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Insomnia or sleeplessness in simple words is difficulty in falling and staying asleep. Sleeplessness is very common and can affect multiple levels in our body and mind. The estimated prevalence of difficulty in initiating and maintaining sleep is about 30%

DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders and serves as the principal authority for psychiatric diagnoses
  

Symptoms of insomnia as per DSM-5 criteria are as follows:

 

A predominant complaint of dissatisfaction with sleep quantity or quality associated with one (or more) of the following symptoms:

  • Difficulty initiating sleep – which means problems in falling asleep
  • Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings
  • Early-morning awakening with inability to return to sleep

In addition,

  • The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioural, or other important areas of functioning.
  • Sleep difficulty occurs at least 3 nights per week.
  • Sleep difficulty is present for at least 3 months.
  • Sleep difficulty occurs despite adequate opportunity for sleep.
  • The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g. narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
  • The insomnia is not attributable to the physiological effects of a substance (e.g. drug abuse, medication).
  • Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.

Commonest causes of insomnia:

 

    • Primary insomnia: Insomnia due to primary sleep disorder

 

    • Secondary insomnia: Insomnia due to some underlying causes like- 
      • Poor sleeping habits
      • Medications
      • Depression
      • Anxiety
      • Stress
      • Disorders like – Hyperthyroidism, Restless leg syndrome, hyperacidity, etc.
      • Sleep apnoea
      • Lifestyle habits like working late, using mobile phones/laptops and watching TV till late

 

Treatment options:

 

  • If insomnia is due to poor sleeping habits, it can be corrected by going to sleep and waking up daily at the same time which will create a steady rhythm. 

 

  • Avoiding the use of mobile phones, laptop, and television just before sleeping or till late night can improve sleep as they emit blue light which has been shown to impact health. Natural exposure to blue light during the daylight hours boosts people’s energy, alertness and mood. However, elongated exposure to these waves during the evening can disrupt circadian rhythm and cause various health effects including a disruption in normal sleep schedules. 

 

  • If the use of these things is really necessary, then you can apply blue light filter screens on your laptop or TV screens and download blue light filter app for smartphones.

 

  • Avoiding vigorous exercise and caffeinated drinks a few hours before going to sleep is recommended.

 

  • Treatment of the underlying cause of insomnia is the treatment for insomnia too, e.g. if the cause of insomnia is hyperthyroidism then treating hyperthyroidism will improve sleep. Similarly, treating anxiety or depression will improve sleep if they are the causes of insomnia. Stopping medicines which cause insomnia can help improve sleep if that’s the cause. Sleep apnoea is also one of the causes of insomnia and can cause daytime drowsiness with many other complications.

 

  • Homoeopathy can not only treat primary sleep disorder but also treat many of the underlying causes like depression, anxiety, hyperacidity, restless leg syndrome, stress, hyperthyroidism etc. In-depth study of patient’s psyche helps in understanding deeper issues of patients and hence helps in treating at multiple levels.

 

  

So, ideally, cause of insomnia should be identified first and then treated accordingly.

Do not get addicted to sleeping pills before knowing the cause for your insomnia.

 

Sleep well!

By.

– Dr Kruti Trivedi (B.H.M.S., C.C.A.H., C.D.E.)

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