One of the most common in everyday life and in the clinical practice of physicians sleep insomnia is insomnia, or it is more correct to say insomnia . This academic name comes from the Latin terms in – “inside”, somnus – “dream”, that is, “inside dream”. That is, those disorders that arise in connection with the state of sleep. Either these are difficulties in falling asleep, or difficulties in maintaining sleep, such as frequent awakenings, or early morning awakening, that is, difficulties in ending sleep. All this is included in the phenomenology of insomnia syndrome .
Types of insomnia
The criteria for making a diagnosis of insomnia include the degree of satisfaction with sleep, as well as the presence of a sufficient amount of time and conditions for sleep. And the third criterion is the presence of the effects of insomnia , that is, a violation of daytime wakefulness, which arises due to a violation of night sleep.
These violations are quite diverse. Any sleepy person can gradually remember them all: fatigue, impaired attention, concentration or memorization, impaired interaction in society with other people, mood disorder, irritability, drowsiness during the day, reduced motivation and initiative, a tendency to make mistakes at the wheel and at work, muscle tension , headache, gastrointestinal disturbances, anxiety about the state of your sleep. Such an abundance of complaints may be due precisely to an insufficient night’s sleep.
If a person has a violation of night sleep and daytime wakefulness, which he associates with a violation of night sleep, is it safe to say that he has insomnia syndrome ? No, this must be done one more criterion – it is the frequency of holdings rastrojstva sleep. According to the international classification of sleep disorders, insomnia is a real disease when it is repeated 3 or more times a week. That is, in one week a person 3 nights does not sleep well, in another week – 4, in the third – 5, then this is insomnia , and if 2 times – no.
Insomnia is divided into two types. Insomnia short-term (or more often it is called acute insomnia ) is a sleep disorder that lasts no more than 3 months. Insomnia chronic is a sleep disorder that lasts more than 3 months. Such a division is generally accepted, since it is believed that in 3 months the sleep disorder already “breaks away” from its root cause. The most common cause of acute insomnia is stress, but it cannot be the cause of chronic insomnia. At this time, the cause of sleep disorders are usually psychological mechanisms. There is an excessive attention of a person to sleep, “looping” on the problem of his sleep. The person begins to worry that he will not fall asleep, and this really does not fall asleep.
The presence of insomnia can lead to various disorders of the body. At the household level, everyone understands that not to sleep is bad. But the presence of health problems in insomnia confirmed by scientific studies. It was shown that patients with insomnia primarily manifest social consequences affecting other people or the sphere of human activity. So performance decreases by about 2 times.
From population studies, it is known that the presence of insomnia is associated with a high risk of developing depression (the lifelong risk of developing depression in people with insomnia increases by 4 times), alcohol abuse and drugs. Very often, a person first of all begins to resort to affordable ways to improve sleep, first of all – to alcohol, getting addicted.
It is also shown that insomnia increases the risk of getting into a traffic accident for drivers. This is due to the daily effects of sleep disorders, when the rate of reactions decreases, attention worsens, drowsiness increases, and the person becomes actually dangerous to others.
The so-called medical risks of insomnia – the threat to the health of the person himself is much more difficult to prove than the social risks, because the social ones are assessed by population statistics, and in order to evaluate the medical ones, special studies are needed.
Hyperactive model of insomnia
Currently, a hyperactivity model is being used to explain the causes of insomnia . Its essence lies in the fact that people who have insomnia are hyperactive in everything: their brain works too intensively. This was shown, for example, when conducting research using transcranial magnetic stimulation. A person was given a stimulus to the cortical region that controls the movement of a particular muscle, and a stronger response was received from people suffering from insomnia than people without any disorders. Although seemingly those areas of the cortex that were stimulated in no way associated with sleep are not associated. They simply provide arm movements.
A similar kind of hyperactivation is observed at other levels of the regulation of the organism, for example, in patients with insomnia, the prevalence of sympathetic nervous system tone over the parasympathetic one is revealed . The sympathetic is a part of the nervous system, which is responsible for stress reactions, for activation, and the parasympathetic – on the contrary, for rest. In people with insomnia, the sympathetic part always dominates, even during the daytime, and when they fall asleep, no matter what type of sleep they are in, slow or fast, their nervous system is too hyperactive , hence the name of the model.
At the endocrine level in patients with insomnia , cortisol secretion is increased, and the level of this hormone, instead of falling in the evening and at night, on the contrary, increases before going to bed, more precisely, before they go to bed and begin to suffer from sleep disturbances. This important hormone, which indicates the intensity of the stress response, is also produced excessively.
The presence of hyperactivity of the nervous system is the background, it determines a person’s susceptibility to the development of insomnia. In addition, there must be some provocative factor. Most often, this factor is emotional stress. Such cases usually occur at the level of interpersonal interactions, conflicts: people do not share something, then they get excited, do not sleep, they think what to do next. This stressful reaction can for some time lead a person out of the “normal sleep zone”, and he will not sleep well for a while. But then, when the stress response ends, sleep is restored.
Sleep research and treatment
A very successful term is used abroad – “memorized insomnia, ” that is, a person himself teaches the bad , makes “not sleep”. The action of such a supporting factor may lead to the fact that insomnia from short-term , associated only with stress, becomes chronic, permanent, associated with the wrong behavior of a person in relation to his sleep. He is afraid of his sleep and stops believing in him. A person tries to force himself to sleep, and this goes deeper and deeper into insomnia, then begins to take sleeping pills, gets used to them, and so on.
A separate type of chronic insomnia is paradoxical insomnia , when the main problem arises not in the dream itself, but in its perception, when the person does not feel his sleep. He comes to the doctor and says: “Doctor, I never sleep.” The doctor says, “No, you are sleeping, just don’t feel it.” It is impossible to convince this person if he doesn’t do sleep research.
Only a sleep study allows you to clearly determine how much sleep a patient actually has and suggest why he does not feel it. Most often, the reason for such an underestimation lies in the psychological phenomenon, when a person remembers wonderfully what is happening to him in wakefulness and does not remember what was happening to him in a dream. If he wakes up several times a night, lies awake, then in the morning he remembers these periods. But if between them, he sank into a state of sleep, this information is not saved, and it is in the morning he did not remember -o flashback ceases only sleepless night. Accordingly, a person will consider himself absolutely right in his opinion and we will never convince him unless we conduct an objective study of sleep.
Ostrum It is quite simple to treat insomnia , most often it passes by itself. When the action of the stress factor ends, most people’s sleep is restored and they don’t come to the doctor. Usually patients come to the pharmacy, they are asked to give them something to sleep, they are given a collection of soothing herbs or a medicine that contains elements of these herbs with a soothing effect, and the problem is solved. Sometimes they ask for something “stronger”, they are not given this in a pharmacy, because real hypnotics are sold only by prescription, and this requires a visit to a doctor.
With the treatment of chronic insomnia, which lasts 3 months or more, the situation is much more complicated, because very often patients suffer for years and do not receive qualified help. As a result, unfortunately, they become regular consumers of sleeping pills with the need to gradually increase the dose – this is called the “addiction phenomenon” when more and more drugs are required to obtain the same effect: first half a pill, then a whole pill, then two , then four and so on.