insomnia depression
Introduction
Introduction to insomnia depression Insomnia depression is mainly characterized by a shortened incubation period of REM sleep (normally 90 minutes, and less than 50 minutes after the first REM sleep in a depressed patient). Early awakening and deep sleep are reduced. As the patient ages, the sleep disorder will change in the latter half of the night. It is getting more and more serious, mainly because it is difficult to fall asleep when you wake up early and wake up. The patient often wakes up at two or three o'clock in the middle of the night, and his thoughts are entangled in sorrow and not extricating himself. The severity of insomnia is directly related to the severity of depression. When the condition is serious, the sleep time is extremely shortened, but there is no obvious sleepiness during the day, and only extreme fatigue and loss of feeling are felt. This is because the level of awakening is increased, making it difficult to fall asleep during the day. The symptoms of insomnia vary in severity, and light ones have difficulty falling asleep. Sleeping and easy to wake up, can not sleep after waking up, and sometimes wake up when sleeping, but sleep but dream more; in severe cases, can not sleep all night, insomnia can also appear alone, but also with headache, dizziness, Heart palpitations, forgetfulness, etc. appear at the same time. basic knowledge The proportion of sickness: 0.16% Susceptible people: no special people Mode of infection: non-infectious Complications: hypertension, coronary heart disease, breast cancer, hemiplegia, diabetes
Cause
Insomnia, depression, cause
Malfunctions in living (23%):
Life lacks regularity, does not work on time; or work and restlessness, busy and idle, busy nights, night bed, free bedtime, leading to disorder of the biological clock, autonomous rhythm disorder, destroying normal sleep rhythm, leading to insomnia.
Emotional disorders (23%):
The liver is lost, the qi is not comfortable, the stagnation is stagnation, the fire is inflammatory, the heart is disturbed, the god is uneasy, but the thoughts are too much, the pain is spleen, the blood is dark, and the spleen does not produce blood, the mind is lost. Raising, God does not keep the house, so it is difficult to sleep at night.
Physical deficiency (22%):
The body is weak, or after a long illness, it hurts the kidney yin, the kidney water can't be cherished in the heart, the water is not good, the fire is alone; or the five ambitions are too strong, the heart fire is warm and the kidney water is warm, the heart is not paying, The heart is full of fire, the heat is worried, so it is difficult to sleep.
Unpleasant appetite (22%):
Overeating, gastrointestinal damage, stomach cramps, heart and restlessness; or stagnation of food, causing stagnation, stagnation in the heat, close to the heat, stomach and gas, so that can not fall asleep.
Poor environment (10%):
Poor bedroom environment, such as frequent noise, air turbidity, mosquito and harassment, strong light stimulation, excessive warm and cold, and changes in regional time difference, can lead to emotional instability, restlessness, leading to insomnia.
Pathogenesis:
Genetic factors: If there are patients with depression in the family, then family members are at higher risk of developing the disease, which may be due to genetic susceptibility to depression. Among them, bipolar depression is more hereditary. However, people who do not have a family history of depression will have depression, and people who do not have depression have a family history, suggesting that genetics is not the only decisive factor.
Biochemical factors: Evidence suggests that disorders of biochemical substances in the brain are important factors in the onset of depression. There are many neurotransmitters in the brain of people with depression. The sleep patterns of patients with depression are very different from those of normal people. In addition, certain drugs can cause or aggravate depression, and some hormones have the effect of changing mood.
Environmental factors and stress: Severe loss, loss of love, interpersonal tension, financial hardship, or dramatic changes in lifestyle can all contribute to depression. Sometimes the occurrence of depression is related to physical illness. Some serious physical diseases, such as stroke, heart attack, and hormonal disorders, often cause depression and aggravate the original disease. In addition, one-third of people with depression have a problem of substance abuse.
Personality factors: People with the following personality traits are prone to depression: pessimism, poor self-confidence, poor grasp of life events, and excessive anxiety. These personality traits can exacerbate the stimulation of psychological stress events and interfere with the individual's handling of events. These personality traits are mostly developed during childhood and adolescence, and the trauma of this period has a great impact.
Prevention
Insomnia depression prevention
Psychological adjustment method for preventing insomnia and depression
Arrange life reasonably and cultivate a variety of interests. Moderately tight and orderly work can avoid psychological loss and make life more fulfilling, thus improving people's mood and depression, while also cultivating a variety of interests. Those who love a wide range of people always feel that time is not enough. Life is rich and colorful, which can dispel unhealthy emotions and enhance the vitality of life.
Try to find opportunities for emotional experience
First, think about the business you are engaged in, always forget the innovation, make new achievements, and leap to a new level. In addition, you should care for others, and share your joys and sorrows with friends, family, and colleagues.
The second is to participate in public welfare activities for the benefit of future generations. It is best to have a hobby, whether you play singing, writing, or collecting philatelic coins, you will enter a new realm and look for fun in your hobbies. Keep your mood quiet. Faced with a lot of information, keep a quiet mood, learn to absorb modern scientific information, improve resilience, and classify many information. This will avoid the sense of information fullness and mutual interference, and appropriately change the environment. In an environment that is too comfortable, people tend to induce psychological imbalances. The new environment, accepting challenging work and life, can stimulate people's potential and vitality. You can also change the environment and change your mood so that you can always maintain a healthy and up-to-date mentality and avoid psychological imbalances.
The third is to correctly understand the relationship between itself and society. According to the requirements of the society, we should adjust our own consciousness and behavior at any time to make it more in line with social norms. It is necessary to correct the relationship between the individual and the collective, the individual and the society, and correctly treat the success or failure. This can reduce psychological imbalances.
Insomnia massage
Head massage. Massage the Yintang point 30 times from the bottom to the top of the middle finger, then massage the eyebrows along the eyebrows and the temples 30 times each.
Ear massage. Use your thumb and index finger to massage 30 from top to bottom, and then lick both sides of the earlobe 30 times to redness.
Abdominal massage. Take the supine position before going to sleep, put your hands hot, ring the abdomen, clockwise and counterclockwise 30 times each, in addition to the sleeping effect, there are spleen and stomach to help digestion.
Neck massage. Massage the ear with the index finger 30 minutes after the mastoid depression, take the neck 30 times, with a pressure on the neck.
Foot massage. After washing the feet at night, press the thumb and press the heart of the Yongquan points for 90 times, and have a strong kidney to regulate the liver and sleep.
How to improve sleep quality
Many things can affect the quality of sleep. Holger, Dean of the Groshansdorfdorf Sleep Disorder Treatment Hospital, Germany. Dr. Hein made six good suggestions for improving sleep quality.
1. Keeping your feet warm: The results of the study showed that the quality of sleep for women with cold feet was worse than that for women with comfortable feet. Dr. Hein suggested 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 suggested: 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. Hyin recommends that only tulips can be placed in the bedroom, and the tulips are not at risk of causing an allergic reaction.
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.
7. Drinking some Chinese herbal medicines every day can also help insomnia, help calm the nerves, and the quality of sleep can be effective in 20 minutes after drinking. For example, "Miao medicinal liquor" helps insomnia is good for the body.
Complication
Insomnia and depression complications Complications, hypertension, coronary heart disease, breast cancer, hemiplegia
The effects of insomnia on health are first manifested in the physiological disadvantages caused to them. According to research, the long-term insomnia, the skin is dull, and the upset is only the slightest. Many patients with severe insomnia suffer from other serious physical diseases that are harmful to health after suffering from long-term insomnia. Although insomnia is very common in life, we must pay attention to it, it will cause many other diseases. The effects of long-term insomnia on patients include: insomnia may lead to high blood pressure, coronary heart disease, cerebral hemorrhage, breast cancer, hemiplegia, diabetes and other diseases.
If we are troubled by long-term insomnia and do not sleep for two consecutive nights, we can have autonomic dysfunction that regulates blood vessels and nerves, and sympathetic excitation, which causes his blood pressure to rise; if he sleeps only 4 hours a night, The amount of insulin secreted will decrease, and if this condition continues for a week, it will be enough to cause symptoms of diabetes in healthy people.
Insomnia symptoms for more than one month, can be called long-term insomnia in the clinic, long-term insomnia can last for several years to several decades, and some even produce a habitual insomnia, such as a lot of stress, often can not sleep. Long-term insomnia must be taken seriously and actively taken to take measures.
Five major hazards
1. Forcing people to desperate situation: The most serious consequence of the harm is the emergence of self-harm and suicidal thoughts. Depressed mood can cause depression and pessimism in patients with depression. They are always immersed in self-denial and inferiority, and pessimistic about the future.
2, physical torture continues: the harm is not only the damage of mental health, but it also brings a lot of physical symptoms. Such as loss of appetite, fatigue and so on. These physical discomforts can involve various organs, and the symptoms of autonomic dysfunction are more common. The physical symptoms of patients with depression often have no evidence, and they are mostly non-specific and difficult to locate, but they do not necessarily exclude physical illness.
3, persistent emotional disorders: a common point of depression is that the patient will experience the most painful and bad mood. And this kind of pessimism is not obvious external factors, so it is very difficult to solve, so that the mood of patients with depression is always in pessimism. On the other hand, depression and anxiety are always accompanied by menopausal depression. These patients with depression are not only depressed, but also have unexplained anxiety and panic.
4, ruin the human spirit: the second manifestation of the great harm of depression, that is, it can make a normal person who is full of energy become languid all day, and in serious cases will be in a state of ignorance. Moreover, people with depression have no interest in everything around them. They have no enthusiasm for work and study, and their thoughts are slow to reflect. People who are neatly tidy have become unscrupulous.
5, deprivation of sleep: depression patients often have refractory sleep disorders, manifested as insomnia, difficulty falling asleep, early waking, disordered sleep, poor sleep quality and other forms.
Symptom
Insomnia Depressive Symptoms Common Symptoms Difficult to fall asleep or easy to wake up Refractory Insomnia Falling into sleep hallucinations Indigestion Constipation Fatigue Cognitive impairment irritability Retreat syndrome Children's terror disorder
Symptoms, wake up early in the middle of the night, suddenly wake up in the dark, wake up and can no longer sleep;
Symptom 2, repeated unpleasant past events in my mind or worried about the future;
Symptom 3, there is difficulty falling asleep, easy to wake up in the middle, more dreams;
Symptoms 4, no clear feeling after morning, can not restore full energy; dizziness, fatigue, weakness or drowsiness during the day;
Symptom 5, impaired cognitive function, decreased ability to work and study, decreased memory, inability to concentrate;
Symptom 6: Emotional Disorder: The patient has a bad mood, depressed mood, or anxiety, irritability, restlessness; loss of interest in daily activities, loss of pleasure, frowning and worrying all day;
Symptoms 7, slow thinking and low self-evaluation: performance thinking declines, patients often feel that thinking slows down, the brain is not good, all aspects of ability have declined, often self-blame, self-evaluation is too low;
Symptoms 8. Mental retardation: The patient's mental exercise is significantly inhibited, association is difficult, speech is reduced, speech is low, and movement is slow;
Symptoms IX, other symptoms: patients often have appetite, sexual desire is obviously reduced, obvious weight loss, weight loss; severe insomnia, most of them fall asleep difficult, nightmare easy to wake up, wake up early, can not fall asleep after waking up, depression often shows morning light and night light law;
Symptoms ten, accompanying symptoms: Emotional response is not only manifested in the state of mind, but also always accompanied by certain changes in the organism, such as dry mouth, constipation, indigestion, weakened gastrointestinal function, or pain in the body's indefinite part, sometimes due to physical symptoms It masks the symptoms of depression and causes misdiagnosis for a while.
Examine
Insomnia depression check
1. Brain CT and MRI examinations. Head CT is a convenient, rapid, safe, painless, non-invasive new examination method that clearly shows the anatomical relationship of different cross sections of the brain and the specific brain tissue structure. Therefore, the detection rate of the lesion and the accuracy of the diagnosis are greatly improved.
2. Blood routine, blood electrolytes, blood sugar, urea nitrogen.
3. ECG, abdominal B ultrasound, chest penetration.
4. Chemical examination of cerebrospinal fluid.
5. Brain ultrasound examination, brain glucose metabolism, imaging brain oxygen metabolism, imaging brain metabolism imaging.
Diagnosis
Diagnosis of insomnia depression
1, identification of insomnia:
Epworth sleep scale (ESS); nocturnal polysomnographic recording (NPSG) recording; multi-sleep sleep latency test (MSLT), etc., is useful for differential diagnosis. MSLT can detect that patients can have several naps in a few hours of a day, the total daytime sleep time increases, the sleep latency is normal or shortened, and the characteristic manifestations are REM-based sleep (SOREMPs). The more SOREMPs appear More, the more helpful the diagnosis of narcolepsy, found that more than 2 SOREMPs can be diagnosed as narcolepsy.
However, the specificity of more than one SOREMPs for the diagnosis of narcolepsy is not absolute. Arrhythmia, unplanned changes, chronic sleep deprivation, obstructive sleep apnea, periodic leg movements during sleep, etc., can occur 2 or more SOREMPs, clinically should pay attention to 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. Common causes of secondary insomnia are as follows: 1 any physical disease 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 wine Insomnia caused by coffee, vegetables or drugs; 4 mental disorders. Most people with mental disorders have symptoms of insomnia, especially in patients with anxiety and depression. As long as the clinical manifestations (including medical history, physical examination, and various examination results) are sufficient to diagnose one of the above diseases, the diagnosis of primary 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. This is common in daily life, without any treatment, the body can do natural adjustment, so the lack of disease does not diagnose insomnia.
2, the diagnosis of depression:
Common symptoms of depression are as follows: 1. loss of interest, no sense of pleasure; 2. loss of energy or fatigue; 3. mental retardation or agitation; 4. self-evaluation is too low, self-blame, or guilty; Lenovo's difficult or conscious thinking ability decline; 6. Repeated thoughts of wanting to die or suicidal, self-injury behavior; 7. Sleep disorders, such as insomnia, early awakening, or excessive sleep; 8. Loss of appetite or significant weight loss; Loss of libido. A diagnosis can be made by the presence of 4 of the above 9 symptoms.
Single episode of depression: Also known as a single episode of major depressive disorder, it refers to only one episode, no manic symptoms, mixed depression symptoms, and mild mania symptoms. The first time suffering from depression and compounding the above symptoms is also called single-episode depression, because it is unknown whether the patient will develop the disease in the future, and if it is re-occurring, it is called recurrent depression. Most patients have reduced mental activity, slow thinking, slow response, low whispers, inhibition of will activities, indifference to the surrounding environment, decreased ability to work and study, worry all day long, lack of happiness, pessimism and pessimism.
Menopausal depression is most common in women. It is reported that women enter menopause, and about 46% of them suffer from this disease, which is significantly higher than other age groups. Clinical symptoms are the main manifestations: loss of appetite, upper abdominal discomfort, dry mouth, constipation, diarrhea, palpitations, blood pressure changes, pulse increase or slowness, chest tightness, numbness of the limbs, chills, fever, loss of libido, menstrual changes and sleep disorders , dizziness, fatigue, etc.
Depressive neurosis, also known as neuropathic depression, is caused by psychosocial factors and is often related to the patient's personality deviation; it is a neurotic disorder characterized by persistent low mood; often accompanied by anxiety and physical discomfort And sleep disorders. The patient has treatment requirements, but there is no obvious motor inhibition or hallucinations, delusions, and life work is not seriously affected.
Postparturm depression (PPD) is a psychological disorder characterized by a series of symptoms such as depression, sadness, depression, crying, irritability, irritability, and even suicidal or infantile tendency after childbirth. The most common type of levy. It usually occurs 2 weeks after birth, and its cause is unknown, which may be related to genetic, psychological, childbirth and social factors.
The common manifestation of depression is characterized by depression, which is characterized by depression or grief for at least 2 weeks. In addition, 4 of the following symptoms are required: (1) Loss of interest in daily life, no feeling of happiness (2), significant loss of energy, continuous fatigue without reason; (3), decreased self-confidence or inferiority, or guilty feelings; (4), insomnia, early waking or excessive sleep; (5), loss of appetite (6), the concept or behavior of suicide or suicide; (7), sexual desire is significantly reduced; (8), difficulty or concentration of attention; (9), association difficulties, conscious thinking ability decreased significantly. Depressed moods have large fluctuations throughout the day, often the heaviest in the morning, then gradually reduce, to the lightest at night.
