Insomnia or sleeplessness a common problem

Many of you have a common complaints of insomnia or having difficulty in sleep.It is easier to prescribe an alprazolam or diazepam tablet.Frequently you have problems of sleep and you seek such prescription from your doctor.Many of you get it from the chemist shop directly where drug control system is not very effective.

Let us analyze the problem.

You go to bed!,close your eyes! and try to sleep!,but you can’t.Why?….. You try to sleep but you can’t sleep.Your eyes are closed but your mind is working,your thoughts jumping from one topic to another topic,you are changing postures on the bed.You look at the time in your mobile phone kept near your head and you see,oh!my god it is 12.45.Again you remember you have to do a lot of work tomorrow.Again your thoughts filled your mind,you get up for toilet and take a glass of water and back to sleep.And its very late around 3A.M. when you could get your sleep and next morning you have to get up early and you are mentally tired.No freshness in mind to work properly.The story can differ person to person.Now the question is what should you do?

I am writing some points below which would help you out in the majority of such situations:

1.Avoid taking tea, coffee or chocolates in evening.There is a system in our brain which keeps us alert.You don’t need to remember the name of this system.Ascending Reticular Activating System.Its work gets activated by the chemicals found in tea,coffee, chocolates and tobacco.Apart from this,use of tea and coffee in evening would cause more urine to form in your body and you would have to disturb your sleeping process to empty your bladder at night.

2.Your mind takes some energy to initiate sleep.For this you need to have glucose level adequate at the time of sleep.So never skip your dinner otherwise you would be unable to sleep or you feel difficulty in sleeping.

3.Nature of food affects your sleeping process.Proteins keep your mind alert and interferes withwth initiation of sleep.If you take many boiled eggs or protein rich substance in your dinner,you may have difficulty in sleeping.Carbohydrates helps in sleeping process,if you eat more carbohydrate you can get sleep easily.Mind it,I am talking about your dinner,those protein rich food are good for your breakfast to keep you alert whole day.

4. If you still feel difficulty after the above point correctly addressed,you have to check for negative energies in your room.Avoid red color curtains or bedsheets in your bed room.Red color increases your blood pressure and blue color decreases it.High blood pressure keeps you alert so hinders your sleep.You keep pillows to raise your head from your body level during sleep,do you know?why you do so!.Because your head should get less blood pressure in comparison to body.Avoid multicolor printed bedsheets,pillow covers and curtains.Your cot height should be low because every thing at higher energy level tends to be unstable.When your cot height is more,more difficult for you to get sleep.Higher cot level keeps you at higher potential energy.You should not keep television in your bedroom.If you have no other choice,cover your television with black cotton cloth.Your bedroom should have proper ventilation for fresh air from outside.Your bedroom should be dark properly to initiate sleep.Your dress should be comfortable and your bed too.

5.If you are alcoholic you should go to bed earliest possible. If you have taken alcohol in evening and its effect removed before going to sleep,it would be next to impossible to initiate sleep and you may have headache.In such condition you can try soft drinks or sugar water solution with lime juice.

6.If you are concerned about any problem which you cannot share with anyone,you can write your all negative feelings in your diaries or notebooks.Believe me! you would get a nice sleep.

7.You are worried about tomorrow regarding some urgent work,chalk out your plan and sequence of your actions on a paper,then go to sleep.Don’t keep any worry of your mind mentally unadressed before going to sleep.You can find the best solution of your problem just before sleep and you would get a nice sleep.

8.A real story as an eye opener for health care provider…

When I was in my health centre a man Mr. X. approximately 35 years old came to me at 11 P.M. said,”sir!  I am unable to sleep,please give me some sleeping pills!”It was easier for me to prescribe him some sleeping pills.But I created little problem for myself and tried to probe him about his mental condition and thoughts.I took time to listen his problem.His problem was following: a married man with his three kids living together in town.His younger brother around thirty years old,lives in his native village with his wife and kids.His younger brother had taken some money one year back and refused Mr.X. to return that money.That money, which Mr.X.could not get back from his brother,generated tension in his mind.Mr.X. was only concerned for his own wife and kids.He was thinking that he had lost his money by helping his younger brother and there is no hope of getting back.His younger brother told him straight that he didn’t owe any money.So Mr.X couldnot sleep by thinking about his monetary losses.

I asked Mr.X to recall twenty five year back, of childhood days. “recollect the scene when you were young and were living together with your younger brother!both of you running,playing and enjoying together in your childhood days!Imagine!how pleasant was that!suppose, you had few pennies and your brother asked you to give some money to buy some lozenzes!what you would have done!”

Mr.X replied,”sir!I would have given the whole lot of pennies to him with great pleasure”.l said,”Then why are you bothered for the money which he is not returning back!Do a phone call to him and say that you don’t want your money back and add,  in future also if he needs more,you would give him with great pleasure. “

Now Mr.X was changed totally.His paradigm shifted.Now he is looking his situation with a new angle.He got satisfied and did exactly as I had advised him.Now he is sleeping well without any difficulty. he doesn’t require sleeping pills.

This happens in thousands of cases of sleeplessness where tactful listening to the person with problem can provide drug free solution to sleeplessness.But we take a couple of minutes only in prescribing sleeping pills.

If you have taken into account of all the previous concepts of sleeplessness. Some more things can be considered.

1.Your bedroom should be free of noise and unwanted lights or illuminations.

2.Your bed should be arranged such that your head is directed south while you sleep.Here one thing is important to note that,you remain at higher energy level by your thoughts and you find difficult to sleep.The south direction decreases your energy level and makes it easier for you to sleep.Further I would like to add,those people who have low self esteem or feeling lack of energy,should sleep facing east direction.

3.Your bed should be placed in your bedroom such that,it is nearer to the southern or western wall of the room.

4.It is a nice idea to go through your textbook or magazine if you are not feeling sleepy on the bed.This will focus your thoughts to the contents of the book and the time when you feel sleepy,just put aside your book and sleep.

5.If you are a spiritual person,repeatedly chant a mantra while you are on bed and your eyes closed,mentally without using your lips,you would get the sleep.

6.If you don’t have any mantra to chant,just do reverse counting from 1000 to 1 mentally,you would fall asleep.

7.If you have insomnia,take cold bath in winter and take warm bath in the summer season.

8.If you believe in yoga, get a CD of yoga nidra and play it in your bedroom and follow the instructions while lying on bed.

9.Listen to your favourite music at low volume to concentrate your mind.

Headache a totally different approach

For many of you headache is a commonest complaint in your day to day life.This hampers your working potential and many times it is so unbearable that you can enjoy nothing.Even for a clinician it is most challenging to figure out the exact cause without some of the costliest investigations.I am here not for the professionals and my target population is the general community for whom I have dedicated my blog.
Whenever you get headache you generally take NSAIDS(analgesics like aspirin,paracetamol,ibuprofen,diclofenac,nimesulide etc.)sold over the counter.Those drugs help you sometimes relieving your headache as long as their level maintained in blood and sometimes you are simply helpless and nothing is working.
A wide variety of factors are responsible for your headache,it is only you or your primary physician who takes your history carefully can understand the exact cause.In my life I have seen approx 3 lac patients from general community in my life and whatever I have got I would like to share with you.
1.If you are not sleeping adequately,you can have headache.Sleeping is important for your brain to relieve your brain from all the junk files and traces and invalid registeries.When you sleep you tend to clear your RAM by shifting the important contents to your hard disc so after getting up your processing speed gets enhanced.One more beautiful thing of sleep is that, whatever our repressed desire in our mind which overloads our subconscious level in our whole day interaction with society,gets released in the form of dreams we get during REM sleep(In our 90 minutes of sleep cycle there is a stage of approx 25% of each sleep cycle in which there is a Rapid Eye Movement-REM)now the question is ,how many hours should we sleep.In my opinion one should sleep for 8 hours daily.
2.Sleeping is good for your brain but you should take care that the room in which you are sleeping should have proper ventilation otherwise your sleeping would give you headache.Why?You are in a closed room and utilizing available oxygen(We take in oxygen gas and give out carbon dioxide gas in breathing)of that room and increasing carbon dioxide gas in the room which may cause headache.Specially this is common for such people to have headache who live in Air Conditioned room and not running their airconditioner or their air conditioner is such that,it is not drawing fresh air from outside so the oxygen level of that room gets reduced and carbon dioxide gas increased.In kitchen where there is no ventilation,Housewives cooking food on LPG use to consume oxygen of that room on my the burning stove and another by the breathing housewife.If such room has no adequate ventilation the housewife may complain headache due to work in low oxygen and high carbon dioxide level.Further the housewives of low socioeconomic strata burning coal or wood for cooking may also get headache due to inhalation of excessive carbon dioxide generated in the combustion of fuel.If you are sitting in air condition car and your air-conditioner is on but it is recycling internal air of the cabin,it will accumulate carbon dioxide and the oxygen gas would be reduced in the chamber and you may get headache.So you are advised to run your car AC in such mode in which it draws external air but at times when you are driving through a place which is full of dust and smoke you should revert your Car AC in internal air recycle mode.
So to relieve headache one needs good sleep and fresh air and plenty of oxygen.
3.Your eye strain due to any cause may give you headache.If you have some problem in vision,and you require some corrective glasses,and you are not wearing your glasses,you may have headache.
Those persons who are watching TV ,computer,laptop or mobile screen for longer periods may have headache.They are advised to pause such activities and watch some distant object and some near object in alternate fashion.This will be a good exercise for their eyes.After which just close the eyes and gently and delicately massage your eyeball.This would reduce your blood pressure by occulocardiac reflex.
4.When you have not taken any meal for long,you may have headache.Here two complaints together arises first is gas problem,since your stomach is empty and your gastric juice coming in stomach which have nothing to digest so the gas is formed and you may have fullness of abdomen due to gas and headache together apart from this you may experience giddiness due to low blood glucose level in prolonged fasting stage.Your headache can be relieved by carbohydrate rich diet.Further in such prolonged fasting stage your systolic blood pressure may be high due to stress.Your blood pressure commonly recorded and expressed as for example 120/80 in which the 120 is your systolic pressure and 80 is your diastolic pressure.When heart pumps it contracts which is called systole and when it receives blood it expands called diastole so the pressure is expressed as systolic/diastolic blood pressure.
5.Almighty has made our facial bones hollow.There are empty spaces in the wall of our cheek bones,forehead bone and some bones which a common man has not seen behind the forehead bones.Do you know why the almighty has created such hollow bones in our face?This is because the sound produced from our vocal chords gets resonance due to those hollow spaces of facial bones.Those hollow spaces are called sinuses.Those hollow cave like spaces have got only one door for each which opens deep inside our nose.Some times when we are exposed to infection and/or dust which enters our nose and blocks the only door of any of those rooms.All the secretions and bacterias remain trapped there.Those bacteria are such bacteria which grow in the absence of oxygen.They cause damage in those hollow rooms or sinuses and we the doctor say it sinusitis (inflammation of sinuses).This sinusitis is also a common cause of the headache.To relieve such headache apart from the over the counter sold NSAIDS,you need two more things one to take steam inhalation by putting some pain balm like material which contains eucalyptus oils just of the size of a match stick head in one litre of boiling water.This steam would decongest your nose and sinuses and their door would be opened and the contents of the sinus would be drained and two,some good antibiotics like amoxycillin and dicloxacillin combination for at least five days.The dose should be adjusted for weight,age and other clinical condition.warning!all the drugs should be used underguidance of registered medical practitioner only.One more thing I would like to say here,whenever you use antibiotics,you should take one vitamin B Complex capsule also per day for the period you use antibiotics.Because when you use antibiotics to kill the harmful bacteria of your body,it also kill many helpful bacteria in your intestine which make Vitamin B Complex for you.So you may get symptoms of vitamin B complex deficiency if you don’t take the B Complex capsule together.You may have glossitis and stomatitis(inflammation of tongue and mouth).
How steam plus balm inhalation relieves your sinusitis and headache..When the sinus congestion gets cleared,its contents get drained and you feel light headed after steam inhalation.Apart from this the bacteria which grows in absence of oxygen gets killed by oxygen entering in those space after clearance of blockage by steam and the remaining microbes can be killed by antibiotics.
6.If you have any infection in ear you may get headache.Ear has three parts.outer most which leads to a tunnel ends on a thin sheet(ear drum)anything you pour into the tunnel would not go beyond that sheet.Any infection of this external portion can be treated with antibiotic or antifungal ear drops plus oral antibiotic or antifungal medicines.
To be continued…….
Beyond the sheet (ear drum)there is another small chamber called middle ear.This part has also a tunnel which ends to a door which opens in our throat and communicates with our upper airway and food way(pharynx)That door is generally closed and opens when we swallow anything.If you swallow anything while you are lying down this door gets opened and any secretions or material in upper pharynx may enter to the tunnel by gravity and block that tunnel.From that tunnel finally go into middle ear and cause infection and headache.Your middle ear can also get infection from outside if your ear drum is perforated.Your middle ear infection and symptoms may be relieved by NSAIDS,Antibiotics,steam inhalation and what else?Have you chewed bubblegum or chewing gum.I am not joking!You can improve your middle ear drainage by chewing bubblegum or chewing gum while standing or sitting in upright position.This process opens the middle ear’s tunnel door at the time of swallowing of your saliva and helps to drain the tunnels and middle ear cavity under the influence of gravity when you are sitting or standing erect.
7.If your blood pressure is very high,you may have headache.But for the blood pressure to cause headache,generally the diastolic pressure should be greater than or equal to 120 mmHg.To relieve such headache your blood pressure should be controlled to normal level.Many of you may ask,what is considered normal blood pressure?
Normal blood pressure systolic is 100 to 139 mmHg and diastolic 60 to 90 mmHg.If your blood pressure reading comes in above range your blood pressure is normal.One more thing I should add,the pressure should be taken at least 5 minutes of rest in lying down position.Many times when you do heavy exertion,your blood pressure gets increased far beyond the limit specified above,but that increase is for the time being and settles down when you be at rest.Contrary to my above statement there may be inverse phenomena in the atheletes who are accustomed to heavy exercises.
8.If you are a user of tobacco or a smoker you may get headache because of nicotine accumulation in your body.Our brain is suspended in water(called cerebrospinal fluid) within skull bone.We know that when we put any thing in water,its apparent weight gets reduced by buoyancy(an upward force equal to the weight of displaced water by that object)The sheet around our brain which suspends brain into that water is sensitive to stretch and we feel headache if that sheet has greater load or stretching.For that buoyancy the weight of brain which is around 1400 gram is reduced to 400 gm.If the amount of the cerebrospinal fluid is decreased the apparent weight of the brain would be increased.
So the tobacco user or smoker accumulate nicotine in their body which reduces the cerebrospinal fluid,thereby increasing the load on suspending sheet(meninges) of the brain and causes headache.Such headache may be relieved by cessation of smoking or tobacco use for 24hour or longer eo that nicotine level is decreased.
8.Some ladies have headache prior to menses which are generally due to hormonal imbalance.This is better to take guidance from a gynecologist for such headache.One more thing I would like to say the women should not take aspirin for headache at the time of menses because that will increase their menstrual bleeding excessively.Those persons who have asthma,bleeding disorder or peptic ulceration should avoid taking NSAIDS(aspirin,diclofenac,aceclofenac,ibuprofen etc.)In pregnancy also NSAIDS should be avoided.
9.Ladies who are taking oral contraceptive pills may experience frequent headache.For them they are advised to use alternative birth control method. experiencing headache should not be given aspirin.
11.Any person who have jaundice or liver disease shouldn’t be given paracetamol.
12,If you have cavities in your tooth or any oral infection,you may get headache.If you cannot afford to go to the dentist and undergo root canal treatment.You can do following:
-Rinse your mouth with chlorhexidine mouth wash for one minutes after each meal.(warning!do not swallow)and spill out the mouthwash after one minute.For fifteen minutes don’t drink or eat anything.After fifteen minutes rinse your mouth with water and spill out.
-Avoid vigorous vigorous brushing to your teeth,rather you should clean your teeth with your finger for few days.
-You can take amoxycillin and cloxacillin combination for your tooth infection in a dose adjusted for your age or body weight(warning !antibiotics should be used under advice of registered medical practitioner only)apart from this metronidazole should be added for better coverage of deep anaerobic infection in your tooth.These should be taken in appropriate dose for at least five days.Here the most important point is,if you have taken alcohol in last 48 hours,you must not take metronidazole at any cost.Further you should avoid alcohol for at least three days after your last dose of metronidazole.
-If you have dental problem you should take calcium and vitamin D3 supplementation,food reach in calcium are fish,particularly its head,if you can chew it totally.Those who are vegetarians the milk and all the dairy products are rich in calcium,custard apple,sitaphal,are also rich in calcium.Those who are very poor to afford this? Don’t worry a millet ragi which is extremely cheap and is one of the richest source of calcium.
10.You may have headache if you are working in area where illumination is very high or very low or inappropriate for that work.That headache can be corrected with proper color combinations of your workplace and application of prescribed luminous intensity in the work area.You can use tinted glass or protective goggles when the things are not in your control.
11.You may have headache if you sit in awkward posture for long or on a chair with poor ergonomic designs.For such headache you are required to do some aerobics for one or two minutes to improve your blood circulation.
12.You can have headache in excessive noise around you which is 85 dB or more.For this you sit relaxed ,put your both palms to their respective sides of the cheek,close your each ear with the tips of your thumb,close your eyes and keep index finger over each eyeball,each middle finger at the sides of your nostrils.Press all three fingers gently and breath in and out through your nostrils and listen to the sounds of breathing for two minutes.You would be at ease.
13.In our brain the pipelines of blood gets stretched on increased pressure in them.This is causes headache and labeled as migraine.There is frequently vomiting and some triggering event by dust,bright light,caffeine or sweets and short acting betablockers or calcium channel blockers are given but you are not advised to take those medications unless and until a qualified doctor has examined you and prescribed you.
14.Brain tumor,brain hemorrhage,meningitis all can give you headache and I am not going to advise you except that it is purely a subject matter of expert doctor and only he can help you.
15.If you believe in acupressure you can give rotatory pressure by your thumb to another thumb for 20 seconds for each side and both the great toes bulge by your one thumb for 20 seconds your headache may be relieved.
16.If you are working in hot environment for long with excessive sweating,you may have headache,such headache can be relieved by taking ors,cold drinks etc and you are required to come to the area where there is less heat stress.
17.If you are in extremely cold environment,then also you may have headache,such headache can be relieved in returning back in normal temperature and getting some hot beverages like tea,coffee,hot milk,soup etc.
18.When you are climbing up at high altitude fastly or descending down from the high altitude fastly,in both the conditions,you may have headache.Such headache can be prevented by gradual ascent or gradual descent to allow your body for acclimatization or adaptation.
19.One more thing that whenever you move from high temperature zone to low temperature zone or vice versa you should stay in intermediate temperature zone for 30 minutes.Such zones are called NT(normal temperature)rooms whose temperature should be the average of high and low temperature zones’actual temperature.
Thank you for patient reading!