In what cases it is customary to talk about insomnia (insomnia)? First of all, when a person several times a week (from 2-3) can not sleep in the evening or after an accidental nightly awakening for half an hour. At the same time, lack of sleep strongly affects the quality of his life. Irritability, apathy, impaired concentration – These are the eternal companions of those people who experience insomnia episodes. Despite such unpleasant manifestations, only a quarter of those who suffer from insomnia, turn to to the doctor. According to doctors, this is a big mistake!
“According to WHO, an adult needs to sleep 6 to 8 hours a day ,” explains Alexey Danilov, professor, neurologist, project manager “Ecology of the brain . “ – Reducing the amount of sleep speeds up the mechanisms of aging in the body. After a day without sleep, chemical processes begin in the brain, leading to mental disorder. After two days, the hormonal background changes and the neural connections in the cerebral cortex are broken. And after 3 or more days, brain cells begin to break down, the load on the internal organs, primarily on the heart, increases. It is known that sleep deprivation is the hardest torture for a person, as the body and mind are rapidly being destroyed.”
Types of insomnia
Doctors distinguish between two types of insomnia – primary and secondary.
Secondary insomnia It occurs against the background of other disorders and diseases. For example, sleep disorders often accompany restless legs syndrome (RLS) – in this case involuntary movements with the legs interrupt sleep; or apnea – short-term breath-holding, which can either interrupt sleep as well, or lead to oxygen starvation, due to which in the morning the person feels not rested. “In some cases, insomnia can be triggered by more serious illnesses ,” adds Ilya Egorov, MD, a general practitioner, – In particular, insomnia may be one of the manifestations of circulatory disorders or brain tumors. In particular, that part of it (the region of the epiphysis), which is responsible for producing hormone melatonin, contributing to sleep. Another cause of insomnia can be diabetes. In this case, the person is worried about the feeling of thirst, hunger, which prevent him from falling asleep, and the frequent urge to urinate makes his sleep intermittent.”
Primary insomnia It is not caused by somatic or mental disorders, and includes all other factors that can disrupt sleep. “ Stress, information flow and high-speed communications force us to live according to a schedule that conflicts with our internal biological clock (circadian rhythms), according to which all organ systems of our body function ,” explains Alexey Danilov. – As a result, there are disturbances that can manifest themselves in the form of a phase shift of the sleep-wake cycle. ” Often the cause of primary insomnia is a violation of conditions that contribute to deep prolonged sleep – active physical and mental work before sleep, too dense dinner, uncomfortable bed, uncomfortable air temperature in the room.
Of course, correction of secondary insomnia is impossible without treating the disease or disorder that caused it. Whereas in order to cope with primary insomnia, it is enough to change the habits that facilitate the process of falling asleep, and the conditions in which you sleep. Only in rare cases it may be necessary to take sleeping pills. drugs.
Effects of insomnia
Lack of sleep is a risk factor for developing infectious diseases and diabetes of the second type. American scientists from Yale University School of Medicine found that the failure of the biological clock leads to an increase in the susceptibility of our body to various bacteria and viruses. So, many people working on the night shift often become infected with infectious diseases, which is obviously caused by disturbances in biological rhythms. Christopher Morris, a professor in the sleep medicine department, argues that the risk of developing type 2 diabetes is associated with the fact that nocturnal activity weakens glucose tolerance.
“The constant tension of the adaptation systems of the human body due to lack of sleep is also a powerful factor in the development of stroke. For a while, the body copes with stress, but sooner or later the defense weakens. Lack of sleep and chronic stress closely related to it contribute to hypertension , atrial fibrillation and other problems that multiply the probability stroke”– notes Anton Rodionov, Associate Professor, Department of Faculty Therapy, First Moscow State Medical University I.M. Sechenov.
Non-pharmacological correction of insomnia
According to the majority of doctors, sleeping pills do not provide for restoring the structure of sleep, therefore they cannot give a complete treatment for insomnia. But changing habits, changing sleep conditions facilitate the process of falling asleep and significantly improve the quality of sleep. Non-drug methods in this case give a more lasting and lasting effect. Of course, to achieve the result will take time. Depending on the severity of the situation, treatment may take from several weeks to several months. What do doctors advise first?
– Go to bed and get up at the same time. This is necessary for the normal operation of the biological clock. Go to bed when you feel a surge of sleepiness, which happens every hour and lasts an average of five minutes.
– Can not sleep – get up. If within 20 minutes, after you lay down in bed or woke up in the middle of the night, you never fell asleep, do something that will help you relieve tension. For example, do a simple chore.
– Refer to the possibilities of light therapy. In special medical institutions, circadian rhythm malfunction is corrected with the help of special instruments emitting white light. At home, you can also use this technique by installing a fluorescent lamp in the room. It is useful to include it in the morning so that the body is tuned to wakefulness.
– Choose before bedtime calm, pleasant activities. Such as reading and listening to light, slow, relaxing music, because reading reduces the level of stress by 68%, soft slow music – by 61%. Moreover, set before bedtime, the so-called buffer period, free from intense mental labor.
– Engage physical education. Any exercises done during the day ultimately have a beneficial effect on quality of night sleep. Scientists explain this fact very simply: an organism that spends energy on vigorous activity must fully recover, so it falls asleep quickly in the evening and sleeps soundly. It is important to remember that heavy loads at night should be avoided.
Strength training is best practiced between 13 and 18 hours, because at this time there is a slight natural increase in the temperature of the human body, increases the overall level of endurance and increases the work of the lungs. Cardio training – sports walking, running, cycling – it is better to plan for the morning, since it is during this period that they contribute to lower blood pressure and have a positive effect on sleep. In the evening, before bedtime, a rather unhurried half-hour walk.
Alexey Danilov, Professor, Neurologist, Head of the project “Ecology of the brain”
– Prepare the right dinner. “On the one hand, foods that can and should be eaten before bedtime should contain a generous portion of substances that are necessary for the formation of hormones ( somatotropin and melatonin) and skin cells that are synthesized at night . – explains Elena Morozova, general director of the Elena Morozova Slimming Clinic , – Dinner, on the other hand, should encourage fast sleep and restful sleep. These include, for example, white turkey meat, which is very easily digested. In addition, in this meat a lot of tryptophan – a substance that is a natural sleeping pill. Good for dinner low-fat dairy products – they have a lot of calcium, which has a calming effect on the nervous system.”
– Create a comfortable sleep environment. Choose a comfortable mattress, pillow, bedding made from natural materials. Air the bedroom and lower the temperature in it to 18-20 degrees. Faster cool down – fall asleep faster. In this case, a hot shower or a bath will help to deceive the body – when you come out of it, you will begin to cool faster, the body will perceive this as a signal of readiness for sleep.
Drug treatment of insomnia
Often, people without much need resort to drugs that help them fall asleep, considering them to be the fastest way to deal with the problem. “Only herbal preparations are relatively safe in this case , – believes Ilya Egorov, – These include drugs with the extract of motherwort, peony, valerian. All such drugs are categorized as sedatives, so they help some people improve the quality of their sleep.”
The use of more serious sleeping pills is permissible only in rare cases, for example, in a situation of acute grief, when a person cannot fall asleep because of an experienced shock or other similar situations. The main task of sleeping pills – to stop the excitation that occurs in the brain.Previously, the main agents used to treat insomnia were barbiturates, which are also contained in valocordine, Corvalole, and benzodiazepines. Now, non-benzodiazepines are prescribed for these purposes more often – hypnotic drugs of the new generation, which affect not all areas of the brain, but sleep centers. Drugs of the old generation are more likely to cause side effects.
“With prolonged use, hypnotics begin to depress the nervous system and cause headaches, daytime sleepiness , nausea, digestive disorders, – says Alexey Danilov, – There may be more serious negative effects, such as rapid heartbeat, chest pain, difficulty breathing, confusion, skin rash. A sudden cessation of sleeping pills does not rarely lead to the so-called cancellation effect, and the return of sleep disorders, sometimes in a stronger form. Appointment of sleeping pills should be carried out strictly by a doctor, strictly by prescription .”
Relatively newer treatments for insomnia are drugs with synthetic analogues of the hormone melatonin. The doctor can prescribe them if insomnia is associated with a violation of human biological rhythms. In particular, these medicines are recommended for those who often change their time zones for one reason or another. Preparations with melatonin are considered relatively safe, however, they should not be taken longer than 2 months.