Insomnia
Introduction
Introduction to insomnia Insomnia usually refers to a subjective experience in which the patient's sleep time and or quality is unsatisfactory and affects daytime social function, including difficulty falling asleep, frequent awakening, and/or early morning wake up. Can cause people's fatigue, uneasiness, general malaise, listlessness, slow response, headache, memory inactivity and other symptoms, its greatest impact is mental, serious schizophrenia, common clinical types are: primary sleep Disorders, secondary sleep disorders, pseudo insomnia. basic knowledge The proportion of illness: 2%-5% (people who have experienced insomnia cover almost the entire population) Susceptible people: no special people Mode of infection: non-infectious Complications: depression
Cause
Cause of insomnia
Physiological factors (25%):
Physical illness and medication can affect sleep, such as indigestion, headache, backache, arthritis, heart disease, diabetes, asthma, sinusitis, ulcer disease, or taking some drugs that affect the central nervous system.
Lifestyle (15%):
Sleep problems are also common due to lifestyle, such as drinking coffee or tea, drinking in the evening, sleeping on food or late dinner, causing full food to be digested, mass smoking, intense physical activity before bedtime, excessive mental activity before going to bed, night shift Work, take a nap during the day, go to bed irregularly, and get up time irregularly.
Mental reasons (20%):
Possible causes are stress, excessive anxiety, nervousness or anxiety, sadness or depression, anger, and prone to sleep problems.
Environmental factors (15%):
A noisy sleep environment, the sleeping environment is too bright, polluted, overcrowded.
Prevention
Insomnia prevention
Precautions
The main aspects should be as follows:
1 is a diet that is light and rich in protein and vitamins.
2 Participate in qigong, Taijiquan and other sports that emphasize mental exercise and improve the ability of nerve regulation.
3 Life is regular, go to bed regularly, dinner should not be full, do not drink tea and coffee and other stimulating drinks before going to bed.
4 sleep Nadun Ning, lecithin and other health foods, have a good role in regulating nerve function, help to improve sleep.
Improve sleep quality:
We know that sleep is extremely important for brain health. People generally need more than 8 hours of sleep, and must ensure high quality. If the time of sleep is not enough or the quality is not high, it will have a bad influence on the brain. The fatigue of the brain is difficult to recover. It may affect the function of the brain. If you have insufficient sleep or poor sleep quality, you should increase your sleep time, such as taking a nap in the summer and trying to improve your sleep.
According to the general point of view, sleep is the main way to eliminate brain fatigue. If you have insufficient sleep or poor sleep quality, it will seriously affect the function of the brain. People who are already very smart will become confused. Many people suffer from it. Diseases such as neurasthenia are often caused by severe sleep deprivation.
In short, more than one-third of a person's life is spent in sleep, just a good sleep, can regulate physiological functions, maintain the balance of the nervous system, is an important part of life, poor sleep, Insufficient, the next day will be wrong, the whole body is weak, sleep and health work and learning are very close.
Insomnia prevention
If you sleep for eight hours a day, one-third of a person's life is spent in sleep. The quality of sleep is closely related to people's mental and physical health. There are four elements in sleep, which affect the quality of sleep. Very big.
Sleeping appliance
Whether it is the bed in the south or the shackles in the north, when it is placed or built, it should be north-south. When people sleep, the head is north and south, so that the body is not disturbed by geomagnetism. The hardness of the paving should be moderate. People have to turn over often because of their stimulation, it is difficult to sleep, and they are sore after sleep. The height of the pillow is generally one shoulder (about 10 cm) of the sleeper. It is easy to cause the physiological spur of the cervical vertebra. In the summer, the pillow should be frequently turned over to prevent the bacteria from entering the mouth and nose, and the lung diseases are increased.
2. Sleep posture
People with heart disease, it is best to have more right side lying, so as not to cause the heart to be stressed and increase the incidence of disease. If the brain is painful due to high blood pressure, the pillow position should be properly raised. In addition to the high pillow, the lung patients should also change the sleeping side frequently to facilitate the discharge of the sputum. The stomach sees fullness and hepatobiliary diseases, and the right side sleep is appropriate. If there are pain in the limbs, the stress is relieved from the pressure and the bed is lying. In short, the choice is comfortable, which is conducive to the sleeping position of the disease and helps to sleep well.
3. Sleep time
Sleep time should generally be maintained for 7 to 8 hours, but not necessarily forced, depending on individual differences, sleep fast and sleep deeply, generally no dreams or less dreamers, sleep 6 hours to fully recover. Slow sleep and shallow sleepy eyes, often dreamers, even if you sleep for 10 hours, it is still difficult to refresh, you should go through various treatments to get an effective sleep, just prolong the sleep time is harmful to the body, because everyone has different The circadian rhythm will vary from person to person in the arrangement of sleep sooner or later. In fact, different circadian rhythms make two situations of sleep, namely "night owl" and "lale", which is conducive to improving work efficiency and quality of life, and vice versa.
4. Sleeping environment
The quality of sleep is closely related to the sleeping environment. In the temperature of 15 to 24 degrees, you can get a good night's sleep. The smoke left by smoking after closing the window in winter, and the incomplete burning gas will make people sleep. In the vicinity of the source of high-frequency ionizing electromagnetic radiation, long-term sleep is not good, but it is better to migrate in the distance. In summary, if people can master the four elements of scientific sleep, they can effectively Improving the quality of sleep, putting more energy into work, and scientific sleep are new demands put forward by people in modern life.
Six recommendations for improving sleep quality
Many things can affect the quality of sleep. Dr. Holgerhain, the dean of the Groshansdorfdorf Sleep Disorder Treatment Hospital in Germany, made six good suggestions for improving sleep quality:
1. Keeping your feet warm: The results of the study show that the quality of sleep for women with cold feet is worse than that for women with comfortable feet. Dr. Hein recommends sleeping in thick socks.
2. Do not open the window: the substance that causes people to be allergic and the noise that affects sleeping enter the bedroom through the open window. Hein recommends: close the window to sleep.
3. No cleaning at night: Sprays and chemical cleaners used in cleaning the room may irritate the respiratory tract and affect sleep. Hein recommends: only clean the bedroom in the morning.
4. Only tulips can be placed in the bedroom: there can be no flowers in the bedroom, because they can cause allergic reactions. Hein suggested: only tulips can be placed in the bedroom, and the tulips will not be in danger of causing allergic reactions.
5. Wipe off cosmetics: Sleeping with cosmetics can cause skin irritation, and people who apply perfume at night should consider the possibility of triggering asthma.
6. Sleep 15 more minutes a day: Dr. Hein mentioned a new scientific result: women need 15 minutes more sleep each day than men.
4 types of insomnia and improvement
First, stress-type insomnia
Occupation type: business managers, civil servants, researchers.
Insomnia performance: difficulty falling asleep, shallow sleep, more dreams, easy to wake up, usually this part of the woman to the night, although lying in bed for a long time, but still thinking about various work problems in my mind, can not sleep peacefully, even if asleep However, various images will appear in the dream, and the next day I will get up and feel dizzy, as if the clouds are foggy.
Insomnia: moderate (continuous insomnia 10 days - 30 days)
Causes of insomnia: This part of the person is in the environment of survival of the fittest, so the work pace is fast, the pressure is high, the work schedule is not fixed, the mental state is too tight, the emotional instability is the direct cause of insomnia, often a big task is coming. I can't sleep.
Patching: first decompression, then go to sleep, as long as the method is right, the normal sleep will return to normal.
If you are not sleeping in bed for a long time, don't worry, just relax and relax:
1. Aromatherapy method: A scented lamp on the bedroom, the faint lavender scent will gradually relax the nerves, and unconsciously enter the dream.
2. Massage method: feel yourself very tired, don't rush to sleep, give yourself a beauty massage, under the light fingers of the beautician, your mind will relax with the facial muscles, usually two hours of massage than to fall asleep More relaxed.
3. Lullaby: Listen to special sleeping songs, such as Schumann's Serenade, Green Island Serenade, can help you fall asleep - there are hypnotic music, relaxing music, and music albums for sale in audio and video stores.
4. Meditation: Sit on the legs, put your hands on your knees, breathe slowly, try to clear the distracting thoughts in your mind, don't want anything, every 30 minutes, this trick is more useful for those women who dream more at night, 5. Sports: It is best to do proper sports every week, such as playing badminton twice a week for 2 hours, or walking for 30 minutes, 3 times a week, which can increase the blood oxygen supply in the brain, insomnia naturally Its gone.
If you really don't have the time or the conditions to enjoy these decompression policies, then try Napoleon's rest method. When Napoleon is going out, he needs to deal with the military affairs day and night, unable to fall asleep, in order to maintain sufficient physical strength and agile thinking. He forced himself to sleep for 20-30 minutes every 4 hours. He is like this in the sand. Besides, if you are a SOHO family, you can also take a nap to make up for it.
Second, bad hobby type insomnia
Occupation types: freelancers, brokers, creative people, cultural company employees, engaged in fashion-related work.
Insomnia performance: difficulty falling asleep, more nightmare, wake up after the mind is ignorant.
Causes of insomnia: caffeine, alcohol, and nicotine are the three major culprit in direct insomnia. Now more and more women are used to drinking tea, coffee, drinking cola during meals, chocolate, which contain caffeine ingredients. It stimulates the nervous system, makes the adrenaline secretion strong, plus 12 hours of action time, drinking more during the day, naturally can not sleep at night, and the nicotine in the cigarette also stimulates the nervous system while raising blood pressure, Severely hinder the breathing during sleep. Women who smoke will feel sleepy. This is the reason. Alcohol seems to make people drunk, but it can also cause wake up when sleeping, and feel tired when you wake up.
Insomnia: mild (1-3 days insomnia)
Patching program: This group of insomniacs can quickly eliminate the trouble of insomnia as long as they quit bad hobbies.
1. Try to avoid "positive" contact with the three major insomnia factors, quit smoking, stop drinking, and strictly control the intake of caffeine, especially after 2 pm.
2. Do not do excessive excitement after dinner, such as Judy, disco music is fast, and belongs to body movement, so after going home, it is easy to over-excite and lead to insomnia.
Third, anxiety-type insomnia
Occupation type: Female leaders who are more than 30 years old, such as private business owners, financial executives, etc.
Insomnia performance: Anxiety, panic, unable to fall asleep again after awakening at night.
Causes of insomnia: This part of women is in the stage of continuous improvement of their careers, and marriage, family, and interpersonal relationships all affect emotions, so it is easy to affect the nervous system leading to insomnia.
Insomnia: severe (insomnia for more than 3 months)
Patching plan:
1. Suggestion: Relax physically and mentally, lying on the bed, and suggesting yourself: my arms are relaxed, my legs are relaxed, my head is relaxed, and I am going to fall asleep.
2. Exercise: Take a relaxing walk, soothing yoga to promote metabolism and regulate mood.
3. Peace of mind: Avoid excessive stimulation, such as not watching the thrills at night, murderous films, but also be careful not to bring home the troubles of work.
Fourth, depression
Occupation type: technical staff, professional women who do not often interact with people.
Insomnia performance: expression is indifferent, unwilling to interact with people, lack of self-confidence, 2-3 points in the night after waking up, it is difficult to fall asleep, my heart is complicated, and I woke up the next day and have dizziness and other physical symptoms.
Causes of insomnia: Introverted personality makes them not good at expressing everyday. If they encounter problems, they are prone to low and melancholic emotions.
Insomnia: severe (insomnia for more than 3 months)
Patching program: Strengthen interpersonal interactions and participate in group activities. It is best to ask a specialist for treatment. It should be added that people with anxiety-type insomnia and depression-type insomnia usually need long-term efforts to improve their sleep, so they need a specialist ( Psychiatrist) Make a comprehensive solution to your work, body, and work situation.
For those who have long relied on drugs to fall asleep, they should consult a doctor in time to change this habit. In addition, some weight-loss drugs have a serious impact on sleep quality because they act on the nerves. It is recommended not to take them.
Complication
Insomnia complications Complications depression
The harm of insomnia to the human body is mainly mental, and generally does not make people fatal, but long-term insomnia can make people tempered, aggressive, memory loss, lack of concentration, mental fatigue, insomnia and human mental impact Causes organic diseases, it will also reduce human immunity, making people's body consume more, because the secretion of auxin is mainly after sleeping at night, so the insomnia of children will reduce the secretion of auxin, which is not conducive to the body. Growth and development.
Symptom
Insomnia Symptoms Common Symptoms Nightmare is sensitive to sound and falls asleep. Sleeping hallucinations are difficult to determine. Insomnia, insomnia, headache, intractable insomnia, weakness, difficulty falling asleep or awakening
Clinical manifestation
1. It is difficult to fall asleep.
2, can not sleep well.
3, wake up early, can not fall asleep after waking up.
4, often wake up from nightmares, self-satisfaction all night is a nightmare.
5. After the sleep, the energy did not recover.
6, the onset time can be long or short, the short can be improved in a few days, the elderly are difficult to recover for several days.
7, easy to be awakened, some sensitive to sound, and some sensitive to light.
8, many insomnia people like to think about it.
Insomnia can cause fatigue, anxiety, general malaise, listlessness, slow response, headache, and inability to concentrate. Its greatest impact is mental, which can lead to schizophrenia.
Insomnia type
(1) Classification by disease duration
1, transient insomnia (less than a week)
Most people experience transient insomnia when they experience stress, stimulation, excitement, anxiety, when they are sick, at high altitudes, or when their sleep patterns change (such as jet lag, shift work, etc.). It improves as the event disappears or the time elapses, but transient insomnia, such as improper handling, can lead to chronic insomnia.
The main treatment principle for transient insomnia is intermittent use of low-dose sedative sleeping pills or other drugs that help sleep, such as anti-depressants and good sleep hygiene.
2, short-term insomnia (one week to one month)
Serious or persistent stress, such as major physical illness or illness, death of relatives and friends, serious family, work or interpersonal problems, may lead to short-term insomnia, which is clearly associated with stress.
The principle of treatment is short-term use of low-level sedative sleeping pills or other drugs that can help sleep, such as anti-depressants and behavioral treatments (such as muscle relaxation). Short-term insomnia can lead to chronic insomnia if not treated properly.
3, chronic insomnia (more than one month)
The causes of chronic insomnia are complex and difficult to find. Many chronic insomnia are caused by a combination of causes. The causes of chronic insomnia are as follows:
(1) Physical illness can lead to insomnia. (According to many chronic diseases, it is related to insomnia)
(2) Insomnia caused by illness or emotional disorder.
(3) Insomnia caused by drugs, alcohol, irritants, or drugs.
(4) There are sleep cycle disorders or irregularities leading to insomnia.
(5) The uncomfortable feeling of the calf before going to bed or the involuntary twitching of the sleeping foot causes insomnia.
(6) Sleeping and snoring, irregular breathing or other breathing disorders leading to insomnia.
(7) Primary insomnia With the accelerated pace of life and increased living pressure, more and more patients with insomnia.
(2) Classification by cause
Primary sleep disorder
Long-term nighttime sleep disorders, no explanation for neurological symptoms of insomnia, depression or other mental disorders and physical illnesses, some patients may be lifelong, different from normal people who can only meet 3 to 4 hours of nighttime sleep, such patients often Some symptoms of sleep deprivation occur, and various drugs or measures are taken to ensure the sleep time. These patients have short sleep time, especially the short sleep time of the fourth period, often awakening, low threshold of awakening, easy to be accompanied by mental disorders, but the spirit Whether the obstacle is the cause or the result is not clear.
2. Secondary sleep disorders
Also known as environmental insomnia, often secondary to pain or other physical illnesses, or secondary to drug abuse, depression, duration is often short-lived, common incentives:
(1) Physical reasons: restless legs syndrome often causes difficulty in falling asleep, pain caused by joint or nerve involvement, abdominal discomfort caused by peptic ulcer or tumor, increased frequency of arousal caused by cardiopulmonary disease, and hyperthyroidism accompanied by hyperthyroidism Insomnia can occur in palpitations, etc.
(2) Environmental factors: due to changes in work or life, such as night shifts, moving, riding a boat, the time difference of air travel, and the light in the bedroom, noise, etc. can cause insomnia, generally can adapt in a short period of time.
(3) Mental factors: excitement and anxiety are the main factors of short-term insomnia, mainly due to difficulty falling asleep; depression, anxiety is the main factor of long-term insomnia, often awakened, morning wake up is too early, EEG records can be seen scattered The awakening period was significantly prolonged and increased. People with neurasthenia are troubled by remembering the various environmental stimuli they hear or see during each awakening period, while normal people can ignore them. In addition, elderly people with brain degenerative diseases often have insomnia.
(4) drug factors: amphetamine, caffeine, ephedrine, aminophylline, isoproterenol, etc. can cause insomnia, long-term use of general sleeping pills can often lead to a relative reduction in REM sleep, after withdrawal can be caused by rebound Nightmare.
3. False insomnia
The patient has enough sleep time, but often complains about lack of sleep.
Examine
Insomnia check
The most important way to understand insomnia is to use the EEG multi-lead tracing device to monitor the whole-night sleep process, because sleep complaints and daytime sleepiness have different causes, and EEG multi-lead tracing for accurate diagnosis It is essential.
On the basis of medical history and key neurological examinations, in order to identify insomnia caused by organic lesions, the necessary selective auxiliary examination items include:
1. CT and MRI examinations.
2. Blood routine, blood electrolytes, blood sugar, urea nitrogen.
3. Electrocardiogram, abdominal B ultrasound, chest penetration.
Diagnosis
Insomnia diagnosis
diagnosis
Diagnosis relies mainly on medical history, and there are many reasons for insomnia. Finding the causes of insomnia caused by sleep disorders, physical illnesses, emotional factors, lifestyle and environmental factors is also the content of diagnosis.
Differential diagnosis
Epworth sleep scale (ESS), nocturnal polysomnographic recording (NPSG) recording, multiple sleep Latency Test (MSLT), etc., useful for differential diagnosis, MSLT can be found in patients for 1 day There are several naps in a few hours, the total daytime sleep time increases, the sleep latency is normal or shortened, and the characteristic manifestation is REM-based sleep (SOREMPs). The more SOREMPs appear, the more helpful it is. In the diagnosis of sleeping sickness, it is generally found that SOREMPs more than 2 times can be diagnosed as narcolepsy.
However, the specificity of more than one SOREMPs for the diagnosis of narcolepsy is not absolute, arrhythmia, unplanned work change, chronic sleep deprivation, obstructive sleep apnea, periodic leg movement during sleep, etc. Or above SOREMPs, clinical attention should be paid to the identification.
For secondary insomnia caused by organic diseases, attention should be paid to the identification of primary disease.
Clinical attention should be paid to the identification of sleep disorders as follows:
1) Secondary insomnia, the common causes of secondary insomnia are as follows: 1 Any physical illness affecting the central nervous system. 2 physical pain or discomfort, such as itching or pain of skin diseases, cancer pain, etc., often cause insomnia. 3 Insomnia caused by alcohol, coffee, vegetables or drugs. 4 mental disorders, most people with mental disorders have symptoms of insomnia, especially in patients with anxiety and depression, almost all insomnia, as long as the clinical manifestations (including medical history, physical examination, various test results) is enough to diagnose one of the above diseases, the primary Diagnosis of sexual insomnia is not considered.
2) Other sleep disorders, such as night terrors, nightmares patients may have insomnia, if there is a typical night terror and nightmare symptoms, do not consider insomnia.
3) Transient insomnia disorder, which is common in daily life, does not require any treatment, the body can be naturally adjusted, so those with insufficient disease will not diagnose insomnia.
