The Impact of Sleep Disorder


Merriam Webster defines sleep the natural periodic suspension of consciousness during which the powers of the body are restored. It is also a state of torpid inactivity. A state marked by diminution of feeling.

Sleep is a period where our conscious mind is resting and our subconscious mind is still working so all our involuntary muscles is working.

Sleep has been a major area of work in my space as a dentist and as a hypnotherapist, particularly since I am sleep challenged myself.

Sleep is the period of repair and rejuvenation, for the physical and the emotional body. It is a period of sorting for the mind.  I shall talk about this over the week, but as of now, physiologically speaking we are talking about REM sleep, NREM sleep, detoxing of the lungs, the body cycles coming to a balance etc. Etc.

Emotionally speaking we are talking of sorting of thoughts eliminating the unwanted, preserving what we perceive as relevant. We are also talking about predictive dreams, venting of excess.

Being sleep deprived is one of the most, physiologically and psychologically dangerous states. Sleep disorders have entered the Indian population, contesting with the American. But the other side is that it is estimated that one third of the population goes t sleep where they are standing when it is time to sleep.

As of now the impact of sleep disorders on morbidity and mortality is not very widely appreciated.

With sleep disorders there is an increasing in daytime sleepiness and resultant increase in traffic accidents.

There is a study that states that disturbed sleep cycle during child rearing has its effects at a later stage.

Sleep disruption makes it difficult to cope with many medical disorders. It also reduces the attenuation of school and work ability, giving rise to psycho-social consequences and a constriction of leisure and pleasure time. There are specific effects linked with each condition.

Sleep apnoea increases risk of myocardial infarction and stroke. Cognitive deterioration, presumably on basis of repeated nocturnal hypoxia and sleep disruption has been described in a number of studies, and personality change is part of continuous fatigue leading to marital friction, divorce difficult interpersonal relation, etc.

Insomnia though often trivialized by doctors, is a common symptom albeit often self-limiting. In up to 80% of the cases insomnia reported in general practises due to anxiety and depression.  Even in a specialized clinic one third of the cases are related to anxiety and depression.  Many insomniacs tend to self medication, which could be ineffective and dangerous. When associated with other disorder this could be a trigger for suicidal behaviour. If the patient resorts to hypnotic medication to deal with sleep it could interact with alcohol intake. Long term use of benzodiazepines can impair cognitive powers particularly in elderly.

Narcolepsy is a disorder with the longest duration from onset of symptoms before diagnosis. It impacts the quality of life, in a study of impact of various disorders to the quality of life, narcolepsy rates second only to quadriplegia.

Historically we have a belief system or rather a misconception that sleep is a passive period, but contrary to it, sleep is the active restorative processes of the body. Some authors look at the small hours of the morning a high risk window for mortality. F.Scott Frtozgerald wrote in 1945, that in the real dark night of the soul it is always 3 O’clock in the morning. Many studies show an increased mortality in late sleep and early waking hours.

Studies have shown that nocturnal asthma is pronounced in the latter part of the sleep and particularly during the REM phase. Though asthma is not fatal in itself, people dying of asthma tends to do predominantly in the night. This could be due to patho-physiology of the sleep.

There are large number of medical disorders that exhibit peak mortality at night, then are specific though rare disorders associated with sleep… this is seen in south asian men and is thought to be REM related arrhythmia.

American cancer society shows, that deviation from age appropriate sleep that is two hours longer or shorter than normal leads to increased mortality, which is more pronounced in women than men. This effect increased with age.

A random survey of more variable sleep patterns was among young adults that are between 18-34yrs of age and older adults that are over 65, as compared to middle aged adults.  People sleeping a normal duration of 7-8hrs reported lower rates of illness.  There are patho-physiological changes during sleep which lead to increased morbidity, like hypercapnic and hypoxic drive is diminished particularly in REM sleep. There are patients for whom epilepsy is exclusively sleep related. Gastro-oesophageal reflux is more common at night. Certain patterns of headache such as cluster headaches have an onset during sleep.

Care giving of elderly person is associated with disruptive sleep for the caregiver causing patho-physicologic changes that sometimes becomes intolerable.

Many sleep related disorders appear in the hospital, sometimes even requiring hospitalization, present as diminished productivity, could be either circumstantial or direct consequence of fatigue related accidents.

Fatigue peaks occur in the early hours of morning and a second fatigue peak occurs in the mid afternoon. These peaks show up as increased incidence of road traffic accident. Studies suggest that 20% of all the drivers have fallen asleep behind the wheel at least once. One third of heavy trucking accidents are the result of the driver slipping into sleep deficit fatigue. Aircraft pilots flying jets have exhibited similar dips during electroencaphalograhic recordings.

There is a seven fold increase in road traffic accidents in patients with sleep apnoea, and in a study 60% of these patients describe falling asleep at the wheel at least once a week.

Sleep walking infrequently leads to accidents but occasionally leads to death it is very rare that sleep related homicide is reported.

Some statistics of sleep disorders.

  • Narcolepsy about 0.15% manifests this.
  • Obstructive sleep apnoea about most common in middle aged overweight people. 4-8% men and 2-4% women manifest it.
  • Restless leg syndrome definitive data not available, 5-15% manifest it, of the subjects 11% were pregnant women 15-20% people with uraemia and about 30% with rheumatoid arthritis.
  • Shift-worker sleep disorder about 2-5%
  • Sleepwalking 1-15% though more common in children.
  • Sleep terrors is seen in 3% of children and <1% of adults.
  • Nocturnal leg cramps definitive data is not available, but about 16%of healthy people do present it.
  • Nightmares are seen in 10-15% of children between 3-5 years, it is enough to disturb their parents about 50% adult, have occasional nightmares and 1% have frequent that is more than once a week.
  • Isolated sleep paralysis is seen in 4-050% of patients, and 40% patients with Narcolepsy also present sleep paralysis.
  • Impaired sleep related penile erections are in 10% of the men as chronic.
  • Sleep enuresis is seen in 40% of 4 year olds, 10%6 year olds, 5% 10yr olds, 3% of 12year olds, 1-3%of 18yr olds. Primary enuresis comprises of 70 -90% of all cases while 10% of it is due to secondary enuresis.
  • Insomnia is seen in 30% annually and one third of them complain that the problem is severe.
  • Primary snoring is seen in 40-50% of the men and lover>65yrs.
  • Sudden infant death syndrome is estimated to occur in 1-2 / 1000 live births.

Sleep disorders like sleep apnoea, particularly when associated with other medical diseases, are associated with increased mortality.

Sleep related problems can cause financial loss. Three is a loss of productivity as a consequence of shift work and the increased medical care of shift workers. Admission to the hospital of elderly people with sleep duration, the cost of sleep debt fatigue related accidents are all factored in and in a country like America it is about 16,000 million. Increase in work time, which is almost 8% over the last century has the consequence of decreased leisure and sleep time. The consequence of this is fatigue and a drop in the quality of life. This again does not manifest tangibly but it reduces productivity and impairs performance.

In adolescents there is a decreased ability to retain learning, and an increased sleepiness, in the severely sleep deprived aggressive anti-social behaviour is also seen.

Unfortunately neither the medical fraternity nor the society takes this aspect of human requirement seriously.

reference :

sleep apnoea workshop hosted by Elder Pharmaceuticals.

Impact and Epidemiology of sleep disorders by Colin.M.Shapiro,William.C.Dement.



World sleep awareness day


Sleepy head…?

How many of us have been called that at some point or the other and resented it.

Have you had situations where you felt you could not keep your eyes open? Has this caused you an important assignment, or a contact, or sheer publec embaressment.

Did you ever wonder if your sleep levels were normal or not?

Just take this test,

0                    no chance of dozing

1                    slight chance of dozing

2                    moderate chance of dozing

3                    high chance of dozing.

Situation Score
Sitting and reading.
Watching TV
Sitting inactive in a public place. Eg theater or a meeting.
Lyind down to rest in the afternoon when circumstances permit.
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In acar,while stopped for a few minutes in traffic.

Total your score.

0 – 9                normal             you need not worry

10-13               mild                 you may be excessively sleepy depending on the    situation. You may choose to seek medical attention.

14 -19              moderate         you may be excepetionally sleepy depending on the situation. It might be  essential to seek medical attention.

20-23               severe              you are excessively sleep seek medical attention.

Things to Know About Endometriosis.


This is the endometriosis awareness month.

Endometriosis is a condition that results from the appearance of endometrial tissue outside the uterus and causes pelvic pain, especially associated with menstruation.

Endometriosis is the ectopic presence of endometrial glands and tissues. Endometrium is the mucous tissue of the uterus which thickens during the menstrual cycle to prepare the uterus for the possible embedding of embryo.

6-10% of the women of reproductive age suffer from it. The stigmata include dysmenorrhoea, chronic pelvic pain, irregular uterine bleeding and/or infertility.

It is quite under diagnosed and has a latency period of 6-years before diagnosis.

It is debilitating and affects the quality of life.

The definitive cause of endometriosis is elusive though several causes are cited.

Common signs include

  • Painful periods particularly of the lower back and abdomen.
  • Pain during intercourse.
  • Pain during urination or bowel movements, particularly during periods.
  • Excessive bleeding
  • Additional symptoms like fatigue, diarrhoea or constipation, bloating or nausea during periods may be there.

Often when endometriosis gets diagnosed when the woman concerned has an issue in conception, or an infertility issue.


  1. Retrograde menstruation: menstrual blood flows into the pelvic region instead of out, this could stick the pelvic wall causing nevi.
  2. Transformation of peritoneal cells or the cells of the inner side of the abdomen into endometrial cell.
  3. Embryonic cell transformation hormones like estrogens may transform embryonic cells in the early stage of development.
  4. A surgical scar behaving like an implant.
  5. Endometrial cells transplanting through blood vessels or lymphatic system.
  6. Immune system disorders.

All the above are proposed pin-pointing a particular cause is rather elusive.

Risk factors that could aggravate endometriosis.

  • Never giving birth.
  • Starting periods early
  • Delayed menopause
  • Menstrual cycles of less than 10 days.
  • Increased oestrogen levels in the body or greater span of exposure to oestrogen.
  • Low body weight index.
  • Alcohol consumption.
  • Maternal and matrilineal history of endometriosis.
  • Any medical condition that prevents natural menstruation.
  • Uterine abnormalities.

The signs and symptoms appear as pain and dysmenorrhoea after few years of menarche. It temporarily ceases with pregnancy and stops with menopause. Untreated endometriosis could result in infertility or ovarian cancer.

Its not about Bruises and cuts


March 1st is the Self Injury awareness day.

Self injury is not any celebrate non-suicidal behaviour that inflicts physical injury to the body. This helps to deal with intense emotional distress or awaken the person from a sense of numbness or dissociation that sets in after emotional trauma.self injury 3

The physical pain validates and makes the pain real than the emotional one.  Though morphing the emotional pain to a physical one relieves the pain, the underlying issue remains.

People who tend to cause self injury are spread across age, gender, social-economical status, ethnicity, personal strength and even sexual orientation.

The types of self injury are very unique and absolutely personal.

The severity of the injury is not proportionate to the level of emotional distress. Whatever the severity, help is essential. The need to talk to someone is great.

Since self injury happens as a cope up mechanism for intense emotional trauma, it can manage through alternate handling.

  1. Call someone up and talk for few minutes until the emotional overwhelming calms. It could be talking about anything.
  2. Acknowledge the emotional pain.
  3. Learning to express the feeling.
  4. Take a deep breath and resist the impulse at least for 15mnts.

Self injury is a sign of emotional distress. Severity or type of injury is not dependent on the level of emotional injury nor is it dependent on the personal strength of the individual.

Admitting emotional pain and seeking help is the thing to do and it takes tremendous courage to do so.

Of course when you begin to open up, there could be incredulousleness, blame game and judgemental advices but walk through it without paying heeds.

Even with therapy there could be occasional relapses.

As a hypnotherapist, for self injury is either about an undead past life or a Karmic obsessor. Both of which can be healed.

Sometimes people are unable to connect to their emotional self, particularly if over intellectualizing and analyzing has worked well for them before. Then this connect has to built very gradually and gently.

What worked for me was, a bit of meditating in the morning,

  1. Sit comfortably without resting your head. Feet firmly on the ground.
  2. Visualize that you are taking in the energy from the earth as deep as you can and release the breathe briskly through the nose. Do this seven times.
  3. The next visual is taking in the energy from the sun, take a deep breathe and release it very very slowly. This is seven times too.
  4. Just try to visualize the blending of the two energies that you have assimilated within you.
  5. This makes you sensitive to the environment round you, you will become aware of various sounds and smells around you, do not channelize the thoughts just let it flow and write them down as it flows. The writing should be in long hand, no spell checks or grammar checks do not read what you have written. Just write for the next 10mnts.

The writing is cleansing the intellect, after couple of days you will become aware of a pattern, sometimes there is anger that is release sometimes, grief there is also awaking of the creative streak from within.self injury 4

Another exercise that helped was geometric drawing in the night before i go bed. The only criteria I put for myself was the drawing had to geometric and it had to begin from the centre of the page. People have found relief with zendala’s and zentangles too.

For hypnotherapy consultation DM on @parwatisingari. or leave a message at the comment box and I shall get back.




Stand against Bullying


The Friday of February is the world stand against bullying day.

Bully is defined as forceful subjugation by use of power or intimidation.

It could happen anywhere and the frequency spikes with each successful episode of bullying. Houses, schools, yards, cyberbullying there are all out there.

Many times we do not understand the fine line between bullying and ragging. Actually the varying intensity of the same. Many countries have anti-bullying laws in the India has too, but somehow the anti-ragging takes over the entire limelight.

Lets look at what is bullying. Bullying could be

  • Personal
    • Name calling
    • Teasing
    • Taunting
    • Threatening
    • Even sexual overtones in conversation would fall in this space.
  • Social
    • Exclusion,
    • Intimidating others to isolate, or ex-communicate
    • Spreading rumours.
    • Embarrassing people in public.
  • Physical
    • Kicking, pinching, hitting
    • Spitting
    • Tripping, pushing shoving
    • Breaking property
    • Making lewd hand gestures.

The perpetuator and victimology is discussed in the blog The Big Bully. Bullies are usually victims of bullying themselves. They are then unable to face the humiliation and feel very helpless, bullying others brings back the sense of power in them.

To deal with a bully

  1. Ask external help. Particularly if it is physical then authorities like the police do help.
  2. Though every victim is effected in the personal space, it cannot be taken personally usually the perpetuator is a victim of bullying too.
  3. If you are dealing with scars of bullying it is a good idea to take the help of a hypnotherapist and release that scar from your space.

For anti-bullying laws in India. read here. For hypnotherapy sessions to deal with bullying click here.



Patients charter for tuberculosis.


The patient’s charter outlines the right and responsibilities of people with tuberculosis. It empowers people with the disease and their communities through this knowledge. It is endorsed by the WHO.  Stop TB partnership, national governments and civil society organizations.

Patients have the right to


  • Free and equitable care for tuberculosis.
  • Quality care meeting and international standards.
  • Benefit form community care programs like DOTS


  • Be treated with respect and dignity.
  • Social support of family, community and national programs.


  • Information about available care services,
  • Be informed about condition and treatment
  • Know drug names, dosage and side effects.
  • Access to medical records in local language.
  • Have peer support and voluntary counselling.


  • A second medical opinion with access to records.
  • Refuse surgery if drug treatment is at all possible.
  • Refuse to participate in research studies.


  • Have privacy, culture, religious beliefs respected.
  • Keep your health condition confidential
  • Care in facilities that practise effective infection control.


  • File a complaint about care and to have a response,
  • Appeal unjust decisions to a higher authority
  • Cote for accountable local, national patient representatives


  • Join or organize peer support groups, clubs and NGO’s.
  • Participate in policy making in TB programs.



  • Job security from diagnosis through to cure.
  • Food coupons or supplements if required.
  • Access to quality assured drugs and diagnostics.


Patients have the following responsibility.


  • Inform healthcare staff all about. Your condition.
  • Tell staff about contacts with family, friends etc.
  • Inform family and friends and share your TB knowledge.


  • Follow the prescribed plan of treatment.
  • Tell staff of any- difficulties with treatment.


  • Encourage others TB-Test if they show symptoms.
  • Be considerate of care-providers and other patients.
  • Assist family and neighbours to complete treatment.


  • Show solidarity with all other patients.
  • Empower yourself and your community.
  • Join the fight against TB in your community.

This is part of the Axsheya and DOTS program of TB prevention, feel free to print, share and use this information.

Know the RO water purifier price for your home.


Water purification

Once up on a time there were no industries,  no deforestation and less pollutions, so water was clean like the air. The dead and decaying plants and animal carcass created antibody giving the rivers their mysterious healing power.

Now things are different, water is polluted, and we need to purify water. So how does water get cleaned? What are processes that allows purification. But before that let us look at the relevance of water.

Earth is made up of 82% of water was what we learnt at school, the USGS water science school says that it is 71% lets stay with that. This water manifests as different water bodies, oceans, seas, lakes, rivers and even within us.

In our everyday life we need water to sustain us, we either drink it or used it cook, we also use water to bathe and clean. Water is an essential part of our existence.

The 2014 WHO report claims that 842,000 deaths/year are courtesy waterborne disease. These deaths could have been prevented if adequate care had been taken. Clean, safe portable water is necessity. Indiscriminate urbanization like remote location is hugely challenged when it comes to sanitation. This also raises challenge to safe and hygienic drinking water. Water contains, ions, algae, nutrients, parasites sometimes minerals and lot more.livepure2

various methods are used for purification, these methods are established depending on the purpose of water consumption.

  • Boiling water of course is the most traditional way of doing things
  • Filtration. This is a physical process and eliminates water and gross particle suspensions.
  • Distillation or boiling water condensing it and collecting it is another popular method.
  • Sedimentation, uses basin or clarifier, it separates amorphous metal hydroxide from water, this is commonly called demineralization.  Studies however say that removing minerals from water could cause digestive and urinary problems.
  • Slow and rapid sand filtration, are biologic process where sand is used . water seeps through the layers of sands, slowly until it is safe for consumption.  In the rapid sand filter activated carbon is used which removes taste and odor from water.
  • Flocculation and coagulation is the term that is used  when chemical components are added to water to remove unwanted particles both organic and inorganic.
  • Chlorination is another popular methods, but this harmful both to germs and humans.
  • Iodinization is done using 2% tincture of Iodine, this kills, bacteria and viruses when added to water but is only moderately effective when it comes to Protozoa.
  • Calcium hypochlorate or Pool Shock is used. It is safe and effective as long as it is not mixed with other chemicals or algaecides. It is quite economic to. But it is essentially an alternate chlorine product.
  • Finally we have the ultra violet rays. For this method to be effect the water needs to be clear.

Despite the efforts of the municipalities to ensure that water supplied to houses are safe, the water is not safe to portable and consumed.  Being aware of this most of us boil or filter the water. Boiling does eliminate lot of germs but it has its limitations. Water needs to boiled for at least 20mnts to kill the microorganism. It could get recontaminated when it cools down.  It consumes time and alteration of taste occurs with the escaping oxygen.

UV Light is a safe way to purify water, it can destroy the micro-organisms. This process is the ultraviolet germicidal irradiation and it uses 250-270 nanometer wavelength of ultraviolet light rays. Unlike the chlorinated water, it does effect the taste or smell of water.

UV light process is a physical one and not a chemical one. it renders the microbe ineffective by destroying the genetic material inside the cell. Though it is possible render water totally sterile, it is not practical when it comes to household applications, which is the claim is the water is 99.99% microbe free.

With UVLight the advantage is major disease causing bacteria like E.coli, typhoid, dysentery etc. get nullified without changing the taste or smell of water.

There are a few limitations however like

  • UV purification is effective when the light is strong and exposure to the water is adequate.
  • The water should be  clear of suspended and dissolved particles so that its intensity is not reduces.
  • Unfiltered water could shield microbes from UV-rays.

The RO and UV purification system offered by Livpure makes it the best option as  passes the water through 6 filters, including the RO filter filtering the water so that it is almost crystal clear, this is now allows the intensity to be optimal, water is clear there is nothing to shield the microbe from the UV rays, so the  water becomes microbe free. Finally essential minerals are incorporated into the water to ensure that the water is healthy.

livepureLivpure has products of various efficacy and economy… you could choose the right one for you here.. RO water filter prices..if you are confused how to choose you could invite the Livpure expert to check the quality of the water in your zone and choose the right one.