunately, in the pathological condition of severe fatigue, the causes are rarely eliminated without specialized treatment. Therefore, despite temporary remissions, previous problems return with a vengeance.
It is always important to understand why you feel tired. If the condition continues for a significant amount of time and it’s not just that the day is too busy, then you need to consult with a specialist, because this not only interferes with life, but can also be a symptom of a serious mental or somatic disorder.
Consequences
Clearly, chronic sleep deprivation is a serious problem for both individuals and society as a whole. If you don't solve it, what consequences will it lead to?
I think many are familiar with the short-term ones: drowsiness, problems with performance, bad mood, sometimes anxiety, aggressiveness and impulsiveness [21], [22]. The relationship between mood and sleep is complex and bidirectional because low mood and anxiety can exacerbate insomnia and vice versa [23]. In addition, depressive symptoms can sometimes be improved by increasing sleep duration [24]. Also, with a lack of sleep, criticism of one’s own state and the ability to control emotions decrease, which leads to risky behavior [25–28].
In the longer term, lack of sleep can lead to hormonal imbalance, which, along with overeating, can lead, for example, to obesity - due to increased synthesis of ghrelin, which increases appetite (another episode with another pack of chips?), to type 2 diabetes mellitus , cardiovascular diseases [29–31]. Problems with learning and memory are common—and may be related to the volume of gray matter in the hippocampus (a brain structure traditionally associated with memory processes). In a study of healthy children and adolescents, hippocampal volume was positively correlated with sleep duration [32]. In old age, the risk of dementia increases because it is during sleep that the brain most actively gets rid of metabolic waste products, including beta-amyloid and tau protein, which are associated with neurodegenerative diseases.
You can read more about the connection between sleep and intellectual decline in the Biomolecules “Sleep and Aging II: How does the sleep of the elderly and sick differ from the sleep of the young and healthy?” [33], and about the glymphatic system, which plays an important role in this, in the Naked Science article.
It is unlikely that there will be a person who wants to experience even part of the palette of these consequences for himself, although this list is still far from complete. However, this is exactly the picture we bring ourselves closer to every evening by staying up late and then getting up at 6 am to study or work.
Pathological conditions
Increased fatigue may be a sign of:
Why does my head hurt after a long sleep?
- Insomnia. Sleep disorders appear as a result of stress and loss of interest in life. Without enough sleep at night, the patient suffers from daytime sleepiness.
- Idiopathic hypersomnia. With this disease, a person sleeps fully at night, but during the day he is constantly in a state of doze. It is difficult for him to deal with his studies and work responsibilities. At the same time, he feels irritability and apathy.
- Narcolepsy as a sleep disorder. The patient cannot overcome lethargy and weakness; he sleeps constantly. Feeling anxious and suffering from hallucinations, a person may become frightened by the slightest sound, becoming irritable and nervous.
- Pickwick's syndrome, or hypoventilation of the obese. People with 3-4 degrees of obesity move little. As a result of their heavy weight, they experience difficulty breathing and thickening of the blood. During sleep, breathing stops, apnea. Since sleep is interrupted, they feel overweight and unimportant. In addition to lethargy, they look tired and constantly want to sleep.
- Iron deficiency anemia. A drop in hemoglobin levels leads to a decrease in oxygen supply to tissues.
- Hypotension. Slow blood flow through the vessels prevents the brain from being saturated with oxygen. Hence the hypoxia of the brain. At the same time, headache, dizziness, and nausea appear.
- Thyroid diseases. Due to a lack of thyroid-stimulating hormones, drowsiness, absent-mindedness, and chilliness appear. Along with loss of strength, they suffer from a constant desire to sleep.
- Vascular diseases, osteochondrosis. Narrow vessels, their compression due to inflammation of the spine, impairs blood circulation in areas of the brain.
Fatigue often occurs in spring or autumn, when the body needs vitamins and sunlight. Treatment of diseases of the psyche and nervous system involves taking sedatives. Medicines in this group cause symptoms of hypersomnia and fatigue.
Help yourself
While it is still possible to find a job that you can come to at a comfortable time, rescheduling your first lesson at school is, unfortunately, more difficult. Therefore, taking care of their own health (mental and physical) falls on the shoulders of adolescents themselves. The first thing to remember is sleep hygiene, which, fortunately, has been talked about a lot lately. Here are some principles:
- regular daily routine (same time of going to bed and waking up);
- avoiding bright, cold light half an hour before bedtime. Now on many phones you can set up an evening mode - a warmer and dimmed screen light will turn on automatically at the same time;
- Wake up at the first alarm and immediately turn on bright lights. Sleeping for five minutes does not add vigor.
These small changes can make your life easier and make waking up in the morning a little less unbearable. But there is hope that one day measures will be taken at the global level. For example, in the USA there is a social movement Start School Later in support of later start of classes for high school students [34]. If for our country 8:30 is the standard start time for classes, then in America classes can start even at 7:55! Recently, California passed a law according to which, gradually, by July 2022, classes in all schools will begin no earlier than 8:30.
How to overcome drowsiness
If you have no energy during the day , it’s difficult to concentrate, constantly want to sleep, help your body quickly overcome this unpleasant condition:
- review your diet;
- walk more in the fresh air;
- go to bed at the same time ;
- dress appropriately;
- find new sources of positive emotions;
- avoid stress and overwork.
What to eat so you don't want to sleep during the day
Start the day with a full breakfast containing complex carbohydrates: oatmeal, buckwheat, rice porridge, durum pasta, potatoes, whole grain bread. They will give you a boost of energy for several hours, and in the first half of the day you will be alert and productive.
No matter how busy you are, don't skip lunch. Don't limit yourself to snacking on the go, but don't eat too much either.
Don't skip dinner; it's hard to sleep on an empty stomach. In the evening, eat easily digestible proteins: lean meat, fish with a side dish of vegetables, dairy products.
To strengthen your immune system and look good, eat fresh fruits and vegetables more often. Do you constantly feel apathy and irritation? Eat a banana or chocolate. They contain the joy hormone serotonin, the production of which in the fall .
Autumn is not the best time for strict diets. Strict dietary restrictions are more difficult to endure than in summer or winter. The risk of developing depression and rapid weight gain increases when returning to the previous diet.
Physical activity
Do not encourage the body's desire to fall into winter sleep , provide it with moderate physical activity. Spend more time outdoors. Try to walk for at least an hour every day. If you regularly exercise, do not stop training, but you can reduce the load a little.
If, due to increased appetite and cravings for sweets, you have gained a few extra pounds, do not exhaust yourself with additional training. They will become stress for the body. He may respond by increasing his appetite or becoming even more drowsy.
Keep a daily routine
To stay alert and productive, you need to sleep at least 7-8 hours a day. Make your bed comfortable (orthopedic mattress, low pillow, blanket appropriate for the temperature in the bedroom). Ventilate your bedroom before going to bed. Two hours before bedtime, give up coffee and strong tea (black or green), but you can drink mint infusion, milk with honey.
Dress properly
I want to wear open summer dresses and a thin jacket for as long as possible. But, if you freeze on the way to work, then once you warm up, you will want to sleep. And you will increase the risk of catching a cold or the flu. Keep things on hand that you can wear if it suddenly gets cold.
Positive emotions
Positive emotions and new impressions will help you overcome drowsiness and become more energetic. Read interesting books, watch good films, funny comedy shows, listen to your favorite music, update your wardrobe or the interior of your apartment. But, if you cannot cope with depression on your own, consult a doctor and discuss with him the need to take tonic vitamin complexes, antidepressants or drugs to improve brain function.
