DocGenie Blog

Written by Dr. Roshan Jain (MBBS JJMMC Karnataka, MRCP Psychiatry UK, MMedSc Univ of Nottingham,UK), one of the best psychiatrists in Bangalore.

Amnesty International lists sleep deprivation as a form of “torture”. Depriving yourself of good quality and adequate quantity of sleep is a form of self-harm. And many are doing this to themselves, on a daily basis, by staying awake longer than required and habitually sleeping in the early hours of the morning.

Sleep deprivation is a self-perpetrated affliction. It is caused by lifestyle choices or the effects of stress, emotional and psychological problems. In other words, individuals were ‘able but unwilling to sleep’, or they ‘were willing but unable to sleep’ due to emotional or mental health ailments. So, if you choose to deprive yourself of adequate sleep, then be prepared to suffer from ensuing psychiatric illnesses. These include ‘insomnia’ followed by anxiety, panic attacks and depression. You also have an increased risk of physical health issues (such as diabetes, high blood pressure, stroke and heart disease).

Why do we torture ourselves?

In the modern world, we live fast-paced, techno driven lives filled with distractions and discontentment. We unduly strive for everything and are seldom satisfied upon achieving it. And setting higher expectations from ourselves and others inadvertently leads to enhanced pressures and stress. We perpetrate these pressures and demand on ourselves. And it seems that sleep is one of the first things we’re willing to sacrifice as the demands rise. 

We live by myth (and perhaps a casual attitude) that sleeping one hour less will give us one more hour of productivity.  And even after the demands for that extra work or study or caring has settled, many don’t return to natural required sleeping pattern. They choose instead to engage in purposeless activities that eat into precious sleep time.  Many habitually sleep late as their ‘virtual life’ (updating or chatting on social media) has taken over real life rest time.

Perhaps, this self-induced torture is underpinned by a lack of awareness and understanding of the importance of the body rhythm and sleep-wake cycle. 

Is sleep more important than food?

Undoubtedly!  If you fast or starve for a few days or a week, then at the end of it, you would be famished, weak and maybe little thinner.  That’s it. If you deprive yourself of sleep for few days or a week, you would not be able to function properly.

Many of the adverse effects of sleep deprivation may be invisible. Research suggests that even small amounts of sleep deprivation take a significant toll on our physical and psychological health including a negative impact on thinking capacity and productivity. Insufficient sleep, for example, profoundly impairs our ability to consolidate and stabilise learning that occurs during the waking day and disturb our concentration.  In other words, it wreaks havoc on our memory.

Memory problems is a common trigger for seeking professional advice from a neurologist or a psychiatrist in Delhi. Upon evaluation, a common clinical finding is one of long-standing insomnia.  

So how much sleep do you need? 

There isn’t a clear definition of exactly how long a person must go without sleep to be considered sleep deprived.  Research suggests that a person is sleep-deprived if they get less sleep than they need to feel awake and alert. In other words, they need to rest as much as is necessary to wake up rested and refreshed. 

Studies report that 95 % need about 7-8 hour per night. 2.5 per cent need more than 8 hours and 2.5% less than 7 hours (that’s 1 in 40).

Understanding Insomnia

Insomnia is difficulty falling asleep or staying asleep even when a person has the chance to do so. In other words, willing but unable to sleep. Other features include waking up too early in the morning, unrefreshing non-restorative sleep, fatigue, irritability, reduced motivation, behaviour problems like impulsivity or aggression, and associated impact on work and personal life.

Most of us have experienced brief periods of insomnia, and we know what it feels like to still be awake staring at the ceiling and wishing for sleep. People experience short-term insomnia when they’re anxious or overwhelmed with life circumstances, or when they travel in different time zone and experience jet lag. This short-term and passing sleep disruption is common and usually resolve without any medicinal treatment.

Insomnia is chronic or long-term if the above sleep disturbance is experienced for at least three nights per week for three months or longer. Insomnia may have many causes (see below). People with chronic insomnia require professional advisory, lifestyle changes, and therapeutic intervention.

Typical Causes of Insomnia

• Medical: Nasal/sinus allergies, gastrointestinal problems such as acid reflux, Hormonal problems such as hyperthyroidism, Arthritis, Asthma, Neurological conditions such as Parkinson’s disease, Chronic unremitting pain, heart problems, etc
• Psychiatric: stress, anxiety, depression, and other long-term psychiatric conditions
• Unhealthy lifestyles and sleep habits: Delayed sleep, Shiftwork, Daytime naps, work in the evening and late into the night
• Foods and substance: Caffeine, nicotine, and alcohol
• Certain medicines – such as some antidepressants, epilepsy drugs and steroid medication

Tips to improve quality and quantity of your sleep:

Healthy sleep habits or good ‘sleep hygiene’ can make a big difference to your quality of life. Try to keep the following sleep practices on a consistent basis:

• Stick to a sleep schedule – sleeping and waking at the same time, even on the weekends. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.
• Prioritise sleep over every other less relevant aspect of your night and life.
• Start winding down at least 45 minutes before you turn off the light. Skip smartphone, computer and other backlit devices as it confuses the brain and is a recipe for wakefulness! You won’t fall asleep if you’re all wound up from answering email, or doing other work before sleep.
• Write down what’s on your mind — especially unfinished to-do’s and unresolved issues — just before you go to bed. If you leave items in your working memory, they’ll make it harder to fall asleep, and you’ll end up ruminating about them if you should wake up during the night.
• Avoid mind stimulating drink such as coffee/tea/fizzy drink/nicotine and alcohol
• Create a ritual around drinking a cup of herbal tea, milk or listening to soft music that helps you relax, or even reading a dull book that will put you to sleep!
• Use light to help manage your circadian rhythms. Expose yourself to sunlight in the morning and avoid bright light in the evening. This will keep your circadian rhythms in check.
• Avoid daytime or afternoon naps. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.
• Exercise daily. 45 to 60 minutes of exercise is the best, but even light exercise is better than no activity. Otherwise regular walk or jog for 30 – 45 mins would bring enormous health benefits.
• Practice early evening yoga for relaxation. Yoga is effective in combating insomnia, stress and depression.
• Evaluate your room. Ensure your sleep environment is conducive to for good sleep. Keep it cool, free from noise and light. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.
• Sleep on a comfortable mattress and pillows. Consider changing the mattress that you have used for years as it may have exceeded its life expectancy (about 9 or 10 years for most good quality mattresses).
• Where possible avoid rotating shift work as well as working or studying late at night.
• For some artificial light therapy, treatment with Melatonin hormone substitute as well as a short course of hypnotic (sleeping pills) medication. Remember, these hypnotic drugs are addictive and should be taken for no more than 2-3 weeks under expert supervision. 
• Good sleeping habits and attitudes are the best approaches for short and long-term sleep problem. Ensure a minimum of 7 hours of sleep every night. Avoid regular daytime naps unless you have a hectic schedule and require it to recuperate.

If there is one thing that you must try to do well in any given 24 hours, is to sleep well. And that means you must commit at least one third (8 hours) of those 24 hours for sleeping. Remember, sleeping is more important than food.

At the end of the day, the time spent in bed is time well spent. But ensure it is restful, not restless. Our sleep and health must take priority over everything else.

“A good laugh and a long sleep are the best cures in the doctor’s book.” – Irish Proverb

Recommended resources:

1. National Sleep Foundation: https://sleepfoundation.org/sleep-disorders-problems
2. Insomnia, NHS Choices: http://www.nhs.uk/conditions/insomnia/pages/introduction.aspx

Read Dr Jain’s previously published articles on coping with addiction, dealing with trauma, and drinking responsibly.  

About the Author

Dr Roshan Jain is one of the best psychiatrists in Bangalore. He is a UK qualified specialist with extensive experience in psychiatry, addictions, psychotherapy, teaching, and motivational work. Based in Bangalore (India), he offers in person-centered mental health evaluation and interventions. He has worked tirelessly in reducing the stigma associated with mental health problems through speaking events and mental health awareness education, workshops & publication.

DocGenie is an online telemedicine platform that provides you with quality healthcare from the best doctors in the comfort of your own space. On DocGenie, you will find a select few, highly-qualified doctors, unlike other online platforms with thousands of doctors. So you can be assured of receiving excellent, honest, personalized care from the best professionals.