Desynchronised

Last night I couldn’t sleep. I talked to my sister online for a while, but then the lights went out and so did the internet. My phone wouldn’t sign in to MSN so I had nothing to do. I tried to find a candle in the dark but was unable to find it. The only thing left to do was try to sleep. 

There were a thousand problems. It was terribly hot; temperatures often reach 38 to 40 degrees here in Chandigarh. Mosquitoes were celebrating the absence of the repellant and the spin of the fan, and the thin blanket was unable to shield me from their bites. I wondered if there was any difference in temperature between Nepal and India, and right then, I wanted to go back home. 

The blackout had started at around midnight. I decided to sleep at a quarter to one. It was three and I was still awake. I usually start counting when I can’t sleep. I usually fall asleep before I reach a hundred. But this time, it didn’t work. I was up to four hundred when I decided to stop.

We, as physicians, have dismantled sleep into two phases and four stages. I didn’t even get into any of these stages. We say that sleep is either synchronized or desynchronized.  People usually spend one third of their lives asleep. If this trend continued, I would be spending only one percent of my life sleeping and the rest like a zombie, trying to sleep. 

By quarter to five, I had already given up on sleep. Maybe I had had too much coffee last evening. But as far as I could recall, I had only had a cup, that too in the afternoon. I had not taken any medicine, tea or alcohol. So what could it be?  Maybe stress? Exams were coming and I had a lots of things to cover. Maybe I was anxious due to my new hectic schedule. I had done my regular exercise and the ward had been quite busy, so I was considerably tired. I was drowsy yet unable to sleep.

Then I got an idea. It has been a long time since I wrote anything for V.E.NT! Magazine. Usually I have no spare time but this time, I tried writing. I was typing when I finally fell asleep. I woke up at eleven the next morning. Fortunately I didn’t have morning duty.

There have been days where I don’t sleep at all. Even as a physician, I was never able to manipulate sleep. So this time when I had a posting in psychiatry, I thought I should get myself acquainted with the methodologies of the psyche. 

You spend one third of your life asleep. You are either a long-sleeper requiring nine hours of sleep or a short-sleeper requiring six hours of sleep. Sleep is divided into various stages that cannot be explained here for lack of space. If you are sleep deprived for a long time then your body will recover by letting you sleep for prolonged periods which usually last for 15 to 16 hours. 

If you are sleep deprived for four to five days, the psychological symptoms become prominent with a decreased attention span, drowsiness and a decreased initiative to perform. You also tend to fall into micro-sleep cycles, each lasting a few seconds. Disorientation and hallucinations appear only after the fifth day of sleep deprivation. Though sleep is essential, one thing must be clear that you will never die from a few days of insomnia. Our body is set to recover the loss at any instance.

It should be understood that insomnia is common, 15 to 30 percent of people complain of insomnia. You should only be concerned if your sleep pattern is disturbed three times a week continuously for a month. This is when you should consult your physician.

Here are some basic sleep hygiene techniques:

1. Try regular daily physical exercises (preferable not in the evening).

2. Minimize your daytime napping. Avoid it if possible.

3. Avoid fluid intake and heavy meals just before bedtime.

4. Avoid caffeine intake before sleep (tea, coffee, caffeinated drinks).

5. Avoid regular use of alcohol (especially avoid the use of alcohol as a hypnotic for promoting sleep).

6. Avoid reading or watching television while trying to sleep.

7. Sleep in a dark and quiet room. 

8. Be regular with your bedtime.

The best way to avoid insomnia is to develop a good sleeping habit to restore body function and conserve energy.