It’s the fourth night in a row that she’s woken up in a sweat just an hour after finally falling asleep. She chugs down a bottle of water that’s always on her bedside table before getting out of bed to pace around her room.
The realization that she’s going to have to face yet another day without proper sleep hits her and she can’t help but cry.
Ritu Pradhan, 17, from Biratnagar has been facing this problem for nearly two years. Initially, she used to stay up past midnight watching TV or talking on the phone and go to bed around one or two in the morning.
Over time, she couldn’t fall asleep even when she was dead tired and used to toss and turn around in bed for at least an hour before finally falling asleep.
“Now I just can’t sleep and when I eventually do, I have nightmares and wake up within half an hour or so of falling asleep,” says Pradhan as tears well up in her eyes. “I’ve tried everything they’ve advised me. From not watching TV before bed to ensuring my room is completely dark at night, but nothing seems to work.”
Insomnia, the inability to fall asleep, or stay asleep through the night, is a problem that plagues a lot of youngsters these days, according to Dr Kamal Raj Thapa, MD, and Resident at Bir Hospital.
People with insomnia usually wake up during the night and have trouble getting back to sleep, wake up too early in the morning and feel tired upon waking, besides the obvious difficulty to fall asleep.
Oftentimes, insomnia is a symptom for hyperthyroidism, a condition in which the thyroid gland makes too much thyroid hormone, various mental disorders, and even a side effect of smoking or excessive alcohol consumption rather than a standalone diagnosis, or a disease.
Doctors are of the opinion that the underlying causes for insomnia in most cases are usually stress and anxiety. Oftentimes, people with insomnia keep thinking about getting enough sleep. The more they try to sleep, the more frustrated they get and the harder it is to sleep.
Insomnia also varies as to how long it lasts and how often it occurs. It can be short-term (acute insomnia) or can be of a long duration (chronic insomnia). It can also come and go, with periods of time when a person has no sleep problems.
Acute insomnia can last from one night to a few weeks. Chronic insomnia is when a person can’t sleep at least three nights a week for over a month. Stress most commonly triggers short-term insomnia. If you do not address acute insomnia, however, it may develop into chronic insomnia.
“It is important to remember that not getting eight hours of sleep every night does not mean you suffer from insomnia. Different people have different sleep needs. Some people do fine with six hours of sleep while some might need 10 to 11 hours,” says Dr R. D. Joshi, Head of Department of Medicine at Kathmandu Model Hospital.
Joshi explains how most youngsters nowadays are sleep-deprived. He sees a lot of male patients who complain of headaches because of lack of sleep on a daily basis.
The hectic lifestyle with studies and work leaves them with very less time to sleep. Normal bedtime for many is as late as one or two in the morning, if not later. And they usually have to wake up early to go to college or work, which means they are not getting the required amount of sleep.
Ankit Malla, 27, businessman, functions with less than five hours of sleep a night. He’s trying to establish a vehicle business and has to prepare plans and meet prospective clients everyday. When he gets back home after a long day, he’s busy planning and scheduling appointments for the next day.
“Even when I go to bed, I keep thinking about the work load for the next day. Sometimes, I get up after going to bed just to think and pull my thoughts together,” says Malla, sheepishly admitting that he feels drained and has headaches every single day.
According to Joshi, those who have insomnia suffer in silence, unwilling to accept that they’re having trouble going to sleep which is why they seek no treatment or counseling.
“If insomnia stems from depression, then it becomes a psychiatric condition that needs a mental health expert’s intervention. But mostly people just have trouble falling asleep in which case they don’t need psychiatric intervention but it is always best to get some medical help,” says Joshi, reiterating how in some cases an easily treatable condition like hyperthyroidism can be the cause of insomnia.
The thought of seeking medical advice has never occurred to Malla whereas Pradhan came to Kathmandu because her family insisted she visit a well-known neurologist. But based on her sleep history, the doctors didn’t run any tests and recommended she go for counseling sessions instead.
“I came with a lot of hope. I thought finally I’d have a solution for my problem. But it seems like there is no cure for insomnia and I’ll have to endure this for the rest of my life,” she says.
Joshi however contradicts Pradhan and asserts that insomnia is a reversible condition. In Pradhan’s case which clearly looks like an anxiety disorder, he believes by changing sleep patterns or exercising daily she can do away with the problem.
“In 80-90% of the cases, the only medical help the patient needs is counseling. As in the case of Pradhan, proper counseling could possibly solve the problem.”
Oftentimes, insomnia develops over a period of time due to bad sleep habits. From having no fixed bedtime to poor sleeping environment to consuming large amounts of coffee or alcohol, insomnia can be triggered because of many supposedly inconsequential habits.
Working late nights and daytime napping can also cause insomnia after a prolonged period. People don’t notice these behavioral changes until it’s too late and it manifests itself with sleep problems.
Some common side effects of insomnia are drowsiness, irritability, and loss of appetite, muscle pain, and depression. Sleep deprivation also puts one at a greater risk of diabetes, obesity and heart diseases.
Malla is an example of how insomnia can wreck havoc in your lifestyle as he’s always skipping meals; but despite that, he has gained a lot of weight in the past six months.
Also, he admits his friends and family keep complaining that he’s irritable and more moody than ever before and says that it’s definitely the lack of sleep that’s brought about this change in him.
Alprazolam is the most commonly used sedative for insomnia. Though many youngsters try to acquire it without prescription, pharmacies nowadays have become strict and don’t sell it without one.
Binod Bogati, pharmacy in-charge at Pratik Pharmacy, says that he gets threatened by some severely sleep-deprived boys who want the drug without a prescription.
“If lack of sleep makes it hard for you to function during the day because you’re sleepy and tired, a doctor may prescribe sleeping pills for a limited time. Avoid using over-the-counter sleeping pills for insomnia since they may have undesired side effects. Also, you should not take any medication without being advised,” says Joshi.
If not tackled at its earliest stage, then insomnia can lead to health scares as there are evidences that lack of sleep can lower your immune system’s ability to fight infections.
Insomnia might not be a worrying case in itself but it’s a condition that needs to be addressed so that extreme cases like Pradhan’s can be avoided. Sleepless nights don’t have to be endured if you seek timely help.
If you are sleep-deprived, you might want to try a few things before seeking medical help.
• Take a warm bath to relax.
• Exercise more.
• Keep your bedroom at a cool temperature.
• Listen to relaxing music or sounds, like waves crashing, waterfalls, or classical music.
• Make your bedroom as dark as possible.
• Keep a set schedule as to what time you should be in bed and stick to it.
• Try herbal tea or green tea to combat the effects of insomnia.
• Do your homework, finances, think too much before bed.
• Think about the past as this can sometimes lead to emotional turmoil.
• Watch horror or mystery shows before bedtime.
• Drink caffeinated drinks or have alcohol.
• Eat anything spicy or fried foods.
• Smokers take longer to fall asleep, they wake up more frequently, and they often have a more disrupted sleep; so quit smoking if you do.
• Take naps during the day.