Those with great faith, who are able to accept whatever comes and whatever goes and surrender everything into the hands of God, are usually able to sleep peacefully, like babies in the lap of the Mother, says DR ANITA DUGGAL
The entire globe is enveloped in a cloud of fear due to the pandemic and its effects on our lives and livelihoods. There is an inevitable impact of this stress on mental health and one of the earliest symptoms is sleep disturbance. Disturbed sleep can cause our mental health to deteriorate and spiral down, precipitating a mental disorder.
Sound sleep is essential for our wellbeing and to function properly. When we sleep badly with interruptions we feel tired, groggy and grouchy the next day. In Ayurveda, sleep is considered one of the tristhamba, that is one of the three pillars of life and therefore essential for life.
Why is sleep so important? It allows the body and mind to rest and recharge which is essential for their proper functioning. It is restorative in that it allows the body to heal and repair itself and is essential for the normal functioning of the immune system. The brain restores its energy supply system and many hormones are secreted in accordance with the sleep wake cycle; for example growth hormone which is essential for metabolism is secreted more during sleep.
Sleep is important in maintaining mood and good memory function. We know how sleep deprivation affects our mood. We become irritable and anxious and it affects our attention, concentration, memory and performance. Disturbed sleep in the long term can affect not only our mental health but also our cardiovascular health. Therefore ensuring sound sleep is vital to health, both mental and physical.
What are the common causes of sleep disturbance? Very commonly worries and anxiety but other causes include hunger, thirst, overeating, heat or cold, overstimulation and excitement, alcohol and illicit drugs and some prescribed drugs. Sleep disturbance is often a symptom of mental disorders such as depression, anxiety, psychosis.
Physical pain and discomfort or other physical health conditions can also disturb sleep. Another important cause is irregular sleep habits and cat-napping in the day. Suppressing the natural urge for sleep when we stay up late to go out or watch something interesting disturbs the sleep pattern. The internal circadian clock can be disrupted by bright lighting in the evening as well as by working night shifts.
Our sleep requirements change with age. A newborn can sleep up to 18 hours, a school age child 9 to 11, and adult 7 to 9 and in older age slightly less.
What can we do to improve sleep? Well there are many things we can do but most importantly we must address the underlying cause. Night sedation is generally best avoided but if it cannot be avoided in severe cases, use it as a short term measure only. It has addictive potential and carries the risks of sedation, dizziness, falls and confusion.
Try to gradually establish a regular sleep-wake routine and stick to this. That means going to bed and waking at a fixed time every day, to set a healthy routine. The body and mind need regularity to prepare for meals, sleep and so on. One then normally starts to feel hungry or sleepy at the scheduled time. A balanced daily routine is important for the optimal functioning of the cyclical biological systems.
Ayurveda promotes going to bed early and waking before 6am as the ideal in terms of synchronising with the natural time cycles. Waking before sunrise between 3 and 6 am during Brahma Murta, is highly recommended as this gives freshness and clarity to the mind. It is also the ideal time for meditation. Waking after 6am means that one wakes during the Kapha time period and one may feel sluggish, heavy and drowsy at this time.
Cat-napping in the day is generally best avoided or kept to a minimum as it affects the quality of the night sleep and makes one feel lethargic and heavy during the day. According to Ayurveda it is best avoided except in childhood, old age, in certain health conditions and in the summer season when it is recommended as it has a cooling effect.
A wholesome diet is important for sound sleep. If one skips meals or the diet is too light and erratic, Vata increases and can disturb sleep. It is best to avoid stimulant food and drinks at night such as meat, very spicy food, coffee, coke or other caffeinated drinks, citrus and sugars. Caffeine intake during the day should also be limited. Salads are generally too light and Vata aggravating to be taken in the evening.
A carbohydrate meal in the evening is more soothing and conducive to sleep. The evening meal should not be too heavy with articles such as meat or fried foods which are difficult to digest and the meal should be taken two to three hours before sleeping, allowing time for it to be digested. It is difficult to sleep if the body is digesting a heavy meal.
At bedtime a milky drink or light snack can be taken. Warm milk with a pinch of nutmeg or a herbal tea such as Chamomile can be calming. Alcohol is best avoided at night as it can disturb the quality of the sleep.
It is important to avoid over-stimulating the nervous system in the evening by too much time in front of computer screens and the television, listening to loud exciting music, watching thrillers and so on. These excite Vata and will disturb the sleep.
The bedroom environment should be restful, quiet and comfortable with no bright lights which can disrupt the normal secretion of Melatonin, the hormone which induces sleep.
Regular exercise done outside in green space as part of the daily routine is helpful in relieving tension that builds up. In the evening, however, only mild exercise in the form of gentle stretches can be done. Vigorous exercise before sleeping is too alerting.
One of the hardest things but most important is to keep oneself from trying to solve problems at night and ruminating. One has to try to restrain the mind and reserve the night for sleep, not problem solving. Sometimes it can be helpful to write down what needs to be dealt with next day and then leave this for the next day.
Vata induced sleep problems are associated with restlessness, very light sleep and difficulty getting off to sleep. The individual may feel light, ungrounded with cool hands and feet. Massage of the soles of the feet with warm pale Sesame oil can be helpful to pacify Vata. Simple head massage without oil can also be very calming.
If one is overheating as often happens in the summer season, then cooling the feet in cool water before retiring to sleep can help. For Pitta induced sleep problems, Coconut oil can be used for massage. A couple of Lavender oil drops can be placed near the pillow for a calming effect.
Sleep promoting Western herbals include Chamomile and Valerian and Ayurvedic herbals such as Ashwaganda and Brahmi, but any herbal medicine should be taken only after consultation with a qualified practitioner. Herbal medicines can also interact with Allopathic drugs, hence the need to exercise caution.
Progressive relaxation techniques are helpful in preparing the body and mind for sleep. Breathing exercises, progressive relaxation of the body, mindfulness and visualisation techniques can be used. Yoga nidra is a special guided meditation practice that allows the body and mind to enter a deeply relaxed sleep-like state which is conducive to sleep.
Dealing with the plague of worries when they arise is often the difficulty. For this a spiritual perspective is also necessary. Cultivating an attitude of acceptance of whatever comes, in the understanding that it will teach us something and will ultimately bring something positive to our lives, can help us to let go of the tension and fear of difficult circumstances to some extent.
I have observed that those with great faith, who are able to accept whatever comes and whatever goes and surrender everything into the hands of God, are usually able to sleep peacefully, like babies in the lap of the Mother! We cannot develop this kind of faith overnight, but whatever helps to strengthen faith will inevitably give us more strength and peace of mind.
Dr Anita Duggal is a retired psychiatrist resident in the UK. She studied Social Anthropology at the London School of Economics and Political Science and was awarded an MSc with distinction in 1992. She has also studied Ayurveda in the UK as well as in India and was awarded an MSc in Ayurvedic Medicine from Middlesex University in the UK in 2007. Although she has worked mainly within mainstream Mental Health Services, she has always maintained a strong interest in Ayurveda and its approach to mental health.
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