Is India sleeping enough? Why insomnia is a growing public health threat

There is a health concern unfolding across India each night, often without visible symptoms, and it is not receiving the attention it deserves. Insomnia, defined as the persistent difficulty in falling or staying asleep, is steadily emerging as a significant public health issue across the world.

Studies indicate that nearly one in three adults experience symptoms of insomnia, while a smaller but important proportion live with chronic sleep disorders that affect daily functioning. In India, it is not uncommon for individuals to consult a physician promptly for a persistent cough, yet endure months of poor sleep without seeking care. As a result, sleep disorders remain among the most under-recognised and under-treated conditions.

The World Health Organization is increasingly focusing on non-communicable diseases, and India has one of the largest burdens of these conditions. While most of us think of obesity, hypertension, diabetes, heart disease and cancer, sleep disorders are often overlooked. Yet they are more common than many of these conditions and can significantly worsen these co-morbidities.

This is an area that calls for greater awareness and timely intervention. It is critical as sleep is not a passive state. It is one of the most physiologically active phases of the human body. During sleep, the brain consolidates memory, clears metabolic waste and regulates hormones that influence immunity, metabolism and emotional stability. Over time, inadequate sleep can increase the risk of cardiovascular disease, type 2 diabetes, obesity, anxiety and depression.

The science underlying this is unambiguous and well-established. At the centre of sleep regulation is the circadian rhythm, the body’s internal 24-hour clock that governs processes ranging from melatonin release to core body temperature. When this system is aligned, sleep occurs naturally and the body wakes feeling restored. However, modern lifestyle is placing this delicate balance under strain. Late-night screen exposure can suppress melatonin production. Irregular shift work can disrupt alignment between the biological clock and the external environment. Urban stress can keep the nervous system in a state of persistent alertness that interferes with deep, restorative sleep. Social media platforms, designed to sustain engagement, are also extending wakefulness beyond what the body would naturally accommodate. These are not merely lifestyle choices, but factors with clinical implications.

Young Indians are particularly affected. Academic pressures, competitive professional environment and high levels of digital engagement are contributing to a rise in sleep disturbances among adolescents and young professionals. This is an area that is still being studied, yet the potential long-term implications for public health are considerable. At Apollo Hospitals, we recognised early that sleep medicine must move beyond being a niche sub-speciality. The Institute of Sleep Health at Apollo Speciality Hospitals in Chennai is among the country’s dedicated multidisciplinary centres for sleep care. It brings together pulmonologists, neurologists, psychologists and dental specialists to diagnose and treat a wide spectrum of sleep disorders.

However, there is a growing need for broader systemic change. Sleep assessments can be more routinely integrated into clinical practice. Public health communication can also begin to accord sleep the same importance as nutrition and physical activity.

In the relentless pace of contemporary life, sleep is often the first thing we sacrifice. Science is emphatic that this is a false economy. Rest is not a reward for productivity; it is the biological foundation that makes productivity possible. Protecting sleep is not a wellness trend, but a public health imperative.

Dr Preetha Reddy is Executive Vice Chairperson of Apollo Hospitals Enterprise Limited.