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 deepsleep. 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.
Symptoms
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.
Causes
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 insominia. 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.
The Cure
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 insominia. 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,
that is 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.
Yogasanas
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 (92 o to 96 o 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.
In Acupuncture and Acupressure ..these points found useful :GV 20,EX 6, P7, P6, H7,UB62,GB 34
In Ayurveda:
All the Brihath Trayis (Charaka samhita, Susrutha Samhitha and Ashtanga Samgraha) described Mahisha ksheera(Milk of Buffalo) as the Agryaoushada(Best Medicine) for insomnia.
Main cause of Nidranasa(Loss of sleep) is Vata vriddhi and Alpa nidrata(disturbed or sleeplessness) is pitta vriddhi.So, In short sleeplessness is a Vata paithika condition and hence the treatment should be based to alleviate Vata and pitta.
The main drug is : Aswagandha( Withania somnifera) if there is involvement of both physical and mental conditions and is found best if insomnia is associated with stress,anxiety, tension etc..
