The 22-year-old call centre employee hated his job. It paid well, but he had different ideas. He wanted to study but had to drop out of college to support his family. He felt he had lost out on life. Insomnia troubled him, and worsened as his shift timings changed every week. Even after working 12 hours at a stretch, he found it difficult to sleep. A chemist at a medical shop offered him sleeping pills. These initially helped. Then he started taking two different drugs. When he finally visited a psychiatrist, it did not take long for the doctor to figure out that he was suffering from acute depression.
The drugs were stopped and he underwent counselling. His insomnia is now a thing of the past.
Insomnia is a major disorder affecting many urban Indians. Dr Kausar Abassi, psychiatrist at the Orange City Hospital and Research Institute in Nagpur, says that insomnia is one of the most common complaints from patients; in fact the third most common after gastrointestinal problems and chronic pain.
Dr Rupali Shivalkar, psychiatrist and assistant professor at the Institute of Human Behaviour and Allied Sciences, New Delhi, finds that nearly half her patients in the outpatient department complain that they have problems sleeping.
Dr Abassi says that research indicates that insomnia might lead to diabetes, cardiovascular diseases, and affect the functioning of the immune system, resulting in a person not being able to fight even minor infections such as a common cold. He elaborates: “Many hormones that help fight infection are created when one is asleep, hence insomnia can end up weakening the immune system.”
Lack of proper sleep can also affect hormone production, stress and energy levels and eating patterns. Apart from diabetes and obesity, insomniacs also suffer from psychosomatic symptoms such as headaches, acidity and palpitations.
Dr Shamsah Soonawalla, consultant psychiatrist, Jaslok Hospital, Mumbai, says, “Lack of sleep is associated with reduced ability to concentrate, learning difficulties, decreased attention to detail and increased risk of motor vehicle accidents.”
It is commonly believed that to stay healthy all one needs is a nutritious diet and regular exercise. But, restful sleep for a minimum number of hours is equally vital.
Dr Abassi says that walking even three kilometres every day is enough to induce proper sleep. He recommends that an average person should sleep at least 52-55 hours every week.
Studies carried out in the US have shown that a good night’s sleep allows our brain to review and consolidate the streams of information gathered while we are awake.
There are many reasons why many people sleep less. Lack of sleep could be related to stress at work or in personal life, long commutes, lack of exercise or even boring 24X7 routines that are endemic to city life.
A number of emotional problems are connected to a lack of sleep. Insomniacs may suffer from low self-esteem, find it difficult to cement interpersonal relationships and achieve reasonable targets.
Says Ruchir Verma, a business school student in New Delhi, “There are times when we cannot concentrate at all in class as we have not slept properly for days on end, having been up completing daily assignments.”
Most insomniacs admit to experiencing increased care or sympathy from others because of sleeplessness. Sometimes, the concern of others becomes their crutch. They start enjoying the attention as it makes them feel good whenever the burden of not being able to sleep gets to them.
Many who suffer from sleeplessness get stressed around bedtime. This is because worrying about not being able to sleep itself causes stress. The very thought of going to sleep, or the sight of the bedroom, is enough to trigger thoughts of helplessness and anxiety.
WRONG COPING METHODS
Some people try to cope with their sleeplessness by moving out of the bedroom to read, smoke or eat. Many just pop sleeping pills without understanding its ill-effects.
Says Dr Shivalkar: “Sleeping pills are useful only for a short period. In the long term, it hampers the quality of sleep. Sleep has to be a natural process and both quality and quantity are important.”
Many insomniacs resort to drinking more in the hope that it will help them sleep better. Alcohol may have some sedative properties but it also ends up disturbing sleep. One may also have to cope with early morning hangovers.
Take, for instance, the case of an executive in a Nagpur company, who took to drinking in the hope that it would help him sleep. It didn’t. Nor did sleeping pills. A friend finally took him to a psychiatrist. It was only after several sessions that the truth emerged. He had gone into depression after a female colleague he was very fond of had got married. After three counselling sessions, he was back to normal. No more medication was required.
Once he was able to view the relationship in the right perspective, the acute stress he suffered from disappeared.
A 21-year-old commerce student in Nagpur is another example of how counselling can cure insomnia. She had been suffering for four months when the family doctor prescribed sedatives. Initially, these worked, but it was still a restless sleep and she did not feel rested in the morning. She was then referred to a psychiatrist. After a couple of sessions, she was diagnosed with depression. In the last few weeks, her condition has improved drastically and in another month, she will be taken off medication.
RELAX AND SLEEP WELL
The more relaxed a person is, the greater the likelihood of getting a good night’s sleep. Relaxation techniques such as meditation have been proved to help people sleep. These can lower stress levels, leading to a deeper, more restful sleep.
Often, drinking water helps to induce sleep. Dehydration causes stimulants, hormones and cellular waste to build up in the blood, causing irritation and aches. Drinking water helps in flushing these wastes out of the body.
One of the exercises that is helpful in inducing sleep involves lying on the back with palms open towards the ceiling. Close your eyes and give auto suggestions to each part of your body to relax. Start with the toes, ankles, legs, knees, thighs and move upward one by one till the whole body is relaxed. Imagine all the negativity and stress leaving your body. You will feel much lighter as you slide into deep sleep.
TREAT THE ROOT, NOT SYMPTOM
Often, insomnia is a symptom of some other disease. People, generally, ignore the cause and try to treat insomnia instead. Dr Manish Kansal, managing consultant psychiatrist, at Shanti Home, Shanti Mukund hospital, New Delhi, points out that almost 80% of patients who complain of insomnia, suffer from some psychiatric illness such as depression, stress and anxiety.
“Sleeping pills are not the solution. Psychiatrists use these only initially to give a chemical cover, and discontinue these as soon as possible. Drugs that induce sleep such as alprazolam and diazepam are to be given only to those with a doctor’s prescription but, in India, these are sold over the counter and people get addicted to them,” says Dr Kansal.
Warns Dr Abassi: “Insomnia can lead to any illness and can affect any organ of the body. Increased acidity might lead to gastric ulcers. Insomnia can also lead to excessive smoking, drinking too much tea at night or staying glued to the television set. Avoid watching television or using the computer before going to bed.”
Dr Soonawalla sums it up: “Often, simple lifestyle adjustments such as dietary changes and exercise are enormously helpful in managing insomnia.” The best antidote to insomnia is re-examining your lifestyle as sleeplessness and related illnesses are all linked to the way we live and think.
Common types of sleep disorders
Sleep apnea refers to breathing interruption during sleep. Sleep apnea is a very serious disorder and can be life-threatening. Common symptoms include frequent waking episodes at night and gasping, gagging or choking for air during sleep.
Restless legs syndrome
Restless legs syndrome (RLS) is a neurological disorder characterized by uncomfortable, tingly or creeping sensations in your legs, creating an uncontrollable urge to keep them moving. RLS is not necessarily confined to your sleep time. The symptoms generally occur when you relax or lie down. There may also be small movements of the toes, feet or legs when you rest. As a result, you may have trouble going to sleep, and your sleep is very restless.
Periodic limb movement disorder
This disorder causes rhythmic jerking of the feet or legs, particularly the calves, during sleep, to the point of disruption. It is not linked to a cramp in the leg or a change in body position
Narcolepsy is a chronic neurological disorder which impairs the ability of your central nervous system to regulate sleep. As a result, you may fall asleep even during activities such as walking, driving or cooking.
Tips to avoid insomnia
Do not drink tea, coffee or aerated drinks after 5pm.
Maintain regular hours for going to sleep and waking up.
Do not take a siesta if you do not feel sleepy.
Do not smoke after 9pm.
Your dinner must be light, with more carbohydrates and less fat.
Drink a glass of water one hour after dinner.
Take a short walk after dinner.
Wait at least two hours after dinner before going to bed.
Wear comfortable clothes.
Drinking a glass of milk before sleeping is a good idea as milk contains tryptophan—an amino acid that helps induce sleep.
Your bedroom should not be cluttered. Make it cosy with proper upholstery and furniture.
Ensure good ventilation in your bedroom.
Don’t use your bed for activities such as eating or watching TV. Reading, though, is advisable before you finally doze off.
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