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The Hindu
6 days ago
- Health
- The Hindu
The science of sleep and the role of sleep aids
Some people seem to fall asleep the moment their head touches the pillow, while others toss and turn, counting imaginary sheep or scrolling endlessly on their phone. For the latter group, a growing market of sleep aids exists from white noise machines and rain sound playlists to herbal teas, melatonin pills and age-old practices like drinking warm turmeric milk before bed. Do these sleep aids help? And what makes falling asleep so effortless for some, yet such a challenge for others? Experts point to a complex mix of biology, lifestyle and environment. What is sleep? According to Sridhar R., senior consultant, Interventional Pulmonology, MGM Hospital, Chennai, sleep is broadly divided into two categories : Rapid Eye Movement (REM) sleep and Non-REM (NREM) sleep. NREM has three stages, from light sleep (N1) to deep, restorative slow-wave sleep (N3). REM, where vivid dreaming occurs, is vital for memory and emotional processing. A typical night involves four to six sleep cycles, each lasting 70–120 minutes, moving fluidly between NREM and REM stages. While adults require 7 to 8 hours of sleep, Indu Khosla, senior consultant, Paediatric Pulmonology, Narayana Health SRCC, Mumbai, notes that newborns may sleep up to 22 hours a day, children need 9 to 12 hours, teenagers 8 to 10 hours and older adults 6 to 8 hours. Interestingly, she adds, 'Indians and Asians generally take less sleep than their Western counterparts.' Experts explain that those who nod off quickly may simply have a robust circadian rhythm the body's internal clock and lower pre-sleep arousal. Others may benefit from optimal 'sleep hygiene': regular sleep times, low stress before bed and minimal light exposure. On the other hand, for people who lie awake, causes can range from excessive evening caffeine and screen use to underlying sleep disorders like insomnia or obstructive sleep apnea (OSA). Sounds and habits Auditory aids -- white noise, pink noise, rain sounds, whale calls, Indian classical ragas, even traditional conch blowing can help by masking sudden, disruptive sounds. M.S. Panduranga, senior consultant , Neurology, Dharamshila Narayana Superspeciality Hospital, explains,'The brain processes sounds even during sleep. A continuous, uniform sound acts like an acoustic blanket, reducing the chance of arousals from irregular noises.' Pink noise, such as steady rainfall, can even synchronise brain waves and consolidate sleep. Indian classical music, says Dr. Sridhar, offers a 'structured broadband quality' that relaxes without the jarring impact of random noise. For babies, rhythmic sounds may mimic the mother's heartbeat in the womb, aiding sleep but Dr. Khosla cautions against creating long-term dependence on such aids. Sindhu V., consultant, pulmonology, SRM Global Hospitals, Chennai explains, 'India's mix of traditional and modern habits has a clear impact on sleep'. Late-night chai -- rich in caffeine -- and prolonged screen exposure suppress melatonin, delaying sleep onset. Blue light from devices signals the brain to 'stay awake,' a problem most pronounced in urban areas. In rural regions, sleep tends to follow the natural light cycle -- early to bed, early to rise, whereas city dwellers often push bedtimes later due to artificial lighting, socialising or work. 'Practices such as yoga, meditation and warm milk before bed, rooted in Indian tradition, can help counteract these modern disruptions,'Dr. Sindhu said. Sleep associated health risks Insomnia -- sleep disorder where people struggle to fall asleep, stay asleep, or both, even when they have the opportunity for a full night's rest, Obstructive sleep apnea( OSA)-- another sleep disorder where your upper airway repeatedly becomes blocked during sleep, causing pauses in breathing (apnea) or shallow breathing (hypopnea) , restless leg syndrome -- a neurological disorder that causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations and narcolepsy -- a chronic neurological disorder that disrupts the brain's ability to regulate sleep-wake cycles, leading to excessive daytime sleepiness and other sleep disturbances are among India's most prevalent sleep disorders. OSA, often linked to obesity, enlarged tonsils, craniofacial structure-- the intricate framework of the head and face, encompassing the skull, facial bones, muscles, nerves, and teeth, which develops from complex embryonic processes like neural crest cell migration disrupts deep sleep and can cause hypertension, heart disease, and memory impairment. Dr. Khosla stresses that even children especially those living with obesity, Down syndrome, or neuromuscular disorders can suffer from OSA, making timely diagnosis through sleep studies crucial. Towards healthier sleep While there is some evidence that herbal remedies including chamomile tea, ashwagandha, brahmi, and turmeric milk promote relaxation, self medicating with over-the-counter sleep medications can be risky. Dr. Sridhar advises professional consultation, particularly for chronic insomnia (trouble sleeping three or more nights a week for over three months) or when sleep issues are linked to other health conditions. Quality matters as much as quantity. 'A regular sleep schedule, reduced evening caffeine, limited screen time, a calm sleep environment and moderate daytime activity can make falling asleep and staying asleep much easier', says Dr. Panduranga. For those still struggling despite good habits, doctors recommend seeking evaluation rather than relying indefinitely on home remedies or sound machines. While International health bodies such as World Health Organization supports research and guidelines on sleep disorders and includes certain prescription medicines for short-term use in specific cases, their primary advice too is to build lasting, good sleep hygiene. As experts puts it, 'Good sleep is not a luxury , it's a biological necessity. Every stage of sleep has a role in keeping your body and mind healthy. If you're not getting it, your health will eventually show it.'
The Hindu
11-08-2025
- Health
- The Hindu
How ovarian health impacts the body beyond fertility, and when you need to get checked
For many Indian women, the twenties involve balancing studies, work, relationships and life choices, with reproductive healthcare often taking a backseat. As the reproductive timeline progresses faster for Indian women compared to other populations, this has impacts not only on fertility but also on broader aspects of women's health, say experts. 'Most women produce their best eggs in their twenties,' says N. S. Saradha, senior consultant , obstetrics, gynaecology & IVF, SIMS Hospital, Chennai. 'From there, the number and quality of eggs decline more slowly at first, but faster after 35.' S. Gayathri Devi, clinical director, institute of reproductive medicine, Rela Hospital, Chennai, says that genetics, nutrition, and environmental exposures likely speed up ovarian ageing here. 'Women in Western countries women often reach menopause at 51 or 52. In India, it's 46 to 48,' she says. 'This shorter reproductive span means we must be more proactive in checking ovarian reserves early, especially if cycles are irregular, or if conditions like PCOS, fibroids or endometriosis are present.' A systematic review of Indian studies puts the mean age at natural menopause at 46.6 years (95% CI 44.8–48.4), says Sapna Raina, senior consultant, Narayana Health City, Bengaluru, a difference of three to five years from many high-income countries. 'This earlier menopause, combined with longer life expectancy, means Indian women spend more years in a low-oestrogen state. Without intervention, that can magnify the risks of osteoporosis, cardiovascular disease and cognitive decline.' Beyond infertility: cardiac and orthopaedic risks When the ovaries fail before 40, it is called premature ovarian insufficiency (POI). And it's not rare. 'If your ovaries shut down too early, the issue is not just infertility,' says Dr. Saradha. 'Bones weaken faster, heart health is compromised, and you may face hot flashes, mood swings, and sleep disturbances far earlier than expected.' R. K. Vidhya Lakshmi, senior consultant, obstetrics & gynaecology, SRM Global Hospitals, Chennai, says the impact in India can be even harsher. 'Osteoporosis and heart disease are already common here, so the consequences of early oestrogen loss are amplified.' POI can be linked to autoimmune disorders (about 20% of cases), genetic factors such as X chromosome abnormalities, and certain treatments or surgeries, says Dr. Gayathri Devi. 'The good news is that timely hormone replacement therapy -- oestrogen and progesterone until the natural age of menopause can protect bones and the heart. Coupled with a diet rich in antioxidants, vitamin D, calcium, and regular weight-bearing exercise, women can preserve quality of life.' The silence around ovarian health Despite its impact, ovarian ageing has no dedicated government programme in India. It appears in broader initiatives like RMNCH+A - Reproductive, Maternal, Newborn, Child, and Adolescent Health , Rashtriya Kishore Swasthya Karyakram (RKSK), or the National Adolescent Health Programme, family planning missions or cancer/NCD screening. 'This is an area where we need more organised national attention,' says Dr. Saradha. Professional bodies such as the Indian Society for Assisted Reproduction, the Indian Fertility Society, and the PCOS Society of India are filling some gaps with awareness campaigns and fertility preservation counselling. But their reach is mostly urban. 'With infertility rates projected to double in the next decade, integrating ovarian health into public health policy would be a game changer,' says Dr. Gayathri Devi. Egg freezing and fertility preservation The most effective way to safeguard fertility is to lock in eggs while they're still healthy (for individuals prioritising having biological children). 'For women at risk of losing fertility early whether due to family history, upcoming chemotherapy, or pelvic surgery, egg or ovarian tissue freezing is the best available tool,' says Dr. Saradha. Oocyte and embryo vitrification are now standard in India, offered widely in fertility clinics. Ovarian tissue cryopreservation (OTC), once experimental, is increasingly available for cancer patients and even prepubertal girls, says Dr. Raina. In some cases, OTC can restore hormone function after reimplantation. Dr. Vidhya Lakshmi notes that experimental drugs rapamycin which may slow cellular ageing and regenerative approaches like platelet-rich plasma injections or stem cell therapy are still in research phases. 'They're promising, but not yet ready for everyday clinical use.' Understanding ovarian timelines Unlike cancer screening, ovarian health checks are not a routine part of annual exams. But for women with risk factors such as a family history of early menopause, irregular periods, prior ovarian surgery, severe endometriosis, autoimmune disease, smoking, or severe malnutrition experts advise starting with a baseline ovarian reserve assessment in the late twenties to early thirties, using an AMH blood test and an antral follicle count scan. If results are normal and there are no additional concerns, the test can be repeated every two to three years; if the reserve is borderline or low, annual follow-ups combined with fertility preservation counselling is recommended. Depending on individual circumstances, additional screening for thyroid function, vitamin D levels and insulin resistance may also be helpful. In the years leading up to menopause, bone density scans and cardiovascular risk profiles become important for guiding preventive care. 'Ovarian reserve testing isn't needed for every woman,' says Dr. Raina. 'It's most useful if you're delaying pregnancy or have risk factors. The goal is to use this information to make informed choices, not to create panic.' The conversation about fertility and ovarian health in India has often been couched in societal timelines marriage, childbearing, family expectations. But knowing your biology is about your timeline. 'It's better to act early with proven methods than wait for experimental ones,' says Dr. Saradha. Experts say, 'Every woman deserves the knowledge and tools to decide if, when, and how she wants to become a mother or not at all. That starts with understanding that the ovary has its own clock and that clock is different for Indian women.'
Hindustan Times
24-07-2025
- Health
- Hindustan Times
Neurologist explains difference between normal forgetfulness and dementia memory loss: ‘If it gets worse over time…'
Forgetfulness is common, especially as one gets older. But sometimes, what seems like simple memory lapses can hint at something even more serious. Memory loss is serious in dementia, substantially impacting day-to-day activities. Activities which were once second nature become difficult or appear confusing. The neurodegenerative disease, like dementia's forgetfulness, is persistent, which may worsen over time. When one ages, they often forget. But it's important to know when it goes beyond the safe limits.(Shutterstock) ALSO READ: Does Donald Trump have dementia? Expert points out 4 signs of cognitive decline Dr Elanthirayan GC, consultant, neurology, SRM Global Hospitals, Chennai, shared in an interview with HT Lifestyle key insights on whether forgetfulness in old age is simply a natural part of ageing, or an early sign of dementia. Elaborating on the nature of dementia, Dr Elanthirayan explained that it goes far beyond occasional forgetfulness. He said, 'Dementia is not a compact condition; it is a vast word for decreasing memory power and thinking capacity that is bad enough to make everyday life difficult. The most common type of dementia is Alzheimer's disease.' How is regular forgetfulness different from dementia? The forgetfulness of dementia is significant, affecting daily life functioning.(Shutterstock) Even regularly, there are many common memmory slips, like forgetting wallet at home or misplacing keys. But when this happens persistently and start to affect daily life, then they may hint at something more serious. Dr Elanthirayan broke down the key differences between age-related forgetfulness and dementia. He explained, 'Forgetting names, things where you left them or having trouble in remembering words while speaking for a short period of time are all normal signs of becoming older. Mostly, these mistakes are not serious and can be cured. On the other hand, memory loss caused by dementia is long-term and disruptive. A person could behave the same way by asking the same questions repeatedly. Getting lost or not recognising places you already know. Having trouble with everyday activities like cooking or making payments, not remembering the time or place. Changes in personality or behaviour.' What is the reason behind forgetting things? Memory loss can also happen due to a wide range of other health conditions, not just as a sign of dementia. The neurologist shared, 'Dementia is a common cause of memory loss, but there are many other disorders, and most of them can be treated. Lack of vitamins (like B12), having problems with the thyroid, anxiety or depression, and drugs that can change how your brain works- difficulties to fall asleep, injuries in the head, and consumption of drugs and alcohol. Finding out the reason for memory loss through a medical exam is important because many factors that are not related to dementia can be treated and cured.' When should you visit a doctor? Visiting a doctor on time when memory issues surface can help identify the cause early, allowing for timely treatment and better management of the condition. Dr. Elanthirayan suggested, 'If a person is having trouble remembering things, and it gets worse over time, it is advised to change their environment. If a person is experiencing mood swings or confusion often, it's time to see a doctor. Early diagnosis is important not just to rule out treatable illnesses, but also to successfully manage dementia once it is identified.' Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
The Hindu
05-07-2025
- Health
- The Hindu
How genetic factors influence the onset and progression of Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS), a multifaceted endocrine-metabolic condition, is increasingly being recognised as not only a reproductive disorder but also a genetic and lifestyle-driven health challenge that affects a growing number of women across India. While clinical attention has often centred around irregular periods and infertility, recent studies and clinical experiences point to the crucial and often overlooked hereditary nature of this condition. Affecting an estimated 5 to 20 % of women of reproductive age in India, PCOS is now understood to be a spectrum disorder -- presenting differently across individuals. According to Dakshayani D., head of obstetrics and gynaecology at MGM Healthcare, Chennai, PCOS is a 'multisystemic pathology,' often seen with irregular cycles, weight gain, hirsutism (excessive growth of dark, coarse hair in women in a male-like pattern, typically on the face, chest and back), acanthosis nigricans (a skin condition characterised by dark, velvety and thickened patches of skin, often found in body folds like the neck, armpits and groin) and in some cases, infertility. She notes that some women may show classical ultrasound findings of multiple peripheral ovarian cysts and increased ovarian volume, while others may have no cysts at all. 'PCOS is not a uniform disease; it manifests differently from lean PCOS to obese PCOS with symptoms such as male-pattern hair growth, scanty or heavy bleeding and insulin resistance varying in severity,' she adds. The genetic element The strong familial clustering of PCOS has led clinicians to view genetics as a significant component in its development. 'There is strong clinical evidence that the condition runs in families,' says R.K. Vidhyalakshmi, lead consultant in obstetrics and gynaecology at SRM Global Hospitals, Chennai. 'First-degree relatives -- mothers, sisters and daughters have a significantly increased risk.' Genomic studies support these clinical observations. Variants in genes such as CYP11a, CYP17, CYP19, INSR, LHR, FSHR, and DENND1A -- all involved in steroid hormone synthesis and ovarian function have been identified in women with PCOS. 'PCOS is a polygenic disorder with no single causative gene,' explains Mannan Gupta, chairman, department of obstetrics and gynaecology at Elantis Healthcare, New Delhi. 'Instead, several gene variants act together with environmental triggers.' Sapna Raina, clinical lead at Narayana Health City, notes that the risk of developing PCOS in women with a family history can be as high as 25–50 %, further underscoring the need for early surveillance in adolescent girls with known familial risk. Early recognition is key Given its variable presentation, early detection of PCOS often depends on clinical vigilance and awareness of familial risk. Dhivya Sharona, consultant gynaecologist at Rela Hospital, Chennai, stresses the need to distinguish PCOS from PCOD -- the latter being a condition limited to ovulatory dysfunction. 'PCOS is broader, and includes metabolic and androgenic symptoms even in the absence of ovarian cysts.' She highlights the increasing prevalence among young Indian women, attributing it to a combination of genetic predisposition and lifestyle factors such as poor dietary habits, high stress and sedentary behaviour. Hormonal screening -- including LH, FSH, AMH, testosterone, prolactin, estradiol, DHEAS, TSH and progesterone -- along with imaging (preferably 3D ultrasonography), enables more accurate assessment of ovarian morphology. '3D USG offers a reliable view of stromal volume and blood flow, which are critical in PCOS evaluation,' adds Dr. Dakshayani. Lifestyle intervention and preventive care Despite its hereditary links, PCOS is highly modifiable through early lifestyle adjustments. 'Maintaining a healthy weight, avoiding refined carbohydrates, and engaging in regular physical activity can delay or even prevent the onset of symptoms in at-risk individuals,' says Dr. Gupta. He also recommends stress management, sleep hygiene, and periodic hormonal evaluation for adolescent girls with family history. 'Even a 5–10% weight loss can help regulate menstrual cycles and improve insulin sensitivity,' says Dr. Vidhyalakshmi, adding that prevention starts with education and personalised counselling. Dr. Raina stresses early behavioural interventions in families known to carry a genetic risk. 'Families often share not just genes but habits. Encouraging healthier food choices, reducing processed food intake and promoting physical activity from adolescence can alter outcomes significantly.' Emerging therapies and personalised approaches As understanding of PCOS deepens, treatment is moving towards individualised care models. 'Pharmacogenomics and polygenic risk scoring are being explored to customise treatment based on genetic profiles,' notes Dr. Gupta. 'This will enable clinicians to predict which patients are likely to respond better to specific hormonal or metabolic therapies.' For hirsutism, Dr. Sharona recommends laser hair reduction for long-term improvement, though medications like spironolactone, finasteride and Eflornithine-based topical creams can offer temporary relief. Therapies such as metformin, myoinositols, oral contraceptives and ovulation-inducing agents like Clomiphene, Letrozole and gonadotrophins are tailored based on whether the primary concern is infertility, metabolic imbalance, or hyperandrogenism.'There's no universal treatment for PCOS -- each patient's symptoms and hormonal profile guide the management,' emphasises Dr. Sharona. Despite its high prevalence, PCOS remains underdiagnosed and underreported. 'The social stigma and silence around menstrual health contributes to delays in diagnosis,' says Dr. Raina. 'It is time we normalise conversations around PCOS within families and schools.' With clinical evidence pointing strongly towards hereditary transmission, clinicians believe that family history must be considered a key diagnostic tool -- not just a background detail. By raising awareness, integrating preventive care early and leveraging advances in genetic research, it may be possible to change the trajectory of PCOS for future generations.
Hindustan Times
13-06-2025
- Health
- Hindustan Times
Harvard gastroenterologist shares 4 tips to avoid bloating: ‘Eat kiwi or papaya to break down trapped gas'
Are you someone who suffers from the discomfort caused by bloating? If yes, then some quick fixes could make your life better. Dr Saurabh Sethi, MD (gastroenterology and hepatology) and a Harvard-trained expert, often shares tips related to gut and liver health on social media. On June 13, he shared 4 tips that could help alleviate the discomfort of bloating. Also Read | Nutritionist shares what happens when you start eating berries, beetroot, prunes and other purple foods For the uninitiated, bloating is a condition where your belly feels full and tight, often due to gas. According to the Cleveland Clinic, it's usually a digestive issue, but hormones and stress also play a part. Let's find out the tips Dr Sethi shared to avoid bloating: A post shared by Saurabh Sethi (@ The gastroenterologist suggested eating kiwi or papaya to help break down trapped gas. Per a 2013 study, people who took a papaya-based formula for 40 days had significant improvement in constipation and bloating. The papain enzyme in papaya can make protein easier to digest. As for kiwi, it contains several key nutrients, including fibre, potassium, and actinidin, an enzyme that may help improve digestion and speed up stomach emptying, per Healthline. Therefore, eating it could reduce bloating. Dr Sethi suggested taking a short walk to stimulate natural movement. According to a report by SRM Global Hospitals, walking helps the gas to pass and provides relief. Engaging in a brisk 10–15-minute walk to facilitate the movement of gas through your digestive system relieves built-up bloatng. The gastroenterologist suggested considering simethicone to break up gas bubbles. Per the NHS, simethicone (or simeticone) is a type of medicine called an antiflatulent. It's used to treat farting (flatulence), trapped wind and bloating. People with irritable bowel syndrome (IBS) sometimes take simeticone to ease their symptoms. Although they stated that there isn't enough certainty whether it really works for these symptoms. Sipping peppermint tea can also help ease discomfort and cramping caused by bloating, Dr Sethi suggested. Studies show that peppermint relaxes the gut, which may relieve intestinal spasms and the bloating and pain accompanying them. Peppermint oil is also known for its antimicrobial properties. Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
