My kindred spirit. Only thing i don't suffer from is headaches and falling asleep driving. The driving aspect i put down to the same as you/Caitlin not being affected as a result of something i enjoy, falling under what can frustraiting feel like conditional IH, if i am not stimulated strongly the motivation and procrastination is there too, and why i think there is a dopaminergic aspect involved and why it is so often connected with ADHD. Excited with the mention of GABA, i have charted and wrote a book on IH/CFS/MCAS/ via biochemistry and the interaction of GABA with many co-occuring conditions and pathways such as Acetylcholine & histaminergic, also chloride & potassium channels (creating channelopathies), not to mention the general reticular activation. A section i wrote on sleep inertia... When your alarm goes off in the morning do you ever tell it go away using swear words? Or alternatively get a feeling of dread in the pit of your stomach? Well, that’s sleep inertia, the feeling that you have stayed up all night drinking and partying till 6.55 am, got yourself into bed for 7.15 and during your blissful sleep while your hangover manifests, you pick up a nice cold too. Then your alarm goes off at 7.30 and you realise you have a 12 hour shift ahead of you. Yeh? -Sleep inertia. Sleep inertia is a transitional state from sleep to wakefulness resulting in low arousal occurring immediately after awakening from sleep and producing a temporary deficit in cognitive performance. Several factors are involved in the pathology and severity of sleep inertia, one of the most significant factors is the sleep stage when woken. Abrupt awakening during slow wave sleep results in greater sleep inertia than waking in stage 1 or 2 sleep. Almost everyone experiences some degree of sleep inertia, but it is usually on the mild or moderate side, and can feel a bit like a mild hangover, for example like my ex-wife who would utter the words “I hate mornings” as the first words every day after the alarm went off. I'm surprised she managed to squeeze it in between me wailing NOOOOO, NOOOOOO, it can’t be morning, noooo, it’s just a terrible nightmare, please tell me it’s just a dream, please god NOOOO”. I dunno, maybe i was just saying it to myself in my head! Well, the severe end of sleep inertia heading in that direction, typically it lasts around 10-20 minutes (or until that “first coffee”), anything from 4 minutes to a few hours, although despite the intensity for me, it did settle after the typical 20-30 mins. Blimey, I even remember being like that for school mornings! The most common symptoms of sleep inertia are such things as grogginess, impaired cognitive ability/spatial memory. With the latter you may experience difficulty focusing, and/or reduced memory, however drowsiness/grogginess is one of the most immediate and noticeable symptoms of SI. This grogginess makes it challenging to get out of bed and start the day, especially if it is chore filled. Disorientation is often quoted, however, this is something that is not present with my SI, save for but a handful of times ever, and it was quite alarming, feeling disoriented and confused, and not knowing where i was or what time it is, a couple of times, even not knowing who i was, that’s freaky i can tell you! I would go out on a limb and say this must surely be a very short-lived aspect when experienced, as it was with myself. There is a distinct lack of motivation, basic tasks such as getting dressed, showered or doing one's teeth, stuff that normally shouldn't be an issue can feel like facing Kilimanjaro in your slippers, however there is a name for that, avolition is discussed elsewhere in the book, but it’s presence here almost by default is mighty interesting. It’s a biggie for me, always has been since the dawn of time, not surprising with my hypersomnia issue. "WAKING UP IS THE HARDEST THING I DO ALL DAY" Lynn Marie Trotti Despite my hate-hate relationship with SI, it could actually be doing me a favour elsewhere, in the form of the complaint that so many others with sleep issues have, that of waking through the night and not being able to get back to sleep. That does not affect me, once i am eventually asleep, I'm good till morning. And beyond... Clinomania/clinophillia roughly translates to an obsession with being in bed. The word comes from the Greek words clino, meaning bed, and mania, meaning addiction. Clinomania is closely related to dysania, which is the extreme difficulty of getting out of bed in the morning, and the two are often confused and used in exchange. Clinomania is the strong desire to “go back to bed/be in bed in general”. There is less of an air of menace, uncontrollability, and outright defencelessness against it when compared to hypersomnia and narcolepsy. Dysania is very similar to clinomania and can be looked at as another close branch of it. However, it is soley one aspect, that of experiencing extreme difficulty being able to get oneself out of bed, this can be via a sleep inertia grogginess as desire to go back to sleep, but also crosses over into a lasting, beyond the typical sleep inertia symptoms where the will to get out of bed and face the day is very hard to come by, this also falls under the avolition banner, and it is easy to see how it is a common symptom of M.E./CFS. I have had my fair share of these mornings; it is absolutely overwhelming and often riddled with anxiety at the prospect of “getting up”. Good luck trying to explain it to an outsider in the hope they will understand. Negative feelings are understandably rife behind clinomania and dysania, these thoughts and feelings can manifest of low self-worth & laziness, you feel inadequate and guilty for staying in bed for so much of the time. Truth be told it is not half as bad if for example I was going on holiday that morning, I'm confident it would be similar in others too under specific conditions making it, severity wise, circumstantial. This leads me to believe that at least a very large part of it involves dopamine and the reward system, reflecting the regulation of motivated behaviours, as this is achieved by the coordinated action of molecules, such as hormones and neurotransmitters. These molecules act within pathways and channels that integrate complex signalling, and that, with us is significant beyond belief... The Sleep Foundation recognises dysania is associated with clinomania, however neither term is even moderately known or recognized by the medical community. CORTISOL AWAKENING RESPONSE Morining anxiety or sleep inertia, take your pick. I have had mornings when i have had severe morning anxiety (more so in the past), and i have had numerous mornings with sleep inertia and dysania, but i don’t ever remember them both at the same time, not in significantly equal amounts anyway. I think an examination of the cortisol awakening response and it’s connection to the HPA-axis and circadian rhythm is in order to find some answers here. Waking up is closely associated with a cortisol awakening response (CAR) which involves an increase in cortisol around 60-75%, and up to 150%, peaking at around 30 minutes after waking. (Clow 2004) Morning types show relatively higher cortisol levels in the first hour after awakening than evening types (early birds vs night owls). There is also evidence that cortisol levels peak earlier in the day in morning types than in evening types (Bailey and Heitkemper 2001), and this correlates well with my experience of being a morning hating night owl, i would feel marginally better as the day progressed anxiety wise and could never understand how after around 6pm i was often relatively content as the morning anxiety would tail off through the day on bad episodes. One of the few things i managed to speak to my mam about with regards to her struggles was this, as she said she experienced the same, an overwhelming anxiety in the morning, and she had said that this was one of the reasons she would drink in the morning. Bailey and Heitkemper also wrote about a delayed early-morning peak of cortisol awakening response in night owls, reinforcing what I would experience previously mentioned. Does this go some way to explaining dysania and clinomania? It all points in that direction doesn’t it. This huge elevation in the stress hormone cortisol upon waking has been proposed to be a self defence mechanism somewhat, in view of it serving the purpose of preparing us for the challenges of the upcoming day. I ponder if another reason could be in order to shake off sleep inertia and induce a more rapid transition to a more cognitively alert state, remember when i said i would never experience the two in anger together? As is typical with us that would reflect yet more all or nothing, nether being much fun... Genes involved in hypersomnia, sleep inertia, clinomania & dysania are HLA-DQB1, HCRT, SLC9, & GRIN2. Chronic all day sleep inertia/dysania results in one of the most destructive aspects of my cluster... IDIOPATHIC HYPERSOMNIA
Excelent! Congratulations!👏👏👏👏👏👏👏👏👏👏👏👏👏
My kindred spirit.
Only thing i don't suffer from is headaches and falling asleep driving.
The driving aspect i put down to the same as you/Caitlin not being affected as a result of something i enjoy, falling under what can frustraiting feel like conditional IH, if i am not stimulated strongly the motivation and procrastination is there too, and why i think there is a dopaminergic aspect involved and why it is so often connected with ADHD.
Excited with the mention of GABA, i have charted and wrote a book on IH/CFS/MCAS/ via biochemistry and the interaction of GABA with many co-occuring conditions and pathways such as Acetylcholine & histaminergic, also chloride & potassium channels (creating channelopathies), not to mention the general reticular activation.
A section i wrote on sleep inertia...
When your alarm goes off in the morning do you ever tell it go away using swear words?
Or alternatively get a feeling of dread in the pit of your stomach?
Well, that’s sleep inertia, the feeling that you have stayed up all night drinking and partying till 6.55 am, got yourself into bed for 7.15 and during your blissful sleep while your hangover manifests, you pick up a nice cold too.
Then your alarm goes off at 7.30 and you realise you have a 12 hour shift ahead of you. Yeh? -Sleep inertia.
Sleep inertia is a transitional state from sleep to wakefulness resulting in low arousal occurring immediately after awakening from sleep and producing a temporary deficit in cognitive performance. Several factors are involved in the pathology and severity of sleep inertia, one of the most significant factors is the sleep stage when woken. Abrupt awakening during slow wave sleep results in greater sleep inertia than waking in stage 1 or 2 sleep.
Almost everyone experiences some degree of sleep inertia, but it is usually on the mild or moderate side, and can feel a bit like a mild hangover, for example like my ex-wife who would utter the words “I hate mornings” as the first words every day after the alarm went off. I'm surprised she managed to squeeze it in between me wailing NOOOOO, NOOOOOO, it can’t be morning, noooo, it’s just a terrible nightmare, please tell me it’s just a dream, please god NOOOO”.
I dunno, maybe i was just saying it to myself in my head!
Well, the severe end of sleep inertia heading in that direction, typically it lasts around 10-20 minutes (or until that “first coffee”), anything from 4 minutes to a few hours, although despite the intensity for me, it did settle after the typical 20-30 mins. Blimey, I even remember being like that for school mornings!
The most common symptoms of sleep inertia are such things as grogginess, impaired cognitive ability/spatial memory. With the latter you may experience difficulty focusing, and/or reduced memory, however drowsiness/grogginess is one of the most immediate and noticeable symptoms of SI.
This grogginess makes it challenging to get out of bed and start the day, especially if it is chore filled. Disorientation is often quoted, however, this is something that is not present with my SI, save for but a handful of times ever, and it was quite alarming, feeling disoriented and confused, and not knowing where i was or what time it is, a couple of times, even not knowing who i was, that’s freaky i can tell you!
I would go out on a limb and say this must surely be a very short-lived aspect when experienced, as it was with myself.
There is a distinct lack of motivation, basic tasks such as getting dressed, showered or doing one's teeth, stuff that normally shouldn't be an issue can feel like facing Kilimanjaro in your slippers, however there is a name for that, avolition is discussed elsewhere in the book, but it’s presence here almost by default is mighty interesting.
It’s a biggie for me, always has been since the dawn of time, not surprising with my hypersomnia issue.
"WAKING UP IS THE HARDEST THING I DO ALL DAY" Lynn Marie Trotti
Despite my hate-hate relationship with SI, it could actually be doing me a favour elsewhere, in the form of the complaint that so many others with sleep issues have, that of waking through the night and not being able to get back to sleep. That does not affect me, once i am eventually asleep, I'm good till morning. And beyond...
Clinomania/clinophillia roughly translates to an obsession with being in bed. The word comes from the Greek words clino, meaning bed, and mania, meaning addiction.
Clinomania is closely related to dysania, which is the extreme difficulty of getting out of bed in the morning, and the two are often confused and used in exchange. Clinomania is the strong desire to “go back to bed/be in bed in general”. There is less of an air of menace, uncontrollability, and outright defencelessness against it when compared to hypersomnia and narcolepsy.
Dysania is very similar to clinomania and can be looked at as another close branch of it.
However, it is soley one aspect, that of experiencing extreme difficulty being able to get oneself out of bed, this can be via a sleep inertia grogginess as desire to go back to sleep, but also crosses over into a lasting, beyond the typical sleep inertia symptoms where the will to get out of bed and face the day is very hard to come by, this also falls under the avolition banner, and it is easy to see how it is a common symptom of M.E./CFS.
I have had my fair share of these mornings; it is absolutely overwhelming and often riddled with anxiety at the prospect of “getting up”. Good luck trying to explain it to an outsider in the hope they will understand.
Negative feelings are understandably rife behind clinomania and dysania, these thoughts and feelings can manifest of low self-worth & laziness, you feel inadequate and guilty for staying in bed for so much of the time.
Truth be told it is not half as bad if for example I was going on holiday that morning, I'm confident it would be similar in others too under specific conditions making it, severity wise, circumstantial.
This leads me to believe that at least a very large part of it involves dopamine and the reward system, reflecting the regulation of motivated behaviours, as this is achieved by the coordinated action of molecules, such as hormones and neurotransmitters.
These molecules act within pathways and channels that integrate complex signalling, and that, with us is significant beyond belief...
The Sleep Foundation recognises dysania is associated with clinomania, however neither term is even moderately known or recognized by the medical community.
CORTISOL AWAKENING RESPONSE
Morining anxiety or sleep inertia, take your pick. I have had mornings when i have had severe morning anxiety (more so in the past), and i have had numerous mornings with sleep inertia and dysania, but i don’t ever remember them both at the same time, not in significantly equal amounts anyway.
I think an examination of the cortisol awakening response and it’s connection to the HPA-axis and circadian rhythm is in order to find some answers here.
Waking up is closely associated with a cortisol awakening response (CAR) which involves an increase in cortisol around 60-75%, and up to 150%, peaking at around 30 minutes after waking. (Clow 2004)
Morning types show relatively higher cortisol levels in the first hour after awakening than evening types (early birds vs night owls).
There is also evidence that cortisol levels peak earlier in the day in morning types than in evening types (Bailey and Heitkemper 2001), and this correlates well with my experience of being a morning hating night owl, i would feel marginally better as the day progressed anxiety wise and could never understand how after around 6pm i was often relatively content as the morning anxiety would tail off through the day on bad episodes.
One of the few things i managed to speak to my mam about with regards to her struggles was this, as she said she experienced the same, an overwhelming anxiety in the morning, and she had said that this was one of the reasons she would drink in the morning.
Bailey and Heitkemper also wrote about a delayed early-morning peak of cortisol awakening response in night owls, reinforcing what I would experience previously mentioned.
Does this go some way to explaining dysania and clinomania? It all points in that direction doesn’t it.
This huge elevation in the stress hormone cortisol upon waking has been proposed to be a self defence mechanism somewhat, in view of it serving the purpose of preparing us for the challenges of the upcoming day.
I ponder if another reason could be in order to shake off sleep inertia and induce a more rapid transition to a more cognitively alert state, remember when i said i would never experience the two in anger together? As is typical with us that would reflect yet more all or nothing, nether being much fun...
Genes involved in hypersomnia, sleep inertia, clinomania & dysania are HLA-DQB1, HCRT, SLC9, & GRIN2.
Chronic all day sleep inertia/dysania results in one of the most destructive aspects of my cluster...
IDIOPATHIC HYPERSOMNIA