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What causes sleeplessness?

Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Fri, 16 Oct 2015 in Sleep Disorders
Question: Since the last couple of months, I am not able to sleep properly. I go to bed around 11:30pm and struggle to sleep till 1:30am or 2am. Even if i sleep, i do not get a sound sleep. I wake up frequently. I do not have any tensions or problems to the extent to keep me awake. What do I need to do to get a sound sleep?
doctor
Answered by Dr. Chintan Solanki 2 hours later
Brief Answer:
need evaluation for insomnia

Detailed Answer:
Hello XXXXX,

Thanks for writing to us.

You are suffering from insomnia likely.

Insomnia (sleep disturbance) are of two types:

1. Primary: There is problem of only sleep disturbance and no other physical or psychological problem is there. In this case treatment for sleep problem is needed.

2. Secondary: There is some underlying physical or psychological problem which is responsible for sleep disturbance. In this main treatment is done for underlying problem.

First of all try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.

Medicine from Z group drugs like zolpidem is useful in difficulty in initiation of sleep.
Benzodiazepines group of drugs (clonazeapm, lorazepam, alprazolam, diazepam) are used under medical supervision for sleep problem. All are prescription medicines and must be used after consulting doctor. They can cause tolerance and dependence if used without doctor’s advice.

To help you more answer some questions.

- Since when are you suffering from this problem exactly?

- How did problem start? Any specific incidence or gradually on its own?

- I also want to clarify again though you mentioned if any stress in your life is there?

- Do you have any physical illness?

- Let me know your daily schedule in brief.

- What is your occupation and office timing?

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 17 minutes later
Hello Doctor,

Thank you for your prompt reply. Below are the answers to the queries asked by you:

- Since when are you suffering from this problem exactly? - It has been recent 2 months since I have been struggling to fall asleep and this problem has become prominent. I have a problem since childhood that I get awakened even with slightest of noise and that is the reason I do not even have a clock in my bedroom. If somebody is snoring, i cannot sleep. I become all the more conscious of this noise if I am struggling to sleep.

- How did problem start? Any specific incidence or gradually on its own? - I initially fall asleep and then a slight noise of anything will wake me up. I sometimes even wake up with my own snoring noise. As mentioned above, I have always been sensitive to noise since childhood but now since 2 months it seems to be aggravated. I get a itching feeling over the body sometimes like some small insect might be biting or is moving over my body. But whenever I check, there is nothing. However, late I sleep if the kids wake up, i also wake up.

- I also want to clarify again though you mentioned if any stress in your life is there? - The only stress sometimes I face is managing finances with ad hoc expenses. However, that was a more prevalent problem a year ago. Now I am well placed with a job change.

- Do you have any physical illness? - Nothing apart from diabetes. However, I am prone to frequent cold.

- Let me know your daily schedule in brief - I wake up around 6:30-7am in the morning. Then have some tea and biscuits and read newspaper. The around 8:30am I go to the gym for 1 hour. Post that, I start getting ready for office. The cab reaches my house at 11:30am and then I go to office. I am in office for 9 hours. I have dinner in office itself and reach home by 10:30pm. Then watch TV and chat with my wife for some 45 minutes and go to bed at 11:30pm

- What is your occupation and office timing? - I work as a Manager in a Software company. My office timing is 12:30pm to 9:30pm.
doctor
Answered by Dr. Chintan Solanki 5 hours later
Brief Answer:
need polysomnography, likely primary insomnia

Detailed Answer:
Hello,

Thanks for answers.

You do not get deep sleep adequately likely. Actually one sleep cycle is divided in four stages. And during whole night 4-5 sleep cycles are there. You mentioned that you wake up with slight noise. This needs to be checked with help of polysomnography in which sleep eeg is done during whole night. This investigation will help in ruling out any other sleep disorder.

Reason for frequent common cold is likely sinusitis or allergy. It may affect quality of sleep. Anti allergic medicines can help in both sleep and common cold. Consultation of ENT specialist will help in this regard.

As such there is no likely cause in your history which suggests secondary insomnia. Possibility of primary insomnia is likely.
Try non-medical approach as I mentioned in previous answer for a week and if no success consult psychiatrist for evaluation and medicinal treatment.

I guess that your diabetes in control.

Feel free to ask if you have any more questions.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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