Get advice on sound sleep from our Sleep Expert

I usually get average 5 hours sleep. I used to try to sleep around 10.30 or 10.45. After taking food at 9 pm, I used to watch TV. In the night I used to wake up between 3.30am and 4.30 am. Then I had no sleep. How do I counter this issue?

As you have rightly identified, this is a cause for concern. A reduced total sleep time of 5 hours is less than the recommended total sleep time required to achieve and maintain good health. I would advise you to maintain an accurate sleep log, to identify the number of nights you are having this issue. There are several causes for insomnia, one of which, you have mentioned in your query such as watching tv, or exposure to electronics. It has been studied that the blue light emitted from these gadgets reduces the release of melatonin, a sleep hormone. This reduced concentration alters your sleep architecture. Also at times, early morning awakenings may be a presenting feature of a mood disorder like stress/ anxiety or depression.

Also, I would advise you to maintain healthy eating habits and an exercise routine, including relaxation therapies to reduce one's arousal threshold. Also, note that a rigorous exercise routine close to bedtime and nicotine and alcohol can all have an adverse impact on your sleep. If this persists and it is impacting your next day performance, I would strongly recommend a detailed evaluation for insomnia, and you would need to contact your sleep physician for further investigation.

I don't have a problem in sleeping schedule, but the actual problem comes when it's time to wake up. I find very difficult to wake up early morning for my studies. Can you suggest something to solve this issue?

Unable to wake up in the morning at an appropriate time, or feeling unrefreshed on awakening, can be manifestations of underlying sleep disorders. It will be imperative that you maintain a detailed sleep log of your time in bed and total sleep time before we identify the issue that is leading up to your inability to wake up on time and refreshed. It may be that you are suffering from insufficient sleep syndrome, where you tend to chronically restrict your total sleep time or deprive yourself of sleep, and hence, have difficulty waking up the next morning.

As you mentioned, that you are studying, it is quite common at this age to suffer from a circadian sleep disorder such as delayed sleep phase syndrome. Some of the symptoms of this disorder are finding it difficult to fall asleep, especially till the wee hours of the morning. This then leads to a later wake-up time, which can be accommodated for on weekends but not on the days you need to show up to college to attend lectures. It is important to identify these disorders as they can have a comorbid link with underlying mood disorders such as depression, reduced immunity, obesity and also, have an impact on your productivity and academic performance.

Is sleeping in two breaks like 4 hours in the night and then another 4 hours in day correct?

You have raised a very important point. In a 24-hour cycle that is very hectic, especially when we have jobs that demand shift work, I am often asked if sleeping in two breaks to complete the 8 hours requirement can substitute for a continuous 8 hour sleep period. But I am afraid that this is not true.

Our sleep is most restorative when it is an ideal cumulative result of a homeostatic and circadian rhythm drive. The circadian rhythm is the day-night cycle that has an impact on the human pace-maker or the suprachiasmatic nucleus present in the brain. Dependent on the circadian rhythm are several hormones such as cortisol that are important for our wellbeing. Also, If we restrict our sleep to 4-hour periods in the night, we tend to restrict our REM (Rapid eye movement) sleep periods during the early morning hours. This, in turn, can have an impact on our memory processing.

Hello madam, I am studying for my post-graduation. I have more stress than usual. I have no problem with sleeping, but I do get a lot of dreams. So, please guide me on how to get sound sleep

Stress and anxiety can impact sleep in several ways. At times, it can have an impact on the amount of sleep and sleep architecture itself. You report getting excessive dreams during this period - it is unclear if these are disturbing and if they have a recurring theme. Either way, excessive stress can lead to increased dreams and at times, nightmares that occur during REM (rapid eye movement) sleep. In your situation, the most appropriate intervention would be to introduce relaxing and soothing sleep rituals as well as daytime relaxing or meditative interventions that can help reduce your awakening threshold. Also, maintaining a good sleep-wake schedule and ensuring you have sufficient sleep time will help in your preparation and improve your performance in the examination.

I do not get time to study in the day. Hence I do so in the night. My average sleep is for five hours. Do I need to change this and how?

It is of paramount importance to obtain sufficient total sleep time. Sleeping continuous 7-8 hours is optimum for memory formation and encoding. You are chronically sleep depriving yourself of approximately 5 hours of sleep. Additionally, if you tend to consume caffeinated products to stay awake, this can also be responsible for reducing your total sleep time. It is recommended that you maximise your wake time during your exam preparation period and give due importance to sleep to help with the restorative and rejuvenation process which is essential for your memory formation. This will have an impact on your overall performance as well as overall health.

I sleep from 3 am to around 11 am on most nights. Sometimes, I sleep at around 6 or 7 am. I am always on my phone and not able to give it up. Often, I feel tried. How can I change this?

Sleeping into the wee hours of the morning and waking up late is typical of a delayed sleep phase sleep disorder. Delayed Sleep Phase syndrome can occur secondary for several reasons- social engagements, peer pressure, work stress can all contribute to this. It is more commonly seen in adolescents and young adults. When we are unable to complete our total sleep time, we awake to feel tired and fatigued and chronically sleep deprived. Exposure to mobile phones emits blue light that reduces the 'melatonin' which is a sleep-promoting hormone, and this can cause a delayed in the sleep onset. Also, this has an impact on the sleep architecture and its quality. Delayed sleep phase reaction can create several health abnormalities such as reduced immunity, increased obesity and weight gain. It is also seen coexisting with several moods disorders such as depression. Addressing social sleep hygiene and reducing screen time especially close to desired sleep time is required. Also, maintaining strict wake-up time during weekdays and weekends will help regulate the clock and align the circadian rhythm. Exposure to sunlight on awakening will also help strengthen the circadian drive which is regulated by the internal biological pacemaker, the suprachiasmatic nucleus.

Whenever am free I sleep for long hours at a stretch. Is that ok? Please advice

Sleeping for an excessively long period at a stretch occasionally can just mean that you are trying to play "catch-up" sleep. At times, a prolonged afternoon or early evening can reduce your homeostatic drive or need for sleep. The need for sleep is driven by the previous sleep period and the buildup of neurotransmitters known as adenosine. Caffeine is an adenosine antagonist hence, has a wake-promoting effect. If we sleep for a prolonged period of the day, this will delay our sleep onset at night and may result in a subsequently reduced total sleep time. This can be observed several times on weekends when we tend to sleep for long hours during the afternoon. Uncontrollable excessive daytime sleepiness can also be seen in some forms of hypersomnia sleep disorders and mood disorders.

I get sufficient sleep of 8 hours, yet I keep yawning every day. Is that normal? Please advice

Several factors result in excessive yawning and daytime fatigue. Sleep may be insufficient, if you feel that you are getting the required 8 hours of sleep and yet are fatigued and tired during the day. It may be that your sleep quality is impaired, secondary to intrinsic sleep disorders such as sleep apnea or limb movements. Also, each person's sleep requirement can vary. Long sleepers may require 10 or more hours of sleep per night. Ideal sleep is the amount of sleep post which you feel awake and refreshed on waking up. I would suggest maintaining a strict sleep log, assessing your sleep quality and taking preventive measures. Visit a sleep physician if the problem persists.

I am not able to get sleep even after taking sleeping pills. Please advice

Insomnia is the difficulty of falling asleep or staying asleep; it has a prevalence of approximately 30%. Ideally, evaluating the cause of this is important to guide each patient's individualised therapy. The main cornerstones of treatment are cognitive behaviour therapy which is the first line followed by pharmacotherapy when appropriate. Only Sleep pills are not the ideal to not getting sleep; this can lead to dependence and tolerance. You need to go to a certified doctor to identify the reason that is affecting your sleep pattern.

I sleep at 11.30 pm every day and wake up at 5.30 am. Is that enough? Also, I am dealing with obesity issue. Please advice

According to the time log you have given, you sleep for approximately 6hours at night. The ideal sleep required by an individual is approximately 7.25 hours. However, it varies per individual and the ideal sleep time is what makes you feel fresh and ready to face the day on awakening. Reduced total sleep time is also linked to obesity and metabolic syndrome. If you feel tired and fatigued on awakening, you probably need to get evaluated for any underlining sleep disorders.

In addition, if you find that you are trying to catch-up on sleep by sleeping longer hours on the weekend then you’re likely to be sleep deprived.

I usually go to bed at 10 or 11 pm, but I am unable to sleep the whole night. In the morning, I feel sleepy. Hence, I sleep during the day sometimes. Also, I end up not getting sleep for 3 to 4 days at a stretch. How do I change this? Please help.

You seem to be suffering from severe insomnia – there are some conditions where the circadian clock is not running in sync with a 24 hour cycle however it seems that if we can enforce strict sleep hygiene as well as monitor your total sleep time and time in bed with the help of 'actigraphy' and a self-reported sleep diary we can assess this more clearly.

Also, we suggest you gather information regarding your daily routine, mood, intake of caffeine, exercise, diet and family history details and visit a sleep physician in your vicinity.

Am 16 years old, and I get to sleep only for 3 hours every night. Is that normal? How can I change this? Please advice

Sleeping for 3 hours every night is definitely not normal for your age. Your body and brain are not getting the desired rest it needs which in turn would affect your overall health and performance at school. You need to increase your total sleep time to at least 8 hours per night. I would suggest you seek help from a sleep physician for a comprehensive evaluation to help sort this issue.

I wake up feeling lazy every morning, even though I have slept for 10-15 hours. I can't understand why. Please advice

Average sleep requirement of an adult is 7-8 hours. According to the period mentioned, you sleep for about 10- 15 hours still not feeling refreshed. I suggest you see a sleep physician to evaluate for possible hypersomnia's - a sleep disorder that can cause this. You will be asked to maintain a sleep log, do a fitness test and may be asked to undergo multiple sleep latency tests.

I am sleepless in the night as I study till 4am. Later, when I try sleeping it takes me 2-3 hours to get sleep. Please advice.

According to the time log you have mentioned, you stay awake during the wee hours, typical of a delayed sleep phase sleep disorder. Several reasons- social engagements, peer pressure, work stress can all contribute to this and it is more commonly seen in adolescents and young adults. Exposure to mobile phones, the blue light emitted from the screens, reduces the melatonin which is sleep promoting hormone and this can cause a delay in the sleep onset and also has an impact on the sleep architecture, quality and also on the overall health of an individual.

Addressing social sleep hygiene and reducing screen time especially close to desired sleep time is required. In addition, maintaining strict wake up time during week days and weekends will help regulate the clock and align the circadian rhythm. Exposure of sunlight on awakening will also help strengthen the circadian drive which is regulated by the internal biological pace maker, the superchiasmatic nucleus.

In addition, you mention that the sleep onset is prolonged, use of caffeinated beverages can contribute to this issue as well as the lack of much required 'down time' to unwind and relax your mind.

I am a student at an engineering college and unable to manage time between my studies and sleep. Please advice with some tips.

The average sleep, an adult would require is 7-8 hours. But this is just an approximate number, the actual number of hours you need would differ from person to person. Your ideal requirement for sleep is the amount of sleep which makes you feel awake and refreshed on awakening. That's the amount of sleep you really need. What you need to do is to give the due importance to sleep which is essential for your memory formation that in turn will help you in your studies and also overall health.

Learn to prioritize – time management skills as well as setting realistic goals can help with planning your schedule. Make sure you have sufficient rest periods as well. Every 45 minutes take a small break, walk around , get a sip of water – this will provide an alerting mechanism that will aid in your attention and focus.

Wish you the best – remember "Sleep on Time" for a healthy you!

I am facing sleeplessness for the last 12 years. It's OCPD according to my doctor. She suggested me to have Quitipin 25 and Dicorate er 1gm for 6 months. Now, I can't sleep without these medicines. Please advice.

Co-morbid mood and sleep disorders can be a challenge. You need the medications to help with the mood symptoms. I would encourage you to take the medications as prescribed by your physician and maintain "healthy" sleep habits. At times, your doctor may want to look for underlying sleep disorders such as Sleep Apnea or Periodic Limb Movement disorder. When your symptoms are in control, under the physician's guidance the medications will be withdrawn gradually.

How to control back pain while sleeping?

If sleeping is causing you to develop back pain then you must chose an appropriate mattress either firm or hard and the right pillow. Sleep Posture is very important – at times you may benefit from wedge pillow between your legs. Back strengthening exercises are also recommended.

On the other hand, pain can interfere the quality of sleep – hence addressing the cause is very important to a restful sleep.

I am suffering from Insomnia for last 10 years. It takes me 3-4 hours to get sleep after going to bed. I exercise and walk regularly. I have been taking medicines also. Please advice.

Insomnia is difficulty falling asleep or staying asleep, it has a prevalence of 30%. Ideally, evaluating the cause of this is important to guide each patient's individualized therapy. The main cornerstones of treatment are Cognitive Behavior Therapy- Insomnia which is the first line followed by pharmacotherapy when appropriate. Only Sleep pills are not the ideal to not getting sleep, this can lead to dependence and tolerance. You need to go to a certified doctor to identify the reason that is affecting your sleep pattern.

You are also advised to maintain a sleep log/diary to chart your sleep rhythm. You may be asked to work on Sleep Restriction to improve Sleep Efficiency.

What is the ideal gap between the meal and sleeping time? What time should I eat if I want to sleep at 10?

It is ideal to keep 2-3 hours gap between meal and bedtime. It is equally important to avoid heavy, spicy and fried foods prior to bedtime which can result in heartburn and regurgitation. Also, sit upright or take a walk before going to bed. If you had an early dinner and feel hungry, then a light snack and warm milk prior to bedtime is just perfect.

I sleep at 1 am and wake-up at 8 am due to my studies. However, I feel drowsy all day and can't stay without taking a nap after lunch. How do I change this routine?

7 hours of sleep at night can lead to a mild chronic sleep deprivation that would accumulate with time, this results in excessive daytime sleepiness and hence you feel like taking a nap after lunch. The afternoon- post lunch period is a circadian dip which occurs physiologically, typically between 2-4 pm where we are prone to sleep and this is the time your body and brain are trying to play catch up. It would be advisable if you could increase your total sleep time at night by advancing your time in bed from 1 am to 11/11.30pm. This would ensure that your are more alert and attentive during the work day that would result in an improved outcome in your studies and examinations.

It always takes me 2 hours to actually fall asleep every night. Why is this happening? Is it normal?

It is certainly not normal if you take 2 hours to fall sleep- this is a form of insomnia. Appropriate intervention would be to introduce relaxing and soothing sleep rituals as well as day time relaxing or meditative interventions that can help reduce your arousal threshold. In addition, maintaining good and routine sleep wake schedule and ensuring you have sufficient sleep time.

I would also like to understand if there any particular symptoms /sensations that you experience prior to sleeping. Is there an uncomfortable sensation in your legs at time, do you feel fidgety? Is your mind racing and you are unable to shut it down? You may need to go to a certified doctor to identify the reason that is affecting your sleep pattern, as some of the above conditions can present as insomnia.

I sleep during every lecture in my class, no matter morning or noon and end up missing on all the information. I am fed up with this. It has been 3 years now. What should I do? Please advice.

It is of paramount importance to obtain the sufficient total sleep time during the day. In addition, sleeping continuous hours of 7-8 hours atleast is optimum. You possibly are not sleeping enough during the night. Give the due importance to sleep to help with the restorative and rejuvenative process. If you are sleeping enough and still feel the same then it can be that you have an increased need for sleep – or "Hypersomnia". To understand this further your total sleep/wake schedule over 24 hours will be tracked for a 2 week period. In addition, if you are experiencing other symptoms they must be discussed with your doctor to better understand the cause of this sleepiness.

I want to improve my sleep timings as I have irregular shifts at work. I get good sleep only for 4-5 hours. Please advice

Your concern with your sleep time due to irregular shifts is very true as shift work can reduce TST (Total Sleep Time) on a nightly basis resulting in an accumulation of chronic Sleep debt. This is a matter of public health and a growing epidemic. What you can do is-

  • Rotation of shifts with sufficient time to acclimatize to work schedules and strategies for appropriate weekly off schedules to help maintain sleep schedule.
  • Sufficient light exposure during work hours help sleep schedule.
  • When getting off night shifts reduce sunlight exposure, make environment dark and conducive to sleep, minimize noise pollution.
  • Power Naps just before Night shift.
  • The use of medications both sleep inducing and wake promoting and phototherapy when/if required under the guidance of a physician to help regulate the circadian clock.

Ask our
Sleep Expert

Preeti Devnani

Dr. Preeti Devnani   +

MD, ABPN, D, ABIM, FAASM (USA) is the Clinical Director of the comprehensive Sleep Disorder Clinic in Mumbai and a consultant physician at the Jaslok Hospital and Research Centre Mumbai – Department of Neurology, l Neurophysiology and Sleep Medicine.

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