Sleep disturbance is a very common problem in the modern world. Similar complaints come from about 10-15 percent of the adult population, about 10% of people on the planet use various sleeping pills. Among elderly people, this indicator is higher, but violations occur regardless of the years lived, and for a certain age category their types of violations are characteristic. For example, nightly fears and urinary incontinence are found in children, insomnia or pathological drowsiness in the elderly. There are violations that, appearing in childhood, accompany a person all his life. For example, narcolepsy.
Primary and secondary disorders
Sleep disorders are classified into primary and secondary. The former are not associated with the pathology of any organs, but the latter arise as a result of various diseases.
Sleep disorder can also often occur with problems with the central nervous system or mental disorders. With many somatic diseases, a person suffers from pain, shortness of breath, cough, does not sleep at night.
Drowsiness is often manifested in cancer patients due to intoxication. Pathological drowsiness can be a symptom of hormonal disorders in tumors, encephalitis.
Classification of Sleep Disorders
Doctors distinguish several main types of such violations. Consider the most common.
Insomnia is a disorder that occurs in the process of falling asleep, provoking prolonged insomnia. Often they are associated with a psychological state, so they can occur temporarily, as well as permanently.
Causes of sleep disturbances, such as taking medications or alcohol, often lead to insomnia. Insomnia is provoked by: chronic alcoholism, taking drugs that depress the central nervous system for a long time, abrupt cancellation of sedatives or sleeping pills.
Another variety is called hypersomnia. This is an increased drowsiness. Psychophysiological may be associated with a psychological state, may be caused by the intake of alcohol or medications, mental illness, narcolepsy, and other pathological conditions.
Failure to sleep leads to malfunctioning of wakefulness and falling asleep. Parasomnia is also widespread, that is, a malfunction in the functioning of human systems and organs associated with awakening or sleep. Causes of sleep disturbance: somnambulism, nightly fears, urinary incontinence, epileptic seizures that occur at night.
Symptoms
Symptoms are varied, depending on the type of sleep disturbance in adults or children. It is worth noting that any problems with sleep can soon lead to a change in the emotional state, a decrease in attentiveness and working capacity. Pupils may have problems with learning and mastering the material. Often the patient turns to the doctor for help, not suspecting that the reasons lie precisely in insomnia.
Now we will analyze the symptoms in more detail, considering what consequences they lead to. Psychosomatic insomnia or insomnia can be considered non-chronic if it lasts less than three weeks. People who suffer from sleep disorders - insomnia, at first can not fall asleep, and then constantly wake up in the middle of the night. Often they wake up early in the morning in a broken state, not enough sleep, and this leads to emotional instability, irritability, chronic overwork.
The situation is aggravated by the fact that patients with these problems with increasing anxiety wait every night, imagining what it will lead to. At night, time is much slower, especially when a person suddenly wakes up, and then can not fall asleep. His emotional state is inhibited under the influence of various psychological factors.
Often after stress recedes, sleep also normalizes. Often, problems with falling asleep become a habit, the situation only gets worse, and constant insomnia develops.
Insomnia, which is caused by the use of alcohol or medications, often leads to the fact that the REM sleep phase is reduced, because of this the patient begins to wake up regularly at night. If long-term alcohol consumption is stopped, the body will return to normal rhythm after about two weeks.
When sleep disturbance in adults becomes a consequence of taking potent drugs that affect the nervous system, the effect of such a drug decreases over time, and increasing the dose can only lead to a temporary improvement in the situation. Sleep problems may worsen, even though the dosage is increased. In this state, a person often wakes up, a clear boundary between the phases of sleep disappears.
With mental illness, insomnia is accompanied by a feeling of intense anxiety at night, as well as a superficial and very sensitive sleep. A person often wakes up, feels tired and lethargic during the day.
The diagnosis of "sleep disturbance" is made with the so-called sleep apnea syndrome. At this time, the air flow in the upper respiratory tract temporarily stops, such a pause may be accompanied by motor anxiety or snoring. Doctors distinguish obstructive apnea, which occurs due to the closure of the upper respiratory tract on the inspiration, and central apnea, which are usually associated with disorders in the respiratory center.
Restless legs syndrome can also often lead to insomnia. It occurs deep in the calf muscles, constantly requiring the body to move its legs. Such uncontrolled desire often occurs before bedtime.
Another reason for sleep disturbance lies in the involuntary flexion movements that occur at night in the leg, and sometimes in the thumb or foot. Such bending can last about two seconds, and repeat after half a minute.
Narcolepsy
With narcolepsy, disorders are characterized by sudden attacks of falling asleep in the daytime. Such violations, as a rule, are short-lived; they can occur during a trip in public transport, after eating, due to monotonous work, and sometimes due to prolonged physical activity.
In this case, narcolepsy is often accompanied by attacks of cataplexy. This is called a sharp loss of muscle tone, because of which the patient may even fall. An attack is usually associated with a pronounced emotional reaction, such as laughter, anger, surprise, or fright.
Insomnia is often caused by wakefulness and sleep disturbances. This happens when changing time zones or a constant schedule of intense shift work. Such problems disappear in two to three days.
In medical practice, there is also a delayed sleep syndrome, which is characterized by physical inability to fall asleep at certain hours. Because of this, it is not possible to establish a normal mode of rest and work on working days. Patients with such a violation manage to fall asleep no earlier than two in the morning or even in the morning. Only on weekends or on vacation do they have trouble sleeping.
They rarely turn to a specialist in identifying a syndrome of premature sleep. Although outwardly he may not bother them at all. The patient quickly falls asleep, has a good night, but wakes up too early, and then goes to bed early. Such disorders are usually found in people in old age and do not cause them much discomfort.
Rarely, but still there is a non-24-hour sleep syndrome, due to which a person can not live in normal days. The biological days of such patients increase to 25-27 hours. Such disorders are popular in people with personality disorders and in the blind.
Sleep disturbance with menopause is not uncommon. It is with menopause that restless legs syndrome manifests itself. During this period, the level of the main female sex hormone, estrogen, sharply decreases. This is what causes insomnia and other sleep problems. Doctors advise to go to bed early during menopause, eliminating all unnecessary light sources, and start preparing the body for bed from 7 o’clock in the evening. If you still need to work in the evening, then try to use the directional light by turning off the central lighting in the room.
Children's problems
Sleep disorders in children are most often caused by several diagnoses. One of them is somnambulism, which, manifested in childhood, can accompany the patient all his life.
The essence of the disease is the unconscious repetition of certain actions during sleep. Such people can get up at night, walk around the room, perform some kind of action without realizing it at all. At the same time, they do not wake up, and attempts to wake them up can lead to actions dangerous to their life and health. Most often, this condition lasts no more than a quarter of an hour. After that, the person returns to bed and continues to sleep, or wakes up.
Often there are nightly fears in children that arise in the first hours of a patient’s sleep. He may wake up in a panic in the middle of the night. Such conditions are accompanied by rapid breathing, tachycardia (strong palpitations), sweating, while the pupils are dilated. Only after calming down and recovering, the patient can fall asleep. In the morning, the nightmare of memories may not remain at all.
Urinary incontinence at night is observed in the first third of sleep. Such a sleep disturbance in children belongs to the category of physiological, if they are very small, and pathological, if the child has learned to independently go to the toilet.
Diagnosis of insomnia
In order to find out what to do in case of sleep disorders, it is important to conduct the correct diagnosis. Until now, polysomnography remains one of the most common research methods. It is carried out in a special laboratory in which the patient stays all night.
The somnologist conducts research. Now it’s clear which doctor treats sleep disorders. If you have such problems, you need to contact a specific specialist.
During the diagnosis process, the patient sleeps in a special laboratory, and his sleep is monitored by a large number of sensors that record cardiac activity, bioelectrical activity of the brain, respiratory movements of the chest, air flow inhaled and exhaled in a dream, and the process of blood oxygenation.
Everything that happens in the ward is recorded on a video camera, there is always a doctor on duty nearby. Such a detailed and detailed examination makes it possible to thoroughly study the state of the brain, how all body systems function at each of the five stages of sleep, determine what deviations from the norm exist, and accordingly, find the causes of your problems.
Another diagnostic method is called a study of average sleep latency. It is usually used for excessive drowsiness, it is extremely important in determining narcolepsy.
The essence of the study is five attempts to fall asleep, which are necessarily carried out during normal waking hours for a person. Each attempt is given 20 minutes, a break between them is two hours.
Particular attention is paid to the average latency of sleep with this method - this is the time that the patient needs to go into sleep. The norm is from 10 minutes. If it is in the range from 5 to 10 minutes, then this is a borderline value, and less than 5 minutes is already pathological drowsiness.
Treatment of insomnia and its consequences
Another doctor who deals with sleep problems is a neurologist. The treatment for the sleep disorder that he will prescribe will depend on the identified causes. If a somatic pathology is detected, therapy will be aimed at combating the underlying disease.
If the depth of sleep and its duration are reduced due to the age of the patient, then this process is considered natural, usually requires only an explanatory conversation with the patient.
If you can’t fall asleep
It is important to monitor the patient's observance of the general rules of healthy sleep before starting treatment with sleeping pills. A person should not try to sleep in an overexcited state or, when he is angry, do not eat a lot at bedtime and do not drink alcohol at night, do not drink strong tea and coffee a few hours before going to bed, and do not sleep during the day. Maintain good physical shape, play sports, but do not perform any exercises at night. Keep clean and tidy in your bedroom.
If you have trouble sleeping, then it’s recommended that you go to bed and get up at about the same time, and if you haven’t been able to fall asleep for half an hour, you should get up and do abstract things. The desire to sleep should appear on its own. Nightly soothing treatments, such as a warm bath or a walk, are recommended. The methods of relaxation and psychotherapy help to cope with insomnia.
Drugs Against Insomnia
Tablets for sleep disorders often refer to the benzodiazepine series. During violations of the process of falling asleep, medications with a short duration of action are prescribed. These include Midazolam and Triazole. Because of their intake, the likelihood of side effects increases - amnesia, confused consciousness, excessive excitement.
Long-acting drugs include Flurazepam, Diazepam, Chlordiazepoxide. They are taken with frequent awakenings, they can cause drowsiness in the afternoon. “Zolpidem” and “Zopiclone”, which are believed to have an average duration of action, will help to cope with this. The risk of becoming dependent on them is much lower.
With insomnia, antidepressants are often taken. They are not addictive, they help elderly people suffering from chronic pain or depression well. This is Mianserin, Amitriptyline, and Doxepin. They also have enough side effects.
In severe cases, sleep disorders use antipsychotics with a sedative effect. This is Promethazine, Levomepromazine, Chlorprotixen. Older people are often prescribed vasodilator drugs. Papaverine, nicotinic acid, Vinpocetine can help to fall asleep. Remember that taking any sleeping pills can only be done as prescribed by the doctor, and after the course is completed, the dose should be gradually reduced to get rid of the addiction.
Non-prescription sleeping pills that can help with insomnia, too. But it must be taken with caution. Donormil, which will prolong the period of sleep, Melaxen, which will make up for the lack of the hormone melatonin in the body, can help. In the form of drops, "Sonilux" is released, which has a sedative effect. This is also a sleeping pill without prescription. Helps to overcome anxiety and a sense of aggression.
One of the most popular and common means is Valocordin. Although sold over the counter, it contains barbiturate. Helps to cope with pain in the heart, psychomotor overexcitation.
Insomnia Prevention
It is not easy to cure insomnia, therefore, it is effective to prevent sleep disorders.
To do this, you must carefully observe the regime for, go to bed on time and get up in the morning, give the body moderate physical and mental stress. Carefully use drugs that affect the central nervous system, as well as control the intake of alcohol, sleeping pills and sedatives.
Prevention of hypersomnia will be the prevention of traumatic brain injuries, as well as neuroinfections, which can cause excessive drowsiness.