Insomnia is a condition that involves difficulty in falling asleep or staying asleep. Sleep is one of the most necessary requirements of the human body. It is necessary to remove fatigue and be refreshed physically and mentally. Various systems of the body are put to rest during sleep, including the digestive system. Hence, good sleep helps in efficient functioning of the various systems. If a person is unable to sleep, he tends to be irritable and feels exhausted. It also causes forgetfulness and difficulty in concentrating on the work at hand. There can be increase in the blood pressure and heart attacks in those who are susceptible to it due to insomnia or lack of sleep.

The number of hours of sleep needed varies from person to person but few hours of sound sleep is needed for all.

There are many reasons for insomnia. Advancing age, chronic sickness, anxiety, mental stress, use of brain stimulant substances like alcohol and tea/ coffee, and etcetera, are some of them. Heart burn, dyspepsia, body or joint pain, are other conditions causing difficulty in sleeping. Many people suffering from insomnia use sedative drugs like benzodiazepine (diazepam), for sleeping. A middle aged lady recently consulted me for prescription of sedatives as she does not sleep without them. But consuming them for many days carries the risk of habituation. Thus the dose taken will fail to induce sleep and one has to take higher doses to be effective. These drugs have to be taken just when a person is ready to sleep and on the bed. If one takes a sedative tablet and moves around, desired effect does not occur. Instead of sleeping, a person can experience unpleasant sensations like hangover or headache and discomfort. These drugs can cause adverse effects like low blood pressure, abnormal posture or rigidity of a limb.

It is advisable to take meals early in the evening. This prevents the abdominal discomfort and flatulence which occurs after a meal and disturbs one in falling asleep. One should avoid taking coffee and other stimulant substances one to two hours prior to sleep time. Apart from causing brain stimulation, coffee also causes heart burn and dyspepsia. Thus, it disturbs sleep in more than one way. Some recommend drinking hot milk at night to get sleep. Logic being that milk contains tryptophan which releases serotonin, a neurochemical substance which induces sleep.

Choice of night clothes worn helps in avoiding insomnia. The clothes worn for sleeping should be loose and comfortable. The material should preferably be cotton. Nylon tends to stick to the body causing discomfort. It also feels warm, hence a person feels uneasy.

Saying prayers before sleeping was a tradition started by wise ancestors for solving the problem of insomnia. After saying a prayer, the mind becomes relaxed and deep sleep automatically follows.

Reading a good book after lying down is a good measure to induce sleep. The book should be soothing to the mind like a good classic or spiritual/philosophical one.

Watching television throughout the evening excites the mind and hampers sleep. Hence, a person having problems sleeping should avoid watching television or movies, at least an hour before sleeping.

A very simple measure to get good sleep is to do some deep breathing after getting into bed. Taking slow and deep breaths up to a count of 50 to 100 will relax the mind and induce sleep. Breathing exercises of yoga when done regularly are also very effective in curing insomnia.

The problem of insomnia can be solved very well without drugs. Only thing needed is that the individual follows the necessary measures regularly and patiently.

Dr Rachna Pande, Specialist, internal medicine