Health

Sleepless Nights

Millions of people suffer from insomnia, a sleep disorder difficult to cure. The young and the elderly are particularly affected and with the increasing number of distractions in life, sleeplessness is difficult to shake.

Soraya Auer

With a gentle swaying motion, Sultana Haque's six-month-old son is falling asleep. She has him tightly wrapped up in a blanket with her orna covering his face so his inquisitive eyes stop searching around the bedroom. “Mithun is a good sleeper,” says the 29-year-old mother quietly. “It's me who has the messed up sleep pattern – and it didn't start because my baby began crying at night.”

Since she was 17 years old Sultana has suffered from insomnia, which is trouble falling asleep or staying asleep through the night. “If I stay up past a certain point, I just can't sleep,” she explains. “When I was at school or university, I'd stay up past that point because of an essay or exam. Now, the baby wakes me through the night so if I'm woken after around 2am, there's just no more sleeping for me.”

With an estimated 20 million Bangladeshis suffering from sleeping problems (according to Rightdiagonosis.com), Sultana's experience is not unique. Anyone can suffer from the sleep disorder and something as simple as having a light on can result in a sleepless night. Teenagers and young adults are particularly famous for staying up into the early hours. Their insomnia is somewhat self created but no less serious than those who can never sleep despite wanting to.

“It's very important for someone to get a full night's sleep and know how to sleep,” says Dr Shamim Matin Chowdhury, a psychiatrist who specialises in treating children and young adults. “If someone doesn't sleep well, they can't work or perform well. They will feel bad, depressed and the feeling of hopelessness will create a vicious cycle of more sleeplessness.”

Dr Chowdhury explains, “Your body's biological clock needs to tell you to sleep at a certain time and if you don't, your clock is disturbed and you remain awake when you should sleep, and fall asleep when you should be awake.”

There are different types of the sleep disorder; transient insomnia lasts for less than a week and is often a symptom of another problem; acute or short-term insomnia affects a person for less than a month and is often related to stress; and chronic insomnia which can be a symptom of something else or the primary condition. In the worst cases, chronic insomnia has been known to cause sufferers muscular fatigue, hallucinations, mental fatigue and double vision.

Ayon Ahmed (not his real name) says he cried a lot during his bouts of insomnia, mostly out of frustration. “When it got really bad, it wasn't uncommon for me to have 'light' hallucinations,” says the 23-year-old professional. “Insomnia shapes your life whilst you're in its grip. I was not fun when I had a bout of chronic insomnia. I wouldn't want to have friends around me. I had little to say, I was often in a foul mood. It also changes your perception of life.”

Ayon began suffering from insomnia from the age of eight. “I was a restless kid even when I was young, I'd always be up longer than the other kids anyway and it just got worse and worse.” His mother would stay in his room to help him feel settled as he tried to sleep, but sometimes he would still be awake when she came to wake him in the morning.

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“It definitely affected my education,” claims Ayon, who genuinely wanted to and enjoyed learning. “I could never properly concentrate. I'd get to the end of a class and not really be sure what had been going on. Presumably I actually occasionally 'slept' with my eyes open.”

Like Ayon, Bilquis Khan, a retired interpreter, says there are nights she just knows she won't fall asleep. “If I sleep tonight, I know I won't sleep tomorrow. It affects me on alternate nights. I can't lie in bed, it's like someone's pushing me around.” Bilquis spends her restless nights watching TV, reading or walking on the roof. “I look after my grandchildren and mother during the day, I'm busy but it still doesn't make me tired enough to sleep.” She adds, “My mind stays very active.”

“Insomnia is very prominent among young people and elderly people,” says Dr Chowdhury. She explains that the older one gets, the less sleep the body needs and how sometimes this causes insomnia. “Doctors prescribe sleeping pills to older people and avoid giving it to the younger. We wouldn't want a teenager to be addicted or dependent on sleeping pills. Older people don't get addicted as they are always looking to take less medication or avoid it altogether.”

Sultana may not be very old but she has tried to stay away from medications. “A few years ago I had a really bad patch of insomnia so I took some sleeping pills. It was great because it knocked me out but the next day, I was groggy.”

Bilquis, who has suffered chronic insomnia for at least eight years, says she's been looking for a quick fix. “I have no idea what to do. I'm lazy so if it doesn't work for me within a few days, I just give up.” She attempted taking sleeping pills but says, “as soon as I left the medication, it was the same problem all over again, it was of no help. I don't think there's a treatment that will cure it so I'm just used to it.”

As insomnia is both a symptom and a condition, treating the sleep disorder can be a challenge for doctors and psychiatrists. As a symptom, it can help doctors give a successful diagnosis. But as a stand-alone condition, however, insomnia is harder to treat. Ayon, for example, tried hypnosis, including self-hypnosis, valerian root in several forms, meditation, diets, medication, various herbal remedies, and just plain exhausting himself. He says polyphasic sleep, the practice of sleeping multiple times in a day for short periods, helped but it was difficult to stick to and often inconvenient.

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“When someone isn't sleeping you have to look at their whole life to diagnosis and treat them properly. What and when are they eating, what exercise they are doing and so on,” says Dr Chowdhury. In reference to young people particularly, the psychiatrist says, “it's because of the very troubled lives they lead, what with social pressures, education, pressures from the family and personal issues that young people suffer from insomnia.

“We try to give them counselling for how to cope with life, how to relax, how to take things as they come and how to sleep through reading or hypnosis.”

While Sultana and Bilquis have not managed to shake off their sleepless nights, Ayon, after almost 15 years, has found a way to manage and keep insomnia at bay.

“For me, the cure was a dose of 3mg of melatonin before bed every night, regular exercise, a good diet and not being a teenager, all supplemented with a bi-monthly dose of temazepan. Having a significant other who's really patient has helped as well.” Ayon adds, “I don't know whether my current 'formula' will work forever. I'm just grateful it's working right now.”

 

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