sleep-wake rhythm disorder
Introduction
Introduction to sleep-wake rhythm disorders Sleep-wake rhythm disorder or narcolepsy refers to the sleep-wake rhythm and the required discrepancy, resulting in persistent dissatisfaction with the quality of sleep, the patient has anxiety or fear, and causes the efficiency of mental activity to decline, hindering Social function. There is no definitive epidemiological survey data on sleep-wake rhythm disorders in China. The adult prevalence rate reported in foreign countries is 0.02%~0.16%, and there is no obvious gender difference in the incidence. Arranging a nap time during the day can effectively improve the onset of narcolepsy. If the seizures are frequent, central stimulants such as methylphenidate (Ritalin), pimoline, etc. may be used as appropriate. Some tricyclic antidepressants have the effect of inhibiting fast eye movement sleep. basic knowledge The proportion of illness: 0.02% - 0.16% Susceptible people: no special people Mode of infection: non-infectious Complications: depression
Cause
Sleep-wake rhythm disorder etiology
1. Life rhythm disorders The habits of long-term specific environment formation are related to the occurrence of this disease, and often occur in people who work and live irregularly at night.
2. Psychosocial stress About one-third of patients have pre-existing pressures such as interpersonal relationships, learning burdens, job search, and environmental changes. The anxiety caused by stress can delay the sleep time, wake up, and wake up early, causing the entire rhythm structure to be disordered.
Prevention
Sleep-wake rhythm disorder prevention
According to the World Health Organization, 27% of people have sleep problems. The Global Sleep and Health Program, sponsored by the International Mental Health Organization, launched a global event in 2001 the March 21st of each year, the first day of the spring, as World Sleep Day. The theme of World Sleep Day 2004 is "Focus on Sleep Health."
There are many causes of sleep problems, such as certain sleep disorders, physical illnesses, emotional factors, lifestyle (too much coffee and tea), and environmental factors (noise, crowding or pollution). As long as the problem is identified, it is possible to find a solution to re-establish regular sleep.
Complication
Sleep-wake rhythm disorder complications Complications depression
Sleep disorders can be a complication of certain diseases. Insomnia can also cause a series of changes in the body's physiological activities, and also affect the function of other systems in the body. Long-term lack of sleep can cause many neurological, mental and sub-health symptoms. Such as irritability, depression, alertness and decreased mobility, autonomic dysfunction, digestive dysfunction, etc.; even reduce immune function, affecting physical health and work efficiency, and reducing the quality of life. Conversely, physical dysfunction can be a cause of sleep disorders or a complication of sleep disorders.
Symptom
Sleep-wake rhythm disorder symptoms common symptoms daytime sleepiness night insomnia
The most prominent symptom of this disease is that the patient is excessively sleepy during the day, that is, the brain is awake and inserted into a sudden burst of rapid eye movement sleep, indicating that the patient's brain cannot maintain a stable state of awakening, and that fast eye movement sleep is not only during nighttime sleep. Existed. The patient can quickly wake up from sleep and fall asleep again after a while.
Examine
Sleep-wake rhythm disorder examination
1. The most important way to understand sleep disorders is to use the EEG multi-lead tracing device to monitor the nighttime sleep process. Because of the various causes of sleep uneasiness and daytime sleepiness, EEG multi-lead tracing is essential for accurate diagnosis.
2. Various scales such as the Epworth Sleep Scale (ESS); nocturnal polysomnographic recordings (NPSG) recording; Multi Sleep Latency Test (MSLT) and the like.
NPSG is best for evaluating endogenous sleep disorders such as obstructive sleep apnea syndrome and periodic leg movements or frequent deep sleep conditions such as REM behavioral disorders or nighttime head movements. There is no benefit in the evaluation of insomnia, especially insomnia, which is mainly difficult to fall asleep.
MSLT is often performed after NPSG to assess oversleeping. This method often finds daytime excessive sleep in narcolepsy and REM in the early stages of sleep. MSLT should be performed during the patient's normal awake cycle and then observe a normal night's sleep.
Based on the medical history and key neurological examinations, other necessary optional auxiliary examination items include:
1. CT and MRI examinations.
2. Blood routine, blood electrolytes, blood sugar, urea nitrogen.
3. ECG, abdominal B ultrasound, chest penetration.
Diagnosis
Diagnosis and identification of sleep-wake rhythm disorder
1. The patient's sleep-wake rhythm does not correspond to what is required (ie, the social requirements of the patient's environment and the rhythm that most people follow);
2. The patient has insomnia during the main sleep period, and drowsiness occurs during the waking period;
3. Obviously distressed or impaired social function;
4. Almost every day, and at least 1 month;
5. Exclude secondary sleep-wake rhythm disorders caused by physical illness or mental disorders such as depression.
