Insomnia - Causes, symptoms and treatment. MF.

"Good night, good dreams," - we hear this wish every day and plunge into the most mysterious state - a dream in which we spend a third of our lives. Dreams captivated the imagination of a man from ancient times. The ancient Egyptians, the Babylonians and Greeks, and the Indians believed that in dreams there is a meaning hidden from the eyes, prophecies and secret messages.

Legends and tales were written about the "sleeping princess", people who were buried alive in a lethargic dream, about wandering people under the influence of the moon. .. For two thousand years only philosophers have modeled the essence of the illusory world of sleep. Dreams are dreaming of everything - color and black and white, real and unreal, we and the people around us and mysterious creatures, kind and nightmarish, with sound and soundless. The dream lasts from minutes to half an hour. Not everyone remembers their dreams. It is at this time a person rests, the body is self-healing - in the phase of fast sleep.

The brain during sleep processes the received information, emotions, stores them, it actively exchanges information between consciousness and subconsciousness, between short-term and long-term memory, the program of human behavior is formed. Without sleep, a person can survive for no more than 200 hours. Without sleep, a sense of humor, emotions, memory, creativity, quickness of reaction, lost immunity and working capacity of the whole organism is lost.

What is a dream? Our brain can work normally when its neurons are in active state. And neurons can be active only if they are supported by special chemicals released by the wake centers - neurotransmitters. Brain cells of the brain, "embedded" in the wakefulness system, are scattered throughout the brain( most of all in a black substance) secrete the brain's main inhibitory substance - GABA( gamma-aminobutyric acid).As soon as the active neurons weaken, the inhibitory neurons immediately weaken them even more, the bioelectric activity of the brain is replaced, and sleep sets in. The phase of fast sleep triggers acetylcholine, glutamic and aspartic acid, produced by the cells of the variolium bridge, brainstem.

Paradoxical sleep - neurons are awake, eyeballs move, but the body does not. The so-called "third eye" - the epiphysis - is involved in the regulation of sleep. In the dark, he produces a substance - melatonin, which causes severe drowsiness. An important role in the pathology of drowsiness is given to prostaglandin D3, for example, with craniocerebral trauma, meningitis, and African "sleeping sickness."Thus, sleep is a complex biochemical, bioelectric process.

The first stage of sleep is a slow sleep, a nap 5-10 minutes. The second stage is a shallow sleep - 20 minutes, after that another 30-50 minutes of 3 and 4 stages - a slow and deep slow sleep. Then the second stage repeats, after which the first episode of fast sleep occurs - about five minutes. Then the stages are repeated, the stage of slow sleep decreases, and the rapid one grows, the last episode of sleep can last an hour.

The structures providing sleep are in the hypothalamus, the bridge, the medulla oblongata, the blue spot, and individual parts of the cerebral cortex.

Causes of insomnia

Insomnia is a disorder characterized by the inability to sleep or lack of sleep, frequent awakenings. Clinically, this disorder is assessed subjectively, as the patient's perceived dissatisfaction with the number and quality of sleep, the lack of a sense of rest after sleep.

There is insomnia with somatic and mental diseases: depression, Parkinson's disease, encephalitis, arthritis, asthma, hyperthyroidism, prostatic hypertrophy, degenerative diseases of the nervous system, kidney disease, heart failure, with neuroses, fatigue, alcohol and drug abuse.

To break sleep can a plentiful supper, a strong emotional experience, noisy games, strong coffee and tea before going to bed, smoking. Chronic sleep disorders can cause medications - anticonvulsant, b - blockers, antipsychotics, antidepressants, non-steroidal anti-inflammatory drugs.

March 19 is the day of sleep. The problem of dissonance( sleep disorders) is very urgent. In developed industrial cities, the level of sleep disturbances is growing. More than 10% of the population suffers from insomnia, one in every second has one of the symptoms of sleep disturbance.

The duration of sleep is reduced due to social problems - dislocation at work, uncertainty in the future. Scientific and technological progress - electronic devices, the Internet, telephones, TVs - the flow of information does not allow to relax and indulge in sleep. The problem of sleep disturbance is engaged in research institutes and laboratories, neuroscientists and neurophysiologists. Fully the mechanisms of sleep, the change of its stages and cycles, sleep disorders, especially the paradoxical sleep has not yet been studied. Management sleep - wakefulness mechanisms are found in suprachiasmatic nuclei and in the pituitary gland. Evidently, factors of the external environment - entering the human body with food, water and stressors, especially emotional stressors - also affect sleep and wakefulness. Sometimes the word, without causing physical harm, causes a cascade of nervous and hormonal reactions, as a result of which a person loses sleep.

The mechanism of the impact of stress factors on the phase change of slow and fast sleep remains practically unknown. The role of special proteins( regulatory peptides) is widely studied in the brain and in the body and plays an important role in physiological processes.

Everyone knows a rare occurrence of sleep disorders - sleepwalking or sleeping( somnambulism).A sleeping person walks about the house, then returns to bed and does not remember anything about the night accidents.

It is believed that this is a dream in which parts of the brain responsible for movements are excited. Another much more rare violation of sleep is lethargy - an unnaturally long sleep, from days to months, and even there is an observation when a person slept for 20 years).Lethargy is possible in case of epidemic encephalitis, a significant overdose of some medicines, very severe overfatigue.

If insomnia disturbs the daily rhythm of daily life, you need to see a doctor for diagnosis.

Insomnia test

There are various methods for diagnosing insomnia. For example, the scale of assessing the drowsiness of Epworth. Do you get sleepy in public places, when reading, watching TV, lying down in the afternoon, in the car while stopping at the red traffic light? The answers are scored in 4-point grades, where 0 is the lack of sleepiness.

Full medical examination and examinations are conducted to exclude the abovementioned serious diseases, in which sleep disturbances are only a symptom.

Difficulties of falling asleep, short-term sleep, frequent awakenings, early awakenings are distinguished. The severity can be mild insomnia and severe. Often a patient with sleep disturbance puts on the first place and ignores somatic pathology and neuroses. You need to treat the cause!

Treatment of insomnia

Non-pharmacological methods for treating insomnia are the formation of a sleep ritual, various methods of preparing for sleep, the development of a conditioned reflex to certain actions leading to bed and falling asleep. Therapy of control over stimuli prepares the patient to sleep - go into the bedroom, spread out the bed, pull curtains, lie down, relax and sleep. Restriction of sleep therapy consists in the fact that the patient is given the time spent in bed equal to the duration of his sleep and gradually increases by 15 to 20 minutes a week until he reaches the required level. Relaxation techniques are used to calm the processes of stimulation and overexcitation, as a preparatory stage.

And you do not need to count rams - so you will never fall asleep .

Cognitive therapy should help get rid of the fear of insomnia. If you think about going to bed before going to bed, you can not fall asleep - you can not fall asleep all night.

Snoring leads to insomnia surrounding, and the snorer himself during snoring is deprived of the stage of paradoxical sleep.

Paradoxical intentions - the patient can be made to think that he does not want to sleep and he needs to stay awake - he will fall asleep.

You need to learn to sleep hygiene - diet, exercise, the right environment in the bedroom - lighting, noise, temperature, bedding, use of pads with hops, aromatic candles, sedative teas.

To go to bed it is necessary at the same time, not to eat before going to bed, do not drink before bedtime tonics, colas, coffee, alcohol. Do not go to bed irritated, do not go to bed, if you do not want to sleep. Create comfortable conditions for sleep. Refresh the air( air conditioner, humidifier. ..).

Develop a stereotype - I go into the bedroom, I spread the bed. .. then I will sleep. And do not think that you will not fall asleep. Independently you can take sedatives, tablets herbal preparations - novo-passit, dormiplant, valerian, glycosed, sedavite. Valerian can be taken for a long time, it is believed that it increases the content of gamma-aminobutyric acid. The effectiveness of sleeping pills occurs within 2 weeks. Improves sleep with mint, lemon balm, blackberry leaves.

Drug therapy is prescribed for a short time - 10 - 15 days, use the lowest effective doses, you can start with intermittent doses - 2 - 4 times a week, can be canceled gradually.

Sleeping

1. The first line of pharmacotherapy is:
- benzodiazepines - reduce the time of falling asleep and the frequency of nocturnal awakenings, increase the duration of sleep, enhancing the inhibitory effect of GABA - quazepam, estazolam, flurazepam, triazolam, temazepam;
- nonbenzodiazepine - zopiclone, zaleplon, zolpidem, ramelton.

2. second line: tricyclic antidepressants - amitriptyline, doxepin, antihistamines.

Sleeping pills are prescribed only by a doctor. Each sleeping pill has its pluses and minuses, indications and contraindications and decide what exactly you need - the doctor's business. To relieve agitation, anxiety is used atarax, afobazol, adaptol, noophen. It is shown in the treatment complex - psychotherapy, reflexotherapy, warm coniferous - pearl baths, aromatherapy, hypnosis, electrosleep, music therapy, sanatorium treatment.

Consultation of a neurologist on the topic of insomnia

Question: Do honey in the treatment of insomnia?
Answer: honey is absolutely harmless and can be used to treat sleep disorders. There are many folk recipes using honey: in a cup of honey add 3 teaspoons of apple cider vinegar, stir and take 2 teaspoons at bedtime;mix 1 tablespoon of honey with 1 glass of warm water and drink before going to bed;mix 1 glass of lemon juice, 2 tablespoons buckwheat honey, 2 tablespoons rastolchennyh walnuts and take 1 tablespoon before bedtime.

Question: which herbal preparations can be used for insomnia?
Answer: a lot of folk recipes and herbal preparations are used, for example:
- peppermint, triple leaf watch, valerian( rhizome), cones of hops equally. A tablespoon of collection pour a glass of boiling water, insist half an hour, drink 100 ml 3 times a day;
- rhizomes of valerian, motherwort, hawthorn, peppermint, mistletoe white - mixed in equal parts. A tablespoon of collection pour a glass of boiling water, insist half an hour, drink 1 glass in the morning and at night
- common hops, peppermint - for 1 part;a leaf of a balm of medicinal, flowers of a camomile chemist's, bark of a buckthorn fragile, a rhizome with roots of valerian - on 2 parts. A tablespoon of collection for a glass of water, boil for 15 minutes. Take 1-2 glasses at night;
- 2 tablespoons dry crushed hawthorn fruit for 1.5 cups of boiling water, insist. Drink in 3 divided doses 30 minutes before meals;
- 1 tablespoon chopped red elder root in a glass of water, boil for 15 minutes on low heat, insist half an hour, drain. Take 2-3 times a day for 1 tablespoon.
Valerian, common oregano, St. John's wort, ivan-tea, lavender, onion, mint, oats, lemon balm, motherwort, fennel, hops. ..
Preparation of infusions can also be considered as a psychotherapy - while the herbs are taken away, rubbed, mixed, the person calms down plusbreathes the aromas of herbs. A necessary ritual is worked out - a conditioned reflex - it's time to sleep.

Question: how quickly to fall asleep?
Answer: If the cause of your insomnia has nothing to do with any diseases, simply take a warm bath with aromatic additives( valerian, lavender), drink a cup of tea with soothing herbs and lie down in a warm bed. It helps to fall asleep meditation, during which your body relaxes, and extraneous thoughts chase away.

Good sleep!

The doctor - neurologist Kobzeva S.V.