Vishwanath (Hyderabad): I am 44-years-old engineering professional working in a public sector. I am well built, 6 feet height and weigh 92g. I do not get sleep with out tablets Nitrest. In the beginning I use to take it once in week now it has become daily. I have this problem for the last three years. In between I could avoid it for one complete year. I tried many times to sleep with out tablet. But now a days I am not getting sleep (with out tablet) at the best I may get two-hours sleep that too in the early morning hours. If I do not get proper sleep my complete day schedule is disturbed. I am taking tablets daily. I am also a patient of Atrial fibralletion. I am on Loprin and Concor tablets and these are mainly aspirin and blood thinner tablets. Can you help me to regain my sleep?
Dr M S Kanwar: You have chronic sleep onset and maintenance insomnia. You have developed dependence for Nitrest. The best option for you is to exercise sleep hygiene precautions viz no tea, coffee, chocolate etc after fiver pm, regular exercise programme, stress relievers like yoga and meditation, comfortable noise free sleeping environment, going to bed by 11 pm. If you have problem getting into sleep try not to think about your sleep or any day to day problems and an events, a job which should be left for the day. Change your sleep environment / room among 2-3 options frequently and finally maintain a diary called ‘worry diary’ to pen down all routine thoughts that cross your mind in the bed and think about solutions and answers in day time daily and right down in the diary. Spend half an hour on the diary in daytime daily. Also take Tab Zolfresh 10 mg at 10:30 pm daily night for two weeks and then reduce to five mg daily night for another two weeks.
Jayaprakash (Kochi): I am working as a software developer in Kochi, Kerala. I have been having the sleeplessness for some times, say around a year. So I had started reading a book until I feel sleepy but the reading usually went on till early morning. Usually even if I don't sleep much I don't have much problem, but sometimes I feel completely exhausted and can't do anything and will sleep for hours after that again return to the usual routine. I don't know why this is happening? If you can comment on my problems that would be of great help for me.
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Dr M S Kanwar: Stop reading at late night. Drink a hot glass of milk before going to bed and sleep hygiene precautions Take Tab Meloset 3 mg half an hour before bed time daily for three weeks.
Sindhu (Calicut): I can't sleep properly. I get disturbed sleep. When I get up in morning I feel tired and I don't feel like getting up. I have tried to sleep everyday on time but am unable to get sleep. Please tell me what to do?
Dr M S Kanwar: Your history is inadequate. Physical examination may help decide the reason for your problem. You do need a consultation with Sleep specialist.
Gajanan B Bhosle (Brunei): I frequently get up at night, panting and breathing heavily. Often the dreams I get result in suffocation and I get up. Afterwards it is very difficult to sleep. The dreams are different, but the end result is suffocation.
Dr M S Kanwar: You might need a sleep study to rule out Obstructive Sleep Apnoea or REM sleep related disorders. Sleep study will help you.
Amit (New Delhi): Since last one year, I feel that I am not sleeping that much as I used to sleep before. Noise, change in room temperature, thirst, nature's call and desire for sex sometimes wake me up and then I can’t go back to sleep.
I am 28, male, and single. I had a messy break-up last year and I am in the process of changing my career, which is yet to be stabilised. But whenever I have trouble sleeping, I don’t think about these two issues. I have no problems with them. I don’t get any nightmares. Half an hour of afternoon nap freshens me a lot. I have changed my mattress and pillows also. On an average I am sleeping only six hours every day.
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Dr M S Kanwar: You have sleep maintenance insomnia likely of the psycho-physiological type. Sleep hygiene instructions will help you. Secondly avoid routine afternoon nap. If you still have the problem then see a sleep specialist.
Jignesh Parikh (Chennai): I generally get to bed at around 12:30 pm to 1:00 am, but feel sleepy only after 45-60 minutes of reading. Soon after sleep, I get into my dreams that disturbs me lot and I feel as if I am awake all night. My sound sleep starts only after 5 -5:30 and am unable to get up before 9:00 am that causes me a lot of problems, specially forgetting things and headaches.
Dr M S Kanwar: You have some degree of Delayed Phase Syndrome. However, in view of excessive dreams that you described, you should undergo a sleep study which will help us decide on a couple of disease patterns that can be responsible for these complaints. They are not of serous nature, though.
Raghav (Gainesville): I have trouble going to bed. I get on the bed and struggle for more than an hour and still do not feel sleepy. As a result I end up going to bed very late and the whole next day seems tiresome. Please suggest a way out.
Dr M S Kanwar: Your history is incomplete but you do seem to have sleep onset insomnia. Sleep hygiene precautions will help you. Besides take Tab Zolfresh 5 mg half-an-hour before going to bed for two weeks only.
Roselin (Bangalore): I was checking myself in the quiz, I found out I have apnea. I feel tried and drowsy throughout the day even though I sleep enough. Please advice.
Dr M S Kanwar: If you are overweight, have a short neck or have an anatomical narrowing at the back of your throat and you snore also then you are certainly a candidate for Obstructive Sleep Apnoea. Please get a sleep study done. Narcolepsy can also cause these features.
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Mayank Mehta (Mumbai): Initially I worried about sleeping so I didn’t worry, but now even I worry a lot and I am not getting a good quality sleep. It’s been like this for about three months now. Please Help.
Dr M S Kanwar: Just observe sleep hygiene precaution to begin with.
Sandip Kumar Agarwal (Chennai): I have a serious problem sleeping. I had gone to a psychologist but it didn't help. The sleeping pills stopped working after 10 days please suggest some better ways to sleep.
Dr M S Kanwar: You need a thorough clinical examination and a dig into past sleeping pattern, psychological, emotional and anxiety states to decide the type and severity of insomnia. You will require some pills like Libotryp DS for two weeks followed by Libotryp for three weeks before withdrawing. Meanwhile sleep hygiene precautions should be started immediately. A sleep study should also be done.
M Bhaskar Chary (Hyderabad): I don't get sleep due to snoring. I get up in the midnight and I never get sleep.
Dr M S Kanwar: You need a sleep study.
Geetha (Canada): I tend to oversleep (more than eight hours) Is it normal/harmful ?
Dr M S Kanwar: It is alright provided you don’t feel drowsy and lethargy during the day.
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Biranchi Narayan Acharya (Cuttack): After my Engineering course was over I became a construction engineer. This type of work made me further addicted to go to bed very late (3 AM or 4 AM). The problem with me that however late I go to bed I wake up latest by 7 AM. During my thirties I started consuming alcohol. This helped me sleeping early but made me nearly alcoholic. If I am to get a good sleep, I have to consume liquor. A year before some body suggested to take sleeping pills Alzolam tablets. First I took Alzolam 0.25 mg. It gave marvelous results. But soon I required two tablets of 0.25. At present I am taking two tablets of Alzolam 0.5 mg but still not able to sleep before 12 midnights yet wake up by 4.30 am. I am 43 now. I am really not interested to increase the dose of the tablet neither wants to take those tablets at all. Alcohol is not suiting me, giving very unpleasant feeling during consumption or the day after. Hence I would request for a solution, as many doctors some time tell me that this is a peculiar problem and perhaps no remedy.
Dr M S Kanwar: You already addicted to both alcohol & alprazolam. Stop Tablets and reduce alcohol over next week or two and take no more than two pegs at a time. Take Tab Zolfresh 10 mg at around 11.30 pm daily for two weeks followed by five mg daily for two weeks.
Rahul Bhardwaj (New Delhi): I am a successful IT professional currently working at a senior level with an MNC in Delhi. I have been facing extreme sleeping disorder for last few months despite the fact that I am a non-alcoholic, non-smoking person into early 30s and lead a fairly balanced life. My blood pressure is perfectly in order and my height to weight ratio (Height: 5\' 6\'\', Weight: 68) is also within normal range. There have been times when i have not been able to sleep for 2-3 nights continuously which has resulted in making me feel extremely tired, exhausted during day time. I have just started doing some yoga in morning but still sleeping pattern is quite irregular. Please advise.
Dr M S Kanwar: Sleep hygiene precautions, yoga, meditation and regular exercise should certainly help you. Don’t get hooked to any pills.
Pravin (Hyderabad): I have long standing problem of insomnia and anxiety. I am 22 years of age. My job involves good amount of stress. I have undergone tests (thyroid, liver function test, etc). The results were normal. After that I have been prescribed alprax(4 mg daily).I have been prescribed seconal. Is it commonly available?
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Dr M S Kanwar: You are on the right medication but try to wean them off within a few weeks by observing sleep hygiene precautions and regular physical exercises.
Rana Khan (Pune): I cant sleep with out taking phenergan.
Dr M S Kanwar: You have developed Phenergan addiction. Take Tab Zopicon 7.5 mg daily night for three weeks. Stop using Phenergan.
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