Sleep disturbance

The reasons

Manifestations of sleep disorders

Treatment

Sleep disturbance (sleep disorder) is a subjective feeling of sleep deficiency.

Sleep disorders include

  • presomnic (prolonged sleep),
  • Intrasomnic (violation of the duration and depth of sleep),
  • postsomnichesky (disturbances of speed and time of awakening) disorders
  • or their combination.

During the life of up to 30% of the adult population suffers from such disorders. They often occur in old age.

Classification of sleep disorders:

  • By duration: short-term insomnia, chronic (persistent) insomnia
  • For the reason: primary and secondary disorders of sleep, caused by psycho-traumatic situations, mental disorders, various diseases or taking psychoactive substances.

The reasons

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  • Stressful situations
  • Somatic and neurological diseases that cause physical discomfort and are accompanied by pain.
  • Mental illness, especially with depressive conditions.
  • Substance abuse (alcohol, caffeine, nicotine, psychostimulants, narcotic substances), drugs (dietary supplements, decongestants and antitussives, glucocorticoids, theophylline, phenytoin).
  • Malignant smoking.
  • Obstructive sleep apnea (snoring) syndrome.
  • Violation of the rhythm of sleep and wakefulness (quick change of time zones, work in the night shift, damage to the hypothalamus due to injury or   encephalitis ).

Manifestations of sleep disorders

The following are considered to be standard signs of sleep disorders:

  • Feeling of sleep deficiency.
  • Congestive disorders – the inability to fall asleep at the usual time for the patient, often accompanied by anxiety, fear and obsessive thoughts.
  • Intrasomical disorders – superficial anxious sleep with frequent awakenings.
  • Post-dysmuscular disorders – when satisfactorily falling asleep, the patient wakes up a few hours earlier than usual and then either cannot fall asleep again or plunges into restless, not satisfying sleep. Often observed in the elderly and depressive states.
  • Lack of recuperation after waking up.
  • Drowsiness and drowsiness during daytime.
  • Fatigue.
  • Anxiety at bedtime.

Treatment

  • Elimination of causal factors affecting sleep: pain, taking medicines that cause sleep disorders, depressed.
  • Recommend every day to wake up at the same time.
  • It is necessary to limit the duration of daily staying in bed to the time familiar to the patient before the onset of a sleep disorder.
  • Do not use substances that affect the brain (caffeine, nicotine, alcohol, stimulants).
  • Alcohol should be avoided after 5 pm or less than 6 hours before bedtime.
  • It is not recommended to sleep during the day (except for cases when after a day’s sleep a night’s sleep improves).
  • It is necessary to use a gradually more complicated exercise program in the morning to maintain good health.
  • Excitement before bedtime should be avoided; replace watching TV with easy reading or listening to radio programs.
  • It is recommended to take a hot bath for 20 minutes before going to bed to raise the body temperature.
  • It is necessary to regularly eat at a certain time, to avoid abundant food before bedtime (sometimes a light snack can help you fall asleep before going to bed).
  • In the evenings, it is helpful to use relaxation or meditation techniques.
  • Creating a comfortable sleep environment.
  • Psychotherapy.

Drug treatment of sleep disorders

  • Drug therapy (shown with the ineffectiveness of non-specific methods and psychotherapy). When pain-related sleep disorders – painkillers (diclofenac, for example).
  • When sleep disorders associated with emotional disorders, with persistent insomnia, as well as sleep disorders that worsen health, nitrazepam is recommended – 5–18 mg 30–60 minutes before sleep, bromine – hydrochlorophenylbenzodiazepine — 0.5–2 mg at night, triazoles — 0.125-0.25 mg at bedtime.
  • In small doses, it is recommended for acute disorders (for example, when traveling with a change in time zone or when switching to night mode) – temazepam – 15 mg 1–2 hours before sleep, flurazepam – 15–30 mg overnight. Non – benzodiazepine drugs: zolpidem – 10 mg or 5 mg (for elderly or debilitated patients).
  • For sleep disorders associated with depression, amitriptyline for 1 hour before sleep (initial dose – 50-100 mg). An alternative drug, chloral hydrate 0.5 to 1 g at night.
  • In most cases, with adequate therapy and elimination of symptoms of the underlying disease, complete recovery is possible.

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