Sleep Disorders - Causes, Symptoms and Treatment. MF.

Insomnia, or insomnia, is a disorder associated with difficulties in the occurrence or maintenance of sleep, when hypersomnia a person experiences an increased need for sleep. Violation of the rhythm of sleep manifests itself in the shifting of the time of falling asleep or falling asleep during the day and the disturbance of sleep in the night.

Classification of sleep disorders:

- Insomnia - sleep disorders and the ability to sleep.
- Hypersomnia - lesions accompanied by pathological drowsiness.
- Parasomnias are functional disorders associated with sleep, sleep phases and incomplete awakening( walking in sleep, nighttime fears and anxious dreams, enuresis, nocturnal epileptic seizures).
- Situational( psychosomatic) insomnia - insomnia, lasting less than 3 weeks and having, as a rule, emotional nature.

Also, depending on the disturbances in the sleep process, the pathologies are divided into the following groups:

• Difficulties in the onset of sleep( pre-somnolent disorders).Such patients are afraid of the onset of insomnia that occurred earlier. There was a desire to sleep disappears, as soon as he is in bed. He does not give rest to thoughts and memories, he long searches for a comfortable pose for sleep. But only the appeared dream is easily interrupted by the slightest sounds.

• Frequent nocturnal awakenings, after which it is difficult to fall asleep and "superficial" sleep is characteristic for the pathology of disturbing the sleep process. This is called intrasomnia. Such a person can be awakened by the slightest noise, awesome dreams, increased motor activity, and urges to the toilet. These factors affect everyone, but patients have increased sensitivity to them and difficulties with subsequent falling asleep.
• Anxiety after awakening( post-somnolence disorders) is a problem with early morning final awakening, "breakdown", decreased performance in the morning, daytime sleepiness.
• Separate line in sleep disturbance is the "sleep apnea" syndrome. This is a situation with a periodical sleep during the slowing down of breathing until its complete stop( apnea) at different time intervals. Patients suffering from it have a significant risk of premature death due to the arrest of the cardiovascular and respiratory systems. The "sleep apnea" syndrome manifests itself as a set of symptoms, including increased blood pressure, headaches in the morning, decreased potency, decreased intelligence, personality changes, obesity, increased daytime sleepiness, and severe snoring and increased motor activity during sleep.

Causes of sleep disorders

This syndrome often combines with neurological and psychiatric diseases, they mutually exacerbate each other.

Insomnia is officially considered a sleep disorder for at least three times a week. The main cause of insomnia is currently psychological problems, such as chronic stressful situations, nerves, depression and others.

This also includes mental fatigue, which manifests as fatigue at low loads, drowsiness during the day, but the inability to fall asleep at night, general weakness, lethargy.

Common factors that have a negative effect on sleep are: consumption of caffeinated beverages( tea, coffee, cola, energy), abundant fatty foods before bed, alcohol and smoking, intense physical activity before bedtime.

Sleep Disorders

Insomnia is an unavoidable companion of various diseases. What are the symptoms of Insomnia:

- Depression
- Stress
- Arthritis
- Heart failure
- Side effects of medications
- Renal failure
- Asthma
- Apnea
- Syndrome of tired legs
- Parkinson's disease
- Hyperthyroidism

Almost always mentaldiseases are combined with it - chronic stresses, nerves, depression, epilepsy, schizophrenia, psychosis.

With stroke of the brain, the time of origin of the stroke can even affect negatively the prognosis of the disease, not only with respect to day and night, but also in the view of sleep and wakefulness.

When migraine deficiency, as well as excess sleep can be the nature of a provoking factor. Some headaches can begin in a dream. On the other hand, at the end of a migraine attack the patient, as a rule, falls asleep.

Also, insomnia can disturb anyone with a pain syndrome or other physical anxiety. For example, with arthritis and arthrosis, osteochondrosis, trauma.

Sleep disorders occur in multiple sclerosis and vertebrobasilar insufficiency( insufficient blood flow to the brain through the vessels from the spine), along with dizziness, episodes of loss of consciousness, headaches, decreased mental and physical performance and memory.

Hormonal changes in the body also have a negative effect on sleep. Insomnia worries women during pregnancy and breastfeeding, when a woman is particularly sensitive to extraneous stimuli. In the menopausal period, the so-called hot flushes are caused by hot flashes and sweating, regardless of the surrounding environment. With the selection of treatment together with the attending physician gynecologist, this condition can be significantly alleviated.

With increasing thyroid function( hyperthyroidism), insomnia is one of the characteristic symptoms. Also, patients noted progressive weight loss with increased appetite, increased blood pressure and heart rate, weakness, increased excitability, speech acceleration, anxiety and fear. In addition, there is exophthalmos( shifting the eyeball forward, sometimes combined with an incomplete covering of his eyelids).

Usually after selection of treatment at the doctor of the endocrinologist the given status is possible to facilitate.

Atherosclerosis of the vessels of the lower extremities, especially in the advanced stage, is a rather serious problem. In this disease, the patient experiences painful sensations in the muscles of the legs when they are horizontal or when moving. These pains make you stop when you walk and lower your legs from the bed, which brings relief. This condition is due to lack of blood flow to the leg muscles due to blockage of blood vessels with atherosclerotic plaques. If blood flow reaches critical minimum values, tissues die due to lack of nutrition. It is worth noting that most often this condition is observed in smokers men who have an atherosclerotic process that is ten times faster than that of non-smokers.

Bronchial asthma during the seizure is also characterized by sleep disturbances. Suffice it to say that asthma attacks occur in the pre-morning hours and are accompanied by bouts of coughing, shortness of breath and a sense of lack of air. This condition is usually worsened during colds or worsening allergies. In addition, drugs to stop asthmatic attack and long-term asthma treatment have some exciting effect on the body. Such patients are referred to the doctor pulmonologist for the purpose of selecting adequate therapy and reducing the frequency of attacks.

In renal insufficiency, insomnia usually attracts attention at a late stage with a decrease in the protective capacity of the body( decompensation).Renal failure in most cases develops gradually, over the years, and consists in a gradual, but steadily progressing( increasing) decrease in renal function to remove toxins and toxins from the body. Therefore, they accumulate in the blood, poisoning the body( uremia in rough translation - urine in the blood) This is accompanied by symptoms such as dryness and pallor of the skin with an earthy hue, swelling ammonia from the mouth and skin, blocking, lethargy, itching of the skin and small hemorrhagesunder the skin for no apparent reason. There is also a decrease in weight, lack of appetite, even aversion to protein source foods. The patient first noted an increase in the amount of urine, as a protective reaction to insufficient kidney function, and then a progressive decrease in its number. Such a patient needs constant observation from a specialist nephrologist.

With heart failure and hypertension( increased blood pressure), insomnia can be noted in a chronic process, combined with shortness of breath with physical exertion, headache, fatigue, weakness, palpitation, dizziness when rising from a horizontal position to a vertical position( orthopnea), a decreasemental activity. In addition, one of the drugs for the treatment of heart disease are diuretics. If the doctor does not follow the doctor's recommendations for their admission, they can give patients anxiety in the form of frequent urination at the toilet at night, which also does not promote a sound sleep.

Examination for sleep disorders

In case of sleep disturbance, first of all, visit a therapist or neurologist. After his examination, you may be offered a consultation with a doctor - a specialist in sleep problems - a somnologist.

Of the instrumental methods of objective examination, polysomnography with cardiorespiratory monitoring remains the most significant. This observation during sleep with the help of special sensor sensors records and then analyzes information on EEG( electroencephalography), EOG( electrooculography), EMG( electromyography), ECG( electrocardiography), respiration, oxygen saturation.

This study allows you to assess the ratio of sleep cycles, the order of their change, the impact of other factors on sleep and sleep on other organs and their functions.
Unfortunately, it is not always possible for a doctor to conduct a polysomnography for a patient. Then you have to rely on the survey and survey data. But this with sufficient qualification of a doctor-psychotherapist allows you to appoint the right treatment.

Treatment of sleep disorders

Treatment of insomnia includes many factors:

1) Sleep hygiene is very important. Try to stay in the familiar atmosphere for you, in a comfortable bed, close the curtains, exclude sharp sounds and smells. Go to bed at the same time, even on weekends. Before going to bed, ventilate the room, take a short walk, take a warm relaxing bath, read the book at nightlight.
2) The rational mode of work and rest also contributes to the normalization of sleep. Many people know that the quality of sleep at different times of the day is not the same. Restoration of strength, mental and physical, is much more effective in the period from 22 to 4 hours, and closer to the morning, when the dawn is coming, sleep is not strong.
3) Taking vegetable calming medications( Valerian extract, Persen, Novo-Passit)
4) Only a doctor who evaluates the general condition of the patient after finding out the cause of insomnia may prescribe a drug that will not harm you. Even a medication prescribed by a medic should not be taken longer than the prescribed time - almost all drugs with a hypnotic effect can cause addiction and dependence akin to the drug. Elderly patients are usually prescribed a half dose of sleeping pills.
5) Subjective dissatisfaction with the quality of sleep, but the objective duration of sleep for 6 hours or more, hypnotic drugs are not prescribed. In this case, psychotherapy is necessary.
6) is another factor affecting the human sleep - the daily rhythm, which is called the main cycle of rest - activity. It is one and a half hours. The bottom line is that we can not always fall asleep when we want it. Every hour and a half for a few minutes, this opportunity appears in us - we feel a certain drowsiness, and towards evening drowsiness increases. But if you do not use this time, then you have to wait an hour or more - you will not be able to fall asleep anyway.

Consequences of sleep disturbance

Insomnia can be the first sign of a disease, such as neurosis, depression, chronic stress. And also aggravate and reduce the efficiency, social adaptation and quality of life of a patient with any diseases. Therefore, do not underestimate insomnia and especially self-medicate. Contact a qualified technician.

Which doctors should be treated for sleep disorders.

First and foremost need consultation of doctors of a neurologist and a psychotherapist. The following specialists may be needed:

- Psychologist
- Nephrologist
- Rheumatologist
- Cardiologist
- Endocrinologist

Physician therapist Moskvina AM