sleep rhythm disturbance
Introduction
Introduction Sleep rhythm disorder is a regular disorder of sleep caused by diseases such as circadian rhythm sleep disorders and sleep-wake rhythm disorders. Physiological rhythm disorder sleep disorder: persistent or repeated disturbances lead to excessive sleep or insomnia, which is due to the patient's 24-hour sleep-awakening rhythm pattern and the rhythm required by his or her environment. Sleep-wake rhythm disorder refers to the sleep-wake rhythm and the required discrepancy, resulting in persistent dissatisfaction with the quality of sleep. Patients have anxiety or fear, and cause mental activity to decline and impede social function. This disease is not part of any physical illness or mental disorder. If sleep-wake rhythm disorder is an integral part of a physical illness or a mental disorder (such as depression), it is not diagnosed as a sleep-wake rhythm disorder.
Cause
Cause
(1) Physiological rhythm destruction
Time adjustment, shift work and high-speed aircraft can cause physiological rhythm damage.
In most circadian rhythm sleep disorders, patients cannot fall asleep at the appropriate time. The patient complained of insomnia or excessive sleepiness. The range in which the human day and night system can be synchronized with the length of 24 hours a day is determined experimentally. The range of the drive was found to be narrow, no more than 2 hours. Since most people have an endogenous cycle of more than 24 hours, the human day and night system can only be adjusted to a 23 to 26 hour period. Through the translation of the patient 2 to 4 weeks of sleep-wake time circadian rhythm, greatly contribute to the study of sleep-wake-up day and night disorders. The time-based physiological basis of a circadian rhythm sleep disorder was established in the last century. The human internal clock is very stable and it is difficult to break the normal 24-hour sleep-wake mode. However, shifting work, high-speed long-distance flights, and many uncommon situations lead to irregular, delayed or pre-emptive sleep-wake modes, which can cause normal mode damage.
Round shift classes and shifts equivalent to 21-22 hours a day are more likely to break the wake-up mode than fixed night or night shifts. The shift workers find it difficult to fall asleep at new times, their main sleep stages are shorter than normal and wake up More times. After the poor shift of the shift workers, there was also a lack of concentration and fatigue, and a large number of industrial accidents occurred. The ability to adapt to any type of shift work varies greatly from person to person. In the coming year, people over the age of 40 have poor adaptability. From the industrial stakes of the shift work model, careful planning is the primary priority for the health and safety of the workforce, as well as for the most appropriate industrial output.
The circadian rhythm caused by high-speed flight is the same as the initial shift work. From east to west, for example, from Beijing to Paris, 4 to 5 days after waking up, the body temperature and endocrine rhythm are abnormal. After returning to Paris from Paris, the circadian rhythm disorder can reach 10 to 14 days. Most rest assured seasonal travel salesmen have their own methods of treating this physiological disorder. Avoiding dehydration and drinking is more important than taking diazepam or anti-melanotic hormones.
(2) Sleep-wake-up day and night phase delay syndrome
Sleep-wake-up-night phase-delay syndrome, also known as delayed sleep-phase syndrome, is seen in some patients with insomnia, complaining that they cannot fall asleep at a time acceptable to society, although sleep begins to be normal, if bedtime is delayed 6-8 Hours, a certain degree of heart rhythm pathology was found in about half of the patients. Occasionally, a pattern of late onset of sleep occurs at the same time as the onset of severe psychosis, especially in the manic phase of stagnation and schizophrenia.
The disease can begin in childhood and is lifelong and sometimes familial. Trying to promote sleep, most adult afflictions and co-workers have taken different sedatives or misuse of alcohol. The disease is multifactorial and depends on lifestyle, mood and personality. The illness seriously undermines the patient's education, work and family life. There are different types of sleep phase delays, including stable, progressive, irregular, and non-24-hour sleep-wake procedures until the appropriate sleep time is easy to establish, but many patients find it difficult to adhere to this schedule. Anti-melanotic hormones, vitamin B12, bright light, sleeping pills, stimulants, psychotherapy, and home treatments can all help to adjust sleep-wake behavior to proper circadian rhythm, but these methods are not effective.
(3) 24 hours of rhythm disorder
24 hours of rhythm disorder is a non-24 hour sleep-wake mode, often a sleep-wake cycle every 25 hours, that is, staying up late. It is mainly seen in people who are born blind. Such patients cannot work in a regular occupation. A few cases have found that anti-melanin and cortisol have a free-motion rhythm.
Normal time reversal of sleep and wake-up - sleep during the day and wake up at night, common in children with mental retardation and senile dementia. Night awakening is sometimes accompanied by excessive activity, irritability, aggression, noisy, murderous and destructive behavior, which is most common among children.
Examine
an examination
Related inspection
EEG examination of brain CT
Insomnia, manifested as difficulty in sleeping or waking up early, often accompanied by sleep is not deep and dreams. Insomnia is a common sleep disorder. Insomnia can be seen in the following situations:
1. Insomnia caused by mental factors: mental stress, anxiety, fear, excitement, etc. can cause short-term insomnia, mainly due to difficulty in entering the sleep and easy to wake up. After the mental factors are relieved, insomnia can be improved. Patients with neurasthenia often complain of difficulty sleeping, sleep is not deep, and dreams, but EEG records show that sleep time does not decrease, and the time and frequency of awakening increase. These patients often have headache, dizziness, forgetfulness, and fatigue. , easy to be excited and other symptoms. Insomnia in depression often manifests as early awakening or lack of sleep, and EEG tracing shows a significant increase in arousal time. Mania shows difficulty sleeping and staying up all night. Schizophrenia can be affected by delusions and can be difficult to fall asleep.
2. Insomnia caused by physical factors: pain, itching, stuffy nose, difficulty breathing, asthma, cough, frequent urination, nausea, vomiting, bloating, diarrhea, palpitations, etc. caused by various physical diseases can cause difficulty in sleeping and not deep sleep.
3. Physiological factors: Insomnia can be caused by changes in the living and working environment and the first-time alienation, unaccustomed environment, drinking tea and coffee, and insomnia after short-term adaptation.
4. Insomnia caused by drug factors: reserpine, amphetamine, thyroxine, caffeine, aminophylline, etc. can cause insomnia, and insomnia can disappear after stopping the drug.
5. Dilated brain lesions: Chronic poisoning, endocrine diseases, nutritional metabolic disorders, cerebral arteriosclerosis and other factors caused by diffuse brain lesions, insomnia is often an early symptom, showing reduced sleep time, intermittent wake-up, deep sleep disappearance Drowsiness and disturbance of consciousness can occur when the condition worsens.
Diagnosis
Differential diagnosis
Sleep disorders include: lack of sleep; want to sleep but can not sleep, until two o'clock in the morning to sleep, poor sleep quality; despite sleeping all night, still feel unable to eliminate fatigue.
Heterostatic sleep: behavioral or physiological abnormalities during sleep.
Primary insomnia: It is difficult to fall asleep or stay asleep, or feel uncomfortable after waking up (even if sleep is normal, you feel inadequate rest).
Primary narcolepsy: The patient complains of excessive sleep, prolonged sleep, or a daytime sleep episode.
Narcolepsy: The patient can't control the onset of sleep with a sudden loss of muscle tone (stumble). Note: Stumble is an instant entry into the REM sleep phase, and this symptom involves REM disorders.
Respiratory-related sleep disorders: excessive sleep or insomnia is caused by sleep-related breathing difficulties, including the following symptoms:
Obstructive sleep apnea: The respiratory system is still active but the airflow has stopped (hiccup).
Central sleep apnea: short-term respiratory arrest, often associated with a central nervous system disorder.
Mixed sleep apnea: a combination of obstructive sleep apnea and central sleep apnea. A symptom similar to insomnia.
Physiological rhythm disorder sleep disorder: persistent or repeated disturbances lead to excessive sleep or insomnia, which is due to the patient's 24-hour sleep-awakening rhythm pattern and the rhythm required by his or her environment.
Night terror: more common in children, no threat to health. Usually, night terror occurs in the fourth sleep stage of the child, when the child is difficult to wake up, but will scream after being frightened. When you finally wake up, your child may still feel fear, but remember that the sleep mental activity has caused night terrors.
