INSOMNIA AND SLEEP
Sleep is a natural process that allows the body and brain to recover from daily activities. During sleep, body make chemicals [mainly melatonin] that help us to grow and repair, and makes our immune system more active to fight against various infections and illnesses.
Sleep is also important for restoring emotional balance and healthy mood state. People differ in the amount of sleep they need. Teenagers and young children need 10 hrs of sleep while for adults 8 hrs. of sleep is sufficient. And as we get older, we generally require less sleep.
Dr. Damanjit Kaur (MD Psychiatry)
The infants (ages between 4 and 11 months) require 12 to 15 hours of sleep each day.
The little ones (ages one to two years) need between 11 and 14 hours of sleep per day.
Children of the preschool age (ages 3 to 5) require between 10 and 13 hours of playing each day.
Students in schools (ages 6-13) require between 9 and 11 hours of work each day.
Young adults (ages 14-17) require between 8 and 10 hours of sleep each day.
The majority of adults require between 7 and 9 hours of sleep. But some individuals may require just 6 hours or as many as 10 hours to sleep every single day.
Adults older than 65 (ages 65 and above) require between 7 and 8 hours of rest every throughout the day.
Women who are in the first 3 months after pregnancy generally require more sleep than they would during their normal.
Premenstrual syndrome affects sleep in women, causing hypersomnia or hyposomnia
What is insomnia?
It is a repeated difficulty with sleep initiation, maintenance or quality that occurs despite adequate time and opportunity for sleep thus resulting in daytime impairment.
What causes insomnia?
It may begin when stressors increase in life. People may experience sleeplessness due to thinking about personal problems, work or their finances. And if the issue is major we may become preoccupied with inability to sleep. This sets a vicious cycle of anxiety and worry about not sleeping may lead to insomnia.
51% of people in India go to sleep between 11pm-1am.
16% believe they have insomnia. While 48% complains of back pain due to insomnia. Approx. 80% of people with insomnia complains sleepy at work 1-3 days a week. According to a study it has been reported that in 24 hours, person feels extremely sleepy thrice; at the onset of sleep, between 3-4pm, and 3-4 pm. that is why large number of accidents happen around 3-4 am early morning.
What are the common complaints of insomnia?
· Circadian insomnia shows the following symptoms;
· It’s hard to fall asleep.
· You find it difficult to sleep and often wake up several times during the night.
· You awake too early and you are unable to fall back asleep.
· Feeling anxious, irritable, worried especially at bedtime.
· Feeling physically and mentally tired throughout the day.
What are the consequences of insomnia?
· Fatigue, impaired concentration in work.
· Insomnia in elderly can worsen their dementia.
· Staying awake decreases performance at work and may lead to absenteeism.
· It also affects interpersonal relationships.
A. During the day
· Organise your day- take meals everyday on regular time, taking medicines, doing daily chores.
· Exercise regularly everyday
· Avoid napping during the day
· Set time for problem solving and decision making during day to avoid worry at night.
B. During evening
· Put the day to rest. If you still have things on mind write it on a diary to be dealt tomorrow.
· Light exercise early in evening would help.
· Get into the routine of “Winding down”, allowing at least 30 mins of quite activity like reading and listening to music before bed time.
· Avoid smoking. Don’t use alcohol to make you sleep.
· Make sure the bedroom temperature is neither too cold nor too warm.
· Ensure that the bed room is dark and morning light does not filter in.
· Avoid heavy meals at night. Foods like fatty food, fried meals, spicy dishes, citrus fruits and carbonated drinks at night triggers indigestion leading on to sleep disturbance.
· Cut down caffeine and nicotine because it is a stimulant which may cause lack of sleep.
C. At bed time
· Develop a calming bed room routine such as taking shower bath, listening to relaxation music.
· Go to bed when you feel ‘sleepy tired’ and not before.
· Don’t read, watch tv, use cell phone, computers or tabs or have conversation while in bed. Build in a 30 to 60 mins pre bed buffer time i.e., device free. Scientists says that blue light that emanates from most of digital devices can interfere with hormone called melatonin which is vital for good sleep. approx. 95% of people with sleep problems have increased screen time.
· Turn the light off.
· If after 20 mins of tossing in bed, you haven’t been sleeping then get up and stretch, read or do something calming in dim light before trying to sleep again.
D. During the Night.
· If you wake up early in the night, don’t lie awake for more than 30 mins.
· Get up at the same time each morning; don’t keep sleeping till late in the morning trying to make up for ‘last night’.
· Try to keep away from bright lights because they hinder the production of melatonin which helps in facilitating sleep.
The basic concept of sleep hygiene is that your environment and habits can be optimized for better sleep. You don’t have to change everything at once, but small steps can move you towards better sleep hygiene. In order to achieve maximum productivity, we tend to skip sleep. However busy we might be, a good night’s sleep, especially in the “Golden Hours” is a must for the overall wellbeing and higher levels of productivity
And lastly, if you have long lasting or severe sleep related issues, it is suggested to talk with a doctor for an appropriate course of treatment.
Dr. Damanjit Kaur (MD Psychiatry)
Faith Hospital, Chandigarh