An interview with Dr. Githanjana Mendis Consultant Neurologist
Insomnia or lack of sleep means difficulty in initiation of sleep or getting up intermittently during sleep or very morning awakening. This is a common complaint and some people have this problem off and on, some have it continuously.

Sometimes it could be due to sleeping during daytime, so they can’t sleep in the night says Dr. Githanjana Mendis.

The causes are due to psychological conditions, 1)Stress tension and worries 2) Depression. 3) Physical causes such as discomfort at sleep. 4) Infections etc.

Once you rule out that the day sleeping time is minimal, lack of sleep at night is real and serious attention should be made.

Insomnia can affect young and the old but it is more commoner in old age and affects males and females equally.

It is very clear that when a person suffers from lack of sleep, this itself is a worry that aggravates lack of sleep. If he or she worries that she can’t sleep it becomes a mental strain and the patient will find it impossible to sleep. Relaxation is the best answer and is important to avoid stress and tension before sleep. Relaxation tapes, are available and these tapes can induce sleep and help to get rid of anxiety and depression. Baroke tapes are freely available and these help a great deal. In most of the situations a double glass of hot milk tea will settle. When circulation to the stomach is encouraged, it will make the brain to relax to go to sleep. Coffee induces insomnia. Having to pay attention to lack of sleep, if a patient still suffers from lack of sleep the underlying cause should be taken note of. Depression or a physical problem may be a more likely cause that needs attention. If depression is the main cause for sleeplessness or early morning awakening, the patient should be treated according to the type of depresion. Paying special attention to the detailed history of the patient, his life style etc., so that treatment could be given accordingly.

If physical injury is the cause, this should be eliminated. If these two causes are eliminated, and if insomnia still persists, investigation such as EEG, brain scan is needed to find out the underlying cause. Medication could be mentioned. We must try as much as possible to avoid medication, as this could be a habitual practice. If medication is the only answer it should be given only for a short time.