The term insomnia literally denotes a complete lack of sleep. It is, however, used to indicate a relative inability to sleep that consists of difficulty in falling asleep, difficulty in staying asleep, early awakening or a combination of any of these complaints. Insomnia deprives the person of mental rest and thereby interferes with his activities in the day time. It constitutes a severe health hazard when it becomes a habit.
Sleep is a periodic state of rest for the body which is absolutely essential for its efficient functioning. It is the indispensable condition to the recuperation of energy. It gives relief from tension, rests the brain and body and a person wakes up in the morning fresh and relaxed. Sleep has been aptly called the " balm of hurt minds and the most cheering restorative of tired bodies. "
The amount of sleep varies within very wide limits from individual to individual. Normally, seven to eight hours of sleep every night is adequate for most people. Some, however, do well with four to five hours because their sleep is deeper and more refreshing.
Insomnia is common among the elderly for a variety of reasons. The sleep of the elderly is often punctuated by brief periods of wakefulness during the night. IN such cases it is the quality rather than the quantity which is most affected. With age, there is a gradual reduction of period of deep sleep. Sleep requirements also diminish with ageing. From nine hours of sleep per night at the age of 12 the average sleep needs decrease to eight hours at the age of 20 , seven hours at 40, 6 1/2 hours at 60 and 6 hours at 80.
Although difficulty in staying asleep is the most common type of insomnia, the single symptom that most frequently makes the onset of insomnia is the difficulty in falling asleep. The signs of pathological insomnia are dramatic changes in the duration and quality of sleep, persistent changes in sleep patterns, lapses of memory and lack of concentration during the day. Other symptoms are emotional instability, loss of coordination, confusion and a lingering feeling of indifference.
The most common cause of sleeplessness is mental tension brought about by anxiety, worries, overwork and overexcitment. Suppressed feelings of resentment, anger and bitterness may also cause insomnia. Constipation, dyspepsia, overeating at night, excessive intake of starches, sweets, tea or coffee and going to bed hungry are among the other causes. Smoking is another unsuspected cause of insomnia as it irritates the nervous system, especially the nerves of the digestive system. Environment factors such as overcrowding, excessive noise and poor bedding or housing conditions may also lead to transient sleep difficulties. Often, worrying about falling asleep is enough to keep one awake.
Sleeping pills are no remedy for sleeplessness. They are habit-forming and become less effective when taken continuously. The side-effects of sleeping pills include indigestion, skin rashes, lowered resistance to infection, circulatory and respiratory problems, poor appetite, high blood pressure , kidney and liver problems and mental confusion.
Diet is an important factor in the treatment of insomnia. Research has shown that people with chronic insomnia almost have marked deficiencies of such key nutrients as B-complex vitamins and vitamin C and D as also calcium, magnesium , manganese, potassium and zinc. The sleep mechanism is unable to function efficiently unless each of these nutrients is present in adequate amounts in the diet.
Of the various food elements, thiamine or vitamin B1 is of special significance. It is vital for strong, healthy nerves. A body starved for thiamine over a long period will be unable to relax sufficiently to induce natural sleep. The valuable sources of this vitamin are whole grain cereals, pulses and nuts.
A balanced diet with simple modifications in the eating pattern will go a long way in the treatment of insomnia. Such diet should exclude white four products, sugar and its products, tea, coffee, chocolate, cola drinks, alcohol, fatty foods, fried foods, foods containing additives, preservatives, colouring and flavouring, excessive use of salt and strong condiments.
The patient may adopt an all-fruit diet for three or four days at the beginning of the treatment. In this regimen, he should have three meals a day of fresh juicy fruits such as oranges, grapes, apples, pears, peaches, and pineapples .This will help cleanse the blood stream and relieve possible digestive and intestinal disturbances. The bowels should be cleansed daily with a warm water enema during this period.
After the all-fruit diet, the patient may follow a modified eating pattern in which breakfast should consist of fresh and dried fruits, seeds and yogurt. Of the two main meals, one should consist of a large mixed salad and the other should be protein based. A cup of milk sweetened with honey at bedtime is helpful as the amino acid tryptophan contained in the milk induces sleep. Celery is also considered beneficial in the treatment of insomnia. Its characteristic small arising from the concentration of plant hormones and essential oils induce sleep.
Taking meals late in the night often leads to sleeplessness. The sufferer from insomnia should, therefore, eat his last meal at least three hours before going to bed. Food should never be taken when one is emotionally disturbed or suffering from fatigue or acute depression as it will result in gastric discomfort. Those suffering from insomnia should always take meals in a relaxed atmosphere. This is important at any time of the day, but more especially at night.
Along with dietary treatment, other effective measures should also be adopted to overcome the problem. These include application of hot fomentation to the spine, hot foot bath or an alternate hot and cold foot bath and prolonged neutral immersion bath ( 92 o to 96 o F) at bedtime.
All efforts should also be made to eliminate as many stress factors as possible. The steps in this direction should include regular practice of any relaxation method or meditation technique, cultivating the art of doing thing slowly, particularly activities like eating, walking and talking, limiting the working day to nine or ten hours, and 5 1/2 days weekly, cultivating a creative hobby and spending some time daily on this.