What Is Idiopathic Hypersomnia?

[Overview]

Insomnia

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2018-11-04 12:11 Regarding late night insomnia, I have something to say 2018-11-04 12:11

Segmented sleep has even become the theme of the 2013 Sleep Conference, the annual meeting of the United Professional Sleep Association. This idea has caused a lot of repercussions, and scholars have concluded that the most common insomnia, "late night insomnia", may not be a disease, but a natural sleep pattern. ... more

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[Overview]

Insomnia is a type of unsatisfactory physical disorder with persistent sleep quality and / or quantity. Anxiety or fear of insomnia is the causative psychological factor that causes the disease.

diagnosis

I. Characteristics of symptoms:

Insomnia is a common sleep disorder. Can be secondary to physical factors, environmental factors, neuropsychiatric diseases and so on. This disorder is the so-called primary insomnia due to nervousness, anxiety, fear of insomnia. Its symptoms are characterized by difficulty falling asleep, not deep sleep, easy to wake up, early awakening, dreaming, fatigue or lack of wakefulness after waking. Sleeping during the day seriously affects work efficiency or social function.

Second, the course of disease:

Insomnia occurs at least three times a week and lasts more than one month.

Third, physical illness or mental illness symptoms can be ruled out.

[Treatment]

First, we must first deal with the triggering factors.

Second, drug treatment: symptomatic treatment of sleeping pills can be applied for a short time. Triazolam is usually 0.25 to 0.5 mg per night, or alprazolam 0.4 to 0.8 mg per night. You can also use sulbutamine and clonazepam. But it cannot be used for a long time to prevent addiction.

Third, biofeedback and various relaxation therapies are beneficial to eliminate anxiety and can promote sleep. It is also important to cultivate suitable physical exercise and falling asleep habits, help patients understand sleep physiology, and guide the correct treatment of insomnia. Insomnia

Disease Overview

Good sleep is the main sign of physical and mental health. Insomnia is the most common sleep disorder, which refers to insufficient sleep caused by various reasons, difficulty falling asleep, waking up early, and patients often have mental fatigue, dizziness, headache, tinnitus, shortness of breath, shortness of memory, decreased work efficiency and other manifestations.

Patients generally have a longer incubation period to sleep, shorter sleep time, and increased physiological awakening during sleep. Main manifestations: people with light sleep difficulties, easy to wake up during sleep, and difficult to fall asleep again; wake up early in the morning. In severe cases, it is difficult to sleep at night, often accompanied by headache, dizziness, fatigue, palpitations, forgetfulness, restlessness, and dreams. Patients often feel anxiety and fear of insomnia.

Type of insomnia

1. Transient insomnia (less than one week)

Most people experience transient insomnia when they experience stress, irritation, excitement, anxiety; when they are sick; at high altitudes; or when their sleep patterns change (such as jet lag; shift work). This type of insomnia generally improves with the disappearance of the event or the prolongation of time, but transient insomnia can lead to chronic insomnia if not treated properly.

The main treatment principle for transient insomnia is intermittent use of low-dose sedatives or other sleeping aids such as antidepressants and good sleep hygiene.

2. Short-term insomnia (one week to one month)

Severe or persistent stress, such as a major physical illness or surgery, the death of a friend or relative, serious family, work, or interpersonal problems, can cause short-term insomnia. This insomnia has a clear correlation with stress.

The principle of treatment is short-term use of low-dose sedatives or other sleeping aids such as antidepressants and behavioral therapy (such as muscle relaxation). Short-term insomnia can also lead to chronic insomnia if not handled properly.

3. Chronic insomnia (more than one month)

The causes of chronic insomnia are complex and difficult to discover. Many chronic insomnia are caused by a combination of multiple causes. The possible causes of chronic insomnia are as follows:

(1) Physical diseases can cause insomnia; (According to research, many chronic diseases are related to insomnia)

(2) Insomnia caused by mental illness or emotional disorder;

(3) Insomnia caused by drugs, alcohol, irritants, or drugs;

(4) Insomnia caused by obstacles or irregularities in the wake cycle;

(5) Discomfort in the calf before going to bed or involuntary twitching of the feet during sleep, leading to insomnia;

(6) Sleeping, snoring, irregular breathing or other breathing disorders leading to insomnia;

(7). Primary insomnia.

Introduction to insomnia

The meaning of sleep

One third of a person's life is spent in sleep. During sleep, the whole body, including the central nervous system, is restored and rested. Restoring, rebuilding, and regenerating neurons and related tissues requires rest of the body, and only sleep states can provide this rest. Sleep has many functions, including restoring attention, promoting growth, consolidating memory, and relieving stress. Sleep is an important part of the body's recovery, integration and consolidation of memory. Sleep is an indispensable part of health and is necessary for a healthy life.

Sleep cycle

A sleep cycle usually lasts from 90 to 110 minutes. It must go through the following different phases in order: the first phase is shallow slow wave sleep, which lasts only a few minutes, and is the phase of transition from waking to deep sleep; the second phase of sleep accounts for sleep About 45 percent of the time, eye activity stops, brain activity slows, body temperature decreases, and breathing patterns; the third and fourth stages (stages III and VI) are collectively called deep sleep, this part of sleep is the main part of restoring energy; the last is Move your eyes quickly to sleep. Throughout the night, 4 to 5 sleep cycles usually pass, and each cycle is connected in turn.

What is insomnia

Good sleep is the main sign of physical and mental health. Insomnia is the most common sleep disorder, which refers to insufficient sleep, difficulty falling asleep, and waking up early due to various reasons. The main symptoms of insomnia are the effects on daytime activities, such as feeling fatigue, irritability, emotional disorders, inattention and poor memory, so the ability and efficiency of people with insomnia often decrease.

General definition of insomnia: The manifestation of insufficient sleep or poor sleep quality is related to one or more of the following symptoms :

Difficulty falling asleep;

Woke up multiple times at night and could nt fall asleep again;

Wake up early in the morning

Unable to regain energy after waking up;

Insomnia is a disease that is not widely recognized ...

Type of insomnia

Temporary insomnia

A sudden, temporary insomnia that usually lasts no more than 3 weeks. The etiology includes a variety of psychological and physical factors, such as emotional frustration, depression, anxiety, and anxiety, sudden serious events in life, work It is difficult to fall asleep at night after long-distance travel across several time zones. Sleeping too cold, too hot, too noisy, too bright, uncomfortable or unfamiliar with the sleeping environment can make it difficult for many people to fall asleep. Usually this type of insomnia takes 2 to 3 weeks and can be adjusted to return to normal sleep.

Chronic insomnia

Symptoms last at least 3 weeks. Some patients with chronic insomnia continue from temporary insomnia. Others are caused by somatized anxiety states, such as anxiety, restlessness, excessive vigilance, and repeated thinking. At the same time, the more the patient wants to sleep, the more difficult it is to fall asleep, and the more he becomes overly concerned and anxious about insomnia, this in turn insomnia will in turn increase symptoms and form a vicious circle. Long-term application of sleeping pills may also be an important cause of chronic insomnia. The long-term use of some sleeping pills not only does not help with insomnia, but may worsen insomnia. Habits of drinking coffee and strong tea can cause insomnia.

In addition, symptoms of other diseases such as pain, cough, dyspnea, angina pectoris, excessive nocturia, itching, etc. also cause secondary insomnia. Gastric ulcers, nocturnal asthma, gastroesophageal reflux, and muscle and joint disorders can make it difficult to fall asleep after frequent awakenings during sleep. Taking beta-blockers for a long time due to other diseases. Methyldopa, ephedrine, aminophylline, and antidepressants can all cause chronic insomnia.

The dangers of insomnia

1. Insomnia results in decreased body immunity and weakened resistance to various diseases.

2. Insomnia causes memory loss and headache.

3. Insomnia affects work, study and life.

4. Insomnia can cause autonomic disorders.

5. Frequent insomnia can cause Alzheimer's disease.

6. Frequent insomnia causes premature aging and shortens life span.

7. Children's lack of sleep can affect the growth and development of the body.

Treatment of insomnia

In most cases, paying attention to sleep hygiene can solve the problem of insomnia, for example: changing living habits and sleep habits, going to bed and getting up on time, not drinking coffee before going to bed, and so on. In addition, through effective drug treatment, insomnia can also be solved.

It is important to pay attention to the importance of sleep quality and sleep habits to health, actively go to the hospital for treatment, early diagnosis of insomnia, and find the cause of insomnia. If insomnia caused by physical factors, the primary disease should be actively treated. For insomnia caused by non-physical disorders, the main reason for insomnia should be sought, and the cause of insomnia should be eliminated while taking some drugs that regulate the nervous system to overcome insomnia.

This condition refers to primary insomnia. Appears as a condition of dissatisfaction with the quality and quantity of sleep for a considerable period of time. The patient feels anxiety or fear, and the psychological vicious circle makes the disease persist. Primary insomnia often develops in young or middle-aged people and rarely occurs in children or adolescents. The course of insomnia varies widely. If it is caused by a psychological or medical stress event, the course can be limited to a few months. The most common situation is that progressively worsening insomnia at the initial stage, which lasts for several weeks to months, and then more stable chronic sleep difficulties last for years. Although some patients have experienced only one episode, they will experience significant fluctuations in sleep after encountering certain life events.

Enter insomnia topic

Cause

Some people think that it is related to brain failure, but there is no precise conclusion on the etiology.

symptom

(L) There are certain psychological and social factors before the illness, such as excessive fatigue or tension. But after that, the corresponding stimulus was gone, and the patient's sleep did not improve.

(2) Have a certain personality foundation, showing sensitivity, high alertness, high health requirements, irritability, irritability, etc.

(3) Sleep disorders are the main symptoms, which can be primary insomnia (difficulty falling asleep), intermediate insomnia (shallow sleep, easy to wake up), last-stage insomnia (early awakening), or more dreams, no sleep, no waking up after waking up . These symptoms may be mixed.

(4) Some patients have insomnia only subjective complaints, and sometimes others see him snoring, and still say that they do not sleep after waking up. May be accompanied by anxiety and depression, but often secondary to insomnia symptoms, and the severity is not enough to diagnose anxiety or depression.

(5) Hope to improve sleep quickly, take the initiative to seek medical treatment, and even take medicine or alcohol on their own in order to improve sleep quality.

(6) No physical disease directly related to the physical examination was found.

(7) Sleep EEG can be used to observe the sleep of patients. Sometimes complaints of insomnia are contradictory to sleep effects.

an examination

(L) Key points of diagnosis:

l) Sleep disorder is almost the only symptom. Other symptoms are secondary to insomnia, including difficulty falling asleep, not deep sleep, awakening, dreaming, early awakening, difficulty falling asleep after waking, discomfort after waking, fatigue or day sleepy.

2) The above sleep disorders are maintained at least 3 times a week and maintained for more than 1 month.

3) Insomnia causes significant distress, reduced mental activity efficiency, or hinders social functioning.

4) Not part of any physical or mental disorder.

(2) Differential diagnosis:

1) Secondary insomnia. Common causes of secondary insomnia are the following: any physical disease affecting the central nervous system; physical pain or discomfort, such as itching or pain of skin diseases, cancer pain, etc., often cause insomnia; , Coffee, vegetables or drugs, etc .; mental illness. Most people with mental disorders have symptoms of insomnia, especially in patients with anxiety and depression. As long as the clinical manifestations (including history, physical examination, and various test 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 and nightmare patients may have insomnia. Insomnia is not considered if there is a typical view of night terrors and nightmare symptoms.

3) Transient insomnia. This is common in daily life and does not require any treatment. The body can do natural adjustments, so those with insufficient disease duration are not diagnosed with insomnia.

treatment

(1) Psychotherapy:

1) General psychotherapy. Through explanation and guidance, the patient can understand the basic knowledge about sleep and reduce unnecessary anticipatory anxiety reaction.

2) Behavioral therapy. Conduct relaxation training to teach patients to go to bed to speed up falling asleep and reduce anxiety.

(2) Drug treatment:

1) Benzodiazepines.

2) Antidepressants. Such as Mianserin, Amitriptyline, Doxepin, Maprotiline and so on.

(3) Other:

l) Biofeedback. Can strengthen self-relaxation training, effective for reducing anxiety.

2) Physical exercise. Appropriate physical exercise enhances physical fitness and aggravates physical fatigue, which is good for sleep, but the amount of exercise should not be too large. Excessive fatigue will instead affect sleep.

3) Adjust living habits, such as canceling or reducing siesta, and develop the habit of sleeping on time.