Sleep, the dark sea that I struggle to cross every night, leaves me exhausted. The dreamless, never-ending nights fill me with dread.
I drifted off to sleep in the wee hours of morning, only to be woken up by the scary scream of a woman in a nearby slum. I said a little prayer for her and tried to go back to sleep. A stray dog that would not stop barking kept me awake.
They say counting sheep helps you fall asleep. I try that, only to be reminded of a loved one whom I had lost recently―one who kept lambs as pets. And I am wide awake.
An insomniac’s nights are dull and dreary. So are their days.
I was a bit anxious as I headed to the sleep lab in Apollo Hospitals at Bannerghatta, Bengaluru. Someone who cannot sleep at home may find it even harder to fall asleep in a lab, with electrodes attached to your body.
It turned out that my thinking was partially wrong.
Dhanush B., the technician at Apollo’s sleep lab, insisted that I have my dinner at 7:30pm. I ended up skipping it, as I had to catch up with a group of friends after work. I had two cups of coffee in the evening.
I reached the lab by 8:30pm. As I was preparing for polysomnography, a study used to detect sleep disorders, Dhanush walked me through the process. He answered my queries patiently, some of which I guess were annoying.
Dhanush then made me fill up a questionnaire. There were questions on body mass index, neck circumference, usual sleep habits, sleep complaints, daytime sleepiness, etc. The questionnaire also looks at one’s medical history.
Part two of the questionnaire deals with causes of sleep loss. I ticked two of the 17 statements―‘my sleep routine differs each day’ and ‘I drink coffee in the evening’. The other causes of sleep disorders listed in the segment included changing shifts at work, sleeping with lights on or in a noisy environment, and a bed partner who disrupts sleep. (My partner sleeps soundly, making me envious every single night!) Then there are questions that look at the subject’s state of mind.
Dhanush allowed me to freshen up and unwind for a while. He told me not to use gadgets while I prepared to sleep.
The lab was clean and quiet. I lay down on the bed. Dhanush attached electrodes to my head, chin, hands and legs. Some were to be attached on my chest and ribs. He told me I could take help from a female technician if I wanted. I preferred to connect them on my own. He came back after a few minutes, and I was all set for a good night’s sleep.
It took me a long time to fall asleep. I kept tossing and turning. I remembered having read somewhere that the time one takes to get to sleep is known as sleep latency.
I missed my phone badly. Somewhere in the middle of the night, I fall asleep. A few minutes or hours later, I shook my legs violently. Dhanush, who was monitoring the screen in the other room, came in and asked me whether I was okay.
I was tired when I woke up.
At 10:30am, I got my sleep report. My sleep efficiency (the ratio of total sleep time to time in bed) of 52 per cent was interpreted as poor. “A sleep efficiency rating of 80 per cent or above is considered normal,” said Dr Narendra U., consultant at Apollo Hospitals, Bannerghatta.
Insomnia is when the individual is unable to initiate as well as maintain sleep, said Dr Sumant Mantri, senior consultant at Apollo Hospitals. Anxiety is the most common cause of insomnia, he added. I told him that I find it hard to get to sleep even on days when I am happy. He said there could be something at the back of my mind. “Depression, diabetes, cardiac and respiratory diseases also can contribute to insomnia,” he said.
Individuals who do not get enough sleep should get a proper evaluation done, said Mantri. They should also practise sleep hygiene―a set of sleep rituals or healthy habits that help one get a good night’s sleep. “Keep your bedroom quiet, dark and comfortable. Do not use the space for eating. Make it a point not to work from bed,” said Mantri.
Ditch your gadgets at least one and a half hours before bed. “LED and LCD screens emit blue light, which decrease the melatonin secretion in the system. That could keep you awake at night. Melatonin is the sleep-inducing hormone. Deficiency in melatonin can lead to insomnia,” said Mantri. Treatment for insomnia includes melatonin supplementation.
Not getting enough exposure to sunlight can disrupt your circadian rhythm, leading to sleep problems. Insomnia caused by circadian rhythm disorders are common among those who work the night shift, explained Mantri. “As long as a person does not have daytime sleepiness, there is no cause for concern,” he said.
Sleep study is useful for people with sleep disorders like obstructive sleep apnoea, insomnia, and restless leg syndrome. It helps assess leg movements, oxygen saturation levels, etc.
There are four types of sleep study. Level 4 detects oxygen level. Level 3 is used for detecting apnoeas. Level 1 and 2 are almost similar―the former is conducted in a sleep lab, and the latter is done in a home-based setting. They usually include video recordings as well. Level 1 helps detect and quantify obstructive sleep apnoea, restless leg syndrome, seizure-like episodes and insomnia.
I underwent a Level 1 study, which uses ECG and EEG recordings. Chest belts are used to see chest expansion during apnoeas. Air flow from the nose is also assessed, and drop in oxygen during apnoeas are detected using the pulse oxymeter.
The Level 1 study costs Rs14,000.