Health: A sleep specialist flips her new book to help Mumbaikars with sleep issues

Updated: Nov 17, 2016, 15:54 IST | Snigdha Hasan

With the ever-swelling number of sleep sufferers she came across in her practice, Dr Bhatia, director of sleep medicine at the Neurology Sleep Centre in Delhi, felt it was time she put her 20 years of research to paper

It deserves a third of our day with no compromise. It heals, restores and rejuvenates the mind and body. It keeps our weight in check and skin sparkling. And yet, “in the tripod of health, along with food and exercise,” as Dr Manvir Bhatia says, this leg is the most ignored and abused. With a lethal cocktail of unhealthy lifestyle, odd working hours and addiction to technology, a good night’s sleep has become the biggest casualty of the 21st century.

Dr Manvir Bhatia
Dr Manvir Bhatia

With the ever-swelling number of sleep sufferers she came across in her practice, Dr Bhatia, director of sleep medicine at the Neurology Sleep Centre in Delhi, felt it was time she put her 20 years of research to paper. The result was The Sleep Solution (Penguin Random House), a new title that explains sleep as a physiological process; defines sleep disorders; and provides solutions with a step-by-step guide to a healthy sleep routine.

We spoke to five Mumbaikars, and put across their sleep problems to Dr Bhatia, who delved into her research to offer a solution. We hope sleep never eludes you, but if it does, help’s here.

Ayesha Bachaw, 22 years, PR executive
I can’t fall asleep for anywhere between 30 minutes and two hours after going to bed. I then wake up every night at around 2 am and can’t go back to sleep easily. And I need to get up at 7.30 am.

Dr Bhatia: Your problem seems like a typical case of sleep onset insomnia and fragmented sleep. The first approach to any sleep sufferer’s problem would be to take a 24X7 history, where I would gain an understanding of all that you do after waking up and before falling asleep. Remember, insomnia is a combination of a bad night followed by a bad day, resulting in headache, body ache, fatigue, boredom, etc. Caffeine intake is another consideration. In your case, I’d recommend no coffee at all (it lingers in the blood for six to eight hours) and no tea after 5 pm.

Also, what is the last thing that you do before switching the lights off? Do you allow your mind and body to transit into sleep with a winding down routine? Lie down only when you feel sleepy, and if you still wake up, move to another room and listen to soothing music, read something light or do anything that relaxes you until you feel drowsy again.

Priyank Sheth, 38 years, IT professional
I go to bed at 10, but sleep often eludes me until 4 am. I’ve tried Ayurvedic medicines and yoga. But nothing helps.

Dr Bhatia: This is a case of sleep state misperception. Your bedtime is 4 am indeed and until we set it right, it’s important that you get your seven to eight hours of sleep, which means moving your waking time forward. A lot of people feel they can do with little sleep, but it has long-term consequences. Also, any form of exercise should be wound up three to four hours before bedtime and dinner must be taken two hours before you sleep. Switch off all gadgets 30 minutes before going to bed.

Sleeping pills are the last resort and a lot can be done before that. Keep in mind that nothing changes overnight. You have to be patient and follow every step of the sleep routine — which begins soon after you wake up — diligently.

Aashish Sawant, 40 years, IT engineer
I have worked off and on in the night shift for 16 years. Earlier, I would come home in the morning and get my quota of sleep, but now I work in the day shift, where I leave office by 11 pm. I have a light dinner in office, and don’t eat anything on reaching home. I fall asleep by 1 am, but wake up by 7. I often feel tired, and at times, while driving to office, I’ve dozed off at the wheel.

Dr Bhatia: Your biological clock has been set according to your night shift, which you are still finding difficult to break. Fragmented sleep often results in snoring and weight gain. Is that the case with you? Also, coffee is a no-no. I would recommend a night sleep study, where your sleeping pattern and other body parameters will be measured. To prolong your sleep cycle and set it right, certain medication may be required for a limited period, when prescribed by a doctor.

Also, if very sleepy, take a short nap, and avoid driving or doing any task, which can lead to injuries.

Isha Chawla, 32 years, homemaker and mother of a 5-year-old
My bedtime is often not before 2 am. The slightest noise disturbs me, and my immediate response is to start checking my phone. I need to be up by 7 am for my son’s school. When I have time in the noon for a siesta, I can’t sleep.

Dr Bhatia: You are a light sleeper, and are able to hear ambient sounds in your sleep because you find it tough to enter the deep stage of sleep, which is also crucial to feeling rested.

Your urge to check your phone reminds me of a 15-year-old whose mother approached me because of her mood changes and a steep increase in weight. She would be on her phone till 4 am and wake up by 7. Using gadgets in bed is an absolute no as it stimulates the mind and the light emanating from them suppresses melatonin, the sleep hormone.

For sound sleep, the mind must be relaxed and the body, tired. If you take your child to the park in the evening, it could be a window to do some walking or exercises yourself.

Archana Choudhary, 27 years, HR professional
I get sufficient sleep, but dream through the night. So, when I wake up, it seems like I never slept and I am tired. Many thoughts run through my mind and I find it tough to keep them at bay.

Dr Bhatia: Some sleepers recap the happenings of the day or plan for the following day when in bed, which is not ideal. The winding down period, as I advised Ayesha, is what helps calm a racing mind, and breaks the cycle of thoughts. You could try taking a warm shower, sip on a warm cup of water infused with cinnamon, mint or chamomile, practise yogasanas, engage in light conversation with family members or try aromatherapy before bed.

Take a sleep test
1. Are you a loud, habitual snorer?
2. Do you have choking/difficulty in breathing at night?
3. Do you regularly feel tired, even after waking up from a full night’s sleep?
4. Do you fall asleep while reading, driving or at home during the day?
5. Are you satisfied with your sleep?
6. Do you have difficulty in falling asleep?
7. Do you take sleeping pills?
8. Do you have difficulty in maintaining your weight?
9. Do you have pain in your legs when lying down?
10. Do you have to go to the bathroom frequently at night?
11. Do you have high blood pressure/ diabetes?
If you have answered ‘yes’ to two or more questions, it could be a symptom of a sleep disorder.

Why is shut-eye important?
1. We are not in one constant state of sleep the whole night.
2. Sleep is divided into parts, depending on its varying depths.
3. REM sleep is devoted largely to brain repair and restoration, while NREM sleep is when the body repairs and restores itself.
4. To feel refreshed upon waking up, it is essential not only to have an adequate duration, i.e. seven to eight hours, of sleep, but also spend adequate time in each stage of sleep.

How many hours do you need?
Newborns (0–2 months): 12–18 hours
Infants (3–11 months): 14–15 hours
Toddlers (1–3 years): 12–14 hours
Pre-schoolers (3–5 years): 11–13 hours
Young children (5–10 years): 10–11 hours
Adolescents (10–17 years): 8.5–9.25 hours
Adults: 7–9 hours

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