Always Fallen Asleep

Do I really fall asleep during cultivation practice?
Sometimes, the dozing-off happens when the contemplation of Yidam is carried out and at times, it happens during the chanting of the Yidam-mantra. On occasion, the situation is so serious that it even happens prior to the contemplation of Yidam, before reciting the preceding praise. At better circumstances, the contemplation of Yidam can be done but after reciting the subsequent praise, the dozing-off happens again. Another case is at the time for meditation practice. When the Nine-Round Buddha Breathing Exercise (purification breathing techniques) is finished off and followed by the cultivation of Samadhi, I fall into a sleep without my knowing it. I have always been reminded by fellow disciples that I have fallen asleep.  However, from the beginning to the end, I don’t think that I have ever fallen asleep.
How comes that there is the emergence of such circumstances?
The most ideal state for practitioners is to be ‘men of foresight’ so that they can control themselves not to fall asleep. If you have fallen asleep and you know clearly that you have really fallen asleep, you are somewhat sober despite ‘known till it was too late’. Then you can still be rescued. If you have fallen asleep yet even you do not know it yourself, it is ‘being unconscious’. If it is the case that someone else has reminded you but you still do not think that you have fallen asleep, the extent of this kind of ‘drowsiness’ has already reached the most serious stage. Coming to such a serious plight, practitioners have to be very alert to the situation. They should review themselves again and again, and then make introspection on the reasons for the emergence of such a phenomenon! ‘Buddha’ means ‘the enlightened one’. As a Buddhist practitioner, if one is entirely ‘unconscious’ to even a small health problem of oneself, how will one be able to attain Buddhahood in that case? Moreover, Rinpoche has repeatedly advised practitioners who are in frequent ‘dizziness/sleep’ to pay attention at their daily routine. For example, (they should) regulate and adjust their time of eating, doing exercises and sleeping appropriately, suitably as well as moderately.
Rinpoche has ever said, “Basically, (such people) have to be careful of causing diseases like cervical spondylosis or lumbar spondylosis; recessive/latent leukemia, heart disease and kidney disease.” Disciples asked, “How can these types of illnesses be avoided?” Rinpoche explained, “If only …”
The followings are simple and easy ways to overcome drowsiness:
1.	Have sufficient sleep
2.	Do not eat or drink before sitting in meditation in early morning
3.	Carry out fitness exercise frequently
4.	Open your eyes rapidly whenever you feel sleepy and utter mantras instead (when you are practising diligently in the Centre, the criterion of the loudness you can make is not to bother other fellow disciples). However, you have to pay attention that this does not apply to the time like cultivating meditation to achieve Samadhi.
5.	Don’t make yourselves too fatigue during daytime so that you are more unlikely to feel drowsy.
Hypersomnia:
The most common cause of daytime sleepiness is getting not enough sleep (during nighttime). For instance, most students have had such an experience that they doze-off unconsciously during lessons. They may even have no idea when they have fallen asleep and when they awake, class may be over already; or one may be lying on bed playing with the cellphone before one sprawls unconsciously. If the situation has been reached to this stage, we call it ‘sleepiness’. If the situation is a bit more serious, it can precisely be ‘a sickness’.
We call this kind of sleeping-disorder disease ‘Hypersomnia’. This disease has to be differentiated from generalized fatigue all over the body, listlessness or lack of motivation. The main point for the differentiation is whether one will fall asleep in unsuitable occasions (such as in front of Buddhas’ statues, in front of Rinpoche, in front of Guru, inside Shrine for Dharma cultivation and within Buddhist temples etc.)
An average person takes about one and a half hours to get from a light sleep into a deep one whereas a person who suffers from such a disease may need only a minute or even a shorter time to do so. Suffering from mostly sleep discontinuity during nighttime as well as being waken up easily, these patients’ brains will automatically get into intermittent sleep at daytime. The speed of falling asleep and waking up of these patients can both be surprisingly fast. In the first few seconds when they are waken from such kind of sleep, their consciousness may still be clouded.
City dwellers lead a busy life. Managing work that is piled up like mountains (a large amount) every day, it is a usual practice for them to work overtime. They suffer from a long-term sleep deficit consequently which results in unstoppable sleepiness during their work at daytime, during phone calls, when having meals, in a conference, in the middle of a conversation or even during driving. Some of them choose to sleep for some more hours in their holidays, yet it does not help the situation as the desire for sleep remains as strong (after that). If you find it difficult to resist the invasion of sleeping demon (remark: the invasion of sleeping demon means strong desire to sleep) during daytime and this has lasted for a long time, you may come down with Narcolepsy(渴睡症) easily. It is then necessary to receive diagnosis and treatment. You have to take refreshing medicine prescribed by doctors to relieve the emergence of symptoms. The invented patent medicine nowadays can only remedy symptoms but not yet able to perform a radical cure. Arrange a fixed naptime daily can highly reduce the possible probability of the outbreak of sleepiness which is unforeseen as well as beyond control.
It may be related to genetic inheritance Hypersomnia(嗜睡症), which is a disease about oversleep, can be classified into two main types: ‘primary hypersomnia’ and ‘recurrent hypersomnia’. Both have the same symptoms but of a different frequency of occurrence. A lot of people have misunderstood that the main reason for sleepiness (strong desire to sleep) is inadequate sleep or poor sleeping quality, however, Narcolepsy(渴睡症)is in fact a kind of sleeping disorder which is called ‘Narcolepsy sleep syndrome’ medically.  Specialized psychiatric doctors have pinpointed that Narcolepsy belongs to the sleeping problem of the nervous system in which the patient lacks a kind of substance named ‘Hypocretin’. This substance is made by a few of our brain cells that helps keep us awake. If a practitioner is suffered from congenital Genetic Narcolepsy, he/she is indeed really pitiful because it is relatively remote and vague for him/her to have great achievement in this life! Supreme enlightenment can only be attained through meditation as one has to achieve ‘Samadhi’ before one can acquire ‘Wisdom’!
Those suffered from Hypersomnia lack sleep or have interrupted sleep during nighttime. Some people, however, suffer from insomnia that makes them unable to fall asleep no matter it is night or day; contradictory, there are some people who want to sleep all day long. All these different variety of factors cause tiredness that forces them to nod off frequently during daytime. Besides, it always happens at inappropriate time like at work, during driving, dining, talking on the phone, having conversations or during conferences when they can be asleep (in all of the situations). Moreover, Hypersomnia sufferers usually have lengthy sleeping time at nights and it is also difficult for them to wake up from the prolonged sleep. If they are forced to do so, they will be at a loss of what to do (when being woken). Concerning other symptoms, there are also anxious feelings, in a gradual intensive rage, progressively diminishing vitality, getting fidgety, thought retardation as well as tardy conversations etc. ‘Kleine-Levine Syndrome’ is the best known recurrent hypersomnia though it is uncommon. Hypersomnia patients usually sleep for more than 18 hours a day, yet they cannot keep themselves awake.
The followings are some simple questions for practitioners to self-test themselves so as to know whether they have the tendency of hypersomnia:
(1)	Will you fall asleep when reading silently?
(2)	Will you fall asleep when watching TV at daytime?
(3)	Will you fall asleep when sitting alone quietly in public places? (e.g. in cinemas or during conferences)
(4)	Will you fall asleep after sitting continuously on a bus or in an automobile for an hour?
(5)	Will you fall asleep when sitting down and chatting with somebody else?
(6)	Will you fall asleep when sitting quietly after lunch without drinking any alcohol though?
(7)	Will you fall asleep when you are waiting for the green traffic light during driving?
(8)	Will you fall asleep when you are listening quietly to someone’s talk? (e.g. during the discourse of Rinpoche)
(9)	Will you fall asleep when you concentrate on doing something regardless of the duration spent?
For the above (1) to (9) questions, when you answer each of them, if it has never happened to you, it is 0 mark, 1 mark if it happens occasionally, 2 marks if it happens frequently and 3 marks if it has been happening all the time. When the accumulated scores for the 9 questions are greater than 12 marks, you have probably been suffering from Hypersomnia. You should seek help from sleep-physicians as soon as possible so that the causes of the disease can be found and appropriate treatment can be carried out. Fellow practitioners, if you bury your head in the sand and do not want to calculate it by yourselves, you can leave the calculation to your dharma brothers who will help you do so!
Among the causes of Hypersomnia, ‘Insufficient sleep syndrome’ is the most common; the next place is ‘Sleep Apnea’. After that, it is ‘Narcolepsy’ and then it is ‘Idiopathic CNS hypersomnia’.
•	‘Insufficient sleep syndrome’
	Hypersomnia at daytime, which is caused by insufficient sleep, is the most common one among the disease. As a result of the flourishing industry and trade nowadays, some people still need to go out socializing at night after work. They can only return home to have a sleep at midnight, yet they have to go to work as usual the next morning. This leads to chronic sleep deprivation and causes drowsiness during daytime. Nevertheless, most of them will sleep more on their holidays to compensate for the inadequate sleep. In addition, working for too long time frequently, some container truck drivers suffer from insufficient sleep and it is very easy for them to have traffic accidents. According to statistics, college students in the U.S. these days generally have insufficient sleep and the situation is so serious that it is affecting their academic progress.
•	‘Sleep Apnea’
	When one falls asleep, one’s muscle controls the tongue and soft palate so as to keep the airway patency clear. If the muscle is relaxed, the airway will be narrowed causing partial blocking to happen.  As air current enters through the oral cavity/nostrils, it shakes the throat tissue that produces the phenomenon of snoring. If the throat is already narrowed or the muscle is over-relaxed, the respiratory tract will be blocked completely and normal breathing will be affected. When this happens repeatedly during your sleep, you have probably become the sufferer of ‘Obstructive Sleep Apnea’. When the obstruction takes place, it may last for 10 seconds to 2 minutes or an even longer duration. At this point, feeling an oxygen deficit, the brain of the patient will be alarmed and one’s physical body will be awakened to open up the airway so that breathing can occur again. Though this phenomenon is often ignored, when the cycle is repeated hundreds of times during one’s sleep at night, it will produce serious sleep disturbances.
•	‘Narcolepsy’
	It is a kind of sleep disorder that is related to the abnormality of the sleeping mechanism. It was first found by the affiliated hospital of Stanford University in America. The general symptom for patients is the emergency of sleepy situation during daytime that is unable to be controlled by volition. It may occur several times a day which is unrelated to the amount of sleeping time at night, sometimes, patients will even fall into a lethargic sleep or become catalepsy suddenly (without the awareness of the patients themselves). The catalepsy is due to the temporary loss of the ability to control muscles by the activity consciousness of the brain and the lost can last from a few seconds to as long as a few minutes. In between the time, patients’ mentalities are fully conscious but they are unable to move (not even a finger). The illness of losing the ability to control muscles is originally called Cataplexy and it is an accompanying symptom of Hypersomnia. It often happens when the patients are having a sudden change in emotion like having a good laugh, getting angry, feeling astonished or being scared. Sufferers of this disease are all over the world regardless of age ad race. However, student patients are frequently misjudged as naughty students who like to sleep during lessons and this results in the missing of proper care and appropriate treatment of them. For adult patients, it is usually misunderstood as having pressure or sleep deficit. The symptom of ‘Narcolepsy’ is excessive sleepiness in which patients may fall asleep suddenly during daily routines in daytime at inappropriate places, for example when they are taking a meal, driving or working. It is common to find that these patients have ever experienced several traffic accidents or accidents during work. Nevertheless, Narcolepsy sufferers always complain that they are suffering from insomnia at nights. The frequent illusion of sleeping period or sleeping paralysis may bring about intermittent sleep at nighttime so that they are unable to sleep the night through. Another reason may be because the duration of drowsiness at daytime is so long that it interferes with their sleep at nighttime. Among the 24 hours a day, the total sleeping time of patients of Narcolepsy does not exceed that of normal people.
•	‘Idiopathic CNS (central nervous system) hypersomnia’
	It is characterized by the absence of cataplexy or sleep-onset rapid eye movement periods (remarks: rapid eye movement periods occur 15 minutes after one has fallen asleep). The total sleeping hours in the 24 hours a day is much longer than that of Narcolepsy patients, yet there is no complaint about insomnia at nights. Moreover, the extent of drowsiness is not as severe as that of Narcolepsy patients. In addition, different from Narcolepsy patients who have a momentary vigorous and energetic feeling after taking naps; patients of Idiopathic CNS hypersomnia always feel that they do not have enough sleep.
Before the outbreak of the disease, there should always be some obvious inducing factors, for instance, one is seriously lack of sleep, one’s sleep-waking cycle is very irregular, one is having a long term night-shift work etc. The symptoms that lead to ‘intermittent’ sleep during the sleeping routine can all bring about drowsiness at daytime. Adjusting the time of eating, taking naps and doing exercise of an individual patient, a corresponding appropriate behavioral therapy can be designed, which can help the patient to use the least dosage to achieve the maximum effectiveness. Daytime naps are only transitory means to alleviate and relieve while pharmacotherapy may be effective or in vain. Medical technology for the time being can merely serve to control the condition. Hypersomnia is a lifelong illness which can never be healed. However, according to the web page of The National Institute of Neurological Disorders and Stroke, “The change in behaviours (e.g. working at night and social activities that will delay one’s sleeping time) as well as eating habits can help ease some of the symptoms.”
Some medical diseases such as diabetes, hepatic dysfunction, acute respiratory failure, acute renal failure, early pregnancy, hypothyroidism or acromegaly etc. can make patients suffer from drowsiness because the illness itself can trigger patients to have the symptoms of hypersomnia. Hence, the (only) way to cure this type of hypersomnia is to get rid of the hidden underlying medical diseases. Besides, some diseases of the central nervous system like cerebrovascular injury, brain tumor, multiple sclerosis, encephalitis, Wernicke’s encephalopathy and head trauma etc. can also induce the symptoms of hypersomnia.
To diagnose Hypersomnia, apart from a detailed medical history, one has to undergo certain laboratory examinations including blood sugar, liver function, kidney function and thyroid function etc., in which none is dispensable. Furthermore, multiple inspections with electroencephalogram sleep physiology device and multiple sleep latency tests are often required. Imaging diagnosis of brain tomography or nuclear magnetic resonance may sometimes be employed to diagnose the type of Hypersomnia. As for the treatment of Hypersomnia, it is essential to depend on a valid diagnosis so that the cure can be done on the basis of different symptoms.

Talking till now (let’s be more specific), if a practitioner keeps falling asleep during cultivation practices and the phenomena and the situation have never been improved or getting even worse, is it due to the karma of one’s previous lives? In that case, you are not only poor, but also pathetic! Earnestly hoping for the Supreme Accomplishment? Better confess quickly by praying, “The various bad karma I committed in the past, …”!

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		As mankind have not yet achieved Saints, it is inevitable that they may sometimes make mistakes. Our Guru always teaches that we should frequently introspect our behaviour to make sure that our demeanour is always on the right track. In case, when mistakes are made, if and only if we can truly repent and have the courage to make corrections, the karma made will easily be cleared and thus we can still be able to reach the bright Sacred Land from the dark one day.
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