Insomnia Treatment in Delhi, India

Insomnia is a common sleep disorder that causes trouble falling or staying asleep. It affects around 10-30% of the world's population.

Types of Insomnia

• Acute insomnia

Acute insomnia is also known as short-term insomnia. This short-term insomnia lasts from more than one week to less than three months when sleep is disturbed at least three days per week.

• Chronic insomnia

Chronic or long-term insomnia happens when sleep is disturbed at least three days a week for more than three months.

Insomnia can also be 

Primary Insomnia occurs when it occurs without any other reason, and secondary Insomnia occurs when another health condition or circumstance is the reason for the sleep disturbance,

Symptoms of Insomnia

Insomnia symptoms include:

• Difficulty in initiation of sleep 
• Waking up too early
• Daytime sleepiness
• Waking up multiple times at night (difficulty in maintaining sleep)
• Feeling irritated and tired during the daytime
• Stress, anxiety, or irritability
• Lack of concentration
• Continuous worries about sleep

Causes of Insomnia

Common causes of insomnia include:

• Primary: When insomnia is independent of any known mental or physical health condition or life circumstance.
• Stress: Stress related to work, health, finances, and personal problems may keep patients active at night, making it difficult to sleep.
• Poor sleeping habits: Poor sleep habits, such as an , frequent naps, stimulating activities before sleeping, uncomfortable bedding or sleeping environment, watching TV, playing video games, or surfing through smartphones before sleep, often interrupt the sleep cycle.
• Travel and work schedule: Long-distance travelling or working overtime can affect the sleeping cycle. We disrupt the body's circadian rhythm, leading to insomnia. Travelling across time zones, sleeping late at night, or waking up too early in the morning with frequent changing shifts may cause sleep continuity problems.
• Overeating before bedtime: Having a heavy dinner or snack before bedtime can cause physical discomfort while sleeping. Heavy eating often leads to acidity, which may keep a patient awake at night.
• Mental health disorders: Anxiety, panic, post-traumatic stress disorder, depression, and mood disorders like bipolar disorder are significant causes of sleep disturbance. At the same time, psychosis and substance use like alcohol and drug abuse or dependence also often result in sleep disturbance.

Other sleep disorders can also cause insomnia —like Restless legs syndrome, obstructive sleep apnea syndrome, periodic limb movement disorder, and central sleep apnea syndrome.

• Medical conditions: Health issues are directly linked with insomnia. Chronic pains, headaches, cancers, diabetes, heart problems, Parkinson's, asthma and other lung conditions can cause severe sleep disruption.
• Medication—Certain medications can also result in sleep disturbance, such as those for Parkinson's disease, Psychostimulants and amphetamines, Cold medicines, Steroids, and anti-seizure medications.

Diagnosis of Insomnia

The key aspect of diagnosing insomnia is reviewing the sleep history and finding and ruling out conditions contributing to or causing sleep disturbance. Depending on the situation, the diagnosis may be aided by:

• Sleep study: A sleep study, also known as polysomnograms, is a comprehensive test used to diagnose sleep disorders. It is recommended to check if sleep apnea or any other sleep disorder is the cause of insomnia.
• Blood test: The doctor may order a blood test to rule out a few medical conditions that might negatively impact sleep.
• Reviewing sleep habits: The doctor may ask sleep-related questions or a complete questionnaire to understand the sleep-wake cycle, including the level of daytime sleepiness. 
• Sleep Diary: The doctor may also ask to keep a diary for a few weeks to understand the cause and pattern of insomnia.

Treatment of Insomnia

Sleep-Hygiene Practices may help improve insomnia. One can follow these easy-to-follow steps to improve sleep,

• Keep regular and fixed wake-up and sleep times, 
• Use your bed only for sleeping
• Do not sleep in the time
• Avoid screen and smartphone 1 hour before sleep 
• Reading a book or listening to soothing music may help
• Deep breathing relaxation or listening to guided meditations may help
• Progressive muscular relaxation may help
• Taking a bath before bedtime may help
• Sometimes, changing the bed or sleeping in another room may help
• Cognitive-behavioural therapy (CBT) 

Cognitive-behavioural therapy for insomnia helps control and eliminate negative thoughts that lead to sleepless nights. It's a structured intervention for insomnia that helps identify the cause. It helps replace the thoughts and behaviours leading to sleeping problems with habits promoting sound sleep.

Medications

Behaviour and lifestyle changes help to improve sleeping patterns in most cases. However, in some cases, if they do not work or only partially work, then medications may be prescribed for a short duration. Sleeping pills should be taken for a short duration only, as they can be addictive, so they should not be continued without a doctor's supervision. Treating underlying anxiety, depression, and other mental health disorders with proper medications can also improve sleep.

Non prescribed sleep aids

Non-prescribed sleep medications like melatonin can be taken if they help, but they should not be continued for the long term, and proper assessment should be done if insomnia persists.

Complications of Insomnia

Sound sleep is crucial for health. Sleep disturbances affect a person mentally and physically. People with chronic insomnia usually have a lower quality of life.

Major complications of insomnia include:

• Lower performance and concentration at work
• Slow reaction time
• Fatigue and tiredness
• Increased risk of mental health disorders such as depression, anxiety or mood disorders.
• Increased risk of diseases like high blood pressure and heart disease
• Lowered immunity
• Short-term memory problems
• Weight gain

Review

Reviewed by Dr Madhusudan Singh Solanki, Principal Consultant - Neurosciences, Neurology on 31 May 2024.