Why having a night-time routine is a MUST for those who have trouble sleeping

I’ve been having trouble sleeping. It’s been weeks of waking up with breathlessness and a racing heartbeat several times through the night. And it’s exhausting and frustrating to say the least. The anxiety, improper sleep schedule and erratic lifestyle I lead became so overwhelming to me that I convinced myself taking sleeping pills was the only way out.

I’m not alone on this for sure. A recent ResMed commissioned study suggested that a huge 55% of Indians face trouble sleeping at least three times a week, and only 21 per cent of the surveyed population wake up feeling fresh. With the way our lives our going (unchecked and sleep deprived), according to Dr Susheel Bindroo, Director, Interventional Pulmonologist, Sir HN Reliance Foundation Hospital, India will soon be the world’s capital for sleep disorders. Clearly, it’s time to take stock of the situation. If you suffer like I do, here are a few tips that can help.

Several factors cause it  

Looking for a comfortable position on an uncomfortable mattress? Are you surrounded by bright lights and loud noises at night? Do you indulge in scrolling through your phone or any other device at bedtime? If so, chances are, all these habits may be causing sleep trouble. Using the screen, or consuming caffeine can keep your mind stimulated for long-hours, when it’s actually supposed to wind down and rest. Other triggers can also be attributed to causing sleep disorders. These can be physiological and pathological causes. Dr Bindroo elaborated: “People can have trouble sleeping when the sleep pattern gets disturbed. This is usually due to a lack of discipline because of work schedules, stress, or if you do not follow a regularised lifestyle.”  

Of these factors, stress is unavoidable. We live in a world where mental health issues such as stress, anxiety and depression have become exceedingly normal and a part of our daily lives. A survey conducted by India's National Institute of Mental Health and Neurosciences sheds lights on this. As per its 2022 survey, nearly 150 million Indians are in need of mental health services. Another study conducted by the the Centre of Healing in Delhi, stated that as of 2020, 88 percent of Indians suffered from stress and anxiety. The number has only increased since.

It’s also a vicious cycle where over time, it seems like the cause and effect are interconnected with one another. In the ResMed survey mentioned above, 81 per cent agreed that poor sleep negatively affects one quality of life. Around 24 per cent of people who struggled with poor sleep also stated that it affects their emotional state throughout the day. Anxiety can be coupled with one or more triggers too. According to Consultant Psychiatrist and Psychotherapist Dr Renu Sheth, trouble sleeping can also be attributed to, “Consuming drinks like tea, coffee, alcohol, stimulant drugs, etc. just before or a few hours prior to going to bed or worries, excessive thoughts and even fear can lead to disrupted sleep.”  

As for the pathological side, Dr Bindroo says, “The pathological disturbance in sleep is because of multiple disorders. The most common one is obstructive sleep apnea, when there are micro-arousals where the brain wakes up because of obstructions in the respiratory system. Some people can have central sleep apnea, where the brain stops sending signal to the respiratory muscle, to breathe. That time also it will lead to fractured sleep. 

Should you take medication?

Simply put, no. Taking any sort of sleep-inducing drugs may not be a wise decision, especially not self-medicated. Dr Bindroo explains, “Whenever someone faces any kind of sleep disorder, one needs to diagnose that particular disorder, because there are different treatments for different disorders. Based on the history and testing, the sleep specialist will recommend a treatment. But blindly taking a pill is a no. I would suggest not taking any kind of pills without consulting a doctor—whether its sedatives, hypnotics or melatonin containing tablets, which are increasingly popular now.”

Sleep-inducing medications, like any other drugs, can have long-term adverse effects on the human body. He adds, “One of the first effects, is that over a period of time, the drug will stop working on your body. The second thing, if one doesn’t know the dose or correct prescription, then they may fall asleep the next day which will decrease one’s efficiency. Overdosing can lead to an individual going into a coma and sometimes, it can even be a risk to one’s life.”  

Similarly, Dr Renu says that she would not recommend medication for sleep disorders that can be correctable or which have come about due to poor sleep habits. “I would recommend medicines only if the issue is related to a physical or mental illness, in case it was hampering a person from functioning on a day-to-day basis.”  

What you can do instead  

Having a regularised night-time routine is probably the most effective ways of getting a good night’s sleep. Amidst the din of city life, a filled social calendar and constant professional asks, a winding-down routine at the end of your day will go a long way to calm your mind and manage your anxiety. “Having a good bedtime routine does not only help our body rest, but it also reduces stress and helps us restore energy. Our body functions on a natural biological clock that tells us when to sleep and when to be awake. If our biological clock is off and we have sleepless nights, it could possibly lead to stress, anxiety and can affect overall mental health,” cautions psychologist and counsellor, Tanvi Mehta.  

So, if you’re having sleep trouble (due to non-medical reasons), then we’d definitely recommend re-looking at your night-time routine. This includes being away from the screen and all devices, darkening the room at least an hour before your sleep, avoiding caffeinated drinks in the evening/night, listening to calming or soothing music, practising a few moments of mindfulness through meditation or journaling and taking time out to listen to what your body needs. “Those who struggle with anxiety can set a ‘worry time’. This may sound counter-intuitive, but setting aside specific time in the day (could be 20 minutes) just to worry has shown to prevent constant worrying through the day and especially at night. This is because you know that for those 20 minutes all you are doing is worrying. Therefore you’re not pushing aside the worries, you are addressing them in a time sensitive fashion,” reveals junior psychologist, Tanisha Bhatia.  

To sum up, it’s vital we all maintain a good sleep etiquette—have a fixed time of sleeping and waking up. From creating a calm ambience at night to not consuming too much digital media, have rules in place. Also, bid goodbye to stressing over sleep, with the right mantras, it will sort out.