Insomnia (insomnia)
Insomnia (insomnia) is a sleep disorder that is characterized by a violation of falling asleep, the sleep process, dissatisfaction with the duration or quality of sleep, early awakenings, daytime sleepiness due to lack of sleep. At the same time, the duration of sleep does not play a significant role, since the duration of sleep varies from person to person. This problem bothers people of all ages, but most often older people complain of insomnia.
The content of the article:
Causes of insomnia
Classification of insomnia
Symptoms of insomnia
Diagnosis of insomnia
Treatment of insomnia
Prognosis and prevention of insomnia
Insomnia (insomnia)
Causes of insomnia
Improper sleep hygiene. A full sleep provides for many factors: a comfortable pillow, a hard bed, fresh air in the room, optimal temperature. Violation of these factors may well affect the duration and quality of sleep.
Diseases of the nervous system (depression, neuroinfections, neuroses, concussion). For a full sleep, the normal functioning of the nervous system is extremely important. Any disorders of the nervous system inevitably lead to a complete lack of sleep, light sleep, frequent awakenings.
Anxiety, stress and anxiety. Psychologists say that hypochondriacal people are prone to exaggeration of even the most insignificant problems, as well as a detailed analysis of their actions. At the same time, it is before going to bed that many people have time to think again about problems or difficult life situations. As for stress, it threatens everyone without exception. It can be caused by a variety of reasons: the illness of a loved one, the change of seasons, problems at work. The result of the negative effects of stress and anxiety is a decrease in the body’s defenses, which is why insomnia appears.
Improper nutrition. Overeating is fraught with serious health problems. After a hearty dinner at night, the food lingers in the stomach until the morning. As a result, there is a feeling of heaviness in the stomach, and fermentation processes in the stomach are activated. A person begins to experience discomfort, his sleep becomes sensitive, he often wakes up.
Somatic diseases. Any somatic diseases have a bad effect on sleep. Arthrosis, infectious diseases, ulcers, angina pectoris, arterial hypertension are especially harmful to normal sleep. A reduction in sleep duration and a failure of circadian rhythms almost always occurs with chronic diseases.
Failure of the biological clock and violation of the circadian rhythm. This is due to working the night shift or forced time zone change. At the same time, a person feels quite cheerful in the evening and cannot fall asleep, his working capacity decreases, and drowsiness appears only in the morning.
Taking stimulants and medications. It has been proven that tea, coffee, alcohol, dark chocolate, nicotine and narcotic drugs can stimulate the human nervous system and prevent the process of falling asleep. Some medications act in the same way on the body: antidepressants, medications for the treatment of bronchial asthma and cardiovascular diseases.
Bedwetting. This pathology can occur due to immaturity of the nervous system, diabetes mellitus, allergies and other reasons. Usually, patients with urinary incontinence have sleep disorders due to fear of involuntary urine discharge. These fears lead to the fact that they find it very difficult to fall asleep and are light sleepers.
Classification of insomnia
Depending on the duration of sleep , there are four types of insomnia:
Transient. The duration of this type of insomnia is about a week. It is usually associated with problems in the emotional sphere of a person. In particular, it may occur due to strong emotions or sudden life changes.
Short-term. Such insomnia usually lasts from a week to a month. Symptoms of insomnia begin to actively manifest themselves, so the patient should consult a doctor for advice.
Chronic. This type of insomnia is diagnosed if sleep problems bother the patient for more than a month. Chronic insomnia is dangerous because it will no longer be enough for a person to get a good night’s sleep to restore working capacity.
Family. This type of pathology is not subject to treatment. Usually, sleep problems bother a person for a couple of weeks. The inability to fall asleep and get a good night’s sleep can eventually lead to death.
Depending on the etiology of the disease, it is customary to distinguish primary insomnia, which arose due to personal or unexplained reasons, as well as secondary, which arose due to somatic, psychological and other reasons. According to the severity, insomnia of mild, moderate and severe degrees is distinguished. For a mild degree of the disease, rare episodes of sleep disorders are characteristic, for an average — moderately pronounced, for severe — daily sleep disorders.
Symptoms of insomnia
The general clinical signs of the disease, on the basis of which the diagnosis is made, include complaints of the patient about difficulties with falling asleep and poor sleep quality, episodes of sleep disorders at least three times a week, concern about the deterioration of well-being after a sleepless night. Chronic lack of sleep can negatively affect the learning and memorization process. All signs of insomnia can be divided into three large groups: presomnic, intrasomnic, postsomnic. Usually, patients are diagnosed with signs of only one or two groups. Simultaneous manifestation of symptoms from all groups is diagnosed only in 20% of patients.
Presomnic violations
The main complaint of patients is problems with falling asleep. Normally, the stage of falling asleep lasts about 3-10 minutes. However, a person suffering from insomnia may need from half an hour to two hours to fall asleep. An increase in the duration of falling asleep can be triggered by anxiety and fears, taking medications, late rise, pain reaction.
After the patient goes to bed, he immediately loses the desire to sleep. He begins to be burdened by heavy thoughts, he cannot choose a comfortable position for a long time, feels an unreasonable itch. Similar problems caused by sleep disorders can be accompanied by strange rituals that are peculiar only to sick people. For example, a patient may have a fear of falling asleep, up to fears of going to bed.
Intrasomnic disorders
In this case, the main complaint of the patient is the lack of deep sleep. Even the most insignificant stimuli can cause sudden awakening. Light and sound are especially acutely perceived. A person can wake up because of a nightmare, rapid heartbeat, filling of the bladder, respiratory disorders.
Of course, a healthy person in the case of such stimuli can also wake up. However, after waking up, he is easily and quickly able to fall asleep. In addition, after such episodes, the quality of his sleep does not suffer. This group of disorders also includes a significant increase in motor activity, which is manifested by the fact that a person begins to shake his legs in a dream.
Postsomnia disorders
In some patients, insomnia may also manifest itself after waking up — they feel broken in the body, cannot wake up early, feel drowsy during the day, their performance decreases. Immediately after waking up, there may be a severe headache or a rise in pressure. Patients may also complain of frequent mood swings, which only exacerbates psychological discomfort and affects the quality of sleep.
Diagnosis of insomnia
The doctor can make a diagnosis based on the physical condition of the patient and his complaints. There are two main criteria that allow you to accurately diagnose the disease: a significant decrease in the quality of sleep and a long process of falling asleep, the duration of which is more than half an hour. For an accurate assessment of sleep disorders, the patient may be offered to keep a sleep diary for a month.
According to the indications, consultations of other specialists, laboratory tests, polysomnography may be prescribed. The latter technique involves studying the patient’s sleep with the help of special computer equipment. Usually, polysomnography is prescribed in case of ineffectiveness of drug treatment, as well as the presence of motor activity and respiratory disorders during sleep. With the help of this study, you can evaluate the work of the body during sleep, get a complete picture of sleep and find out the duration of its phases.
Treatment of insomnia
Insomnia treatment must necessarily include several diverse techniques at once. Special attention is paid to the elimination of the causes that caused the pathology. Depending on the etiology of the disease, its form and severity of the course, the following methods of its treatment can be used:
psychotherapy (psychological counseling, relaxation techniques, cognitive therapy);
normalization of sleep hygiene;
correction of sleep and wake cycles (melatonin intake, phototherapy, chronotherapy);
treatment of somatic or neurological diseases that have provoked sleep disorders;
drug therapy;
physical therapy.
Many people who are concerned about sleep disorders take sleeping pills. However, you can take medications only after a doctor’s appointment. They have many contraindications. In particular, sleeping pills should not be taken by nursing mothers, pregnant women, patients with respiratory disorders. Medications against insomnia, which are sold in pharmacies without a prescription, include adaptogenic drugs (melatonin, melatonex), drugs that improve cerebral circulation (memoplant, tanakan), sedatives (valocordin, corvalol).
With a severe course of the disease, doctors can prescribe potent medications that, in addition to a positive effect, can cause side effects such as worsening of the reaction and drowsiness during the day, as well as temporary amnesia. Such drugs include:
antihistamines (donormil, diphenhydramine) — soothe and accelerate the process of falling asleep;
tranquilizers (phenazepam) — help to eliminate anxiety, fear, relax muscles, calm the nervous system;
benzodiazepines (somnol) — reduce the number of night awakenings, improve the quality of sleep, accelerate falling asleep;
barbiturates (meprobamate) — help to get rid of depression, reduce anxiety.
Physiotherapy techniques have also shown their effectiveness in the treatment of insomnia:
massage — improves blood circulation of the brain and spinal cord, accelerates metabolism, relaxes spasmodic muscles;
therapeutic baths with herbs, sea salt, pine needles — have a calming effect and improve blood circulation throughout the body;
magnetotherapy — has an analgesic, decongestant, anti-inflammatory effect, improves the work of the centers that are responsible for sleep;
darsonvalization of the head — increases immunity, improves lymph outflow and blood flow in the brain, eliminates vascular spasms.
Great importance in the treatment and prevention of insomnia is given to the observance of sleep hygiene. To do this, you need:
falling asleep and waking up at the same time;
do not eat before going to bed, avoid smoking and drinking alcohol, prefer vegetable and dairy dishes for dinner;
lead an active lifestyle;
try to avoid daytime sleep (even short-term);
avoid emotional experiences in the evening;
an hour before bedtime, do not read, do not play computer games and do not watch TV;
ventilate the room well before going to bed;
sleep on a comfortable, even and moderately soft bed;
sleep in the dark, because in this case the body begins to produce melatonin — a substance that is considered a natural sleeping pill as it promotes rapid relaxation of the body;
if you can’t fall asleep for half an hour, don’t force yourself, but get up and do something relaxing until you get a feeling of drowsiness.
Prognosis and prevention of insomnia
Getting rid of insomnia is quite real. However, in order for the treatment to end quickly and be effective, you need to consult a doctor as soon as possible. In this case, we can hope that proper sleep hygiene, medication and physiotherapy will allow you to quickly and easily get rid of sleep disorders. However, in the case of a severe chronic course of the disease, the process of its treatment may be lengthy.
It is possible to prevent the appearance of the disease if you follow the correct work and rest regime, avoid stress and emotional overload, and play sports. It is advisable not to overeat before going to bed and have dinner for the last time three hours before falling asleep. Before going to bed, it is necessary to ventilate the room well and take a warm bath.
