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Tossing and turning through the wee hours of the night is a familiar experience for me. Over the years, I’ve become accustomed to having poor quality sleep. And whenever I strike up a conversation on the topic, I hear accounts of other people who live through the same scenario. It’s almost as if hard-working people are expected to experience sleep deprivation. 

This may be one of the reasons why a study was done on sleep-related disorders in India, found that 9% of the general population suffers from chronic insomnia and about 30% experience occasional cases. But normalizing insomnia isn’t going to change the negative impact it has on people’s health.

Why sleep continues to elude us

Before I jumped into correcting my sleep pattern, I needed to figure out why something as basic as sleep came so hard to insomniacs like myself. Most people experience acute cases of insomnia through their life, which is usually triggered by the stress from certain events. But when sleeplessness becomes a regular part of your life like it has with me, you’d have to look further to figure out the reason behind this. 

Some of the common reasons we all know for sleepless nights are continued stress, disruptions due to travel or work schedules, and poor sleep habits such as irregular bedtimes or uncomfortable sleep settings. Eating too much close to your bedtime can also make it harder to fall asleep. All these are aspects that make your body work overtime and make it hard for it to wind down for the night. Common culprits like caffeine, nicotine or alcohol are also stimulants that can wreak havoc on your body and interfere with your sleep. 

Chronic insomnia could also be indicative of medical conditions, medication interactions and even mental health concerns like depression and PTSD. Getting these underlying causes treated could drastically improve your sleep quality and duration. 

As a 25-year-old professional, I knew my unhealthy lifestyle is probably the reason for my insomnia. But for a lot of people living with chronic ailments like asthma, blood pressure or chronic pain, diabetes, thyroid issues and such, their disease can be the reason for their sleeplessness. They could also be experiencing sleep-related disorders like sleep apnea, or restless leg syndrome that came with these chronic ailments. 

Most of these factors that affect our sleep can actually be treated by getting the help one needs in time. If one could amount all these problems to a common factor, that would be the lack of awareness regarding healthy sleep in India. According to studies, the awareness of sleep disorders are abysmally low in the nation, leading to further problems.

How to sleep better 101

Once I started doing my research into my insomnia, I started realizing all the little things that were affecting my sleep negatively – how my long work hours and the third cup of coffee could be the reason why I couldn’t get a good 8 hours of sleep. 

But finding a reason for it wasn’t good enough. I had to try out all the tricks in the book to improve my sleep too. 

The first practice I was recommended by many, was to improve my sleep hygiene. According to the sleep foundation, this means cultivating the best bedtime habits and daily practices to ensure uninterrupted sleep, from which you wake up feeling refreshed. Improving sleep hygiene is about being mindful and setting intentions with regard to your sleep. Some of the things that I tried to do was: 

• Make sleep a priority – We are often tempted to forgo sleep to work, study or even socialize. But sleep is vital to our wellbeing and it needs to be given its due. I made sure to calculate the ideal number of hours of sleep that I needed to wake up feeling refreshed and I started working on achieving this.
• Know when to wake up – Having a fixed wakeup time can go a long way in maintaining your circadian rhythm. I started waking up at the same time through the week, whether I was working or not and this went a long way in correcting my sleep schedule and quality.
• Make gradual changes – It’s not possible to change your routine in a single go. I tried to make the change that I needed by going to bed an hour earlier and waking up an hour earlier. This gradual change helped me adjust to my new and healthier lifestyle.
• Avoid stimulus – When we’re accustomed to spending hours browsing our phones or watching television to fall asleep, we often forget that these stimuli work against you and your sleep. I had my usual routine of watching youtube videos before sleeping, but I started reading instead of this, as electronic devices can cause mental stimulation that makes it impossible for our minds to wind down for the night.
• Optimize your bedroom – Your sleep environment is just as important as your sleep time routines. Make sure that you make your bedroom cosy with comfortable bedding, set it to the perfect temperature for sleeping, block out any lights from coming in, drown out any distracting sounds with a noise machine and relax your mind with calming scents.

For those who’ve lived with very poor sleep hygiene, these simple practices could make a huge improvement in their sleep. But for me, they were not enough. There were still problems with my sleep quality. I’d wake up after 4 hours of sleep and struggle to go back to bed. This is when I realized that I needed to do much more than tending to my sleep hygiene – I needed professional help. 

 

Getting professional help for insomnia

Now that I’d made up my mind to get help with my insomnia, I realized that I couldn’t find a specialist for this purpose in India. Sleep labs and specialists are not a known concept in India and I ended up turning to the next best thing – my therapist. 

Dealing with depression had opened me up to the concept of psychiatrists and with my sleep troubles as well, he came to my rescue. When I started going to therapy, I was asked to completely overhaul my lifestyle. From my sleep hygiene to my screentime, everything had to change and this helped for a little while until it didn’t. 

But when sleep continued to elude me, my therapist suggested that I seek out more intensive solutions to my troubles. He prescribed a pill that could help put me to sleep and would keep me asleep through the night. When I started taking the medicine, I was blown away by the immediate change I could experience. No more tossing and turning!

While sleeping pills got the job done, they were not a sustainable solution to a bigger lifestyle problem. Soon enough, the sleeping pills started making me lethargic even during the day. And I realized that I had to find a non-medication alternative. There were many people who could fix their sleep by using these pills and they worked for them without any problems. But that wasn’t the case with me. So I had a long conversation with my doctor weighing the pros and cons of staying on sleep medication and decided to gradually wean off the pills and find a more holistic approach.

This is what led me to discover CBT-I or cognitive behavioural therapy for insomnia. This treatment, according to the sleep foundation,  is focused on changing sleep habits and associated factors and also addresses misconceptions that could worsen sleep quality. This method is considered the safest and effective to manage insomnia and reduce all the associated problems that came with it. 

Just like all behavioural therapy, CBT-I involves regular visits with a specialist, who’d ask a patient to track their sleep, provide sleep quality assessments and work with them to change their sleep for the better. But living in a smaller town, it wasn’t possible for me to find a specialised therapist who offered this service.

But there are a number of online programs that offer CBT-I sessions. While they required a lot of self-discipline, they were an effective long-term solution to a problem that had troubled me for years. The sessions included practising sleep restriction, where I wasn’t allowed to nap during the day or go to bed too early so that I could stay asleep through the night. Stimulus control instructions is another aspect of CBT-I that analyzed possible points where my habits contributed to my insomnia and addressed them. But the most important aspect was sleep hygiene education where my sleep diary was analyzed and I was provided with custom practices that could address the lifestyle habits that worsened my insomnia. This included watching the time go by, as I tried to fall asleep and spending time on my mobile phone to distract myself. 

Most importantly CBT-I equipped me with techniques for Relapse Prevention where I was taught how to stay true to my therapy and continued to practice them. While there were instances of falling off the wagon sometimes, it has become much easier for me to get back into the routine, as opposed to earlier where one sleepless night could lead to months of insomnia. 

While I seeked out a remote consultation with a doctor for my CBT-I sessions, there are also online courses on popular learning platforms where CBT-I courses are taught. While they may not be as customized as a doctor’s session, they will go a long way in better educating you about your sleep and lifestyle.

Winding down…

After living with insomnia for years, it was hard to comprehend the fact that the right treatment could help cultivate healthy habits in just a few weeks. But focused therapy has done an amazing job in assisting me to better know myself, my habits and improve them to maximize my well-being. 

While many people take their sound sleep for granted, a lot of people continue to struggle every night to get enough sleep. But there are a number of ways – from good sleep hygiene to sleeping pills – that can boost healthy slumber. 

If all else fails, turn to a sustainable solution like CBT-I where you will learn more about your lifestyle habits and tweak it to improve your sleep, your energy and even your overall health.

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