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For people of all ages, what is more pleasant than a sound and satisfying sleep at night? It takes away all the clumsiness of the body and refreshes us to continue with the same energy the next day.
But what happens when we can’t sleep properly? What happens when our effort to sleep peacefully at night remains unsuccessful everyday?
This could be the case for a private banker, a corporate boss, or a journalist who has been deprived of sleep at night for months together. Doctors would say the person has caught insomnia as well as hypertension as a byproduct.
Insomnia is considered to be one of the commonest sleep disorders. Almost all of us have some difficulty with our sleep at some point, but that does not constitute insomnia unless it pertains to some specific criteria. Basically, insomnia pertains to problems like poor quality of sleep hampering daytime functions, which happens despite having adequate time and opportunity for sleep.
Severity
How common is insomnia? A consensus among the medical community is that worldwide approximately 30 per cent people suffer from insomnia. Though we do not have an exact figure in Bangladesh, the prevalence does not seem to be any less. While it is commonly believed to be an issue with older people, young people are increasingly getting affected these days.
A research conducted by the Department of Food Technology and Nutrition Science, Noakhali Science and Technology University evaluated the prevalence of insomnia in adults, particularly university students. The study analysed literature from several South Asian countries and found out that the prevalence of insomnia was about 52 per cent in such young people. Even school-going children were identified with insomnia.
An article published in The American Journal of Managed Care estimated that almost 20 per cent of children of 5-10 years suffer from insomnia, while in the adolescents the prevalence is about 34 per cent.
Manifestation
Insomnia may be characterised by either difficulty to fall asleep, or the patient may fall asleep quickly but frequently wake up. Insomnia patients commonly have the problem of getting up soon after falling asleep, and then they just cannot go back to sleep.
Even if they sleep throughout the night, the quality of the sleep is so poor that they feel completely exhausted the day after.
As sleep is essential for normal body and brain functioning, insomnia patients start losing focus. They cannot pay attention, start forgetting things and their judgment becomes erroneous. They may also develop anxiety or depression. Health of their body and mind deteriorates, leading to a complete disruption in normal lifestyle.
Why does it happen?
One question people commonly ask is, why me? It is hard to answer. There is no known hereditary association of insomnia. What is known and what almost everyone knows is that stress has a role to play.
Stress is a part and parcel of our life now, and it is hard to find anyone who has never passed at least one sleepless night due to personal or professional stress. This is short term insomnia which should be resolved in a month or so. But if it persists, it means the insomnia has become chronic or long-term the type we should be worried about.
More so, a lot of people are stressed and having problems with sleep amid all the stress put by the pandemic. Institute of Statistical Research and Training of University of Dhaka recently conducted a web-based survey in Bangladesh. The survey revealed that more than 33 per cent people complained about disturbances in their sleep during the lockdown, of which a majority was aged between 31 and 40.
Some more factors
While stress is a common trigger, there are other factors as well. Ingesting any kind of stimulants like caffeine is bad for sleep if it is taken within 3-4 hours before bedtime. The same goes with smoking as it contains nicotine. Some smokers always want to have a smoke before going to bed which is not conducive to sound sleep.
Also, eating heavily just before sleep is considered detrimental. Dinner should be taken at least 2-3 hours before. If necessary, light snacks can be taken afterwards.
One of our favorite habits is to use our bed for all sorts of entertainment, like watching television, playing games or surfing the internet. Some of us even do our work from home lying on the bed. All these act against a good night’s sleep.
Daytime napping, which is actually one of the favorite pastimes for many, is another factor that significantly reduced the quality and duration of night sleep.
Again, anxiety and depression could be a result or a cause for disturbed sleep, as well as other mental health disorders. Many neurological conditions could also trigger insomnia. Some medication could do it too, especially some anti-hypertensive and anti-asthma medications.
Solutions
We found that a patient is suffering from multiple issues related to insomnia. Scientists have proven that insomnia is linked to obesity, heart disease, diabetes, hypertension and many more serious conditions. It causes loss of productivity, and hampers normal functioning.
So it is imperative to be aware of this. Taking a sedative without a doctor's recommendation is never advisable. Medications to treat insomnia should only be the last resort. Before that, bringing change in lifestyle has to be attempted.
There are several things that can be done. Firstly, a regular sleep schedule that allows at least 06-07 hours of daily sleep must be established. Our body has an internal clock, and if there is disruption in the body’s clock our physiological system breaks down. Also, daytime napping affects the clock negatively, so it has to be eliminated or at least cut down.
A handy bedtime routine
A bedtime routine needs to be established and adhered to. It should consist of completing dinner at least three hours prior to sleep. We should avoid drinking coffee or smoking during that time, and refrain from using bed for office work, television watching or internet surfing.
In fact, watching television, listening to loud music and using mobile devices before sleep is completely unadvisable. Instead, doing something to make the mind calm, like meditation, reading an appropriate book (but not on bed) or listening to music with a soothing tone is helpful.
Sometimes having a warm shower helps or a glass of warm milk is useful. Also, the bedroom should be dark, quiet and not too hot or cold.
If insomnia continues despite all lifestyle modification steps, or it severely impacts daily life, once must see a doctor at once. We should never go straight for sedative, as they may cause more harm than good. It is important, first and foremost, to follow a routine and stick to the schedule even if it takes a long time to fall asleep after going to bed. It takes time to manage insomnia, and it is necessary to keep focus and fight it in the meantime.
Imtiaz Ahmed completed MBBS from Dhaka Medical College.