"My neighbour's clock strikes every half an hour. Cats mewing on the community, footsteps on the floor above, and my husband's breathing in sound sleep. When sparrows start to chirp, I know the new day is dawning, and the night is over."

"I can't get enough sleep on work days," complained a man of 29. Having to get to work at 8:30am forces him to get up at 7:00am. To make up for the lost sleep, he sleeps to the full on weekends, getting up after noon.

"I have formed this terrible habit. Having slept for half the day on Sunday, I can't fall asleep at night. Then on Monday I feel tired and start another week of insufficient sleep," he said.

"I wake up early in the morning. I feel tired and don't want to get out of bed, but I can't fall asleep again," said a woman. She has lost interest in most things she used to enjoy doing and become lazy, unwilling to do anything and feeling tired most of the time.

The cases above are all examples of sleep disorders. These problems, such as insufficient sleep, insomnia and poor quality sleep, have entered spotlight, as International Sleep Day draws near.

Restless pressure

No large-scale survey has been undertaken to study sleep disorders in Shanghai and provide convincing statistics about the population suffering from it. But surveys carried out in other countries suggest 47 per cent of the general population may suffer from sleep disorder.

People have many wrong ideas about sleep. "There is neither the necessity nor the possibility of making up for lost sleep," said Doctor Lu Zheng, an expert from Shanghai Psychotherapy and Counselling Centre.

"You don't need to worry about it if it's temporary, no longer than a week. The human organism can adjust itself," Lu said. Over 20 per cent of all adults experience continual insomnia during certain periods of their lives.

If the problem becomes serious enough to affect daily life and work efficiency, people need to do something about it.

"Some 50 to 70 per cent of insomnia cases are related to psychological, environmental or emotional factors," Lu said. More women than men suffer from sleep disorders, elderly people and those with psychological problems are also more likely to suffer from them.

Sudden changes in life, or serious accidents and catastrophes, especially if they result in death among family or friends, can cause emergent psychological disorders with nightmares and sleeping disruption.

Lu told a case about a man whose employer was about to change the position of some employees. The man became very nervous, for fear that he might be given a job which he couldn't do or be laid off. The nervous situation went on and on. He lost his appetite, could not concentrate on work, and felt exhausted physically and mentally.

Another doctor at the Psychotherapy and Counselling Centre, Du Yasong also mentioned the cases of anxiety and insomnia among students facing major examinations.

Students are faced with great pressure by college entrance examination, and the atmosphere grows tense in their classrooms. When their parents become very concerned about their physical and mental condition, they draw the children's attention to the problem. The interaction often makes the situation worse.

Besides the great pressure people face in the modern society and sudden changes in life, there are many other causes of insomnia, such as physical diseases, mental disorders (depression, anxiety), including side-effects of medicines.

But unhealthy or irregular lifestyles among many locals, especially youths, were the main cause of insomnia said doctor Xu Liang from Shuguang Hospital.

More insomniacs

Insomnia is a frequent problem in today's age of clinical medication. Over half of the patients in psychiatric departments of local hospitals complain of it, and 12 per cent of patients with other diseases also complain about insomnia.

About 10 years ago, insomnia was not considered a serious social health problem and there was no insomnia department in the hospitals.

But the disease threatens more and more people as the city's nights grow ever brighter and noisier while people experience more stress and tighter work schedules.

Professor Wang Qiaochu, the most famous TCM insomnia expert in the city, has witnessed the number of insomnia patients rising rapidly over the last decades. "Each year, the number increases by more than 2,000 people. Last year, statistics show over 10,000 patients came for medical help due to insomnia," Wang said.

"Years ago, most of my patients with insomnia owed it to their weak physical condition, but nowadays their physical conditions are usually over-stimulated," he said.

About 50 per cent of the patients are aged between 30-50 years, when people are under the greatest pressure among all age groups, according to Xu.

Lu suggested good sleeping habits, avoiding extra stimulation, and psychiatric treatment for severe insomnia.

Doctors are very cautious about prescribing sleeping pills to patients, since they often lead to serious drug dependence. Chronic use of sleeping pills can also cause memory weakening and a decrease in people's physical and mental abilities.

"They should stop taking pills as soon as there is improvement, or they should try different pills in order to avoid drug dependence.

"I always recommend my patients take herbal medicines, because artificial drugs have side effects and their residues can damage the kidney and liver," Xu said.

Patients suffering chronic insomnia are more at risk of diseases such as nervous breakdowns, high blood pressure, heart disease and gastric ulcers. Insomnia also damages the brain and accelerates its aging process.

And physical diseases may add to the anxiety of the patient, aggravating sleeping disorders in a vicious circle.

(Shanghai Star March 21, 2003)