Sleep Disorders in Chennai: A Growing Concern

As a Consultant Psychiatrist based in Chennai, I have observed a significant increase in sleep disorders among my patients. Sleep-related issues such as insomnia, obstructive sleep apnea (OSA), restless leg syndrome (RLS), and circadian rhythm disturbances are now more common than ever.

Disrupted sleep affects both physical and mental health, leading to problems like fatigue, mood disturbances, cognitive difficulties, high blood pressure, and increased risk of heart disease. While lifestyle changes and therapy play a crucial role in sleep management, many individuals turn to sleep medications for quick relief. However, not all sleep medications are safe for long-term use.

Commonly Prescribed Sleep Medications and Their Side Effects

1. Benzodiazepines (BZDs)

💊 Examples: Diazepam, Lorazepam, Clonazepam, Alprazolam
⚠ Risks & Side Effects:

• Habit-forming, leading to dependency and addiction
• Drowsiness, confusion, dizziness, increasing the risk of falls (especially in elderly patients)
• Long-term use can cause memory impairment
• Withdrawal symptoms if stopped abruptly

👉 When to Use: Only for short-term treatment of severe insomnia or anxiety-related sleep issues under strict medical supervision.

2. Non-Benzodiazepine Hypnotics (Z-Drugs)

💊 Examples: Zolpidem (Ambien), Zopiclone, Eszopiclone
⚠ Risks & Side Effects:

• Next-day drowsiness affecting work and driving
• May cause hallucinations, nightmares, and behavioral changes
• Risk of dependency and tolerance with prolonged use

👉 When to Use: Can be helpful for short-term relief of insomnia, but should not be relied on long-term.

3. Antihistamines (Over-the-Counter Sleep Aids)

💊 Examples: Diphenhydramine, Doxylamine
⚠ Risks & Side Effects:

• Grogginess, dry mouth, dizziness
• Cognitive impairment, particularly in elderly patients
• May cause rebound insomnia when stopped

👉 When to Use: Occasional use for mild sleep disturbances, but not recommended for regular use.

4. Antidepressants with Sedative Properties

💊 Examples: Trazodone, Mirtazapine, Amitriptyline
⚠ Risks & Side Effects:

• Weight gain, dizziness, and daytime sedation
• May cause blood pressure fluctuations
• Some patients experience restless sleep instead of deep sleep

👉 When to Use: More suitable for patients with coexisting depression and sleep disturbances.

Safer Alternatives for Sleep Management

For individuals struggling with sleep disorders, non-addictive and safer medications are often a better choice.

✅ Melatonin Supplements

💊 How It Works: Melatonin is a natural hormone that regulates sleep-wake cycles.
✔ Ideal for: People with jet lag, shift work sleep disorder, and mild insomnia.
⚠ Caution: Can cause mild headaches or dizziness in some people.

✅ Ramelteon (Melatonin Receptor Agonist)

💊 How It Works: Mimics natural melatonin to promote sleep without dependency risks.
✔ Ideal for: Long-term management of sleep onset insomnia.

✅ Doxepin (Low-Dose Tricyclic Antidepressant for Sleep Maintenance)

💊 How It Works: Helps prevent middle-of-the-night awakenings.
✔ Ideal for: Elderly patients or individuals struggling with staying asleep.

✅ Cognitive Behavioral Therapy for Insomnia (CBT-I)

✔ A gold standard non-medication treatment for chronic insomnia.
✔ Helps patients identify negative thoughts and behaviors affecting sleep.
✔ Improves sleep without side effects or dependency risks.

My Recommendation as a Psychiatrist

While sleep medications can provide temporary relief, they should not be the first or only solution for sleep disorders. Long-term dependence on sleep pills can lead to serious health risks, including cognitive decline, addiction, and worsened sleep quality over time.

Instead, I strongly advocate for:
✔ Addressing underlying causes (stress, anxiety, depression, or medical conditions)
✔ Following good sleep hygiene practices
✔ Considering safer sleep aids and non-medication approaches like CBT-I, melatonin, and behavioral changes

If you or a loved one is experiencing chronic sleep issues, consulting a psychiatrist or sleep specialist can help determine the safest and most effective treatment plan.

📌 Need expert advice on sleep disorders in Chennai?
Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), DNB
Consultant Psychiatrist, Apollo Clinic, Velachery, Chennai
📞 For appointments, call: 85-95-155-808