Many patients complain to physicians about insufficient sleep and chronic problems in sleep patterns. A patient who sleeps 6 to 7 hours may be concerned that she or he is not sleeping long enough, not realizing that 6 to 7 hours may be enough to them.
Many people believe that 8 hours of sleep is required for health, but there is a little medical basis to recommend sleeping 8 hours or more. There is physiological variation in the duration of sleep for everyone. Some people might feel fresh even after 5 hours of sleep and perform all his daily responsibilities perfectly.
There are some people who have significant problems with sleep. There are people who have problems initiating sleep, continuing sleep or waking early. Then there are others who despite sleeping for more than 8 hours do not feel fresh.
The most important cause of sleep problems is environmental. We all have difficulty in sleep if the environment is noisy and disturbing. We also might not get sound sleep if we move to a different place or different time zones. These are common occurrences and resolve on its own with time.
We should be concerned if sleep problems occur as a result of physical or mental illnesses. The common causes of sleep disturbance encountered in the clinics are:
- Physical discomfort as a result of any illness. Like pain due to cancer or injury, respiratory distress due to asthma, dental pain, headache, etc.
- Obstructive sleep apnea where throat muscles intermittently relax and block the airway during sleep characterized by snoring and excessive day time sleepiness.
- Mental disorders like depression, anxiety, psychosis, mania etc.
- Drug causing hyperarousal like amphetamines, LSD
- As a part of the withdrawal of drugs like alcohol and opioids
- Sometimes insomnia is seen without any cause. This type of insomnia is known as primary insomnia. Though any underlying cause is not present, this condition warrants management as lack of sleep can be very distressing to the patients and lead to significant dysfunction.
Our brain has a separate pathway for sleep. Like the clock that hangs on our walls, there is a biological clock in our brain. This clock senses the time as per the sunlight, season, daily activities, etc. This clock has a rhythm of its own. Hence if we travel to different time zones this rhythm is disrupted leading to insomnia or hypersomnia. There is no denying that sleep is an integral part of our functioning, hence needs to be taken care of. All of us have heard of personal hygiene, dental hygiene, menstrual hygiene; we must also be aware of sleep hygiene.
There are a few points that need to be followed for having good sleep hygiene:
- Maintain a regular sleep routine. Go to bed at the same time and wake up at the same time.
- Avoid using the bed for any other activity except sleep and sex.
- Do not drink any stimulants like tea, coffee, red bull or carbonated beverages in the evening as this causes increased arousability.
- Indulge in some exercises like yoga or simple cardio on a daily basis.
- Take a bath with warm water if possible; else wash your hands and feet with warm water before going to sleep.
- If you do not get good sleep after 20-30 minutes in bed, get out of bed. Go outside or take around in the room and the go-to-sleep again. Do not wait in bed for sleep to come.
- Avoid using mobile or laptops while going to sleep. Do not start to check your social media once you are awake in the bed. It is always advisable to turn off your wi-fi and all electronic equipment at sleep.
- Make a habit of reading some newspaper or a book while going to sleep.
- Avoid taking heavy dinner during the evening or any substance that interferes with the sleep pattern like cigarettes, alcohol, and over-the-counter medications.
- Listen to some soft music as per individuals’ habits (might not be useful to all).
If there is difficulty in sleep even after following these steps of sleep hygiene, it is s advisable to seek professional help. There is a strong myth that taking medication for sleep is always addictive and the person will have to continue for a lifetime. It’s a fact that some medications that help in sleep are addictive in nature like benzodiazepines. However, taking these medications for a brief period doesn’t cause addiction. Apart from so-called sleeping pills (benzodiazepines), there are many other medications that help to maintain your biological clock. Hence, it is always advisable to seek help before the problems become complicated. Good sleep is one of the major components of a healthy living.
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