Sleep Disorders. Types. Causes. Diagnosis & Treatment

Insomnia is one of the mass diseases all over the world. The statistics of insomnia is growing every day. Today, 29% of men, 37% of women, 25% of children and 75% of pregnant women suffer from this disease. Insomnia is expressed by disturbed sleep

What is the danger of sleep disorders?

Patients do not always take insomnia seriously and let its treatment take its course. This attitude leads to unpleasant and dangerous consequences in the form of the transition of the disease to a chronic form, neurological disorders, pathologies of internal organs and mental disorders. Not everyone manages to cope with insomnia on their own, and in most cases, the help of a medical specialist is necessary to obtain a good result. Insomnia, or insomnia, is a violation of the quality and quantity of sleep that adversely affects a person's daily life. Insomnia includes interrupted sleep (a person often wakes up), trouble falling asleep (a person cannot fall asleep for more than half an hour), and lack of effective night sleep (a person does not feel rested during the day).

Sleep is extremely important for human health, because it is at this time that the human body restores its strength. The average person needs 6 to 10 hours of sleep. People spend a third of their lives sleeping, and rightfully so. When we sleep, our brain processes the information received, subconscious and conscious elements work, both types of memory (short-term and long-term) and the behavioral characteristics of the body are formed. A person cannot survive more than 200 hours without sleep. Without sleep, people become lethargic, their emotions and reactions disappear, and immunity decreases.

Types of sleep disorders

Sleep disturbance is a fairly common condition. About 30% of the world's population complains of a similar disorder. Systematic insomnia, constant drowsiness, inability to fall asleep due to overexcitation or pain, frequent waking up, superficial and shallow sleep, constant nightmares - all this refers to sleep disorders. The fact that a person has a sleep disorder can be said when he is tormented by insomnia or, on the contrary, constant drowsiness. Sleep disorders are divided into the following types:

  • Presomnic - inability to fall asleep quickly
  • Intrasomnic - in its depth and duration sleep is disturbed
  • Postsomnicheskie - violated the time and speed of awakening
  • Combination of these disorders

Main causes of sleep disorders

Insomnia can occur as an independent symptom or as a result of another mental or somatic pathology. Risk factors that can lead to insomnia are psychological stress, chronic pain, cardiac arrest, hyperthyroidism, heartburn, restless legs syndrome, menopause, certain medications, caffeine, nicotine, and alcohol. Other conditions for insomnia include night shift work and sleep apnea.

Depression also contributes to insomnia. It leads to changes in the function of the hypothalamic-pituitary-adrenal system, which in turn causes an excessive release of cortisol, which can lead to poor sleep quality. Nocturnal polyuria, excessive nocturnal urination, as well as depression, can significantly impair sleep.

Diagnosis of sleep disorders

Insomnia is diagnosed based on the patient's complaints and physical condition. In this case, the actual duration of sleep is not critical; The 5-hour milestone is a kind of minimum: a shorter sleep for 3 days is equivalent to one night without sleep.

There are 2 clear diagnostic criteria for insomnia: a delay in falling asleep for more than 30 minutes and a decrease in sleep efficiency up to 85% or less (the ratio of the time of actual sleep to the time the patient spent in bed).

Violation of the circadian rhythm (early falling asleep and early rising - a "lark" person or late falling asleep and late rising - a "owl" person) is diagnosed as a pathology if a person experiences post-somnia disorders and does not have the opportunity to sleep longer or fall asleep early.

Sometimes a person suffering from chronic insomnia is offered to keep a diary for a month, in which periods of wakefulness and sleep are recorded. In cases where insomnia is accompanied by impaired breathing (obstructive sleep apnea) and physical activity, as well as in case of ineffectiveness of drug therapy, a consultation with a somnologist and polysomnography are prescribed. A computer study gives a complete picture of sleep, determines the duration of its phases and evaluates the work of the whole organism during sleep.

Diagnosis of insomnia is not difficult, more often it is more difficult to determine the true cause or combination of factors that caused insomnia. Often, consultations of narrow specialists are required in order to identify somatic pathology.

Symptoms of insomnia include:

  • difficulty falling asleep, including difficulty finding a comfortable sleeping position
  • waking up at night and not being able to go back to sleep is often also a symptom of anxiety disorders (two-thirds of patients with this disease wake up in the middle of the night, and more than half of them have trouble returning to sleep after waking up in the middle of the night)
  • daytime sleepiness, irritability or restlessness
  • early morning awakening - waking up (more than 30 minutes) earlier than desired, unable to return to sleep, and before total sleep time reaches 6.5 hours. Waking up early in the morning is often a symptom of depression

Treatment of sleep disorders

Transient insomnia usually resolves on its own or after the causes of its occurrence are eliminated. Subacute and even more chronic insomnia require a more careful approach, although treatment of the underlying cause is a fundamental factor.

Successful treatment of insomnia involves maintaining good sleep hygiene. Sleeping at the same time every day, avoiding daytime sleep, active daytime wakefulness can completely eliminate insomnia in the elderly without the use of medications.

Psychotherapy allows you to eliminate psychological discomfort and restore sleep. Acupuncture and phototherapy (treatment with high intensity white light) have shown good results in the treatment of insomnia.

The use of sleeping pills promotes rapid falling asleep and prevents frequent awakenings, however, hypnotics have a number of adverse effects, ranging from addiction to addiction and rebound effects. That is why drug treatment of insomnia begins with herbal preparations (motherwort, mint, oregano, peony, and other medicinal herbs that have a sedative effect) and products containing melatonin. Drugs with a sedative effect (neuroleptics, antidepressants, antihistamines) are prescribed to increase the duration of sleep and reduce physical activity.

The drugs imidazopyridines (zolpidem) and cyclopyrrolones (zopiclone) have a short duration of action, do not cause post-somnic disorders - these are one of the safest chemical sleeping pills. A group of tranquilizers - benzodiazepines (diazepam, lorazepam) to a greater extent inhibits brain processes, thereby reducing anxiety and increasing sleep latency. These drugs are addictive, seriously affect the speed of reaction, and at the same time enhance the effect of barbiturates and analgesics.

The rules for taking medications for insomnia include: adherence to the duration of treatment with sleeping pills - an average of 10-14 days (no more than 1 month); drugs can be prescribed in combination, taking into account their compatibility; one or another drug is selected depending on the concomitant somatic pathology and the minimum set of side effects. For preventive purposes, sleeping pills are prescribed 1-2 times a week. It is important to understand that the use of sleeping pills is exclusively symptomatic treatment. This fact and the mass of undesirable consequences force them to limit their intake as much as possible.