Episode Transcript
Interviewer: So you can't get up in the morning because you always feel tired. Is this normal? We're going to find out now on The Scope.
Dr. Jones, I wake up in the morning because I have to, not because I want to, and I feel tired all the time. I don't believe this is normal, right?
Sleep Duration and Quality
Dr. Jones: Oh, this is so normal. First of all, our audience does know that you're a young woman. And we'll talk about that in just a little sec about all the things that can keep you from wanting to jump out of bed at 6:00 in the morning.
So first, are you getting enough sleep for you? Although the average is about eight hours or a little bit more, and it's a little bit more for adolescents, they probably need nine, and adolescence goes to their mid-20s, most folks think that they really can get by with less, and this isn't really the case. And many of us have built up a sleep debt. That means they're sleepy and prefer to sleep in more to make it up. The fact is that it cannot be made up in a day or a weekend. So if we're behind either chronically, like a new mom, or acutely after a big night of partying or studying, it's hard to get up.
Interviewer: So I can't just go to sleep for 2 hours on Monday and then come on Saturday, just sleep in 24 hours? That just doesn't work.
Dr. Jones: It really doesn't work all that well, no.
Interviewer: Okay. I need to change my plan then.
Identifying Sleep Disruptors
Dr. Jones: The second question is if there's something disrupting your sleep that you don't really know about. You think you're getting your eight hours or so, but you really aren't. Two things that are common come to mind: sleep apnea, snoring when you sleep, and restless legs. Now, snoring isn't just a guy thing. And when you snore, it disrupts your sleep, whether you know it or not. And if your bed partner snores, it disrupts your sleep. Restless legs syndrome is also common, and it can happen even in young women. It's a sense of needing to move around, especially the legs, not getting comfortable with being still, and getting into a good sleep. Iron deficiency can be one of the causes of this, and iron deficiency is more common in women.
Sleep Environment
Of course, you may not be sleeping well because your sleep place doesn't support good sleep. Bad mattress, bad pillow, too many things like dogs or kids or cats or angry partners in the bed. The room is too bright, too hot, or too noisy. Do any of those apply to you?
Interviewer: You know, I have a little dog that kind of tries to steal my pillow. I know.
Dr. Jones: So you're going to bed, getting up at 6:00 and you've got a dog stealing your pillow?
Interviewer: Yeah.
Caffeine and Alcohol
Dr. Jones: Oh, this is sounding worse. Okay. Now, are you drinking caffeine and alcohol at the wrong time of day? So caffeine has a long half-life. It affects sleep for longer than it promotes alertness. I'm going to say that again. It affects sleep for longer than it promotes alertness. Avoid caffeine in the afternoon. Alcohol is often consumed in the evening, which is the time when it can disrupt sleep in ways that you may not even be aware of. So are you drinking it too . . . No.
Interviewer: I kind of, I'm drinking coffee at like 10:00.
Dr. Jones: 10:00, oh boy. Okay.
Interviewer: I just realized that's not really good. Your face is . . .
Dr. Jones: Oh, my face is getting squished. I'm getting wrinkles as we speak.
Interviewer: I know.
Sleep Aids
Dr. Jones: Okay. Are you taking sleep aids? All of the sleeping pills can disrupt your alertness in the morning, and women are very sensitive to the most commonly prescribed sleeping pills. In fact, the FDA has recommended that women taking pills like Ambien for sleep take a lower dose. Even over-the-counter sleep aids, such as Benadryl or doxylamine often combined with nighttime cold medicine can make you groggy in the morning. Of course, if you take your sleep aid in the middle of the night, then when you can't get back to sleep, you'll fight as hard to get up because you still have the medicine in your body.
Interviewer: That brings up a really recent memory of getting sick and getting the flu, and then I take the flu medicine at night, but I take it a little bit later when I go to sleep, which is my usual 2:00 a.m.
Dr. Jones: Well, I'm surprised you even can kind of get up at all.
Interviewer: And then I can't get up because . . .
Dr. Jones: You should be comatose at 6:00 in the morning.
Interviewer: I know. I know.
The Connection Between Chronic Illness and Morning Fatigue
Dr. Jones: Okay. Are you in good health? No, you're in good health. People who are chronically ill, people who have pulmonary problems and don't breathe well, people who are anemic, people with heart failure, people with low thyroid or high thyroid, and people with other chronic systemic diseases are often fatigued and have a hard time getting up in the morning.
Sleep Preferences: Chronotypes and Genetics
Now, are you a teenager? Teenagers all over the world have a tendency to be night people, whether they have a smartphone or not. Even if you are made to go to bed at a reasonable time, like 10:00 p.m., your brain may be awake until midnight. The Kalahari bush people call their teenagers owners of the shade. That means they stay up all night and they sleep in the shade all day.
Anyway, you won't feel really good having to get up at 6:00 to get ready for the school bus or take an early class or get to work by 8:00 if you're a teenager.
Lastly, are you living your chronotype?
Interviewer: And what's that?
Dr. Jones: Are you a night person trying to live mornings? The time that you would like to go to bed is partly determined by your genes. Check out, "Yes, Your Sleep Schedule is Making You Sick," at "The New York Times" and take the quiz, "What Kind of Sleeper Are You?" Or you could go to the Center for Environmental Therapeutics, and that's cet.org/chronotypes and take the Morningness-Eveningness Questionnaire. I took it, and it wasn't a surprise to me that I'm a strongly morning person.
Now, you could probably guess what your chronotype is, but if you want to take a questionnaire, just do it. You are fighting an uphill battle getting up when average people get up, and that will take some workarounds, and there are some workarounds. At least, it's helpful that you know it.
Your morningness or eveningness is partly genetic and partly your age. Teens, as we noted above, were night people, and the elderly tend to move toward morningness. So if you have a hard time getting up in the morning, are you normal? Yep. At least 10% of people have a hard time getting up, and it's probably 50% of young people.
Think about the things we talked about and see if there's something getting in your way. Good luck. Get going. And thanks for joining us on "The Seven Domains of Women's Health."
updated: July 27, 2023
originally published: June 7, 2018