Sleep and sleeplessness

The wonder of sleep is often praised, after losing it. Sleep is a treasure to human beings, which cannot be achieved all the time, when needed by all. If you wish to sleep, the harder you try and concentrate on going to sleep the more horrible it will be and impossible it becomes. It is just like walking towards the rising sun, which will go up, as you walk towards it and finally it settles on your back and vanishes.
Homeopathy gives much importance to general symptoms of the body i.e. symptoms that affect a person as a whole. For example thirst, appetite, sweat, urine, stool, sleep, menses, etc. Since sleep is one among the general symptoms that affect a person in mind and body as a whole, Homeopathy gives much importance to it.
Before discussing sleeplessness, everyone should know what sleep is? Why do we sleep? What are its advantages? What is the minimum requirement of sleep?…& so on.
What is sleep? The rest taken by the human brain is called sleep. Nature switches on the automatic mode for body functions and provides rest and refreshment for the brain, for doing better work on the next day. The brain’s learning, retrieval and communicating skills get refreshed during this period. Sleep is essential for all and it plays a major role in normal body functions and in development and maintenance of health. To have good health, everyone should eat well, work well and sleep well.
Nature has programmed everything with its own biological clock. It implies that man must work or be active in the daytime and take rest at night. But in this tensed, hurried and greedy world, man overworks day and night with overwork or overtime, disturbing or discarding sleep. Deprivation of sleep results in many psychological and physical complaints. With sleep-deprived money, people buy costly waterbeds or some other costly beds and decorate bedrooms to make a pleasant atmosphere for getting good sleep. But the fact is, even in a queen’s bed, thorns (hands) of the biological clock would make anybody feel uneasy, restless and sleepless. i.e. you can buy a bed, but cannot buy sleep.
Everyone would like to sleep for a long time peacefully, without any disturbance of light, sound or emotion. It is for a relaxed old age that people work overtime during the younger days. Overtime work makes one work hard by avoiding sleep but finally makes him to spend much of the money earned, to get peace and sleep. Overtime workers voluntarily lose sleep and later run behind it.
The general benefits of sleep are:

• It relaxes the mind after a hurried, tense day time
• It relieves tiredness accompanied by relaxed muscles
• It slows and steadies the pulse and blood pressure
• It is more refreshing than anything else
• It is really good for physical health and the mind
• It is the best medicine either for physical or psychological complaints
• All harboured thoughts get released during sleep
• Sleep gives peace

Occurrence – Length and depth of the sleep is an age related phenomena i.e. it varies from childhood to old age. All through life, its rhythm and frequency changes constantly. In the first year of the child, the sleeping period rapidly decreases from 20 hours to 16 hours and after that till the adolescent period, it gets slowly decreased from 16 to 8 hours. Then it gets slowly increased for some period followed or alternated by long waking periods.
In old people, it decreases slowly to frequent naps followed by long waking periods i.e. the classical sleep of the aged. Sometimes the increased sleeping mode in the aged continues and people sleep continuously like a child. The occurrence and time of sleep varies. The minimum requirement of sleep also varies, depending on the age. For an adult it is 6-8 hours. In general

• Children sleep more
• Women sleep more than men

Occasions where sleep is more

• Tiredness
• Alcoholism
• Vitamin deficiency
• Febrile period
• Neurological complaints
• Excessive sexual indulgence
• Sleeping sickness (African trypanosomiaisis – spreads through tsetse flies)

Factors which favour sleep

• Night time
• Light music
• Cool climate
• Hot bath
• Warm milk
• Heavy meal
• Reading

Sedative drugs
How it occurs – Usually a person slips into sleep when he/she is exhausted physically or mentally. As soon as he/she feels sleepy, he/she yawns, voluntary tightening and relaxing the muscles by holding a deep breath. The eyelids feel heavy and droop. These are all responses to the signal of the brain to the body to get ready for sleep. If there is no disturbance, execution of sleep takes place smoothly under the favourable situation. It needs nothing more than shutting the eye window and mind door. Now the brain can take rest comfortably. This process of execution is done with stimulus from the sleep centre in the brain.
Sleep centre – The hypothalamic region in the basal part of the brain, called Reticular Activating System (which consists of upper medulla, pons and mid brain), is the centre of sleep. It is the recipient of highest blood supply in the brain. It regulates the autonomic functions of the body i.e. regulates the body temperature, food intake, thirst, sleep, emotions, gastric acid regulation and sexual behaviour. Sleep is induced or controlled by serotonin, a hormone produced by the Raphe nuclei of this system which regulates the human biological clock. Serotonin secretion is more in the case of a child and gradually decreases as age advances. Hence, due to lack of serotonin, old people suffer from sleeplessness.
When the time of the biological clock is altered, it creates a jet lag situation. This situation often occurs in persons who travel for a long time abroad where there is difference in time. This situation leads to more tiredness, even after long sleep, instead of the person feeling refreshed. This type of unsatisfied sleeps leads to insomnia (sleeplessness). It can also occur due to emotions, depression, deep thoughts, stress, painful disease conditions, and hormonal changes.
Symptoms

During start up

• Fatigue , tiredness & drowsiness
• Deep breaths
• Drooping eyelids
• Yawning (contracts and relaxes the muscles or respiration and abdomen)
• Lack of concentration and learning process is diminished

During sleep

• It provides rest or slow relaxed process for all parts of the body
• Slow contraction and relaxation of the muscles
• Slow pulse rate, heart rate and respiratory rate
• Dreams are like live show; everyone can note the smile of children during sleep
• Bedwetting in deep sleep

For good sleep Do’s

• Do regular exercises or meditation
• Take light diet
• Take warm milk before bedtime
• Go to bed in a relaxed mood
• Wear loose garments
• Keep the light dim
• If your work is sedentary, go for a walk in the evening
• Keep away all your work from the bed or bedroom
• Sleep regularly at a particular time and wake up at a particular time
• Keep the room cool and well aerated

Have soft bed spreads, pillows and bedcovers
Avoid

• Sleeping in the day time or evening
• Eating heavy meal before bedtime
• Loud music
• Emotional or thrilling serials or movies
• Change of place
• Coffee and tea
• External stimuli – smoking, alcohol, lights & loud music
• Fear of any kind or irritability

Types of sleep – Sleep has been under continuous research for centuries. There are two types of sleep patterns depending on EEG changes. They occur usually in an alternate manner.
1) Slow wave sleep – It is the initial period of sleep where there is slow & steady breathing without any eye movement. It is followed by short REM sleep which is again followed by slow wave sleep. During this type of sleep, muscles are relaxed. Disorders of this slow wave sleep are automatic or like sleep talking and sleepwalking. It cannot be recalled or recollected by the sleeper. Self-talking and sleepwalking is common in children and rare in adults. Likewise, after getting alternated with REM sleep on the second or third occasion, in the slow wave sleep – dreaming about terrors, screaming and violent behaviour can occur. The reasons for talking, walking and dreaming is less understood and unexplainable. The length of slow wave sleep is more in aged people.
2) REM (Rapid eye movement) – Active or Paradoxical sleep – This type of sleep usually follows after an hour of slow wave sleep. Then for every 1 to 1½ hours, it recurs alternating with slow wave sleep. These cycles repeat several times throughout the night. The period of rapid eye movements prolongs one after another and leads to waking up. During this period, the brain activity will be fast and irregular, and is accompanied by REM. When the brain gets activated by this sleep, we dream and recollect undone work or deep emotions. Twitching or jerking movements can occur during this stage. Usually, in the case of males, this period of sleep is accompanied by penile erections.
Even though REM looks like shallow sleep due to dreams, the arousal threshold is higher, during this pattern. REM is vital in providing ultimate needs to our mental health and refreshment. Lack of REM will lead to tiredness and irritability. Drug induced sleep is mostly deprived of this type of REM sleep. So it always leads to tiredness, hallucinations, behavioral changes and impaired memory. The length of REM sleep is more in children. The newborn or children smile with peaceful dreams during this sleep. Disorders of REM are nightmares, sleep paralysis and hallucinations – it mostly occurs in the early stage of sleep or while getting up. The dreams of REM can be recollected after waking up.
Investigations of sleep
Sleep laboratories investigate about body position, brain activity, trace for sleep apnoea, snoring, pulse rate, heart rate, respiratory movement of chest and abdomen, from the period of lying for sleep to waking up from sleep.
EEG is a graphical representation of the electrical activity of the brain, by means of waves, namely alpha, beta, delta, theta, lambda, MU, etc. In case of triggers or epilepsy, spike wave pattern occurs in EEG. The sleep bundles usually occur in EEG, during slow wave deep sleep.
Researchers conclude that sleep is the ultimate biological requirement and quote it as unpredictable and unexplainable. Its inadequacy leads to physical and psychological complaints. They further say it can also cause premature ageing.
Then, what is sleeplessness or insomnia?
Sleeplessness – insomnia
Silence is a great treasure. Silent sleep is more than that. Sleeplessness (owl’s night) is a condition where people used to keep awake at night due to difficulty in sleeping. It is called insomnia in medical terminology. t is the condition where sleep is unable to be performed perfectly and peacefully for an expected proper time in a continuous manner. Generally, sleeplessness varies from reduction in sleep time to complete sleeplessness. Mostly, it is accompanied with tiredness, sleepiness and restlessness in the mornings with lack of satisfaction of having slept well.
Initially, these persons find difficulty in falling asleep, followed by restless and difficult sleep and also in continuing or maintaining the sleeping for the required time. Even a single sleepless night, amidst sleepers, will have an impact on the person in the sense the person will feel bad about it.

Sleeplessness indicates…

• You are in trouble, either with your mind or body
• You are hiding secrets
• You are overconscious
• You are a silent sufferer

Incidence – Sleeplessness is more common in old people. Its beginnings are mostly seen after retirement or emotional stress. The most common sufferers are the unemployed, divorcee or widow or a hospitalised person. Usually, women sleep more than men. In the same manner, they are the leaders in suffering from sleeplessness also.
Causes – As a general rule, there is no smoke without fire. Likewise, without any causative factor or precursor, there won’t be sleeplessness. Sleep can be disturbed for everyone due to urination or thirst. But insomniac patients will have any one of the following triggers that drowns them in a sleepless state.

• Habits of overwork or extended sleeping schedule
• Overexcitement or anxiety or depression
• Thoughtful and restless
• Nightmares
• Drugs and smoking
• Excess coffee or tea intake
• Painful and chronic diseases
• Fear of strangers
• Fear of sex, due to failures
• Fear or change of environments due to strange places, loneliness, hospital stay, etc.
• Fear of any other cause

Diseases which often cause sleeplessness

• Nervous disorders – Any nervous stimulation of reticular system will disturb the person and keep him/her awake. Any lesion of mid pontine area which separates lower portions from cortex will prevent going to sleep, causing complete sleeplessness.
• Respiratory disorders – Any breathing difficulty can cause arousal from sleep
• Circulatory disorders – lack of oxygen, due to poor circulation

Symptoms of sleeplessness

• Sufferer feels – time passes very slowly and finds it difficult to face nights
• Restlessness
• Frequent urination
• Thoughtfulness

Effects of sleeplessness
In children, sleeplessness can cause

• Dullness
• Lack of concentration

Behavioural changes
In adults

• Restlessness
• Psychological impairment
• Accidents in case of restless, waking drivers
• Violent behaviour
• Suicidal tendency
• Leads to rewinding the thoughts of the day and finding fault with what has happened and brooding
• Losing health and wealth by spending a lot on medicines and hospitals, sometimes, loss in business too, due to lack of concentration

The complaints that can occur on sudden waking

• Palpitations
• Headache
• Giddiness
• Tiredness

Disturbances in maintaining or getting deep sleep may be due to
In children

• Habit of grinding teeth and rolling in bed
• Deliriousness – sleep talking
• Somnambulism- sleep walking
• Nose block due to adenoids or polyps
• Heavily enlarged tonsils obstructing the airway
• Coughing and wheezing at night or lying posture
• Hyperactivity – being restless, they cannot maintain a position to get sleep
• Nightmares
• Aching muscles and aching bones· Frequent urination due to urinary tract infection or bedwetting

In adults or the aged

• Frequent urination due to diabetes or urinary tract infection
• Snoring or respiratory disorders causing sleep apnoea
• Hunger pain or acid pain of peptic ulcer
• Headache
• Hypertension
• Wheezing
• Painful joints or muscles (cramps)
• Abdomen or digestive disorders
• Prostate enlargement and Priapism (persistent painful erection condition of penis)
• Cholesterol stones of gall bladder which float and obstruct the bile duct in lying posture

To get immersed in good sleep and making sleeping easy
Do’s

• Better take a walk before sleep
• Relieve tension, anxiety, fear and expect tomorrow’s dawn of brightness
• Take a warm bath
• Read mind relaxing books for sometime before sleep
• Take a light meal, if there is any digestive or abdominal disturbances
• Get treated for diseases, if any – nose block, snoring, sleep apnoea, sinuses, diabetes, urinary tract infection, psychological complaints
• Stay in comfortable position and situation to get a good start-up.

Avoid using

• Habit forming sleeping pills
• Stimulants

Sleep promoters
Natural – fruits, nuts, milk & heavy foods usually act as sleep promoters
Artificial – alcohol and drugs (tranquilizer – which calms a person’s brain without clouding consciousness, i.e. diazepam group of drugs)
Diagnosis – Being mostly psychological, diagnosing sleeplessness is very much difficult, unless patient reveals everything to the doctor. To do quality service, in an effective manner, analysis of the cause should be done in every case for removing it or getting cured. To attain easy solutions, analyse the physical and mental state of the patient with the history of the patient, from start-up of the complaints which will mostly guide the case. In case of a child, it is much more difficult to find the cause, unless there is a visual pathology or otherwise the child must be analysed in a sleep lab with EEG changes.


Treatment – In allopathy, sedative treatments (which provide tranquilizers) are given for all types of
insomniac patients. The tranquilizer works very temporarily. Also, most of the hypertensive patients, psychologically disturbed patients and diabetic patients are given sedative drugs with their routine drugs, in order to avoid tension. In the same manner, allopathic medicines used for allergic rhinitis or allergic skin diseases and cough have sedative soothing effects. Sleep disturbances related to physical problems like pain, breathlessness or psychological problems like anxiety, drug withdrawal, nightmares and depression are not analysed in detail, but given habit-forming sedatives to get temporary relief. The effects of these drugs, in due course, will diminish. Then again, to get better sleep, doctor and patient go on adding the dose and frequency of the medicines.
Likewise, all the chronic disease sufferers suffer from sleeplessness, which may be due to diseases or drug-induced. They are also given nothing but sedatives. In case of local pathology-like adenoids, tonsils, painful arthritis and cough, allopaths provide antibiotic and anti-inflammatory drugs, which work only for a week or so. After that, the complaints usually re-start. Sometimes people resort to surgery, to eliminate pathology.
Side-effects of sedative drugs – Sleeping pills always give only artificial, temporary sleep, which will not refresh us fully due to lack of REM sleep. Also, taking merely sleeping pills is just like shutting off the light, instead of removing the cause. If you are going to take sleeping pills, don’t forget your next day is going to be more sleepless than the present-day. Since patients use it as a routine, they are not aware of this symptom. If pills are prescribed for depression or other complaints, the patient can take those drugs only if they are ready to go to sleep even in the daytime, to calm themselves.
Sleepiness and drowsiness are the common side-effects. Also all sleeping pills can cause serious side-effects like tremor, stupor, coma, weakness, dizziness, clumsiness, hallucinations, confusion, depression, rashes, slow heart beat, constipation or diarrhoea and sometimes even death can occur with heavy overdoses. The sleeping pills work in all ways to make the brain dull and sleepy. So, you cannot give those drugs to children or persons whose alertness is important in learning or working (for example – drivers, pilots, etc,). Also, the most distinguishing feature of all sleeping pills is habit forming.
Homeopathic approach on sleeplessness – Sleep arises from the balance of the inhibition and arousal stimuli. First of all, calm your mind and shut all your thoughts, then sleep will not or never get away. Some people go on changing the place and positions, covering the face, legs, ears, hands and eyes, switching off the lights, etc., for getting good sleep. Every tic of the clock will alarm, trigger and wake them up. Sleep is not the matter of all those things, but it is in the calmness of the mind. Removing the actual cause could help.
Usually, in Homeopathy, the remedy is selected on the basis of symptoms of the patient, including physical, mental (emotional states, depression, anxious, etc) and family history. Homeopathy treats the patients, rather than the diseases or its effects. Homeopathy acts neurologically and helps the brain attain calmness. So it can give a permanent solution. It gives psychological support to withstand emotional conditions. Homeopathy, with its dynamic approach, can cure sleeplessness wonderfully. The major credit point with Homeopathy is its nil side-effects and also its effective cure which is permanent without any persistent usage of drugs or dependency or habit-forming.
In Homeopathy, the choice of medicine differs for early awakening, sleeping late, frequent awakening, sleeplessness after midnight or before midnight, sleeplessness at night and sleeping in the morning, etc. The complaints which recur after sudden awakening can also be cured completely. Likewise, Homeopathy considers even dreams for choosing the correct and apt medicine. There are lots and lots of medicines in Homeopathy, particularly fear of snakes, ghosts, strangers, etc., – for every type of dream, the choice of drug differs.
The ultimate secret is no magic prescription can cure all your sleeplessness, unless you reveal everything you feel, including the causative factor and take effort in removing it. So, longing for longer sleep ends here with apt Homeopathy treatment and counselling. One important thing for patients used to tranquilizers – it is better to stop it or withdraw slowly or otherwise there will be a rebound of sickness or more sleeplessness. Likewise, the stimulants should also be withdrawn slowly, under the supervision and advice of the doctor.
The results of Homeopathy treatment are not drowsiness but will be very peaceful refreshment. Homeopathic medicines commonly used in case of sleeplessness are Aconite, Arg Nit, Ars alb, Chamomilla, Gelsemium, Hyosyamus, Ignatia, Kali phos, Nat mur, Nux Vom, Opium, Passiflora, Pulsatilla, Rauwolfia, Staphysagria, Rhus Tox, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath. So, you don’t have to suffer from sleeplessness any more.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com / www.drcheena.in

(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)