Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     28 year old male
•     Complaints of: insomnia.

Common causes of poor sleep are (in order of preference):
-Poor sleep hygiene
-Stress, Anxiety and Depression
-Use of excessive tea or coffee
-Substance use
-Thyroid hormone problem

Symptoms of Stress, Anxiety and Depression are (which may or may not be present in your case): low mood, nervousness, restlessness, mild irritability, excessive worry regarding own health, tremor, muscle spasm, heaviness in body, easy fatigability, headache, sleep disturbance, palpitation and dry mouth.

For sleep difficulty follows below principles of sleep hygiene which will help you in long term:
•     Fix a bedtime and an awakening time. Do not be one of those people who allows bedtime and awakening time to drift. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.
•     Avoid napping during the day
•     Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful.
•     Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime
•     Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep.
•     Use comfortable bedding.
•     Find a comfortable temperature setting for sleeping and keep the room well ventilated.
•     Block out all distracting noise, and eliminate as much light as possible.
•     Reserve the bed for sleep. Don't use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping.
•     Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
•     Don't take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
•     Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.
•     Getting Up in the Middle of the Night :Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed "trying hard" to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.
•     A Word About Television: Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.

Your main problem appear to me, is in sleep induction. For long term management you should follow sleep hygiene (even on holidays) as above and treatment of above mentioned causes (if present). You can take help of sleep inducing medicines (like zolpidem, after physician prescription) for short duration to correct your sleep wake cycle.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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Hello again,
Thanks for follow up.

Your nostril may be closed due to following reason:
-Allergy: Need antiallergic medicines like cetrizine once per day.
-Infection: You may need antibiotic treatment for this
-Combination of above causes

It is better to get in person evaluation for this problem from ENT specialist.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.

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Hello again,
Thanks for follow up.

Thyroid hormone problem diagnosed by blood investigation for: T3/T4/TSH
Blood sample should be given in morning empty stomach for reliable result.

After test you are welcome to share report.

Wish you good health.
Regards.

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Hello again,
Thanks for follow up.

Your current medicines (arip mt torrrent, clonotrip) are one of the medicine used for these symptoms (sleep difficulty and inability to sit/stand/ for some time need to walk).

So, continue these medicines as advised by your physician.

Wish you good health.
Regards.

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