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As someone currently in the process of getting diagnosed with a chronic sleep condition, I know first hand how debilitating it can be to try and play video games while knowing that I could fall asleep at any moment while playing.
While kind of embarrassing to talk about, for the past couple of years I have been increasingly suffering from random bouts of unexpected daytime sleep. When relaxed, in situations like watching a film at the cinema or playing a video game on the sofa after work, it’s not uncommon that I will just fall asleep briefly, unexpectedly.
Sometimes it’s only for a couple of seconds, long enough to be mildly disorienting and for me to just snore and wake myself back up. Other times it’s more notable, with 10-15 minutes lost unintentionally while trying to focus on something. I’m currently going through tests with my doctor to try and get to the root cause of the problem.
There are, however, a number of different medical conditions and disabilities, as well as situational factors, which can all cause someone to become prone to chronic unexpected bouts of sleep during what should be enjoyable focused daytime activity.
Narcolepsy is probably the first condition that comes to mind for many when thinking about unexpected sleep. It’s a neurological condition where, generally, a person’s immune system begins to attack their Hypocretin producing cells, disrupting production of a chemical that is designed to regulate the sleep and wakefulness cycle.
Other conditions which can cause chronic daytime sleep attacks include Sleep Apnea (where a person stops and then restarts breathing in their sleep), insomnia (which is trouble sleeping properly at night), and things like Restless Leg Syndrome (an uncontrollable urge to move one’s legs, often worst at night). Any condition that interrupts a person’s ability to get to sleep, or impacts the quality of the sleep that they get, can lead to a person falling asleep unintentionally during the day.
There’s also overlap with other disabilities that we’ve discussed previously on this channel. For example I have combined type ADHD, meaning that among my symptoms I experience hyperactivity, which can often be followed by physical crashes of exhaustion if not regulated. I’m also autistic, and autism has been shown to have strong overlaps with disruption to healthy sleep patterns for a variety of reasons.
Degenerative and chronic conditions can also cause chronic daytime sleep attacks including conditions like parkinsons, multiple sclerosis, chronic pain, and brain tumours.
Lastly, a number of medications can cause daytime sleep issues such as certain antihistamines, anti-anxiety medications, antidepressants, muscle relaxants, and some painkillers.
Beyond the above, simply a persistent sleep debt can cause unprompted sleep episodes during the day. If you’re a parent with a young child, or you’re working unpredictable shifts at work that make a stable sleep routine difficult, or any number of other lifestyle based sleep disruptions can all lead to issues with falling asleep unintentionally during activities such as playing video games.
The above preamble is largely just to establish that bouts of unexpected daytime sleep are not uncommon, and are experienced by a wide range of different individuals with disabilities, chronic conditions, and situational impairments.
There’s a lot of conditions which could make a person unexpectedly fall asleep midway through a gaming session. The question is, how does that impact gaming, and what can devs do to support gamers with chronic, sudden sleep conditions like these?
As someone currently struggling with bouts of unexpected sleep, here are some of the barriers that I’ve faced in games, and some of the solutions which could help ensure that games remain accessible for people in a similar position to mine.
One major consequence of falling asleep unexpectedly while gaming is missing out on crucial context without a way to rewind or revisit lost moments. If I were to fall asleep during a cutscene, or a gameplay segment which progresses automatically without player input, even if just for a minute or so, I may miss out on plot developments that are important for understanding the wider narrative. The same is true if dialogue in conversations automatically progresses without player input.
Does your game allow for rewinding to see what you missed? Can I restart playing from the start of the most recent chapter? Can I rewatch a cutscene from a menu, or reread prior text logs? Can I toggle off auto playing text, so that the narrative only progresses when I actively press a button?
Another important and related question, does your game feature manual saving, or does it only support a single rolling autosave slot? If a game allows me to manually save, in a worst case scenario I could rollback to an old save to revisit content that I missed during a bout of unexpected sleep, but games with aggressive autosave and no manual saving option or no ability to do save rotation may make it impossible for me to revisit sections of the game that I’ve accidently slept through, without having to replay the entire game from scratch.
If I’m playing an online multiplayer game, I need to know whether that game punishes players for going AFK or not. I recognise that if I fall asleep in a ranked competitive online game I might get a loss and lose ranking points because I was inactive, and that made it easier for the enemy to defeat me, but if there’s an additional consequence such as a risk of an account ban due to being inactive during a game, even if that inactivity ultimately only negatively impacts me, it’s important that I know that in advance of those consequences so that I can make an informed decision about whether to play that game online or not.
In games like Elden Ring, where resources are dropped upon death, will a player who has fallen asleep and died be able to locate where to go to recover the resources they drop if they weren’t awake to see where they were when they died? In the case of Elden Ring the answer is thankfully yes, that game is very good about telling you where your dropped resources are, but other titles in similar genres don’t always have a way to locate your dropped resources if you don’t have a memory of where your death location was.
Additionally, in games similar to Elden Ring, resources are often lost permanently if the player dies a second time without going and recovering their resources. As a developer, consider if it’s possible for a player who has fallen asleep and then died in combat and dropped those resources to then die a second time without any inputs being registered on the controller. If the game automatically loads you back into the world, and it loads you in range of aggressive enemies that might come and kill you, this could be an issue. If you have to press a button to respawn, or your respawn location is inherently a safe sanctuary if you don’t move, then players who have fallen asleep may be better protected from accidently permenantly losing those resources.
Worth further consideration, in your game is it possible that a player who has fallen asleep but is mashing a single button, or leaning on a single button and holding it down, might accidentally do something that they can’t undo, such as releasing a rare Pokémon and autosaving over that creature’s release? Ensuring that multiple button inputs in a string are needed to confirm irreversible actions, such as needing to move up and press A, then down and press A a couple of times to confirm your selection before releasing that Pokémon could do a lot to prevent accidently doing something just because you sort of fell asleep and were still half pressing that one button.
Outside of designing your game to minimise issues that are caused during a spell of paused inputs, or offering ways to revisit missed content, is it possible for games to in fact be proactive about protecting players who are prone to unexpected sleep episodes?
While obviously not applicable across the board, I have recently discovered a possible solution for my sleep issues while gaming, specific to a single controller, and offline games that allow pausing.
The new Steam Controller, released a couple of months ago, features controller grips which can detect when a hand is placed on them, or taken off of them. This can be mapped to an input when playing a game through Steam. I have as of late been programming this controller to, when I left go of either the left or right grip of the controller, register that and press the Start button, pausing most games. While not a foolproof solution (I could fall asleep without letting go of the controller for example), it has on a couple of occasions paused a game for me when I accidentally fell asleep.
While this functionality doesn’t exist on all controllers, I would love for more developers to look into other methods of detecting an AFK player and, optionally, pausing the game for them if they’re detected to have stopped sending inputs to the game for a certain amount of time. This would obviously need to be designed with things like cutscenes in mind, areas of the game where you’re not constantly pressing inputs, but if a game could detect periods of input inactivity and pause the game by default, that could help to protect players who had not intended to fall asleep mid game session.
Chronic experiences of sudden and unpredictable sleep episodes aren’t something that gets talked about often in gaming accessibility circles, or accessibility circles moreb broadly. I can’t speak for other people, but I know I’ve not talked much about it because it feels embarrassing to admit. It feels a little like a personal failure. I know logically something is up with my body that I can’t help, but staying awake during the day and sleeping well at night is such a fundamental part of the human experience, something that from a very young age you’re meant to be able to do, that to fail at it can feel like failing on some very fundamental level at being a person.
If you look at a condition like Narcolepsy, and the fact that it impacts around 1 in every 2,500 people, it can feel at a glance like people who fall asleep unexpectedly are a pretty small market of people to support with accessibility efforts. However, when you add on top of that the fact that around 30% of adults in the United States are believed to suffer from Sleep Apnea, the number of gamers impacted by daytime sleep episodes starts to feel a little larger. Add onto that those with ADHD and Autism who struggle with sleep, those with restless leg syndrome, the people whose medications cause daytime sleep episodes, the people whose lives simply don’t allow for getting enough sleep, and you start to see that this underdiscussed area of accessibility impacts a lot more people than you’re probably considering.
Gamers falling asleep mid gaming session are a more widespread issue than most would care to admit. I believe that the video game industry could be doing a lot more to support this segment of gamers enjoying games to the fullest, and not accidently missing out on things while playing.
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