Sleep Disorderse

January 26, 2015

Why our current lifestyle is causing us to get lesser sleep and worse sleep.

Thomas Dekker rightly said that “Sleep is the golden chain that binds our health and bodies together”

Sleep is a necessary biological activity and its disturbance on a regular basis is associated with physical and psychological consequences. The etio-pathogenesis of repetitive sleep disturbance is multi-factorial including predisposition to insomnia like age, female gender, personality traits, psychological issues as well as precipitating factors like life stressors, medical illness or psychiatric disorders like depression and anxiety, circadian disorders. Often disturbance in either sleep initiation or maintenance occurs due to psycho social factors like environmental disturbance, night shift jobs, jet lag, alcohol use etc. Whatever the cause, continued sleep problems result in functional disability due to daytime somnolence, difficulty in concentration, irritability, impulsivity, lack of feeling of wellbeing as well as physical stress and ill health.

Management of sleep disorders requires a thorough assessment of biological, psycho-social and environmental factors associated with the individual. Modifying environment and behaviors to ensure healthy sleep is the first step in treatment. It involves sleep hygiene practices like:

• Setting and maintaining regular bedtime.
• Avoiding exercise 3 hours before bedtime.
• Finishing dinner by 2 hours before bedtime.
• Avoiding consumption of tea, coffee, tobacco 3 hours before bedtime.
• Enjoying a relaxing bedtime routine.
• Ensuring comfortable bedroom atmosphere.
• Avoiding day-time naps.
• Regular exercise during day.
• Avoiding emotionally upsetting activities close to bedtime.
• There are other non pharmacological measures to improve sleep related problems which can be individualized based on patient’s circumstances and needs.

Drug treatment involves short term use of sleep medicines, treatment of underlying physical problems leading to sleep disturbance like pain, cough, apnea etc and treatment of underlying psychiatric issues like depression, anxiety, stress related adjustment problems.

The necessity of good sleep is best expressed in the Irish proverb “A good laugh and a long sleep are the best cures in a doctor’s book”