We are all obsessed by our sleeping patterns. No amount of willpower can get us to sleep. The thought of sleep and the thought of not being able to sleep, rule a large part of our life. Perhaps, “I wish I could sleep better” is the commonest unsaid thought that people have, (becoming a millionaire voiced the most). Have you met anyone who had a problem sleeping, and then she simply told herself, “Now, you need to sleep.” and slept? Unlikely. As these words swim past you, blurry eyed, groggy and wanting to catch that last minute in bed rather than read the newspaper, did you sleep well last night?
My suggestions for you!
Do not be afraid of Insomnia (not being able to sleep adequately). It corrects itself as the body and mind have mechanisms which help you get as much sleep as you need.
When it does seem that restless and sleepless nights will not stop, some of these suggestions may help. Sometimes not being able to get to sleep or getting up early in the morning can be a difficult problem with some solutions that will have effect after some time. The point is to defocus from sleep.
First, let us talk about what is not helpful. Alcohol induces sleep initially, but later in the night it can wake you up. It also increases your depression and is not a brilliant solution in the long term as the amount of alcohol you require for the effect increases and soon you could be addicted to it. Then comes the sleeping tablets. These sell the most in our country. Mostly people buy them off the counter and take them without consultation with the doctor. When sleeping tablets are used it is a must for this usage to be medically supervised. Long term usage can lead to memory difficulties, addiction or liver problems. The best thing is not to start sleeping tablets. However, if you are taking them presently you must not stop them suddenly as you would have withdrawal symptoms which could be serious. Withdrawing from sleeping tablets is necessary but should always be done under the supervision and guidance of a medical practitioner. Also, remember that all medicines prescribed by psychiatrists are not sleeping tablets.
Then, what could help?
Wind Down: The day for most people is extremely active and stressful. The thoughts and problems of the day are likely to influence how you are during the evening and at night. Give yourself time to wind down before you hit the bed. When you get back home, take some time out for yourself. Maybe ten minutes of quietness with no stimulus. Just review your day, summarize what difficulties you faced and what the ongoing problems are. Write it down on a piece of paper and leave it in a box in the living room. You could also wind down with slow activity. Doing things together with your partner, games or television or cooking, anything that interests you, helps. Do not go to bed till you are just ready to sleep. There is no point lying on the bed and trying to worry when you would be able to sleep. Do not try to solve major problems of your life during this time. Try not having a television in your bedroom and try not to read thrillers or watch a Hitchcock or Pataal Lok before you sleep.
Decrease time in bed and distract: When you are in bed, at times negative thoughts just intrude upon your consciousness. If this happens, you need to distract yourself. You have to use various kinds of distraction techniques. Counting backwards is the easiest (and the commonest), but it fails because everyone thinks it is too easy. Here are some variations of it. Count sheep, focus on one point, think of it as gate of a farm, visualize sheep going through the gate and count them. You could also visualize other neutral things. For example, I visualize an earthen pot. I see the pot, feel its texture, sense the cold water in it and continue visualizing till the negative thoughts have died out.
I also repeat to myself the rule of right thoughts for right places. If there are thoughts that are about work or long-term problems, I just go to the living room and add them to the list for the next day. If sleep still evades you do not wait for it. Get up and go out of the bedroom. Do some boring, routine, non-stressful work. I like doodling, someone else may like to iron clothes. Decrease your time in bed while you are waiting to sleep. Once you know that you are unlikely to sleep, rather than tossing, turning and worrying about not getting sleep, just be out of the bed. Return to it when you want to sleep.
Structuring the day: It is important to structure your day; in order to be able to sleep at night. Make a routine of getting up earlier than your usual time for a week. If you get up at 7.30am, force yourself to get up at 7.00 am. Not even five minutes more in the bed. Try not to snooze in the back seat of your car or a couch in front of the television. Do not use too many stimulants like coffee, tea or colas. Be strict with yourself, exercise in the morning and stroll in the evening. Fix a waking up time and stick to it. A month of a routine and no late nights on weekends will make you the master of your sleep.
Sometimes not being able to sleep may be due to a psychiatric disorder. If you experience any of the following features, then it may be useful to consult a psychiatrist:
• If you have sleep disturbance, especially if you wake up earlier than usual and if you have had a low mood for nearly two weeks;
• If you are always on the edge, feel anxious and apprehensive about the future or have started to avoid certain things, certain situations, or are overly worried and concerned, then you could have an anxiety disorder.
• If you have repetitive thoughts ideas, doubts, fears or images and are forced to repeat certain actions over and over again, you could be living with an obsessive disorder
If you snore or if your breathing stops for very brief periods of time when you sleep, or if you are tired through the day, you may have obstructive sleep apnea. It would be useful to get a sleep study done to diagnose the same.
Dr. Achal Bhagat is a Senior Consultant Psychiatrist and Psychotherapist at Apollo Hospital, Delhi