The Real Reason Why Some People Are Lazy

More than a few times per month, I have patients comment that they think others perceive them as being lazy. Whether they like to "sleep in" or have trouble getting up in the mornings, or if they’re prone to taking naps in the afternoon, their sleepiness often elicits other’s perception of them as being lazy or unproductive. Add to this a saying from Proverbs: "Laziness brings on deep sleep, and the shiftless man goes hungry." Given that this type of work ethic runs deep in our modern day culture, it’s difficult to avoid being called lazy if you’re not the first one in the office and the last one to leave.  


However, laziness may have less to do with sleep than it does with how well one is breathing while they’re sleeping. Without assessing the latter, it would be wrong to assume the former. 


Sleepy or Sleep Deprived? 


Typically, most self professed "lazy" people don’t look forward to waking up in the morning. On more than one occasion, patients have complained that they "curse the mornings" when they have to get up. Often it takes multiple cups of coffee, or vigorous exercise, before they feel even somewhat functional. Naps are also a requisite for most of these people and almost all of them crash at night, completely exhausted by the time they get to bed. In the morning, they never feel refreshed—always feeling like they’ve slept only for a few hours.  


The other common misperception people have about other sleepy people is that they must have trouble sleeping or that they have insomnia. However, what many supposed "lazy" people suffer from is not usually due to insomnia—they can fall asleep just fine. In fact, many of these people fall asleep too easily. The difference is, these people just can’t wake up once they do fall asleep.  


So, if these people are not sleep deprived, sleeping more than their peers, why do these people seem so tired and "lazy" all the time? The true answer lies in how well they’re breathing while they’re sleeping. 



To Breathe Or Not To Breathe 


Many supposed "lazy" people that I see in my practice often have a sleep breathing problem called Upper Airway Resistance Syndrome (or UARS for short). This often occurs to those who have a smaller than average airway opening, or a bigger than average tongue to jaw size ratio. And for those who suffer from UARS, this is the primary reason why they’re not getting the deep and restful sleep that they truly need and desperately desire.  


It’s taken for granted that all humans have rigid, open windpipes that allow air to pass easily from the nose through the lungs. What’s unique about the human upper airway, however, is that due to our unique ability to talk, our voice boxes are much lower down, underneath the tongue, which forces the tongue to rotate backwards. This is fine when you’re awake, but when you’re on your back, the tongue and voice box falls back partially due to gravity. Furthermore, when you go into deep sleep, your throat and tongue muscles relax, then with a bit of deep inspiration, the tongue falls back completely to occlude the 1-2 mm airway space behind the tongue. 


If you have UARS, a number of different scenarios can occur: the tongue falls back, and you can wake up after a few seconds, with you panting, in a sweat, your heart racing, and in a state of panic. Or you wake up from deep to light sleep only, never realizing that your sleep was disturbed.  


Also, if you stop breathing for 10 seconds or longer, and then wake up, then you just had an apnea or a "loss of breath" due to an obstructed airway. Five or more apneas per hour is in the range of having obstructive sleep apnea. But even if you stop breathing 20-30 times every hour, each lasting anywhere from 1-9 seconds, you’ll be told you don’t have any apneas, so therefore there’s nothing clinically wrong with you.  


This is the major conundrum many UARS patients find themselves in. Although they’re not found to have a clinically diagnosable problem, they still suffer from the same level of fatigue and exhaustion that many OSA patients experience. This may be why so many UARS patients are often mistaken for being lazy and not properly treated as someone who suffers from a sleep breathing problem. 


Fighting While Sleeping 


Another physiologic phenomenon that many UARS patients experience is that they’re constantly under a low grade state of stress or anxiety.Whether or not they feel this way while they’re awake, while they’re sleeping, their bodies are in a constant mode of "fight or flight." Both hormonally and neurologically, having UARS can put your body under enormous stress. Since you’re never able to reach a deep level of sleep, and stay in a sustained state of light sleep, your entire nervous system goes en guarde, and becomes hypersensitive. Even your emotions and senses are heightened, including your hearing, vision, taste, and smell. Simultaneously, you are exhausted all the time. 


Also, in this constant state of readiness, blood is taken away from your gastrointestinal system, your reproductive organs, your skin or your hands and feet. This may be why so many people with UARS have cold hands or feet or suffer from a rash of gastrointestinal problems. 


Laziness May Be a Virtue 


But there is one positive side to all of this. Contrary to popular belief, I see many people with UARS who self proclaim themselves as being lazy, compensate for their chronic fatigue and lack of energy by becoming overachievers, being highly productive and creative in everything they do, going non-stop during the day, but crashing at night. They’re also much more attuned to their bodies, being proactive about their health, and taking care of whatever illnesses they have before they become huge problems. 


However, there are those who can’t sustain this high energy lifestyle especially as they get older and they start gaining weight. What happens for many of these patients is that they now progress into a more severe form of sleep breathing problem like OSA. 


So the next time you think you’re lazy or think that others perceive you this way, the way you feel and act may actually be due to chronic deep sleep deprivation and not a personality defect. Something else to sleep on.  

Please note: I reserve the right to delete comments that are offensive or off-topic.

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9 thoughts on “The Real Reason Why Some People Are Lazy

  1. Greetings Dr. Park!

    1. What do you know of Executive Dysfunction and OSA?

    2. Why do you believe the medical community is so absent from this issue?

    3. What percent of people have a sleep study with an SaO2 nadir less than or equal to 55%?

    Thanks for your dedication!


  2. 1. If you look at the definition of executive dysfunction, “neurobiological dysfunction affecting planning, organization, organization and self-monitoring,” these symptoms sound like it could be part of what occurs in obstructive sleep apnea. Obviously, not everyone with executive dysfunction will have sleep apnea, but I’m willing to bet that a significant number of people with this condition will have a sleep-breathing problem. The same thing would apply in children or adults with ADD.

    2. The medical community has a hard time thinking multidimensionally, or looking at the big picture. We’re too fixated on the idea that a medical condition is caused by one gene or chemical imbalance. Once a condition is described, we get fixated on that condition, doing study after study, showing that one chemical is associated with one symptom. The more studies are done and written about, the more ingrained into the medical literature it becomes, and the harder it is to question it. It’s like the forest from the trees analogy, except that the medical community focuses on describing only the leaves. Also, your description of what you see close-up from underneath the rear end of an elephant will be very different from what you see from the front of an elephant from a distance.

    3. Having your SaO2 drop to less than 55% is not seen very often. In fact, that is in the very dangerous range. During any type of surgery, we get very concerned even when levels drop into the 70s.

  3. I’ve been diagnosed with chronic fatigue and fibromyalgia. There are times I’m so deep in sleep that I cannot wake up, even when I feel I’m trying. I have constant over growth of yeast; I’m told that has something to do with it. I’ve never had a sleep study. I take ample prescribed medications and vitamins. I’m 41. In spite of barely eating my weight continues to increase and my muscles atrophy. My mood is severely depressed and angry. I feel I’m locked within a decomposing body and am miserable had to leave my job because cognitively I was mush most days. Disability denied me because I’m young and they see no reason I can’t do a sedentary job; except I can’t stay awake. I sleep so much my body aches and I’m getting bed sores and swollen legs, hands. Diuretics don’t help. What can I do to have a quality of life?

  4. Lori, sorry to hear about your situation. It must be really frustrating. I’m assuming you’ve already undergone a full medical evaluation for your condition. A sleep study is a good next step to see if you have a sleep-breathing problem. If you haven’t done so already, take a look at my articles on UARS and sleep apnea. Good luck.

  5. I do have a narrowed upper airway, but never thought much about its potential effect on my breathing from night to night.

    I plan to see an ENT in the next month or so and will bring this up as well.


  6. Thank you I have a great concern for my grandson who is 19 yrs. He sleeps all the time. Meaning it takse alot for my daughter myself ot anyone else to get him up in the morning or even if we visit other people. No he is not on drugs, yes I thought maybe he might be depressed. He can come home from school put his books down lay acroos the bed and bam he is out like a light! He stays up for maybe two to three hours and bam he’s asleep again. The other night we talked about it with him we said there has to be something wrong this is not normal and he agreeds. His school work has declined drastically. He is going to fail and not graduate. Last night we talked about it getting test and taking him to the right specialist, so the what ever it is he can get the proper diagnose and treatment. We nt help and peace of mind. Please help give us some kind of direction in which to start.

  7. my friend seems to be real lazy. but she fights with her mother and wont clean the house for her. what is the reason for this one???