Bangalore wants its students ready for artificial intelligence, its employees available for America, and dinner ready by eight. Then it forwards a message about eight hours of sleep. Apparently, somebody else is supposed to arrange those.
My nineteen-year-old engineering patient slept barely five hours, fitfully. Adults expected a ten CGPA while explaining that AI might make his degree useless. He still had three years of college left. His professional obituary was already circulating.
Distractions consumed his evenings; uncertainty occupied his nights. Study abroad? Change courses? Learn coding? Stop learning coding? Everyone offered career advice. Nobody offered to sit his examination. By bedtime, he was exhausted from considering lives he had not lived.
Sleep helps consolidate learning; losing it can impair attention and emotional control. He worried, slept poorly, struggled to study, then treated that struggle as evidence of inadequacy. Before believing his brain’s verdict, we needed to examine its working conditions.
First, though: was he postponing sleep, or unable to sleep despite allowing enough time? Was enjoyment disappearing too? Five hours describes a night. It does not explain it. Anxiety, insufficient sleep and depression can overlap; they require careful untangling.
My forty-five-year-old patient had a different difficulty. She could sleep. Her employer and family rarely left enough hours available. Working from home had given her two workplaces at the same address, and she was enthusiastic about overtime at both.
American clients stretched her evenings. Her college-going children needed managing. Her husband enjoyed good food and reviewed the cooking. Her husband wanted dinner on Indian time; her boss wanted her working on American time.
On social media, friends were enjoying holidays and restaurant meals. She watched other people unwind while planning breakfast. Even “take care of yourself” sounded like another assignment. Would she also have to research it, buy the ingredients, and clean up afterwards?
Her mood needed assessment. Her workload needed redistribution. Who would take over dinner completely, including deciding what to cook? “Just tell me what to do” leaves the exhausted person supervising. Even after she lay down, she remained the person everyone asked.
The retired professor, sixty-five, had time. Walking helped him sleep; longer walks aggravated his knees. His children lived elsewhere, his elderly parents needed attention, and friends were busy. Retirement had cleared his calendar but not his loneliness.
Then he said he had wasted his life. His achievements made that conclusion surprising, but reciting them would answer the wrong question. I needed to understand what his days felt like now. Had pleasure disappeared? How persistent was the hopelessness?
A respectable biography cannot tell us how bearable someone finds Tuesday. Nor could I assume loneliness explained everything. His mood, pain and sleep all deserved attention. Poor sleep can heighten pain sensitivity; pain can then interrupt the following night.
The three patients shared a complaint, but a standard bedtime checklist would miss much of their difficulty. The student needed his fears heard. The woman needed responsibilities lifted. The professor needed assessment that went beyond his step count.
Depression can involve early waking or excessive sleep, irritability or lost enjoyment. Ask what has changed: does favourite music still move you? Does meeting a friend still appeal? Sleep matters, but the hours awake contain clues too.
Tell your doctor about unusually energetic periods too. Little sleep with exhaustion differs from little sleep with racing thoughts, impulsiveness, or feeling extraordinarily capable. That second pattern warrants prompt assessment for possible hypomania or mania.
For two weeks, record sleep, naps, mood and daytime energy. Mention medicines, pain, loud snoring or gasping. These details help distinguish problems that can feel identical at breakfast: another night gone, another day to somehow get through.
Get enough sleep, keep your wake time reasonably consistent, and get daylight. Check the afternoon coffee: caffeine’s effects can last eight hours. The beverage you hired to rescue your afternoon may still be working when you want the building closed.
Slow, gentle breathing exercises may help you unwind; persistent insomnia benefits from treatments such as CBT-I. Seek assessment if poor sleep, low mood or lost enjoyment persists or disrupts daily life. Thoughts of self-harm need immediate professional support. You deserve help before you reach a breaking point.
A sleepless person becomes the family’s problem. The family rarely asks whether it has become the sleepless person’s problem.
