Insomnia or sleeplessness has assumed alarming proportions in present times, especially among the upper classes in urban areas. This is evident from the wide range of medication for this condition prescribed by physicians and sold by chemists. Instances of persons taking an overdose of sleeping pills with fatal results are quite frequent. Insomnia deprives a person of mental rest and thereby interferes with his activities in the daytime. It constitutes a severe health hazard when it becomes a habit.
Sleep is a periodic state of rest for the body which is absolutely essential for its efficient functioning. Sleep gives relief from tension, rests the brain and body and a person wakes up in the morning fresh and relaxed after sleep. The amount of sleep, however, varies within very wide limits from individual to individual. Normally, seven to eight hours of sleep every night is adequate for most people. Some, however, do well with four to five hours because their sleep is deeper and more refreshing.
Insomnia is common among the elderly for a variety of reasons. The sleep of the elderly is often punctuated by brief periods of wakefulness during the night. IN such cases it is the quality rather than the quantity which is most affected. With age, there is gradual reduction of periods of deep sleep. The older person, therefore, gets roused easier. Sleep requirements also diminish with ageing. From nine hours of sleep per night at the age of 12 the average sleep needs decrease to eight hours at the age of 20 , seven hours at 40 , six and half hours at 60 and six hours at 80.
The signs of pathological insomnia are dramatic changes in the duration and quality of sleep, persistent changes in sleep patterns, lapses of memory and lack of concentration during the day. Other symptoms are emotional instability, loss of coordination, confusion and a lingering feeling of indifference.
The most common cause of sleeplessness is mental tension brought about by anxiety, worries, overwork and overexcitement. Suppressed feelings of resentment, anger and bitterness may also cause insomnia. Constipation, dyspepsia, over-eating at night, excessive intake of tea or coffee and going to bed hungry are among the other causes. Smoking is another unsuspected cause of insomnia as it irritates the nervous system, especially the nerves of the digestive system. Often, worrying about falling asleep is enough to keep one awake.
Sleeping pills are no remedy for sleeplessness. They are habit forming and become less effective when taken continuously. They lower the I.Q., dull the brain and can prove fatal if taken in excess or before or after alcohol. The side-effects of sleeping pills include indigestion, skin rashes, lowered resistance to infection, circulatory and respiratory problems, poor appetite, high blood pressure, kidney and liver problems and mental confusion.
To overcome the problem, one should adhere to a regular sleeping schedule, going to bed at a fixed time each night and getting up at a fixed time each morning. Early to bed and early to rise is a good rule. Two hours of sleep before midnight are more beneficial than four after. It is sheer folly for students, at examination times, to keep awake till long after midnight, drinking one cup of tea after another, as that is only apt to cause blackness and inability to concentrate in the examination hall.
Research has shown that people with chronic insomnia almost invariably marked deficiencies of such key nutrients as B-complex vitamins, and vitamin C and D as also calcium, magnesium, manganese, potassium and zinc. The sleep mechanism is unable to function efficiently unless each of these nutrients is present in adequate amounts in the diet.
A balanced diet with simple modifications in the eating pattern will go a long way in the treatment and cure of insomnia. Such a diet should exclude white flour products, sugar and its products, tea, coffee, chocolate, cola drinks, alcohol, fatty foods, fried foods, foods containing additives, which are chemicals for preserving, colouring and flavouring, excessive use of salt and strong condiments.
In the modified eating pattern, breakfast should consist of fresh and dried fruits, whole cereals, seeds and yogurt. Of the two main meals, one should consist of a large mixed salad and the other should be protein-based. A cup of milk sweetened with honey at bedtime is helpful as the amino-acid tryptophan contained in milk induces sleep.
Sleep is often elusive. Any attempt to force it only drives it further away. It is better to divert the mind with soft music or light reading. While going to bed, visualise a blank black wall occupying the entire field of vision. Turn your thoughts to light and cheerful matters. Use light bed clothes and relax. Do not lie on your back, put on your side with one or both knees brought well up and the head and shoulders slightly forward. During the night, the position of the arms and legs should be changed frequently and a healthy sleeper usually shifts from one side to the other several times in the course of the night.
Controlled breathing is also a great help in inducing sleep. The method is to lie on your side in bed, and then take three deep breaths expanding the abdomen completely. Then hold your brath as long as you can. Next, take three more breaths and repeat the breath-holding. While you hold your breath, carbon dioxide accumulates in the body and induces natural sleep.
Regular, active exercising during the day and mild exercise at bedtime enhances the quantity and the quality of sleep. Exercise stimulates the elimination of lactic acid from the body which correlates with stress and muscular tension. Regular exercise also produces hormonal changes which are beneficial to the body and to the sleep pattern. Walking, jogging, skipping, swimming are all ideal exercises. Vigorous exercise should, however, be avoided at night as this can be over-stimulating.
Yoga helps a majority of cases of insomnia in two ways. Firstly, yoga treatment helps tone up the glandular, respiratory and nervous system. Secondly, yoga also gives physical and mental relaxation as a safety value for one’s disturbing problems. The traditional yogasanas which are effective for insomnia patients are shirsana, sarvangasana, paschimottanasana, uttanasan, viparitakarni and shavasana.
Hydrotherapy is also effective in treatment of insomnia. Application of hot packs to the spine before retiring, hot fomentation to the spine , hot foot bath or an alternate hot and cold foot bath at bedtime are all time-tested methods. The cold hip bath with the feet in hot water and the prolonged neutral immersion bath (92o to 96o F) at bed time, when one’s nerves are usually irritable, are also effective measures.
Along with the various measures for the treatment of insomnia, all efforts should be made to eliminate as many stress factors as possible. The steps in this direction should include regular practice of any relaxation method or meditation technique, cultivating the art of doing things slowly (particularly activities like eating, walking and talking) limiting the working day to nine to ten hours and five and a half days weekly, cultivating a creative hobby and spending some time daily on this, avoiding working against unrealistic targets and completing one task before starting another.