Rajinder Singh*, 59, is a Los Angeles based accountant who has been struggling with sleeplessness for  two months. He’s been married for 30 years and his spouse, Kusum, is a social worker at a local hospital.  They have two grown-up children who are married and live independently in the suburbs of LA. 

Rajinder* has difficulty falling asleep most nights of the week. Often, he gets up at night, begins brooding and has trouble falling back to sleep. He is usually tired during the day and sometimes feels sleepy while driving. He has not yet seen a healthcare provider regarding this situation, but approached us seeking help with his problem. 

Q: What are the reasons for my sleeplessness?

Dr. Sharma: It is not unusual for adults to experience sleeplessness once in a while but in your case it seems to be going on for a sustained period of time. There can be several reasons for sleeplessness. These could be:

  • Stress,  
  • Poor sleeping environment,
  • Drinking alcohol or caffeinated products,
  • Smoking or taking a drug, 
  • Eating heavy meals late in the evening,
  • Use of social media right before sleeping, 
  • Depression, anxiety, post-traumatic stress disorder (PTSD) or other mental health conditions,
  • Medical conditions like arthritis, cancer, diabetes, or obstructive sleep apnea among others.

To zero down on the exact cause of your sleeplessness you need to weigh in on these factors. Consult a healthcare provider if the situation does not improve. Based on their evaluation, you may even be referred to a sleep therapist for further diagnosis. 

Q: What kinds of stress could I have?

Dr. Sharma: Stress can be acute (short-term), chronic (long-term) or non-event led (like boredom). 

Acute stress: This could be through death in the family, divorce or a strained relationship, financial losses, joblessness, undue pressure at work and so on.  

Chronic stress: Everyday hassles like delays in traffic, standing in a long queue, or even community related stressors like living in a high crime neighborhood, being a minority among a majority group are some examples of chronic stress. Persistent life difficulties such as a chronic health issue, disability after an accident, being in a bad marriage, are also major chronic stressors.  

Identify any new stressful situations in the past couple of months and work toward addressing those. 

Q:  What is a poor sleeping environment?

Dr. Sharma: A poor sleeping environment could entail having too much noise around, a bedroom that is poorly ventilated, too cold or too hot, an uncomfortable bed, uncomfortable pillows, and so on.  It could also mean poor sleeping habits like watching television or spending screen time just before going to bed, not having a fixed time for sleeping or waking, working night shifts, traveling, jet lag, and so on.

Q:  How are insomnia and sleep deprivation different?

Dr. Sharma:  Both insomnia and sleep deprivation are related to sleeplessness but they are slightly different. Insomnia is being unable to sleep despite trying to, while sleep deprivation is when you do not give enough time to yourself to sleep. Sleep deprivation can lead to insomnia.

Q: How can I manage my sleeplessness?

Dr. Sharma: Practicing sleep hygiene is essential. Some things you can do are: 

  • make sleep a priority; have a fixed sleeping and waking time, 
  • do not take too many naps during day time, 
  • wind down everything at least 30 minutes before sleeping, have only dim night lights in the bedroom, with no noise sources including TV and cell phones in the bedroom, 
  • make your bed as comfortable as possible and practice relaxation while in bed before sleeping, 
  • do not toss and turn in bed if you wake up at night; instead try to do some boring tasks for a few minutes and then go back to bed. 
  • avoid caffeinated products (even during the day) and reduce or quit alcohol and smoking, 
  • be physically active, 
  • avoid heavy meals in the evening and night time snacking. 
  • An easy rule to remember is the 10-3-2-1-0 rule: Cut caffeine 10 hours before sleeping, cut eating or drinking three hours before sleeping, stop working and get away from the screen two hours before sleeping, and hit the snooze button zero times. 

However, if these measures do not work soon, consult your healthcare provider without delay.

Q: Can Indian traditional techniques help?

Dr. Sharma:  Indian philosophy has given the traditional techniques of yoga and meditation to the world.  These can be very helpful in dealing with sleeplessness.  

  • Relaxation (shava asana) and meditation (dhyana) are great ways to relax the mind especially before sleeping.  
  • In Shava asana, you can progressively relax the muscles of the body, the senses and the mind, by lying still. This can be practiced before sleeping and then gently drifting into sleep. 
  • In dhyana, you can watch your breath – just watching the inhalation and exhalation without any exertion before sleeping and then gently drifting into sleep. 
  • You can meditate on a syllable such as “Aum” by internal silent repetition before sleeping and then gently drifting into sleep. 

Resources:

Here are some resources for more information:

If you have questions, reach out to Dr. Sharma at editor@indiacurrents.com

* Name of the patient has been changed on request. 

Manoj Sharma, MBBS, Ph.D., MCHES® is an Indian American global public health expert, author, and educator who has written several books and publications on mental health. He answers queries from a medical,...