Sleep over it and things will be better in the morning' is a home remedy that even doctors adhere to. While it isn't a panacea for all ills, it does help in giving old problems a fresh perspective. But if even sleep eludes you then all systems can come to a grinding halt. If a person is suffering from insomnia and hasn't slept properly for days, weeks or even months, every waking hour becomes a tiresome routine of repetitive tasks. While the effects of sleeplessness manifest themselves in fatigue and illness, personal relationships also tend to suffer. But one should not mistake the effect for the cause, as insomnia is hardly a personality quirk, but rather a full-fledged disease.

Insomnia falls under the DIMS category of sleep-related problems. DIMS stands for `Difficulty in Initiating and Maintaining Sleep'. The common causes for sleeplessness are emotional turmoil, anxiety and depression. But not everybody suffering from anxiety is sick. It can be a phase-of-life problem -- such as a bride not being able to sleep on the eve of her marriage -- that will pass.

The anxieties of everyday life can often disrupt sleep for several days. That in itself is not a matter of grave concern. But if a person hasn't rested well for three to four weeks and sleep deprivation begins to interfere with his day-to-day life, it's time to seek professional help.

One of the most obvious effects of insomnia is chronic fatigue. The sleep-deprived person starts his / her day feeling exhausted and everything becomes a chore. There are periods during the day when one ceases to function, as the brain goes to sleep but the body remains awake. Memory lapses, irritability, and intermittent behavioural changes are also manifestations of this problem.

The cure lies in getting to the actual cause of the depression and persistent anxiety. The insomniac can start with some self-help exercises, like cognitive therapy where an honest introspection is coupled with positive thinking. Also, emotions shouldn't be bottled up. Talking about problems can often resolve negative feelings.

Popular sleeping pills should be avoided without a prescription. They don't cure insomnia and are addictive. While anti-depressants help, they too should only be taken on a doctor's advice. Chronic Primary Insomnia (CPI) is not always curable. Mainly because its root causes lie in physiological maladies, like long-term cardiac or respiratory problems.

But practising certain principles of sleep hygiene can benefit everyone. Human bodies follow certain daily, weekly or monthly bio-rhythmic cycles. Called circadian rhythms, the sleep-awake cycle is the most important of all, as most other rhythms revolve around it. While most adults require a minimum of eight hours of sleep everyday, you can get by with less sleep, but it is not a healthy practice. Myths about requiring only six hours every night are just that -- myths. It is better to follow a regular sleep-awake cycle. Even if you've had a late night, get up at the same hour every morning or your body rhythm will become disrupted.

Also use your bed only for sleeping or sexual intercourse. The ideal sleep is called electro-physiological sleep. Those who idle all day in their beds get their physiological quota of sleep but their brain misses out on the necessary rest and they cannot sleep properly during the night.

Another common myth is that alcohol aids in getting sleep. On the contrary, it awakens the senses. Though one can drink to the point of passing out, such dangerous behaviour results in a loss of valuable and restful dream sleep. The dreaming stages of a normal night are equally vital to one's health as the non-dreaming stages. The loss of one comes at the expense of an overall good night's sleep.

Avoiding heavy and greasy meals at dinner-time is also essential. While a full stomach often immobilises a person, making sleep the only option, the traditional practice of eating at sunset with a warm glass of milk is more sensible. Having a late dinner inhibits proper digestion and is best avoided.

Soothing, soft music, a pleasant companion, a pleasing perfume, and the right temperature aid in lulling one's senses. Instead of counting cracks on the ceiling plaster, think of pleasant memories. The obvious corollary of this is to avoid jarring noise strong perfumes, frequent disturbances, etc. Those who are convinced that as soon as they get to bed, sleep will fly away, should try to change sleeping positions or rooms.

Dr Vihang Vahia is a psychiatrist. He is affiliated to Cooper and Breach Candy hospitals.- As told to Anu Kumar

Copyright © 1997 Indian Express Newspapers (Bombay) Ltd.