Disturbed Sleep: How to manage
P. Priyadarshi, MBBS, MD, FRCP (Edin)Adequate sleep is as important as air and water. Deprivation of sleep over long periods may lead toloss of memory and concentration, irritability, disturbed relationship at work and in family, brainshrinkage, hypertensions, and accidents; and may promote growth of cancers, aging and death.Although sleep requirement varies from person to person, most medical authorities now agree that
eight hours’ sleep is required for a proper funct
ioning of body and mind.Sleep disturbance may be of many types. One may be early waking, say, at 3 am, and not being ableto sleep again. Another may be difficulty in getting into sleep. A third variety may be shallow sleep,with repeated waking. Thus there may be qualitatively poor sleep or the total sleep duration may bereduced or both occurring together.For proper management of disturbed sleep, a detailed assessment should be made. Medicalconditions disturbing or breaking sleep should be identified and treated. Some common conditionsare: coughing at night, breathlessness associated with asthma and heart diseases, back pain due tolumbar spondylosis, arthritic pains in joints, pain in legs (especially calves) due to vascularinsufficiency, headache of migraine, heartburn/ acidity, toothache, prostate enlargement anddiabetes causing frequency of urination etc.Once these conditions have been taken care of or ruled out, the commonest condition affectingsleep is depression. Often people, who have depression, forcefully deny that they have anydepression and refuse to take help for this matter, although they are ready to take sleeping tablets.
Depression is ‘low mood’. Its symptoms are reduced drive for work, short
-temperedness, heavinessin head, feeling tired with lesser amount of work than before etc. Fluoxetin taken in the morningimproves day-time energy level, reduces irritability and headache and restores sleep in depressedpeople. Depression should be diagnosed and treated by a doctor.In many patients specially in those who work in shifts, biological clock may be distorted or damaged.Most of the living beings have biological clock. Even plants have it. It is because of the biologicalclock that plants like mango tree know that their flowering season has arrived. For restoringbiological clock, one important step is to ensure that you expose yourself to bright daylight soonafter waking. Late afternoon exposure to daylight is also helpful in restoring sleep rhythm. On theother hand, melatonin is a hormone secreted by pineal gland in response to darkness, which helps ininducing sleep. It is an important regulator of biological clock too.Observance of some simple rules may help have better sleep.1.
Never use your bed (preferably bedroom) for anything but sleeping.2.
A bit of yoga or stretching exercises promotes relaxation and helps sleeping.3.
A warm bath before going into bed is good. Some people are helped by
andothers by chanting a
silently in bed.4.
Coir should be soft, firm and large enough. Room should have proper temperature,somewhere between 20 and 28 degrees centigrade, depending on individual choice. Pillowsshould not be too big. A pillow below the knee is helpful while you are sleeping on your side.
This article was published in May, 2010 issue of the
journal, India First Foundation, 5 HaileyRoad, New Delhi.