A brief look at excessive sleep, clinomania, and hypersomnia.
Posted Mar 30, 2020
In an A-Z article I wrote on “strange and bizarre addictions,” I included "sleep addiction" as one of the entries. Obviously, I don’t believe that sleeping can be an addiction (at least not by my own criteria), but the term "sleep addiction" is sometimes used to describe the behaviour of individuals who sleep too much.
Conditions such as hypersomnia (the opposite of insomnia) has been referred to as "sleeping addiction" (in the populist literature at least). In a 2010 issue of the Rhode Island Medical Journal, Stanley Aronson wrote a short article entitled "Those esoteric, exoteric and fantabulous diagnoses" and listed clinomania as the compulsion to stay in bed. Given the use of the word "compulsive" in this definition, there is an argument to consider clinomania as an addiction or at least a behaviour with addictive type elements.
In an online article entitled "Sleep addiction," Amber Merton also mentioned clinomania in relation to an addiction to sleep:
“If you are obsessed with sleeping or have an intense desire to stay in bed, you could be suffering from a condition called clinomania. That doesn’t mean that there aren’t people who can experience symptoms similar to addiction and even withdrawal in association with sleep, or lack thereof.”
The reference to "addiction-like" symptoms appears to have some validity based on these self-report accounts I found online. All of these individuals mention various similarities between their constant need for sleep and addiction. I have highlighted these to emphasize my assertions that some of the consequences are at the very least addiction-like:
Extract 1: “I believe someone can become psychologically dependent on sleep. I am 47 and have used sleep for 40 years to escape from life…I typically sleep 4-6 hours too much each day. Sleep feels like an addiction to me because I crave it several times a day and am looking forward to how I can sneak it in. I don’t seem to be able to control it with will power for very long…I only have short periods when this isn’t a problem. When I am under stress it is at its worse. If I have any free or unstructured time, I can’t control how much I sleep excessively. When my time is heavily scheduled, I really struggle with keeping a full schedule and crave the time off when I can sleep for hours. If I know I’ll have a few hours in between activities free, I will find ways to sneak in some sleep. I am embarrassed about this, don’t tell the people around me the extent of the problems, and devise ways to sneak in sleep without people knowing.”
Extract 2: “I love sleeping. It feels so good I think I could even become addicted if I didn’t HAVE to wake up. I sleep about 12 hours every day and could sleep more if I didn’t have to do daily necessities. I am aware of the fact that people who generally sleep more than they are supposed to, die sooner and have other various health problems. To be honest, I would rather sleep than do most things. I even choose sleep over sex a lot.”
Extract 3: “I often sleep for 12-20 hours at a time. I have depression and am on anti-depressants. I just love sleeping. It’s so safe and comfy. I don’t know how else to explain it. It’s just amazing."
Extract 4: “I sleep AT LEAST 12 hours a day. But on days off I’ve been known to sleep for about 15-20 hours. [I am] addicted to sleep. I’ve cancelled social outings with friends pretending to be sick when really I just wanted to sleep in. I love sleep and I can’t get enough of it. I’ve slept through the entire weekend multiple times before, only waking up Monday morning when my alarm rang. And even after that much wonderful sleep, I was still tired. The second I come home from work every day I eat, shower, and then crawl into bed and sleep the entire evening and night away. My alarm’s the only thing that can wake me up anymore…As for why I love sleep so much, I see a lot of people saying it’s an escape for them. For me it’s more, I don’t like people or going out or socializing, so sleep is my drug of choice. Is it bad? Maybe. Do I care? Not really…I more than love it, and it’s not hurting anyone if we’re being honest."
Extract 5: “I feel like I’m addicted to sleep. Here’s why I think though. I suffered for 13 years with depression and while I know I am still getting over it I don’t feel that’s the reason I’m addicted. During those 13 years, I would have serious bouts of chronic insomnia. The doctors tried too many different sleeping medications, meditation, clinics to help me find a routine for natural sleep without meds. Nothing worked. Now I live in Thailand and my doctor here recommended melatonin tablets, all-natural, as your brain is supposed to produce it anyway to tell you when it’s dark it’s time to sleep and when it’s like light it’s time to wake up. She thinks my brain fails to produce certain chemicals as such with serotonin and now figured melatonin. Since I have been taking a melatonin supplement, I sleep so well, I fall asleep within 20 minutes and I sleep for AT LEAST 8 hours. When I wake up, I just want to go back to sleep again because it feels amazing. I don’t feel like it’s part of my anxiety or my depression. I just think it’s because I had insomnia for so long, it's addictive!”
Extract 6: “To be honest if I could I would sleep my life away. My so-called normal sleeping pattern: I am awake all night. Fall asleep around 4 a.m.-8 a.m. Sleep 12 hours. Repeat. My mind is a broken record, constantly repeating the trauma. I do suffer from depression and anxiety. Sleep is my addiction. When I sleep I feel SAFE regardless?”
Extract 7: “I’ve been addicted to sleep (the escape from an abusive childhood, depression, and PTSD) since I was 10 years old! I want to change though because my body is a mess. I’ve slept for 4 days and sometimes more with short awake periods to eat a little and use the potty. Not enough though, because now my body doesn’t work properly…Oversleeping has its consequences."
Extract 8: “I’m so pleased that I have found this site and other people who are addicted to sleep as this problem has plagued my adult life and I would like it to stop. Take today, for instance. I woke at 5.30 a.m. and was quite awake feeling a little anxious but I could not wait to get to sleep again, so I did and stayed in bed till around 2:20 p.m. I have many days like this, and as the lady above, the sleep state is quite lucid and I do seem to enjoy it rather than getting up and living life for real."
Again, I reiterate that none of these individuals is addicted to sleep but in addition to the addiction-like descriptions, there is also crossover in the motivations for excessive sleep and motivations underlying addictions (most noticeably the association with depression, anxiety, psychological trauma, and using the activity as an escape).
In relation to addiction, these extracts include references to salience (engaging in sleep to the neglect of everything else in their life), cravings (for sleep), the sleep being excessive, repetitive and habitual, sleep leading to negative consequences (conflict), and loss of control. The fact that many of these individuals describe their behaviour as an addiction or addictive doesn’t mean that it is.
While there is no academic paper that I know of that has ever claimed sleep can be a genuine addiction there are countless clinical and empirical papers examining excessive sleep (i.e., hypersomnia) and the different etiological pathways that can lead to hypersomnia. Although hypersomnia is not an addiction, those with the condition (like addicts) can suffer many negative side-effects from the relatively minor (e.g., low energy, fatigue, headaches, loss of appetite, restlessness, hallucinations) to the more severe (e.g., diabetes, obesity, heart disease, clinical depression, memory loss, suicidal ideation, and in extreme cases, death). In one online article that I came across, the similarity between hypersomnia and addiction in relation to depression was evident:
“It’s important to note that in some cases separating cause from effect here can be muddled. For instance, does oversleeping contribute to depression or does depression contribute to oversleeping? Or are both oversleeping and depression the effect of a larger underlying cause? Furthermore, once a person is experiencing both, could they act to reinforce the other as a feedback loop?”
This observation could just as easily be made about most addictions (substance or behavioural). Finally, it’s worth noting that there are many sub-types of hypersomnia and excessive sleep. In a good review of hypersomnia [HS] in Current Neurology and Neuroscience Reports, Dr. Yves Dauvilliers notes the following hypersomnia subtypes (including narcolepsy, which can include excessive sleep but isn’t usually classed as a type of hypersomnia; also note that "idiopathic" means of unknown cause) which I have paraphrased below:
Narcolepsy: This is a disabling neurologic disorder characterized by excessive daytime sleep (EDS) and cataplexy (i.e., a sudden loss of voluntary muscular tone without any alteration of consciousness in relation with strong emotive reactions such as laughter, joking).
Narcolepsy without cataplexy: This is simply a variant of narcolepsy (but without the cataplexy).
Idiopathic hypersomnia: Idiopathic HS is rare and remains a relatively poorly defined condition due to the absence of specific symptoms such as cataplexy or sleep apneas (i.e., loss of breathing while sleeping).
Recurrent hypersomnia: This HS is characterized by repeated episodes of excessive sleep (at least 16 hours a day) lasting from a few days up to several weeks. The most well-known recurrent HS is Kleine-Levin syndrome which comprises both cognitive disturbances (feelings of confusion and unreality) and behavioural disturbances (such as overeating and hypersexual behaviour during symptomatic episodes).
Hypersomnia associated with neurologic disorders: This type of HS causes EDS and can be a result of brain tumours, dysfunction in the thalamus, hypothalamus, or brainstem that may mimic idiopathic HS or narcolepsy.
Hypersomnia associated with infectious disorders: This type of HS can be a result of a viral infection such as HIV pneumonia, Whipple’s disease (a systemic disease most likely caused by a gram-positive bacterium), or Guillain-Barré syndrome (a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system).
Hypersomnia associated with metabolic or endocrine disorders: This type of HS can be a result of conditions such as hyperthyroidism, diabetes, hepatic encephalopathy (a liver dysfunction among individuals with cirrhosis), and acromegaly (a hormonal disorder that develops when the pituitary gland produces too much growth hormone).
Hypersomnia caused by drugs: This type of HS is secondary to many different types of drug medication including hypnotics, anxiolytics, antidepressants, neuroleptics, anti-histamines, and anti-epileptics.
Hypersomnia not caused by drugs or known physiologic conditions: This type of HS can be caused by a range of disorders such as depressive disorder, seasonal affective disorder, and abnormal personality traits.
None of these types of HS is an addiction but clearly the negative consequences can be just as serious for the individual.
Aronson, S. M. (2010). Those esoteric, exoteric and fantabulous diagnoses. Rhode Island Medical Journal, 93(5), 163.
Billiard, M., & Dauvilliers, Y. (2001). Idiopathic hypersomnia. Sleep Medicine Reviews, 5(5), 349-358.
Dauvilliers, Y. (2006). Differential diagnosis in hypersomnia. Current Neurology and Neuroscience Reports, 6(2), 156-162.
Domenighini, A. (2016). Can you be addicted to sleep? Vice, January 24. Located at: https://www.vice.com/en_us/article/mg7e33/can-you-be-addicted-to-sleep
Merton, A. (2008). Sleep addiction. Located at: https://www.plushbeds.com/blog/sleep-disorders/sleep-addiction/
Mignot, E. J. (2012). A practical guide to the therapy of narcolepsy and hypersomnia syndromes. Neurotherapeutics, 9(4), 739-752.