Do you ever get to bed and fail to catch some sleep until the wee hours of the morning? For some people, it can go on for days without managing a moment of sleep. In today’s fast-paced world, sleepless nights are increasingly becoming the norm. For people like Egide Munezero, a university student who juggles studies and a side job to make ends meet, sleep is a rarity. “Most times I study during the day and work the night shift until around 1 a.m., then I have to go back home and do my coursework. I find myself not getting enough time to sleep because in the morning I have lectures to attend,” says Munezero, who works as a waiter in a restaurant and bar. While society praises hustle culture and productivity, an invisible crisis is growing — one that quietly chips away at the mental, emotional, and physical well-being of thousands of people, including Munezero. That crisis is insomnia. “Even when I get time off, I am not able to sleep. I can go to bed and spend hours and hours awake. I end up waking up to do something on the phone or computer,” the 25-year-old says. From the glow of smartphone screens in dark bedrooms to unresolved psychological wounds, a growing number of Rwandans are struggling to get a full night’s rest. Yet many remain unaware that what they are experiencing may be a diagnosable, and treatable — sleep disorder. When sleeplessness becomes a disorder According to Dr. Concorde Ishimwe, a medical doctor at Muhima Hospital, a sleep disorder goes beyond simply feeling tired. It involves a disruption in sleep quality, timing, or duration and can manifest in different forms. A sleep disorder is classified under many different things. It refers to how well you sleep, or your sleep quality. Secondly, it concerns when you fall asleep and how long you stay asleep — what we call sleep timing or sleep duration. All these factors contribute to what we call a sleep disorder,” Dr. Ishimwe told The New Times. He notes that there are different ways sleep disorders can manifest, and experts use the International Classification of Sleep Disorders (ICSD) to understand these types. According to Ishimwe, one of the most common forms is insomnia — the inability to fall or stay asleep. Others include Central Disorder of Hypersomnia, where a person remains half-awake and half-asleep, and sleep disruptions caused by physical conditions like sleep apnea, often found in people with obesity or heart problems. “Normally, a person should sleep between 7 to 9 hours. Children are supposed to sleep more than adults because their brains are still developing. Brain development happens mostly during sleep,” Dr. Ishimwe said. Dr. Ishimwe points out that lack of restful sleep has direct impacts: reduced cognitive function, poor job performance, emotional instability, and, in extreme cases, increased risk of accidents. “You might go to work and feel exhausted, mistakenly thinking you slept, while in reality, you didn’t,” he notes. ALSO READ: Nine health risks linked to sleep deprivation A symptom of something deeper Therapist Josée Nyamutamba Nyetera emphasises that insomnia often signals deeper issues — particularly psychological ones. “There’s a saying: There is no insomnia without a psychological problem, and there’s no psychological problem without insomnia. They go together,” she said. She classifies the condition into two categories: initial insomnia, where a person cannot fall asleep easily, and secondary insomnia, where someone sleeps but wakes up and remains alert through the night. Both are common in Rwanda’s increasingly sleepless population. “Sometimes, we need to listen to the person to diagnose. With physical illness, you can take blood, sputum, or urine, test it, and get results. But in mental health, you must actively listen,” Nyamutamba explained. For example, a disagreement with a friend or family member may be enough to cause multiple sleepless nights. “We can sometimes help ourselves — not every issue needs to be treated as a disease. Some issues we can resolve with parents, friends, or siblings. But there are other, deeper ones where we must seek professional help,” she added. Ignoring it, however, can be dangerous. Long-term insomnia can snowball into chronic mental health conditions or worsen existing medical problems. Hidden causes and dangerous assumptions Not all sleep disorders stem from psychological distress. According to Dr. Ishimwe, biological illnesses like diabetes, heart disease, or obesity can contribute to poor sleep. “Overweight people tend to snore more. Also, people with heart disease — these are all conditions that can lead to sleep disorders, including depression,” he noted. Sometimes, no clear cause is found. “You can also develop a sleep disorder without having any medical condition — it can appear on its own. There are what we call ‘causes unknown,’” he said. But what makes the crisis worse is the tendency for self-diagnosis and self-medication. “Self-medication is not good. You shouldn't just go buy sleeping pills without knowing the cause,” Dr. Ishimwe warned. “If it’s depression, we treat the depression. If it’s diabetes, of course, there are medications for that. But if you don’t know the cause, you cannot treat it.” He likened it to chronic headaches. “You may keep taking medicine from the pharmacy, paracetamol or beta pin — but the real issue, like a brain tumour, is what’s causing your constant headaches. By the time you go, it might already be cancer.” The key takeaway is this: do not guess. Seek help. ALSO READ: Experts weigh in on impact of sleep deprivation on heart health Who can help? In developed countries, people often consult sleep specialists who use devices like polysomnography to monitor brain activity and sleep cycles. While such advanced diagnostics may not yet be widely available in Rwanda, early consultations with general physicians or mental health professionals are a good starting point. Dr. Ishimwe also cautions against common misconceptions: “Actually, many people wrongly believe that a sleep disorder is only about failing to sleep. You can sleep, but sleep badly. Some people talk in their sleep — that too is a sleep disorder.” Some even sleepwalk or act out dreams, which could indicate REM sleep behaviour disorder — a serious but treatable condition. Sleep, it turns out, is far more complex than it appears on the surface. What can be done? While not all sleep issues are severe enough to warrant medical intervention, small lifestyle changes can have a big impact. Establishing a consistent sleep schedule, limiting screen time before bed, and avoiding stimulants like caffeine late in the day are commonly recommended strategies. Physical exercise has also been shown to improve sleep quality — but it’s best done earlier in the day. Creating a calming bedtime routine, such as reading or practicing mindfulness, can signal to the body that it's time to wind down. For those working night shifts, adapting the sleep environment by using blackout curtains or white noise machines can help train the body to rest during daylight hours. Above all, both medical professionals and therapists advise against self-medicating without understanding the root cause of the problem. As Dr. Ishimwe emphasised: “Medically — and not just for sleep disorders, but for all illnesses — you shouldn't take medication without identifying the underlying cause.” A global crisis Sleep deprivation is not just a challenge that Rwandans are grappling with. According to the World Health Organisation (WHO), up to one in three people worldwide experiences some form of sleep disturbance, and chronic insomnia affects approximately 10 per cent of adults globally. Poor sleep contributes to a wide range of health conditions, from heart disease to depression, yet it often goes unrecognised and untreated. Despite growing research and awareness, sleep health remains one of the most neglected public health priorities, especially in lower-income countries. As Rwanda grapples with this silent epidemic, it joins a global community struggling to restore balance in an overworked, overstimulated world. The message is simple: sleep matters. It is not a luxury — it is a necessity. And the more it is treated as such, the healthier people will be as individuals, as families and as a nation.
