Dr. Ramadevi Gourineni is a renowned sleep specialist who practiced in the US for over 20 years before returning to India and setting up Amara Hospital in Hyderabad.  She  talks to Gunjan Sharma about various sleep disorders and why it is important to diagnose and treat them in time  

Q. How prevalent are sleep-related issues in these times? 

According to data we have in India, approximately 10-12% of people suffer from some type of sleep disorder in India. That means these have disturbed sleep at least 3 times a week and have been suffering from a sleep disturbance for about 3 months. 

Q. What are the causes of these sleep disturbances? 

There are many causes, and it depends on the symptoms they are having. Many people show daytime sleepiness. A person may have more than one symptom such as snoring, not breathing properly at night, being uncomfortable during bedtime, and so on. 

Difficulty in sleeping at night is another common factor. But there is a difference between difficulty in sleeping and not getting enough sleep. Then some underlying medical conditions such as depression and other psychiatric conditions affect about 40% of those who face difficulty in sleeping. Some people also suffer from sleep disorders such as destructive sleep apnea. Certain medicines also interfere with a person’s sleep. 

Q. What lifestyle changes should one incorporate to deal with these sleep-related issues? 

Having too much caffeine, especially in the evening, interferes with sleep. In fact, consuming more than 300 milligrams of caffeine early in the day can also disturb your sleep at night. 

Physical inactivity and a sedentary lifestyle can affect sleep. Even older people need some activity for them to sleep better at night. 

Then, exercising late in the evening increases brain metabolism. If you want sound sleep, your brain metabolism should slow down during bedtime. So, one should not do heavy exercise for at least 3 hours before sleep. 

Increased screen time and cell phone use affect our sleep too. The blue light released from the screen of your mobile phone suppresses melatonin, a hormone secreted by the perennial gland that gives the message that nighttime is coming, and it is time to sleep. 

 Last but not the least, drinking alcohol or smoking close to bedtime can disturb your sleep. 

Q. Do you think sleep disorders are becoming common with the younger generation also? 

 Yes, indeed. Youngsters are already addicted to binge-watching TV shows and movies and partying late at night, which is affecting their sleep cycle. In fact, it is parents who are giving mobile phones to children at a young age to keep them busy.  What they don’t understand is that these devices will affect their overall health in the long run.    

We need to promote and prioritize healthy sleep and a healthy environment. There are some basic points everyone should follow for sound sleep: 

1.     Be active during the day. Exercise at least 4 hours before bedtime. 

2.     Have dinner at least 2-3 hours before bedtime. A lot of people take dinner as late as 11 pm and go to sleep right after dinner, which is not a good habit. 

3.     At least 1 hour before bedtime, dim the lights. Bright lights are good during the daytime but lower the lights and keep the environment as natural as possible. If you like to read a book at night, you can focus the light on the book but make sure that it should not fall on your eyes. 

4.     Avoid using phones, laptops, iPad, etc. at night. 

5.     If you watch television at night, then sit at least 10 feet away from the television. If you can, then avoid watching at night.  

Q. Why is it important to treat sleep disorders? 

Not all sleep problems are the same, so firstly it is important to make a proper diagnosis and understand the underlying cause of the sleep disturbance if any. At times, physicians prescribe some sleep-inducing medicine to their patients for a short course. But unfortunately, many people keep buying these medicines on this prescription without even telling their doctor. 

What these people don’t understand is that disturbed sleep could be a sign or symptom of deeper health problems. For example, people who snore can be suffering from obstructive destructive sleep apnea. They face breathing problems at night, which can be a huge problem because when they stop breathing the oxygen level in the blood goes down, which can lead to oxidative stress and cause metabolic syndrome. People can even have heart attacks at night because of low oxygen saturation. 

About 30 percent of those who face sleep disturbance have other underlying causes. So, proper diagnosis and treatment are required.