Sleeping disorders/Insomnia in Nepalis

TRISHNA GHOSH : I would like to share my experiences regarding the clientele group in Kathmandu whom I have been catering my psychological services for the past 3 years every second patient coming to me complaint of sleep problems. On further probing them they would report that they have not been able to get adequate sleep for reasons unknown, sometimes it takes a session or two to help them figure out the reason for sleep difficulties.

Insomnia is defined as difficulty falling asleep, or staying asleep, or both. Up to 50% of the population are affected by insomnia at some time in their life. Women are affected more frequently than men, and people with psychological problems suffer from higher rates of insomnia.

What causes sleep disturbances?

Insomnia or sleep disturbance can be caused by many factors. Transient or short-term insomnia can be related to time changes (jet-lag, travel), altitude, change in medications, life-stress (loss of a loved one, job loss, divorce or separation), and poor sleep conditions (noise, light, disruptive bed partner). Substance abuse issues can also cause sleep problems, such as withdrawal from alcohol, drugs, or medications. Psychological issues such as depression, mania, bipolar disorder, anxiety disorders, or Post-traumatic stress disorder (PTSD) also go hand in hand with disordered sleep. Insomnia can be a prime indicator of underlying psychological difficulties.

Few Symptoms of Sleep Disorders

• Feeling fatigued or exhausted
• Poor concentrating
• In creased irritability

Helpful strategies to overcome sleep problem

• Avoid using sleeping pills or alcohol to fall asleep, this will disrupt your sleep even more over the long-term. Or if you drink excessive amounts of coffee during the day, it will be more difficult to fall asleep later. Often, changing the habits that are reinforcing sleeplessness is enough to overcome insomnia altogether. It may take a few days for your body to get used to the change, but once you do, you will sleep better.
• Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep.
• Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends, even if you’re tired. This will help you get back in a regular sleep rhythm.
• Avoid naps. Napping during the day can make it more difficult to sleep at night.
• Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer, or video game use. Instead, focus on quiet, soothing activities, such as reading, or listening to soft music, while keeping lights low.
• Quit smoking or avoid it at night, as nicotine is a stimulant.
• Limit the number of night or irregular shifts you work in a row to prevent sleep deprivation mounting up.
• Avoid frequently rotating shifts so you can maintain the same sleep schedule.
• Get out of bed when you can’t sleep. Don’t try to force yourself to sleep. Tossing and turning only amps up the anxiety. When you’re sleepy, go back to bed.
• Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off. You can use an alarm, but make sure you can’t see the time when you’re in bed

Sleep Disorders can be effectively managed with psychological treatment and medication (if necessary), once the cause has been identified. In Clients with underlying psychological problems, effective psychotherapy, stress management, and psycho-education in conjunction with sleep therapy can significantly improve their wellness. Clients who receive effective treatment experience improvement in their ability to function normally.