For many of us, the hardest part of the day is the first. That looming alarm call can be the last thing we want to hear or respond to in the morning. It's not unusual to feel groggy, out of sorts and disoriented when waking up. This is known as sleep inertia, and may be caused by waking suddenly, or not getting enough sleep the night before. It may last up to four hours, and can include confusion, feelings of listlessness and discomfort, and the urge to go back to sleep1. However, the latter is not often an option.
So how do we deal with these effects on alertness? This phenomenon is associated with disruptions in the rhythm of sleep and wakefulness2. Therefore, simply getting the right amount of sleep may reduce the effects of sleep inertia3. The ideal proportion of sleep time to time awake (or circadian rhythm) differs from person to person, and is difficult to perfect or predict. A simple start-off point is simply to go to bed earlier, and see if more sleep has a positive effect on how you feel in the morning. Some experimentation may result in a better personal sleep schedule, and thus the possibility of less sleep inertia3. In fact, the ability to wake naturally by oneself after sufficient sleep, rather than as a result of an alarm or other external factor, is associated with improved alertness after waking3.
It can be difficult to get to sleep, however, and even more so, to get good quality sleep. Habits such as reading, watching TV or using media on your phone or tablet can impact on sleep quality. Trying to reduce your exposure to these, and to make your bedroom a quiet, restful and relaxing space in which the focus is on getting good sleep, is a good strategy4. This is known as sleep hygiene, and is a potentially important factor in good quality sleep and sleep duration. Modern sleep hygiene may also include ensuring your phone doesn't beep for non-essential notifications while you sleep.
Other factors that affect sleep quality include stimulants such as caffeine and other common drugs such as alcohol. These can also disrupt the ability to get to sleep and negatively affect sleep quality5,6. Reducing or avoiding these may improve your experience of waking the next morning. On the other hand, moderate amounts of caffeine may be an effective, albeit short-term, solution for some aspects of sleep inertia at its onset7.
Negative reactions to waking may also be associated with mental health issues. The lack of motivation or ability to get up in the morning is commonly linked to conditions such as depressive disorders, anxiety and stress8. They are also associated with insomnia, or the reduced ability to get to sleep when necessary8. This condition may increase the risk of sleep inertia, as above. If you feel you may have developed such an illness, a conversation about this with your doctor is always an option.
1. Wertz AT, Ronda JM, Czeisler CA, Wright KP. Effects of sleep inertia on cognition. JAMA. 2006;295(2):163-164.
2. Scheer FAJL, Shea TJ, Hilton MF, Shea SA. An Endogenous Circadian Rhythm in Sleep Inertia Results in Greatest Cognitive Impairment upon Awakening during the Biological Night. Journal of Biological Rhythms. 2008;23(4):353-361.
3. Ikeda H, Kubo T, Kuriyama K, Takahashi M. Self-awakening improves alertness in the morning and during the day after partial sleep deprivation. J Sleep Res. 2014;23(6):673-680.
4. Dewald-Kaufmann JF, Oort FJ, Meijer AM. The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: a randomized controlled trial. J Child Psychol Psychiatry. 2014;55(3):273-283.
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7. Newman RA, Kamimori GH, Wesensten NJ, Picchioni D, Balkin TJ. Caffeine gum minimizes sleep inertia. Percept Mot Skills. 2013;116(1):280-293.
8. Prather AA, Vogelzangs N, Penninx BWJH. Sleep duration, insomnia, and markers of systemic inflammation: Results from the Netherlands Study of Depression and Anxiety (NESDA). J Psychiatr Res. 2015;60:95-102.