One answer has stayed with me over the years because of how honestly it describes sleeplessness.
'Doctor, my body is on the bed... my mind is still at work.'
It wasn't a software engineer who said it.
It wasn't a student preparing for examinations.
It wasn't even someone going through a major life crisis.
It was a retired gentleman who couldn't understand why his nights had suddenly become longer than his days.
That's the interesting thing about sleep. It doesn't discriminate. Age, profession and routine may change, but the frustration sounds remarkably similar.
People don't usually complain that they aren't sleeping.
They complain about everything that poor sleep quietly steals from them.
Patience.
Concentration.
Energy.
The ability to enjoy an ordinary conversation.
Sometimes even the confidence to make simple decisions.
By the time many people decide to seek help, they've already tried almost everything someone has suggested.
Warm milk before bedtime.
Switching off the phone.
Listening to soothing music.
Herbal remedies.
Changing pillows.
Sleeping earlier.
Sleeping later.
Some of these habits genuinely help. Good sleep hygiene is an important part of healthy living.
But every now and then, during a consultation, it becomes clear that sleep isn't the real problem.
It is the messenger.
One thing psychiatry teaches you quite early is that the mind has its own way of asking for attention. During the day it may remain surprisingly quiet because work, family responsibilities and daily routines keep it occupied. At night, when everything else slows down, thoughts that have patiently waited their turn finally begin speaking.
Some revisit conversations that ended days ago.
Some rehearse tomorrow before tomorrow has even arrived.
Some keep searching for answers to questions that have no immediate solution.
The bedroom becomes silent.
The mind does not.
This is why one of the first questions during a psychiatric consultation is rarely, 'How many hours do you sleep?'
A more useful question is,
'What usually keeps you awake?'
The answer often tells us far more than the clock ever could.
For one person, it may be constant worrying. For another, low mood that has quietly settled in over several months. Someone else may describe racing thoughts that never seem to slow down. Occasionally, persistent sleep disturbance points towards an underlying medical condition that deserves equal attention.
Good mental healthcare is about understanding which story belongs to which person.
That is where sleep disorder treatment becomes much more than helping someone fall asleep.
The goal isn't simply to make the night shorter.
The goal is to understand why sleep stopped feeling restful in the first place.
Depending on the underlying cause, treatment may involve improving sleep habits, structured psychological therapy, medication, stress management strategies or a combination of these approaches. Every treatment plan is individual because every person's relationship with sleep is individual.
One concern that people often hesitate to voice is whether asking for professional help means they have become 'dependent' or 'weak.'
The answer is neither.
Nobody questions the need to investigate persistent chest pain or repeated headaches. Yet many people continue negotiating with poor sleep for months, hoping tomorrow night will somehow be different from yesterday.
Sometimes it is.
Quite often, it isn't.
Living in Pune means adapting to busy schedules, changing work patterns, academic pressures and responsibilities that don't always end when the office closes. It is therefore easy to dismiss disturbed sleep as an unavoidable part of modern life. Common, however, should never be mistaken for normal.
During consultations, Dr. Rujuta Latkar often reminds patients that sleep is not a luxury the mind earns after a productive day. It is one of the ways the brain restores itself, regulates emotions and prepares for the next day. When restful sleep continues to remain out of reach despite sincere efforts, it deserves thoughtful evaluation rather than endless trial and error.
Perhaps that is why the most important question isn't,
'Why am I still awake?'
It is,
'What has my mind been trying to tell me every night that I have been too busy to hear during the day?'
Sometimes, the answer changes far more than the quality of sleep.
It changes the quality of life itself.
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