Night time terror; Insomnia

There is no shadow of a doubt in saying that every one of us has had our share of moments tossing and turning around at night trying to doze off to la la land. You’d try everything from drinking hot milk to counting sheep to lullabies in your desperate attempts to fall asleep. This night time terror we call insomnia tends to visit us every now and then occasionally. But what reality lies behind insomnia? What provokes insomnia? Are there any effective ways rather than counting sheep to get over this? To answer these questions regarding insomnia that constantly quiz the mind, the Health Capsule spoke to Dr.Pushpakumari Ranasinghe, Consultant Psychiatrist at the  National Institute of Mental Health, Angoda.

What is insomnia?
Insomnia is a sleeping disorder also known simply as sleeplessness. According to Dr.Ranasinghe insomnia attacks are of different forms. Some forms of insomnia keep the person up all night and they find it hard to fall asleep while others cause a person to either wake up earlier than they are supposed to or sleep may be interrupted in between. They are generally classified as short term insomnia and long term insomnia. Most of us get a dose of short term insomnia every now and then which Dr.Ranasinghe assures is normal and is not something to stay up all night and worry about(which could end up giving you something to worry about!). But chronic insomnia i.e. long term insomnia may keep a patient awake for as long as 4 or 5 years in some cases! It is not common but also not something that is unheard of.

Causes for insomnia
Dr.Ranasinghe stated that there are many causes for insomnia and that they differ from person to person but the common causes being depression, anxiety, work schedule, jet lag, daily activities and poor sleep habits, a heavy dinner, drugs and medication, sleep apnea, caffeine and age .Depression is the most common cause for insomnia. “When plagued constantly by negative thoughts and distress, people tend to wake up early so they do not get the required sleep time and sleep gets disturbed.”People suffering from anxiety disorders face the type of insomnia where they find it hard to fall asleep. Contemplating on worrying thoughts, losses, disappointments, exam and work related stress, goals and targets are often the roots to anxiety that pave the way to insomnia. Another reason that Dr.Ranasinghe highlighted is the busy work schedule that most people have to deal with everyday. “Work schedules may not be consistent and are prone to change. Their working hours may alternate from late night shifts to early morning shifts. As no regular sleeping habits are practiced in these kinds of lifestyles, the sleep -wake cycle is disturbed which will ultimately result in sleep disorders.”A handful of people who travel complain about sleeplessness. This is because they are suffering from jetlag.  “When people fly to different countries abroad, they cross the time zone. This alters the schedule they are accustomed to including their sleep habits.” People with poor sleep habits definitely end up with insomnia. “Taking catnaps in between daytime, burning the midnight oil and studying too much, working late into the hours, can have an effect on your sleep at night.

Something that many of us are charged guilty of is spending too much of time in front of computers, TVs, and not to be considered least, the main problem today ;smart phones”. This habit, referred to as ‘screen time’ by Dr.Ranasinghe, is also another reason that will taunt you with insomnia. Being a foodie will not help this situation in any way because eating too much can keep a person awake. “What we always suggest is a light snack before bedtime. Eating too much at night interferes with digestion and causes discomfort that may obstruct falling asleep.”Medication taken for other disorders can affect sleep especially when it comes to medical conditions like asthma and thyroid diseases. Another risk factor is sleep apnea. Sleep apnea is a condition where the patient suffers from inhibition of breathing periodically throughout the night. Caffeine in coffee and nicotine from cigars prove another reason that could lead to insomnia. Sleep is also affected by age. “Small children tend to sleep a lot. But as they get older, the sleep time decreases. Especially adolescents, they stay up all night and sleep through most of the day.”  

Aftermath of insomnia
It is no secret that the lack of a good night’s sleep leads to an ill wind on health. Some of the negative effects are reduced stamina and performance, getting easily fatigued, drowsiness, being easily subjected to irritation, annoyance and impatience.

Remedies for insomnia
Dr.Ranasinghe  mentioned that short term insomnia is treatable by improving sleeping patterns and she suggests reducing catnaps taken during the daytime, not staying up too late into the night and reducing  ‘screen time’ is a good place to start. She also recommended taking a soak followed by something to munch on that is not too heavy on the taste buds before hitting the hay which will create comfort and make it easier to fall asleep. Working according to a regularized schedule and maintaining a regular bedtime will also enable stability in the sleep cycle ensuring a good night’s sleep. “The hours of sleep required varies from individual to individual. Some people may require 6 hours of sleep while others might need 8 hours”. She strongly advises against the over consumption of caffeine. Relaxation exercises like yoga will also prove beneficial to overcoming short term insomnia.

“Long term insomnia which we call chronic insomnia is a more serious case and sometimes we treat patients who haven’t slept for years. Sometimes the drugs and medication the patients take for other medical complications might be reason to the disruption of the sleep cycle and we have to take their diseases into account during treatment. There is a centre in our brain which responds to light and darkness and secretes hormones that create sleepiness. But the elderly suffering from dementia have no sense of time. So in these cases, patients undergo light therapy where they are exposed to light at regular time intervals to induce sleepiness.” Dr.Ranasinghe mentioned.

If patients are constantly nagged by worries and problems they tend to fall victim to chronic insomnia. In such cases where they suffer from mental health instability, they are advised to see a psychiatrist to undergo therapy so that their thinking patterns will be changed which will help them to overcome their worries and thereby to overcome sleeplessness.