- 1 Why do sleep disorders occur?
- 2 Varieties of insomnia
- 3 Effects of insomnia
- 4 Symptoms
- 5 Diagnostics
- 6 Treatment
- 7 Prognosis and prevention
Difficulties in falling asleep and nightly awakenings occur predominantly in adults, with the majority of patients being elderly. And at least a tenth of people suffering from insomnia need special medical treatment.
Insomnia: what is it and how is it dangerous
First of all, you should understand what is meant by this term. Insomnia is not complete insomnia (although this is what is most often called any sleep disorder), but partial. That is, a person sleeps regularly, but restlessly, often waking up at night, or has difficulty getting to sleep.
Such a wakefulness-sleep cycle disorder affects the quantity and quality of night rest. The patient is either unable to sleep for a long time, no less than half an hour, or sensitively reacts to external stimuli, wakes up periodically.
Why do sleep disorders occur?
The pathogenesis of pathology has not been fully studied; neurologists do not have a complete understanding of the mechanisms of insomnia development. However, empirically it was possible to establish that all patients brain activity in the process of sleep remains at the same level as during wakefulness. In addition, the metabolism of people suffering from insomnia is accelerated, and the concentration of certain hormones (adrenocorticotropic and cortisol) is increased.
If it is not quite clear how exactly insomnia develops, the reasons for it are clarified in full:
- Strong emotions (both negative and positive), stress, experiences, and other similar phenomena that have a stimulating effect on the nervous system.
- Physiological predisposition, consisting in the congenital characteristics of the organism.
- Psychogenic disorders – depression, various psychosis, neurosis, panic attacks.
- Diseases of certain internal organs or the nervous system, including its organic lesions. Pathology in this case causes pain at night, makes breathing difficult until it stops for a short time (apnea). Nighttime insomnia is often observed in hypertension, epilepsy, schizophrenia, atherosclerosis, pneumonia, and other diseases.
- Nutritional behavior (the habit of filling up at night, for example), the abuse of alcohol, tonic drinks.
- Features of lifestyle, profession, such as a regular change of time zones or shift schedules (involving work at night). In this case, as in the previous paragraph, the so-called behavioral insomnia is formed.
- Taking certain medications, especially psychotropic drugs. These drugs stimulate the central nervous system, respectively, a good night’s rest does not work.
Read also … Why torments insomnia, causes of disorder depending on gender and age
A significant impact on sleep has its hygiene. Full rest is possible only in a clean, well-ventilated area with a comfortable bed, quality linen.
Varieties of insomnia
All types of insomnia are classified according to different criteria. Thus, by origin, a sleep disorder may be primary (if it occurs because of personal or unclear reasons) or secondary. In the latter case, insomnia is a consequence of any mental or somatic abnormalities.
Depending on how severe the clinical symptoms are, the following degrees of insomnia stand out:
- easy – sleep disorders occur occasionally;
- medium – problems occur quite regularly, but signs are moderate;
- severe – insomnia is observed every night, which has a significant negative impact on the well-being, quality of human life.
Insomnia can also be situational, due to certain circumstances, or permanent. Another classification of insomnia divides it into 3 types according to the duration of the flow:
- transient or transient insomnia, which lasts no more than a few days;
- short-term – observed continuously for 3-4 weeks;
- Chronic – sleep disorders are systematic for a month or more.
In addition, insomnia can be evening, night or morning. In the first case it is difficult to fall asleep, in the second one there are frequent awakenings during the night. Morning insomnia is very early, for example at 4 am, getting up with inability to fall asleep again.
Effects of insomnia
What causes insomnia at night? If it lasts only a few days, fatigue simply accumulates and concentration of attention weakens. When insomnia syndrome disappears, the body recovers quickly without sequelae. Drug or other types of treatment in this case is not required.
If, on the other hand, it is impossible to get enough sleep for weeks and months, the health and quality of life deteriorate significantly. Due to prolonged insomnia, severe depression develops, serious somatic and mental disorders appear, and one cannot do without medical help.
According to the time of clinical signs (at bedtime, at night or in the morning), they are pre-, intra- and postsomnicheskie. A patient may develop as one type of violation with the corresponding symptoms, as well as a combination of two or all three.
About one third of elderly patients and one fifth of the middle age group with this diagnosis suffer from the last form of insomnia. Each symptom complex should be considered separately.
The main sign of such a violation is the inability to fall asleep quickly. For a healthy person, 10 minutes or less is enough, and for insomnia, much more is needed. At the same time drowsiness is observed during the day, prolonged insomnia at night, the desire to sleep disappears immediately after bedding.
- the long time it takes to fall asleep – from half an hour to two, sometimes more;
- obsessive thoughts or memories during this period;
- the inability to find a comfortable posture, physical activity, expressed in the constant change of body position;
- discomfort in the form of itching of the skin or its hypersensitivity;
- specific fear of another sleepless night.
To prevent falling asleep, lack of body fatigue or early laying after a late rise in the morning may result. The cause of secondary insomnia can also be pain or discomfort due to somatic pathology. The strong emotions transferred by day or the use of stimulants, tonic drinks also prevent relaxation.
Patients in this case complain of periodic short-term or prolonged, from 1 to 4 in the morning, for example, awakening. In some cases, a person may wake up an hour after falling asleep.
Additionally, symptoms such as:
- Increased susceptibility to external stimuli. Even a dim light or muffled sounds that are not disturbed by a healthy person awaken those suffering from this type of disorder.
- Severe motor activity, indicating the excitation of the central nervous system. This usually refers to “restless legs” syndrome – vigorous shaking of lower limbs during sleep.
- Apnea (breath holding) and snoring.
Short-term awakening or insomnia from 2 am to 5 am may be a consequence of the urge to empty the bladder, nightmares, heart palpitations. The person also wakes up from his own snoring, breathing stops, any sounds and light.
Morning insomnia is waking up earlier than 6 am, after which it is not possible to fall asleep again. Older patients complain about it most often. Additional signs of this type of insomnia:
- fatigue and weakness immediately after lifting;
- daytime sleepiness, lethargy;
- the impossibility of daytime sleep even in the presence of a strong desire to sleep;
- mood swings;
- increased pressure, morning headaches.
Waking up at 4 am can cause a full bladder, various sounds or light. Often, the awakening occurs without apparent reason.
The basis for the diagnosis of short-term, transient or chronic insomnia are primarily subjective complaints. During the survey, a neurologist ascertains the nature of the violation, establishes a connection with psychological factors or existing diseases, medication.
The two main criteria for evaluating the information received are the ratio of the duration of sleep to time spent in bed and the period of falling asleep. The first can not be less than 85%, and the second should take less than half an hour in a healthy person. Diagnosis of insomnia sometimes includes also keeping a special diary, when a patient, during a month, according to the recommendation of a doctor, records periods of sleep and wakefulness.
If the traditional treatment of insomnia by a neurologist does not produce a result, consultation of a somnologist is appointed. Shown special computer examination – polysomnography. The involvement of specialized specialists is also necessary if the cause of insomnia is a mental disorder or a physical illness.
Transient or acute insomnia passes quickly and itself, so it does not need to be treated. The other two forms require the identification and elimination of the cause, as well as symptomatic therapy.
Most patients believe that the only way to cope with insomnia is to take special medications. However, modern medicine has various methods of treatment, and the neurologist does not always prescribe pills.
It all starts with the organization of a full night rest. Very often, a simple airing of the bedroom, the replacement of an uncomfortable mattress and unnatural bed linen help to adjust the mode.
Behavioral insomnia is treated by appropriate methods: the rejection of hearty dinners, coffee and tea (especially in the afternoon), bad habits. It is recommended to walk more and avoid emotional load in the evenings, go to bed at a certain time.
If the patient sleeps some time during the day, then this habit should be abandoned, moving more and engaging in mental activity. As a result, in the evening fatigue accumulates, and there are no problems with sleep.
This is the main method of dealing with sleep disorders caused by psychological factors. Communication with a specialist, in the course of which he uses proven effective techniques, helps to get rid of the cause of nervous tension.
Speaking, analysis of anxiety, misla, emotion – a long-known way to move away from them. Very often, even a conversation with a non-specialist (a close friend, for example) helps to look at the situation from the outside, to realize its insignificance.
Regardless of what kind of evening, night or morning insomnia is diagnosed in a patient, relaxing procedures will be helpful. Among the common ways of relaxation can be distinguished massage and various baths with a calming effect.
A specific method is exposure to white light – phototherapy. Acupuncture also gives good results.
In most cases, drug therapy begins with the appointment of “light” herbal preparations: motherwort, peony tincture, valerian, and combined means. In the absence of a result, antihistamines, antipsychotics and antidepressants are indicated.
Zolpidem and Zopiclone can be distinguished from effective, but fairly safe medicines, while tranquilizers such as Diazepam inhibit nervous activity and are addictive. Another danger of special drugs is rebound insomnia, which develops after their cancellation.
Prognosis and prevention
Episodic sleep disorders for health are not dangerous and pass without treatment. If you have not slept for a week or more, a visit to a neurologist is obligatory, and the effects of insomnia can be serious. For example, pathology can become chronic, which is usually accompanied by depressive insomnia syndrome.
In addition, the therapy of protracted insomnia always requires a lot of time, taking potent drugs. To prevent sleep disorders, adherence to his hygiene, a healthy lifestyle, auto-training, timely treatment of any diseases will help.