Latest news with #insomnia
The Guardian
6 hours ago
- Health
- The Guardian
Can I tame my 4am terrors? Arifa Akbar on a lifetime of insomnia – and a possible cure
I can't remember when I first stopped sleeping soundly. Maybe as a child, in the bedroom I initially shared with my brother, Tariq. I would wait for his breathing to quieten, then strain to listen beyond our room in the hope of being the last one awake, and feel myself expanding into the liberating space and solitude. By my early 20s, that childhood game of holding on to wakefulness while others slept began playing out against my will. Sound seemed to be the trigger. It was as if the silence I had tuned into as a child was now a requirement for sleep. Any sound was noise: the burr of the TV from next door, the ticking of a clock in another room. When one layer of sound reduced its volume, another rose from beneath it, each intrusive and underscored by my own unending thoughts. Noise blaring from without and within, until I felt too tired to sleep. The artist Louise Bourgeois suffered a bad bout of insomnia in the 1990s, during which she created a series of drawings. Among them is an image that features musical notes in red ink, zigzagging across a sheet of paper. They look like the jagged score of an ECG graph that has recorded an alarmingly arrhythmic heartbeat. It sums up the torment of my insomnia: there is a raised heartbeat in every sound. I have been told that to overcome an inability to sleep you must find its root cause, but this quest for an original impetus is guesswork. Was it self-inflicted in childhood, or does it track further back than that, to infancy, to the womb, to genetics? One starting point is Professor Derk-Jan Dijk's view of a 'sleep personality', and the idea that childhood sleep habits can be the same later in life. I was born in London, but my family moved to Lahore when I was three years old, before returning to the UK a couple of years later. In Pakistan, there was vigorous, carefree slumber, on the roof of the house on the hottest nights, with the extended family in close proximity. It was sleep as communal ritual. Then the standstill after lunch when everyone lay down again in siesta. I remember my sister, Fauzia, sleeping beside me on these afternoons. There was no hint of insomnia until the move back to Britain when we found ourselves homeless, living in a disused building in north London for a while, crammed into a single room, before moving into a council flat. In light of Dijk's words, I see how my insomnia might be a reaction against this early chaos, along with my exacting need for order and silence in adulthood, but that is my own armchair analysis. There are so many gaps in sleep science that I wonder if sleep is by its nature too mysterious to systematise. If science can't explain the grey areas around sleep, maybe art can shed a light. It is surprising, given the painting's sense of joyous night-time, that Van Gogh painted his post-impressionist masterpiece The Starry Night in the midst of depression, after being admitted to an asylum in Saint-Rémy-de-Provence in the summer of 1889. A year before, in a letter dated 16 September 1888, Vincent tells his brother, Theo, that he is doing six to 12 hours of non-stop work, often at night, followed by 12 hours of sleep. By the following year he was in the grip of a 'FEARSOME' insomnia. On 9 January 1889, weeks after slicing part of his ear off in a high state of anxiety, he writes to Theo about his torment. He is fighting sleeplessness with a 'very, very strong dose of camphor' on his pillow and mattress, he says, and he hopes it will bring an end to the insomnia. 'I dare to believe that it won't recur.' I read Van Gogh's hope as optimistic desperation. In my case, it has always returned. Yet, even in his 'insensible' state, Vincent tells Theo that he is reflecting on the work of Degas, Gauguin and his own art practice; he continues to think, paint, write letters, with the insomnia existing alongside his productivity. The glittering night sky Van Gogh imagines beyond the confines of his asylum is an embodiment of the way we so often think of the gifted artist at night: synapses fizzing, imagination touched by divinity, a compulsively unsleeping genius channelling a heightened state of buoyant creativity. Countless artists and writers have elected to work after dark, from Toulouse-Lautrec, documenting night revelries at the Moulin Rouge, to Franz Kafka, Philip Guston and Patricia Highsmith. Musicians, too: the Rolling Stones' all-night jam in the lead-up to their appearance at Knebworth in 1976, for instance; or Prince, whose recording sessions could last across a continuous 24 hours. Certainly, if Van Gogh still suffered from insomnia when he was painting The Starry Night, it makes sleeplessness seem beatific – a curse turned gift. There is none of this buoyancy in Louise Bourgeois's night scribblings. She suffered from sleeplessness throughout her life but faced a particularly debilitating bout of night-time anxiety between 1994 and 1995, during which time she made her Insomnia Drawings series. 'It is conquerable,' she said, and for her it was conquered, by filling page after page of a drawing diary with deliriously repeated doodles and circles within circles, a mess of scribbles that look like screams on paper. They are so different from the enormous stainless steel, bronze and marble spiders and other caged sculptures for which Bourgeois is better known, but I feel a peculiar kind of excitement upon seeing these images, with their agitating boredom and alertness, side by side. The artist Lee Krasner also painted her way through chronic insomnia, around the time her mother and then her husband, the painter Jackson Pollock, died – the latter in a drink-driving car crash in 1956, with his lover Ruth Kligman, who survived, in the seat beside him. Krasner's Night Journeys series has some similarities to Bourgeois's drawings, featuring repeating, abstract patterns, but washed in an earthy sepia brown. The patterns are insect-like, as if ants are crawling across the retina. I am inspired by the images. Rather than seeking escape or avoidance of their sleepless state, Bourgeois and Krasner stare it in the face, and it stares back at them, an abyss of maddening monotony. There has only been one instance in my adult life when sleep became easy. Or rather, it became compulsive – as much as the insomnia was, and perhaps even more disturbing. It happened when Fauzia died in 2016, at the age of 45, of undiagnosed tuberculosis. She had been admitted to hospital with an unknown illness, and lay wired to a ventilator in intensive care. When the hospital called to say she had had a fatal brain haemorrhage one morning, the shock of it was too much to take in. So I began to sleep. No amount was enough and I felt increasingly worried by the long, blank nights, which did not bring relief but became as strangely burdensome as the insomnia had once felt. Haruki Murakami's novel After Dark features two sisters, the younger, Mari, mourning the older sibling, Eri, who is in a coma-like state. The book takes place over a single night in Tokyo as Mari roams through the city, meeting its nocturnal characters: a trombonist, a Chinese sex worker, the manager of a love hotel. All the while Eri lies in a trapped and mysterious kind of sleep. It might be an undiagnosed illness, a psychological condition or even a radical protest at the world and her place in it – we are never sure. Mari refuses to see her sister as 'dead', even though there seems no prospect of Eri's waking up. She looks at her sister's face and thinks that 'consciousness just happens to be missing from it at the moment: it may have gone into hiding, but it must certainly be flowing somewhere out of sight, far below the surface, like a vein of water'. This is how I saw Fauzia as she lay in hospital, after her haemorrhage. Even though we were told she'd remain on a ventilator for 24 hours as a formality before being pronounced dead, I kept watching for her to twitch awake, sure that it would happen. It seemed as if she was in a deep sleep, albeit so submerged by it that she had become unreachable. In her lifetime, Fauzia went through long bouts of oversleeping brought on by depression. There seemed to be a rebellion in it, too. From the age of 19, when she first became seriously depressed, she began holing herself up in her room, sleeping for the night and most of the following day. In the medieval era, the act of daytime sleeping, for men and for women, was seen to harm one's reputation. Many still regard it as slovenly and it can be subversive for exactly this reason. For a woman, especially, to refuse to get up and assume her role in the world – which may be one of monotonous domesticity, of caring for others, or of participating in the tedious, lower-rung machinery of capitalist productivity – might be a defiant act of saying 'no'. What might look like inertia, or passivity, can be an active summoning of inner strength, as suggested by Bruno Bettelheim in his psychoanalytic interpretations of fairytales in The Uses of Enchantment. He speaks of Briar Rose (Sleeping Beauty) not as an example of meek femininity but as an adolescent 'gathering strength in solitude'. Her sleep is a temporary turning inward in order to foment, mobilise and psychically prepare for the battles of adulthood to come. A glassy-eyed, self-medicating woman in Ottessa Moshfegh's novel My Year of Rest and Relaxation also 'hibernates' in her New York apartment. She is a Manhattan princess, narcissistic and hard to like, who does not want to experience any of life's sharp edges. Yet there is something I recognise in her overwhelming desire to disconnect from the terrible reality of the world. She plans to sleep for a year and wake up cured of her sadness, and she is. My sleep wasn't a cure, but the oversleeping did eventually lift and leave me feeling less numbed to my own sadness. Now I was glad to be returned to myself, and to my insomnia – an old friend, missed. There is evidence to suggest that women sleep differently from men and feel the effects of insomnia in discrete ways. Professor Dijk cites the familiar list of causes, from lifestyle to social class, wealth and genetics, but he has also found sex-based biological factors, with differences in the brainwaves of women and men when they sleep. Women intrinsically have different circadian rhythms, which are on average six minutes shorter than men's cycles; they experience more deep (or 'slow wave') sleep and may need to sleep for longer; while a mix of social factors, from breastfeeding to lower-paid shift work, means they face higher levels of insomnia. Sleep science makes a significant connection between hormones and sleep for women in the throes of menopause. About 50% of women who suffer with insomnia as they approach menopause are thought to sleep for less than six hours a night. The cumulative effects of this sleeplessness can be so intense that some have questioned whether they might be linked to UK female suicide rates, which are at their highest between the ages of 50 and 54. This brings another kind of insomnia for me, as I turn 50. It creeps duplicitously into my night, so I don't recognise it; I fall asleep quickly but am awake again at 4am with alarm-clock precision. This is not the organic and woozy 'biphasic' interruption believed by some to have been common in the centuries before electric light, in which communities were said to have a first and then a second sleep through the night, getting up to work or chat in between in a brief window referred to as 'the watch'. My brain is pin-sharp, as if the sleep before has been entirely restorative and I am ready to start the day, except there is a move towards a certain line of thought, a search for the faultlines of the previous day, the urgent address of an old argument or decision far in the future. And it is, in its scratchy insistence, so much like Bourgeois's scribbled red balls and Krasner's insects, that I wonder if they were experiencing menopausal sleep disruption while creating their works. Whereas younger insomniacs struggle to fall asleep, those in midlife might doze off quickly but wake up in the middle of the night as a result of hormonal changes, and it is in these 4am 'reckonings' that they encounter the night-time brain, says Dr Zoe Schaedel, who sits on the British Menopause Society's medical advisory council. 'Our frontal lobe [which regulates logical thought] doesn't activate as well overnight, and our amygdala [the brain's command centre for emotions, including fear, rage and anxiety] takes over.' So the very nature of thinking is different at 4am. In the daytime it is primarily logical, but at night we become more rash, anxious, catastrophic. That sets off its own physiological reaction in the nervous system, with a surge of adrenaline and cortisol, as well as rising heart and breathing rates. Between the waking, there is a welter of dreams, so many it seems like someone is changing between the channels on a TV set. Dr Schaedel says this apparent assault of dreams is an illusion. When oestrogen drops, women start sleeping more lightly and waking up in the latter part of the night, in the shallower REM, or dream, phase, which gives the impression of dreaming more because you are waking up more often in the midst of them. Still, I am wrongfooted by this second life in my head, this middle-aged night, as busy, as complicated and as exhausting as the day. When insomnia is at its most agitating, engaging the brain visually may be a way to lull ourselves back to sleep, says Dr Schaedel. This idea makes better sense of Bourgeois's scribbling. Maybe I would find my own recurring patterns on paper if I did the same thing, I think, and so I put a notebook beside my bed. I know I have had a maelstrom of dreams but, when I try to discover them on paper, it is like a stuck sneeze. I write a few words down, but I am left straining for more. A few snatched images come back, but far more float out of view, so much unreachable. The next night I can recall even fewer details, although I know I have dreamed heavily. So my odyssey of dreams evades any attempt at codification. They are determined to remain mysterious, on the other side of daytime. This is an edited extract from Wolf Moon: A Woman's Journey into the Night, published by Sceptre on 3 July at (£16.99). To support the Guardian, order your copy at Delivery charges may apply.
The Guardian
16 hours ago
- Health
- The Guardian
Can I tame my 4am terrors? Arifa Akbar on a lifetime of insomnia – and a possible cure
I can't remember when I first stopped sleeping soundly. Maybe as a child, in the bedroom I initially shared with my brother, Tariq. I would wait for his breathing to quieten, then strain to listen beyond our room in the hope of being the last one awake, and feel myself expanding into the liberating space and solitude. By my early 20s, that childhood game of holding on to wakefulness while others slept began playing out against my will. Sound seemed to be the trigger. It was as if the silence I had tuned into as a child was now a requirement for sleep. Any sound was noise: the burr of the TV from next door, the ticking of a clock in another room. When one layer of sound reduced its volume, another rose from beneath it, each intrusive and underscored by my own unending thoughts. Noise blaring from without and within, until I felt too tired to sleep. The artist Louise Bourgeois suffered a bad bout of insomnia in the 1990s, during which she created a series of drawings. Among them is an image that features musical notes in red ink, zigzagging across a sheet of paper. They look like the jagged score of an ECG graph that has recorded an alarmingly arrhythmic heartbeat. It sums up the torment of my insomnia: there is a raised heartbeat in every sound. I have been told that to overcome an inability to sleep you must find its root cause, but this quest for an original impetus is guesswork. Was it self-inflicted in childhood, or does it track further back than that, to infancy, to the womb, to genetics? One starting point is Professor Derk-Jan Dijk's view of a 'sleep personality', and the idea that childhood sleep habits can be the same later in life. I was born in London, but my family moved to Lahore when I was three years old, before returning to the UK a couple of years later. In Pakistan, there was vigorous, carefree slumber, on the roof of the house on the hottest nights, with the extended family in close proximity. It was sleep as communal ritual. Then the standstill after lunch when everyone lay down again in siesta. I remember my sister, Fauzia, sleeping beside me on these afternoons. There was no hint of insomnia until the move back to Britain when we found ourselves homeless, living in a disused building in north London for a while, crammed into a single room, before moving into a council flat. In light of Dijk's words, I see how my insomnia might be a reaction against this early chaos, along with my exacting need for order and silence in adulthood, but that is my own armchair analysis. There are so many gaps in sleep science that I wonder if sleep is by its nature too mysterious to systematise. If science can't explain the grey areas around sleep, maybe art can shed a light. It is surprising, given the painting's sense of joyous night-time, that Van Gogh painted his post-impressionist masterpiece The Starry Night in the midst of depression, after being admitted to an asylum in Saint-Rémy-de-Provence in the summer of 1889. A year before, in a letter dated 16 September 1888, Vincent tells his brother, Theo, that he is doing six to 12 hours of non-stop work, often at night, followed by 12 hours of sleep. By the following year he was in the grip of a 'FEARSOME' insomnia. On 9 January 1889, weeks after slicing part of his ear off in a high state of anxiety, he writes to Theo about his torment. He is fighting sleeplessness with a 'very, very strong dose of camphor' on his pillow and mattress, he says, and he hopes it will bring an end to the insomnia. 'I dare to believe that it won't recur.' I read Van Gogh's hope as optimistic desperation. In my case, it has always returned. Yet, even in his 'insensible' state, Vincent tells Theo that he is reflecting on the work of Degas, Gauguin and his own art practice; he continues to think, paint, write letters, with the insomnia existing alongside his productivity. The glittering night sky Van Gogh imagines beyond the confines of his asylum is an embodiment of the way we so often think of the gifted artist at night: synapses fizzing, imagination touched by divinity, a compulsively unsleeping genius channelling a heightened state of buoyant creativity. Countless artists and writers have elected to work after dark, from Toulouse-Lautrec, documenting night revelries at the Moulin Rouge, to Franz Kafka, Philip Guston and Patricia Highsmith. Musicians, too: the Rolling Stones' all-night jam in the lead-up to their appearance at Knebworth in 1976, for instance; or Prince, whose recording sessions could last across a continuous 24 hours. Certainly, if Van Gogh still suffered from insomnia when he was painting The Starry Night, it makes sleeplessness seem beatific – a curse turned gift. There is none of this buoyancy in Louise Bourgeois's night scribblings. She suffered from sleeplessness throughout her life but faced a particularly debilitating bout of night-time anxiety between 1994 and 1995, during which time she made her Insomnia Drawings series. 'It is conquerable,' she said, and for her it was conquered, by filling page after page of a drawing diary with deliriously repeated doodles and circles within circles, a mess of scribbles that look like screams on paper. They are so different from the enormous stainless steel, bronze and marble spiders and other caged sculptures for which Bourgeois is better known, but I feel a peculiar kind of excitement upon seeing these images, with their agitating boredom and alertness, side by side. The artist Lee Krasner also painted her way through chronic insomnia, around the time her mother and then her husband, the painter Jackson Pollock, died – the latter in a drink-driving car crash in 1956, with his lover Ruth Kligman, who survived, in the seat beside him. Krasner's Night Journeys series has some similarities to Bourgeois's drawings, featuring repeating, abstract patterns, but washed in an earthy sepia brown. The patterns are insect-like, as if ants are crawling across the retina. I am inspired by the images. Rather than seeking escape or avoidance of their sleepless state, Bourgeois and Krasner stare it in the face, and it stares back at them, an abyss of maddening monotony. There has only been one instance in my adult life when sleep became easy. Or rather, it became compulsive – as much as the insomnia was, and perhaps even more disturbing. It happened when Fauzia died in 2016, at the age of 45, of undiagnosed tuberculosis. She had been admitted to hospital with an unknown illness, and lay wired to a ventilator in intensive care. When the hospital called to say she had had a fatal brain haemorrhage one morning, the shock of it was too much to take in. So I began to sleep. No amount was enough and I felt increasingly worried by the long, blank nights, which did not bring relief but became as strangely burdensome as the insomnia had once felt. Haruki Murakami's novel After Dark features two sisters, the younger, Mari, mourning the older sibling, Eri, who is in a coma-like state. The book takes place over a single night in Tokyo as Mari roams through the city, meeting its nocturnal characters: a trombonist, a Chinese sex worker, the manager of a love hotel. All the while Eri lies in a trapped and mysterious kind of sleep. It might be an undiagnosed illness, a psychological condition or even a radical protest at the world and her place in it – we are never sure. Mari refuses to see her sister as 'dead', even though there seems no prospect of Eri's waking up. She looks at her sister's face and thinks that 'consciousness just happens to be missing from it at the moment: it may have gone into hiding, but it must certainly be flowing somewhere out of sight, far below the surface, like a vein of water'. This is how I saw Fauzia as she lay in hospital, after her haemorrhage. Even though we were told she'd remain on a ventilator for 24 hours as a formality before being pronounced dead, I kept watching for her to twitch awake, sure that it would happen. It seemed as if she was in a deep sleep, albeit so submerged by it that she had become unreachable. In her lifetime, Fauzia went through long bouts of oversleeping brought on by depression. There seemed to be a rebellion in it, too. From the age of 19, when she first became seriously depressed, she began holing herself up in her room, sleeping for the night and most of the following day. In the medieval era, the act of daytime sleeping, for men and for women, was seen to harm one's reputation. Many still regard it as slovenly and it can be subversive for exactly this reason. For a woman, especially, to refuse to get up and assume her role in the world – which may be one of monotonous domesticity, of caring for others, or of participating in the tedious, lower-rung machinery of capitalist productivity – might be a defiant act of saying 'no'. What might look like inertia, or passivity, can be an active summoning of inner strength, as suggested by Bruno Bettelheim in his psychoanalytic interpretations of fairytales in The Uses of Enchantment. He speaks of Briar Rose (Sleeping Beauty) not as an example of meek femininity but as an adolescent 'gathering strength in solitude'. Her sleep is a temporary turning inward in order to foment, mobilise and psychically prepare for the battles of adulthood to come. A glassy-eyed, self-medicating woman in Ottessa Moshfegh's novel My Year of Rest and Relaxation also 'hibernates' in her New York apartment. She is a Manhattan princess, narcissistic and hard to like, who does not want to experience any of life's sharp edges. Yet there is something I recognise in her overwhelming desire to disconnect from the terrible reality of the world. She plans to sleep for a year and wake up cured of her sadness, and she is. My sleep wasn't a cure, but the oversleeping did eventually lift and leave me feeling less numbed to my own sadness. Now I was glad to be returned to myself, and to my insomnia – an old friend, missed. There is evidence to suggest that women sleep differently from men and feel the effects of insomnia in discrete ways. Professor Dijk cites the familiar list of causes, from lifestyle to social class, wealth and genetics, but he has also found sex-based biological factors, with differences in the brainwaves of women and men when they sleep. Women intrinsically have different circadian rhythms, which are on average six minutes shorter than men's cycles; they experience more deep (or 'slow wave') sleep and may need to sleep for longer; while a mix of social factors, from breastfeeding to lower-paid shift work, means they face higher levels of insomnia. Sleep science makes a significant connection between hormones and sleep for women in the throes of menopause. About 50% of women who suffer with insomnia as they approach menopause are thought to sleep for less than six hours a night. The cumulative effects of this sleeplessness can be so intense that some have questioned whether they might be linked to UK female suicide rates, which are at their highest between the ages of 50 and 54. This brings another kind of insomnia for me, as I turn 50. It creeps duplicitously into my night, so I don't recognise it; I fall asleep quickly but am awake again at 4am with alarm-clock precision. This is not the organic and woozy 'biphasic' interruption believed by some to have been common in the centuries before electric light, in which communities were said to have a first and then a second sleep through the night, getting up to work or chat in between in a brief window referred to as 'the watch'. My brain is pin-sharp, as if the sleep before has been entirely restorative and I am ready to start the day, except there is a move towards a certain line of thought, a search for the faultlines of the previous day, the urgent address of an old argument or decision far in the future. And it is, in its scratchy insistence, so much like Bourgeois's scribbled red balls and Krasner's insects, that I wonder if they were experiencing menopausal sleep disruption while creating their works. Whereas younger insomniacs struggle to fall asleep, those in midlife might doze off quickly but wake up in the middle of the night as a result of hormonal changes, and it is in these 4am 'reckonings' that they encounter the night-time brain, says Dr Zoe Schaedel, who sits on the British Menopause Society's medical advisory council. 'Our frontal lobe [which regulates logical thought] doesn't activate as well overnight, and our amygdala [the brain's command centre for emotions, including fear, rage and anxiety] takes over.' So the very nature of thinking is different at 4am. In the daytime it is primarily logical, but at night we become more rash, anxious, catastrophic. That sets off its own physiological reaction in the nervous system, with a surge of adrenaline and cortisol, as well as rising heart and breathing rates. Between the waking, there is a welter of dreams, so many it seems like someone is changing between the channels on a TV set. Dr Schaedel says this apparent assault of dreams is an illusion. When oestrogen drops, women start sleeping more lightly and waking up in the latter part of the night, in the shallower REM, or dream, phase, which gives the impression of dreaming more because you are waking up more often in the midst of them. Still, I am wrongfooted by this second life in my head, this middle-aged night, as busy, as complicated and as exhausting as the day. When insomnia is at its most agitating, engaging the brain visually may be a way to lull ourselves back to sleep, says Dr Schaedel. This idea makes better sense of Bourgeois's scribbling. Maybe I would find my own recurring patterns on paper if I did the same thing, I think, and so I put a notebook beside my bed. I know I have had a maelstrom of dreams but, when I try to discover them on paper, it is like a stuck sneeze. I write a few words down, but I am left straining for more. A few snatched images come back, but far more float out of view, so much unreachable. The next night I can recall even fewer details, although I know I have dreamed heavily. So my odyssey of dreams evades any attempt at codification. They are determined to remain mysterious, on the other side of daytime. This is an edited extract from Wolf Moon: A Woman's Journey into the Night, published by Sceptre on 3 July at (£16.99). To support the Guardian, order your copy at Delivery charges may apply.
Time of India
2 days ago
- Health
- Time of India
Women are ageing into silence. India can't afford to ignore menopause
Every woman who lives long enough will experience menopause — the end of her ovarian function. Yet in India, this transition remains shrouded in taboo, misinformation, and medical neglect. Tired of too many ads? go ad free now While global awareness of women's midlife health gains momentum, India lags dangerously behind. Most Indian women begin menopause in their mid-40s — years earlier than women in developed nations — and often navigate this transition without medical guidance, reliable information, or therapeutic support. If India is to secure a healthier and more economically stable future, we must bring menopause out of the shadows and integrate it into national health policy. A Silent Health Crisis Menopause affects half the population, yet receives a fraction of the attention devoted to other life stages. In India, the absence of public dialogue, policy recognition, and accessible clinical care has created widespread suffering behind closed doors. This silence isn't merely social — it's systemic, embedded in India's healthcare infrastructure and medical education. Consider this: while pregnancy and childbirth receive substantial medical attention and government support, the phase that follows — when women spend potentially 30-40 years of their lives post-menopause — remains largely ignored. This medical blind spot has serious consequences for women's health, economic productivity, and quality of life. South Asian Disadvantage Indian women face a unique challenge. Research shows that South Asian women typically reach menopause between ages 45-47, compared to the global average of 50-52. This earlier onset stems from multiple factors: nutritional deficiencies, early pregnancies, lower body mass index, and limited access to preventive healthcare throughout their reproductive years. Tired of too many ads? go ad free now The implications are profound. Indian women spend more years in the post-menopausal phase, facing elevated risks for cardiovascular disease, osteoporosis, diabetes, and cognitive decline. A recent FP Analytics report reveals that Central and Southern Asia will see the greatest increase globally in women entering menopause by 2050. By 2030, nearly half a billion women worldwide aged 45-55 will be in this transition, with India contributing significantly to these numbers. Without adequate medical infrastructure and education, this demographic shift threatens to overwhelm India's healthcare system. Medical Gaps and Missed Opportunities Cultural discomfort around menopause compounds clinical shortcomings. Many Indian doctors remain hesitant to prescribe hormone replacement therapy (HRT), despite it being first-line treatment internationally. Women frequently report being dismissed when presenting symptoms like brain fog, insomnia, anxiety, or joint pain — symptoms often attributed to 'normal aging' rather than treatable menopausal changes. Dr. , a gynecologist at AIIMS Delhi, notes: 'We see women suffering in silence because they don't know these symptoms are connected to menopause. And when they do seek help, many practitioners lack the training to provide appropriate care.' The medical curriculum in India dedicates minimal time to menopause management, leaving healthcare providers ill-equipped to address this critical life stage. This knowledge gap perpetuates a cycle of inadequate care and continued suffering. The Hidden Economic Cost While India lacks comprehensive data on menopause-related economic losses, international studies paint a concerning picture. In the UK, menopause-related productivity losses cost the economy billions annually through absenteeism, reduced performance, and early retirement. Given India's massive female workforce and rising life expectancy, similar economic impacts are inevitable without intervention. Consider the ripple effects: when women struggle with untreated menopausal symptoms, it affects not just their careers but their families' economic stability. As more women enter the workforce, ignoring their midlife health needs becomes economically unsustainable. From Exception to Epidemic: The Great Transition For most of human history, menopause was a biological rarity. A century ago, when Indian women lived an average of 25-35 years, most died before their ovaries ceased functioning. Today, with life expectancy reaching 71 years for women, India has crossed a critical threshold: menopause has transformed from the exception to the norm. Consider the mathematics of this shift. With menopause typically occurring in the late 40s for Indian women, and life expectancy now extending into the 70s, the majority of Indian women will spend 25-30 years of their lives in a post-menopausal state. What was once experienced by a small fraction of the population now affects hundreds of millions of women. We have successfully extended human lifespan, but we have not extended ovarian function to match. This demographic reality demands a fundamental rethinking of women's health. Every other vital organ system receives extensive medical attention when it begins to fail. We develop treatments for heart disease, interventions for kidney dysfunction, and therapies for liver disorders. Yet when it comes to ovarian failure — which affects metabolism, immune function, cardiovascular health, bone density, and cognitive performance — we simply accept it as inevitable. Beyond Acceptance: Reimagining Ovarian Health But what if menopause didn't have to be inevitable? What if, just like we've learned to support other aging organs, we could extend ovarian function throughout a woman's lifespan? When most people think about the ovary, they think about babies. When they think about menopause, they think 'hot flashes.' However, groundbreaking research in the field of Ovarian Health has demonstrated that the ovary is much more than simply a 'reproductive organ.' The consequences of ovarian dysfunction — whether in early life through conditions like PCOS (affecting 15% of women globally) or in midlife through menopause — help explain why women are sick for 25% more of their lives than men. The ovary serves as the 'central command' of a woman's health and vitality, critical to every major system and function of her body. This makes menopause the single biggest accelerant of unhealthy aging for women, including the onset of heart disease, stroke, obesity, diabetes, autoimmune disorders, osteoporosis, and cognitive decline. My research team at Celmatix Therapeutics, supported by a prestigious ARPA-H SPARK award from the U.S. government in 2024, has been pioneering breakthrough therapeutics designed to extend ovarian function throughout the modern lifespan. This isn't about indefinitely extending fertility. Eggs age on their own biological timeline regardless of ovarian health. Instead, our work focuses on therapeutically regulating ovarian folliculogenesis through drugs that target Anti-Mullerian Hormone (AMH). Women are born with a finite number of ovarian follicles, and AMH acts as molecular brakes, keeping this reserve from depleting too quickly. By strategically modulating these brakes during the years when women aren't trying to conceive, we can extend ovarian function throughout the lifespan. The implications are profound. Rather than accepting that the timing of menopause is fixed, we're working toward a future where it becomes a choice — where women can anticipate living healthy, active lives with fully functioning ovaries well into their nineties. They won't just survive past middle age; they will thrive. A Blueprint for Change Addressing India's menopause crisis requires coordinated action across multiple sectors: Healthcare System Reform: Integrate menopause care into existing programs like Ayushman Bharat and the National Health Mission. Establish specialized menopause clinics in urban centers and train primary healthcare workers to recognize and manage menopausal symptoms. Medical Education Overhaul: Mandate comprehensive menopause training in medical curricula. Develop continuing education programs for practicing physicians, particularly in gynecology and family medicine. Public Awareness Campaigns: Launch national initiatives to normalize menopause discussions. Use regional languages and culturally appropriate messaging to reach diverse populations. Leverage popular media and community health workers to spread awareness. Workplace Adaptation: Encourage employers to implement menopause-friendly policies, including flexible work arrangements, adequate healthcare coverage, and awareness programs for managers and colleagues. Research Investment: Fund studies specific to Indian women's menopause experiences, considering regional variations in diet, lifestyle, and genetics. This research should inform evidence-based treatment protocols. A global imperative India's opportunity to lead in this space is significant. While recent years have seen increased awareness and media coverage of menopause, there's a risk of falling into what I call the 'empowerment' narrative trap — suggesting women should feel proud of being menopausal rather than addressing the catastrophic health impacts. We don't celebrate osteoarthritis, tooth decay, cognitive decline, or heart failure, and we shouldn't celebrate ovarian failure either. The economic implications are staggering. Women comprise 80% of home and professional healthcare providers globally and play an increasingly vital role in the workforce. With more menopausal women in the workforce than ever before, the consequences of untreated ovarian dysfunction ripple through entire economies. When women thrive through better ovarian health, societies benefit immeasurably. For India specifically, this represents both a challenge and an unprecedented opportunity. As the country with one of the world's largest populations of women entering menopause, India could pioneer new models of ovarian health that benefit not just its own citizens, but women globally. The question isn't whether the country can afford to invest in this research — it's whether India can afford not to. The path forward As India's population ages and women's life expectancy increases, menopause will affect an unprecedented number of women. We can either address this proactively or face the consequences of continued neglect. The choice reflects our commitment to women's health and economic participation. Other countries offer valuable lessons. Australia's National Menopause Guidelines and the UK's workplace menopause policies demonstrate what's possible with political will and systematic change. India has the opportunity to leapfrog traditional approaches and create innovative solutions suited to our unique context. The second half of women's lives matters. By investing in menopause care today, India can unlock healthier, more productive futures for millions of women — and strengthen our society as a whole. The time for silence has passed; the time for action is now.
Yahoo
6 days ago
- Business
- Yahoo
Idorsia's QUVIVIQ expands into China as Simcere receives NDA approval – Idorsia and Simcere update their licensing agreement
Ad hoc announcement pursuant to Art. 53 LR Idorsia to receive USD 50 million (an additional USD 30 million) approval milestone payment in return for a reduction in Simcere potential sales milestones and tiered royalty payments. Allschwil, Switzerland – June 23, 2025Idorsia Ltd. (SIX: IDIA) today announced that Simcere Pharmaceuticals Group Ltd ( 'Simcere') has received approval for QUVIVIQ® (daridorexant) from the Chinese National Medical Products Administration for the treatment of adult patients with insomnia characterized by difficulty falling asleep and/or maintaining sleep, with no psychotropic drug control labeling. In addition, Idorsia has reached an agreement with Simcere to update the terms of the licensing agreement for QUVIVIQ in China. André C. Muller, Chief Executive Officer of Idorsia, commented:'I want to congratulate everyone at Simcere and the team that supported them from Idorsia. Together they have been able to take our drug from pre-IND, through to local Phase 1 and Phase 3, and then filing, resulting in this approval at an incredible pace of 2.5 years since the signing of the license agreement. I'm very happy as QUVIVIQ becomes a truly global brand, now available to millions of patients in North America, Europe, Japan and China, and we aim to continue this expansion to new territories.' Ren Jinsheng, Chairman and Chief Executive Officer of Simcere, commented:'I echo the congratulations to both teams that have worked diligently together to get this approval. Importantly, the clinical results achieved in both the global and local trials have enabled QUVIVIQ to be approved with no psychotropic drug control labeling in China. We are committed to make QUVIVIQ available to a great number of patients suffering with chronic insomnia.' Under the updated terms of the agreement, Idorsia will receive an approval milestone payment of USD 50 million, commercial milestone payments of up to USD 93 million, and low- to high-single-digit tiered royalties on future net sales. Arno Groenewoud, Chief Financial Officer of Idorsia, commented:'The updated agreement with Simcere allows both companies to streamline the collaboration. The increased milestone payment of USD 50 million in 2025 underscores Simcere's commitment and confidence in the potential of QUVIVIQ, following its significant investment in sealing this approval for Chinese patients and the corresponding launch preparations.' In 2022, Idorsia and Simcere entered into an exclusive licensing agreement for Idorsia's QUVIVIQ in China. Under the agreement, Simcere has an exclusive right to develop and commercialize QUVIVIQ in the Greater China region (Mainland China, Hong Kong, and Macau). Notes to the editor About IdorsiaIdorsia Ltd is reaching out for more – we have more passion for science, we see more opportunities, and we want to help more patients. The purpose of Idorsia is to challenge accepted medical paradigms, answering the questions that matter most. To achieve this, we will discover, develop, and commercialize transformative medicines – either with in-house capabilities or together with partners – and evolve Idorsia into a leading biopharmaceutical company, with a strong scientific core. Headquartered near Basel, Switzerland – a European biotech hub – Idorsia has a highly experienced team of dedicated professionals, covering all disciplines from bench to bedside; QUVIVIQ™ (daridorexant), a different kind of insomnia treatment with the potential to revolutionize this mounting public health concern; strong partners to maximize the value of our portfolio; a promising in-house development pipeline; and a specialized drug discovery engine focused on small-molecule drugs that can change the treatment paradigm for many patients. Idorsia is listed on the SIX Swiss Exchange (ticker symbol: IDIA). For further information, please contactInvestor & Media RelationsIdorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, CH-4123 Allschwil+41 58 844 10 – – The above information contains certain "forward-looking statements", relating to the company's business, which can be identified by the use of forward-looking terminology such as "estimates", "believes", "expects", "may", "are expected to", "will", "will continue", "should", "would be", "seeks", "pending" or "anticipates" or similar expressions, or by discussions of strategy, plans or intentions. Such statements include descriptions of the company's investment and research and development programs and anticipated expenditures in connection therewith, descriptions of new products expected to be introduced by the company and anticipated customer demand for such products and products in the company's existing portfolio. Such statements reflect the current views of the company with respect to future events and are subject to certain risks, uncertainties and assumptions. Many factors could cause the actual results, performance or achievements of the company to be materially different from any future results, performances or achievements that may be expressed or implied by such forward-looking statements. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein as anticipated, believed, estimated or expected. Attachment Press Release PDFError in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
6 days ago
- Business
- Yahoo
Idorsia's QUVIVIQ expands into China as Simcere receives NDA approval – Idorsia and Simcere update their licensing agreement
Ad hoc announcement pursuant to Art. 53 LR Idorsia to receive USD 50 million (an additional USD 30 million) approval milestone payment in return for a reduction in Simcere potential sales milestones and tiered royalty payments. Allschwil, Switzerland – June 23, 2025Idorsia Ltd. (SIX: IDIA) today announced that Simcere Pharmaceuticals Group Ltd ( 'Simcere') has received approval for QUVIVIQ® (daridorexant) from the Chinese National Medical Products Administration for the treatment of adult patients with insomnia characterized by difficulty falling asleep and/or maintaining sleep, with no psychotropic drug control labeling. In addition, Idorsia has reached an agreement with Simcere to update the terms of the licensing agreement for QUVIVIQ in China. André C. Muller, Chief Executive Officer of Idorsia, commented:'I want to congratulate everyone at Simcere and the team that supported them from Idorsia. Together they have been able to take our drug from pre-IND, through to local Phase 1 and Phase 3, and then filing, resulting in this approval at an incredible pace of 2.5 years since the signing of the license agreement. I'm very happy as QUVIVIQ becomes a truly global brand, now available to millions of patients in North America, Europe, Japan and China, and we aim to continue this expansion to new territories.' Ren Jinsheng, Chairman and Chief Executive Officer of Simcere, commented:'I echo the congratulations to both teams that have worked diligently together to get this approval. Importantly, the clinical results achieved in both the global and local trials have enabled QUVIVIQ to be approved with no psychotropic drug control labeling in China. We are committed to make QUVIVIQ available to a great number of patients suffering with chronic insomnia.' Under the updated terms of the agreement, Idorsia will receive an approval milestone payment of USD 50 million, commercial milestone payments of up to USD 93 million, and low- to high-single-digit tiered royalties on future net sales. Arno Groenewoud, Chief Financial Officer of Idorsia, commented:'The updated agreement with Simcere allows both companies to streamline the collaboration. The increased milestone payment of USD 50 million in 2025 underscores Simcere's commitment and confidence in the potential of QUVIVIQ, following its significant investment in sealing this approval for Chinese patients and the corresponding launch preparations.' In 2022, Idorsia and Simcere entered into an exclusive licensing agreement for Idorsia's QUVIVIQ in China. Under the agreement, Simcere has an exclusive right to develop and commercialize QUVIVIQ in the Greater China region (Mainland China, Hong Kong, and Macau). Notes to the editor About IdorsiaIdorsia Ltd is reaching out for more – we have more passion for science, we see more opportunities, and we want to help more patients. The purpose of Idorsia is to challenge accepted medical paradigms, answering the questions that matter most. To achieve this, we will discover, develop, and commercialize transformative medicines – either with in-house capabilities or together with partners – and evolve Idorsia into a leading biopharmaceutical company, with a strong scientific core. Headquartered near Basel, Switzerland – a European biotech hub – Idorsia has a highly experienced team of dedicated professionals, covering all disciplines from bench to bedside; QUVIVIQ™ (daridorexant), a different kind of insomnia treatment with the potential to revolutionize this mounting public health concern; strong partners to maximize the value of our portfolio; a promising in-house development pipeline; and a specialized drug discovery engine focused on small-molecule drugs that can change the treatment paradigm for many patients. Idorsia is listed on the SIX Swiss Exchange (ticker symbol: IDIA). For further information, please contactInvestor & Media RelationsIdorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, CH-4123 Allschwil+41 58 844 10 – – The above information contains certain "forward-looking statements", relating to the company's business, which can be identified by the use of forward-looking terminology such as "estimates", "believes", "expects", "may", "are expected to", "will", "will continue", "should", "would be", "seeks", "pending" or "anticipates" or similar expressions, or by discussions of strategy, plans or intentions. Such statements include descriptions of the company's investment and research and development programs and anticipated expenditures in connection therewith, descriptions of new products expected to be introduced by the company and anticipated customer demand for such products and products in the company's existing portfolio. Such statements reflect the current views of the company with respect to future events and are subject to certain risks, uncertainties and assumptions. Many factors could cause the actual results, performance or achievements of the company to be materially different from any future results, performances or achievements that may be expressed or implied by such forward-looking statements. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein as anticipated, believed, estimated or expected. Attachment Press Release PDFError in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
