What’s keeping India awake at night?

Alongside initiatives like ‘start-up India’ and ‘stand-up India’, the country appears to be in dire need of a ‘sleep-well India’ movement. All of its amritkaal dreams of prosperity may come to nought if its people are unable to be productive for lack of sound sleep. 

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Recently, three researchers — Karuna Datta and Anna Bhutambare of the Armed Forces Medical College, Pune; and Hruda Mallick of SGT University, Gurugram, Haryana — embarked on a project titled ‘Systematic review of prevalence of sleep problems in India’. They scoured thousands of scientific papers from repositories such as PubMed, Google Scholar, PsycNet, and Epistemonikos, and distilled them down to 100 studies for their analysis. 

Their conclusion? “India has a health burden of sleep disorders.” 

In a (yet to be peer-reviewed) paper they said their “final analysis showed major sleep disorders like insomnia, obstructive sleep apnoea (OSA), restless leg syndrome (RLS), in a sample of 67,844 individuals”.

The overall estimate for prevalence of insomnia was 25.7 per cent — one in four Indians is affected. The prevalence of OSA was 37.4 per cent, and RLS 10.6 per cent. “An increased prevalence was seen in patients of diabetes, heart disease patients and in an otherwise healthy population,” the paper says. 

The study divided the sample group into ‘patient’ and ‘healthy’ subgroups, and compared the incidence of sleep disorders. It was 32.3 per cent and 15.1 per cent, respectively, for insomnia; 48.1 per cent and 14.6 per cent for OSA; and 13.1 per cent and 6.6 per cent for RLS. 

Within the healthy group they found insomnia was prevalent in an “alarming” 34.7 per cent of college students. The consequences included ‘excessive daytime sleepiness’ in every fifth person surveyed.

Lifestyle modification

Pointing out that sleep plays a big role in the progression of non-communicable diseases such as diabetes and hypertension, the researchers call for a task force to delve deeper into the findings. They also suggest lifestyle modifications to reduce the disease burden before taking recourse to drugs for sleep disorders. 

Notably, two of the researchers, Datta and Mallick, were involved in an earlier study that looked at the effect of yoga nidra on reducing sleep disorders. In their paper, published in The National Medical Journal of India, they say they enrolled 41 persons with chronic insomnia for the study on non-pharmacological interventions. Twenty of them received a “conventional intervention of cognitive behavioural therapy” and the rest took up yoga nidra, which is described as a “systematic method of inducing complete physical, mental and emotional relaxation by turning inwards, away from outer experiences”.

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Both worked, but they found that during the ‘non rapid eye moment’ phase of sleep, yoga nidra led to marked improvement in the ‘deeper’ and ‘deepest’ stages of ‘total sleep time’. Yoga nidra improved both ‘slow-wave sleep’ and ‘sleep onset latency’ (time taken to fall asleep).