Catch up on your Zs! Dealing with insomnia

Lack of sleep has to be taken seriously. If you're suffering from a sleep disorder, help is at hand. Illustration: Uttam Ghosh

Insomnia is not something we are born with, and neither is it an illness. It is something that gets triggered and beaten into our systems because of various factors in our lives. Whether it's Vidya Balan who is trying to cure her insomnia or Shah Rukh the night owl, every one of us has had sleepless nights at some point or the other.

It could be because of an impending exam, an important interview or any other anxious thoughts that have been occupying our minds -- but the real problem is when it begins to get out of hand and affects our day-to-day functioning. This is when insomnia needs to be acknowledged medically and when most decide to visit a doctor.

Vidya Balan recently became a brand ambassador for Sleep Awareness Month and went on record to say that she wants to cure her own insomnia. And any doctor will tell you that it can indeed be tackled and cured, simply with the right approach and altering of one's lifestyle.

Dr Shefali Batra, a Mumbai-based psychiatrist, therapist, counsellor and trainer, says that the biggest cause of insomnia is difficult lifestyle.

"We are living in a country where our socio-economic reality is still a struggle," she says. "Often, people are unable to sleep simply because of environmental factors like a noisy neighbourhood, or because there's lack of space in the house," she says.

Different forms of insomnia affect different people.

For instance, there are some common sleep disorders known to occur in the young. While it is a common fact that sleep in general reduces as you age with each decade, it is youth-related insomnia that's a cause of worry to most people.

"Taking a sleeping pill is not the solution to the problem," says Dr JC Suri, professor and head of the Department of Pulmonary Critical Care and Sleep Medicine. Dr Suri is a sleep specialist as well as a chest physician, and also the founder of the International Sleep Disorder Association (ISDA) in Delhi.

"What we do when someone comes in with a complaint is first try to figure out what is causing the insomnia. Insomnia is a symptom of many other issues that are bothering a person; but it is not a disease in itself," he says. "So the correct way to tackle it is to find the root cause behind it."

According to Dr Suri, not sleeping properly is also a cognitively learned behaviour. "When you don't sleep for a couple of nights, your body and mind becomes adjust to this pattern and then fall into a mode of not being able to sleep."

Common causes of insomnia

Environmental factors, stress, traumatic or difficult life events and bad sleeping habits -- not being able to sleep at the right time and give your body rest -- are some of the causes of insomnia. It is also caused by:

• Asthma and shortness of breath
• Anxiety
• Depression
• An inactive lifestyle
• Too much rigorous exercise right before bedtime
• Drug abuse
• Overuse and misuse of caffeine and other brain stimulators
• Stress due to work, exams or relationships
• Erratic napping in the afternoons

Types of insomnia

There are three kinds of insomnia, says Dr Suri, and these occur in different people depending on different factors.

Transient Insomnia: This is usually for a very short period of time, when a sudden event or problem occurs in one's life, like an examination, for instance -- something that either tenses up or excites the mind and lasts for around two to four days.

Short-term Insomnia: It lasts for a few weeks. It can be triggered by a sudden emotional upheaval, like bereavement or the loss of a loved one.

Chronic Insomnia: This is when the sleeplessness continues for months and years and refuses to abate. There are various factors that can lead to chronic insomnia -- a dissatisfying career, a troubled marriage, anxiety and depression are some of the reasons behind it.

How insomnia manifests

Dr Suri points out that there are different ways in which insomnia manifests in people:

• A certain type of insomnia occurs when a person has trouble falling asleep at night. Here, the problem occurs because the person goes to bed, but cannot sleep at all, he says.
• The other kind of insomnia occurs when a person falls asleep but has difficulty maintaining his or her sleep and keeps waking up in the middle of the night. The underlying cause for this is often anxiety or depression.
• Insomnia is also prevalent when a person wakes up earlier than s/he should every morning.
• Often, a person's biological clock is set to sleeping eight hours every night, from one particular time to another. It is difficult for him/her to then switch to another time frame and this can lead to sleeplessness. For instance, if someone sleeps at 1 am every night and wakes up at 9 am, getting eight hours of sleep, it will not be possible for him/her to get sleep as early as 8 or 9 pm. Even if s/he tries, tossing and turning for a couple of hours is inevitable and sleep will finally come only at around 1 am. There are solutions to this problem, however, like prescribing melatonin, and exposing the person to sunlight in the morning.

Is there a cure?

For those who suffer from transient insomnia, the solution is easy. It is with the other two -- short-term and chronic insomnia -- that an effort is needed and that is where the ISDA comes in.

Dr Suri says that it is completely possible to cure insomnia through cognitive behaviour therapy, which tries to alleviate psychological problems like depression and anxiety in patients by tackling thinking patterns and problems. "Sleep disorders are multi-faceted and come from various roots and causes," says Dr Suri. "We integrate different solutions and methods to tackle them."

These are some of the ways in which the ISDA tries to cure insomnia in patients who visit them:

• An attempt is made to free them of medication.
• Cognitive Behaviour Therapy (CBT), which includes counselling, is administered. Here, the root cause is identified, and ways in which the underlying anxiety or problem can be solved are tackled.
• Consultation with a neurologist.
• Practicing relaxation techniqus.

How do I tackle my sleep disorder on my own?

• Avoid distractions at night like the television and Internet.
• Do not smoke during bedtime.
• Avoid taking naps in the afternoon and if you do, make sure you take them at the same time each day for a fixed period only.
• Do not go to the gym after 5 pm as this can increase the levels of adrenaline in your body and make you overactive.
• Identify the cause of your insomnia.
• Practice relaxation techniques.
• Alternative therapies like massages also work for many people. Reflexology and aromatherapy are two techniques which deal with calming the nerves and bringing cognitive changes to the mind.