Nowadays, when all city residents are endlessly in a hurry to get somewhere, many of them begin to complain about deteriorating health conditions associated with the rhythm of life and increased psychological and emotional stress. Of course, problems with the cardiovascular system come first, but nervous diseases also cause no less concern. One such disorder is insomnia. You can fight it. Some strong sleeping pills can be easily obtained without a prescription in regular pharmacies or ordered online.

If a person was unable to get enough sleep the night before, then his performance is significantly reduced; he is sometimes unable to make adequate decisions, solve production problems, perform work involving significant physical activity, or drive vehicles. The problem of insomnia is one of the most acute in modern society. It is not always possible to fight it on your own. Drinking an increased dose of alcohol in the evening is not an option, it will not even be considered. At the pharmacy you can buy completely harmless sleeping pills without prescriptions for sound sleep.

Insomnia

There are many causes of insomnia and they are individual for each person, although they are not unique. Most note emotional and mental overstrain, stress, overwork, lack of rest, circulatory disorders, neurological diseases, constant pain in patients with chronic diseases, for example, cancer patients.

Other reasons include excessive consumption of coffee and strong tea, energy drinks, overexertion, which can be associated with both everyday problems and scandals in the family, watching horror films, reading interesting book before bedtime and many other phenomena and actions.

In most cases, it is quite difficult to pinpoint the cause. But the methods of dealing with insomnia are almost always the same. Not everyone wants to practice evening walks or make it a rule to drink a mug of warm milk with honey before going to bed. Belief in the power of pharmacology defeats common sense! And most of them rush to the pharmacy the next day to buy sleeping pills.

Classification of sleeping pills

All sleeping pills can be divided into strong and weak acting. Potent drugs for sound sleep cause a significant change in the psychological and emotional state, cause euphoria, and disturbances in the structure of sleep. In terms of their effect, they can be equated to soft drugs. Just like drugs, they are highly addictive, form dependence, and in case of overdose they are deadly (especially when taken simultaneously with alcohol). Therefore, they are sold strictly according to prescription.

List of over-the-counter sleeping pills

Over-the-counter sleeping pills include very common and widely available drugs - Corvalol and Valocordin.

They contain phenobarbital dissolved in alcohol. It is phenobarbital that has sedative and hypnotic effects. The disadvantages include the fact that in the event of an accidental or deliberate overdose, it causes a strong inhibitory effect on the psyche, which cannot recover for a long time. But this is rare and more often people suffering from chronic alcoholism who have tried during the period of abstinence ( severe hangover) use any pharmacological preparations containing alcohol.

The main use of Corvalol and Valocordin is the relief of acute or subacute heart attack which is achieved through a sedative effect, constant irritability, chronic insomnia. Do you want to know which is better: Corvalol or Valocordin?

Herbal sleeping pills

Natural-based drugs are the most harmless, accessible and inexpensive:

Valerian and motherwort, tinctures. Sedative effect;

Persen is a whole complex of herbs that cause a sedative effect;

Dormiplant - tablets based on valerian and lemon balm extracts. Sedative effect;

Novo-Passit. Pills. Sedative effect.

All these drugs are freely available and can be found in almost any pharmacy. Another plus is that medications are very inexpensive and available to any pensioner. The disadvantage is a weak sedative effect and, as a result, a low hypnotic effect. Many people complain that it is not always possible to overcome insomnia and achieve sound sleep with their help.

Homeopathic remedies

This category includes the “Calm” and “Nevoheel” tablets. The drugs are generally available, do not cause inhibition, are harmless, but no clear sedative effect is observed. Some people get help, some don't.

Strong over-the-counter insomnia medications for sound sleep

Donormil

Belongs to the group of histamine receptor blockers. It helps well both at the stage of falling asleep and during night sleep. Despite the good effect, side effects should also be taken into account: daytime sleepiness, attention problems, lethargy, dry mouth, feeling “broken”. It is not recommended for admission to people for whom increased demands are placed on their duties; if possible, receive quick solutions, to maintain attention - transport drivers, military personnel, doctors, dispatchers of potentially dangerous industrial facilities, etc.

It is necessary to prescribe the medicine very carefully to elderly patients, especially those suffering from kidney and liver diseases, and men with prostate adenoma.

Officially, the over-the-counter sale of Donormil is prohibited, but for some reason it was not included in the quantitative list. Many pharmacists take advantage of this and dispense Donormil without a prescription. In reality, taking into account these oversights, Donormil can be classified as publicly available drugs. It is also not recommended to take Donormil with alcohol.

Phenazepam

The situation is similar to the state of affairs in relation to donormil: on the one hand, over-the-counter release is prohibited, on the other hand, it is not included in the federal list of quantitative records. Considering that this drug is very dangerous, many local Regional Health Departments, on their own initiative, made appropriate additions to the federal list, adding phenazepam (donormil less often). According to reviews, phenazepam has excellent hypnotic effect and allows you to sleep soundly all night.

Melaxen (Melatonin)

Melatonin is a natural hormone produced by the pineal gland. It regulates sleep patterns well and causes virtually no side effects (no daytime sleepiness, lethargy or impaired attention are not observed). This is due to the fact that despite the chemical structure of the drug, it is an analogue of a completely natural hormone that is produced by the pineal gland of any healthy person. The sleeping pill Melaxen is not addictive; overdose does not occur even if the therapeutic dose is exceeded. It is recommended to use melatonin according to the instructions.

Melatonin facilitates the process of falling asleep, after which it is quickly completely metabolized and the stage of natural, full sleep begins. A person wakes up well rested without feeling any side effects.

There is pure melatonin, it comes from the world of sports and is not as expensive as Melaxen.

Advances and forecasts in the treatment of sleep disorders

In the first stages, it is worth trying taking herbal medicines (valerian, motherwort, persen). If there is no effect, you can switch to melaxen, which will certainly produce a better effect than herbal or homeopathic medicines. In order to start using donormil or phenazepam, you must first consult with a therapist or neurologist.

Children under 12 years of age who are characterized by increased excitability, anxiety, and sleep disturbances can be safely prescribed herbal preparations.

Now let's move on to the most powerful sleeping pills.

What is the most powerful sleeping pill?

Over-the-counter sleeping pills usually do not have serious side effects and can be used by people of all age groups.

There are several groups of sleeping pills:

1. Barbiturates (Barbamil, Chloralhydrate, Phenobarbital) – derivatives of barbituric acid

A representative of this group is Chloral hydrate.

Chloral hydrate

It has a good hypnotic and sedative effect, and also has analgesic and anticonvulsant effects. As a strong hypnotic, Chloral hydrate is used due to its rapid absorption and effective sedative and hypnotic effects. At the same time, sleep in its cyclicity and duration (from 5 to 7 hours) is close to physiological, and occurs within minutes.

For adult patients, Chloral hydrate is prescribed in the form of enemas or orally in large dilutions together with enveloping drugs.

It must be taken into account that Chloral hydrate can cause vomiting or a decrease in blood pressure, and with its prolonged use, addiction can develop (chloralomania).

It is not used for inflammatory diseases of the digestive tract (esophagitis, gastritis, colitis, proctitis), ulcerative-necrotic lesions of the gastrointestinal tract and diseases of the liver, kidneys, heart and blood vessels, alcohol addiction. Chloral hydrate is prescribed with caution during pregnancy and breastfeeding, as well as for chronic fatigue syndrome.

1. Benzodiazepine derivatives (Nizatrepam, Triazolam, Flunitrazepam)

Rohypnol

Rohypnol (Flunitrazepam) is considered an effective sleep aid. It also has a sedative, relaxing, antispasmodic effect, reduces nervous system excitability and anxiety.

After taking the drug, sleep occurs within minutes and lasts 5-8 hours.

It is dangerous to combine the use of this sleeping pill with the use of alcohol or alcohol-containing medications, psychotropic drugs and other sleeping pills, due to the risk of developing reverse reactions, severe hypotension, headaches and dizziness.

Rohypnol is not prescribed for children under ten years of age, patients with hepatic and renal failure, pathologies of the cardiovascular system, drug addiction and individual intolerance.

Melatonin-based sleep aids

1. Melatonin is a synthetic analogue of the natural sleep hormone (Melaxen, melatonin and Circadin)

Effective sleeping pills medicines, which do not affect the patient’s well-being during the day and do not have a negative effect on the structure of sleep. We have already talked about one of the representatives of these drugs - melaxen above, so we will not describe it again. As for Circadin and its cheaper analogues, you can see them in the article Circadin analogues.

How to get “special” sleeping pills?

And now a few words about sleeping pills, which will definitely not be sold to you without a prescription. In reality, getting them is not that difficult. You just need to put in a little effort and it will take a little of your time. In fact, all this is done quite easily. You can read about how to do this here.

• Melatonin for tanning Melatonin for tanning, or melanotan? Why is it dangerous to use? special drugs for tanning, reviews. What is melatonin? Melatonin […]
• Burns: first aid Checklist of emergency measures (for people familiar with first aid) 1. Check breathing and heart function. If there is no breathing or [...]
• Examples of bleeding and methods to stop it Bleeding from head injuries Head injuries can cause extreme heavy bleeding, but when examining the area of ​​blood flow, do not [...]
• snoring causes and treatment Causes of snoring A person’s breathing is accompanied by an unpleasant, rattling sound stream. This occurs due to weakened vocal [...]
• birth control pills the whole truth Since 1960, birth control pills (BOPs) have been one of the most fully studied drugs in history. Although the research results […]
• how to quickly fall asleep and get enough sleep With the onset of cold weather, many of us stop getting a good night's sleep. The reason is simple - in winter we don’t have enough sunlight. It's quite […]

About author

Leave a comment Cancel

• @gmail.com

Can't sleep?

We will send melatonin for sleep to any city in Russia

• No: 27 A, East Madison St Baltimore, MD, USA
• http://www.healthplus_clinic.com

Enter your email and we’ll send you a coupon with 10% off your next visit. Add any text here

© 2015 Health Plus Theme. All Rights Reserved

Painkillers and pain relief for oncology: rules, methods, drugs, regimens

Pain is one of the key symptoms of cancer. Its appearance indicates the presence of cancer, its progression, and secondary tumor lesions. Pain relief for oncology is the most important component complex treatment malignant tumor, which is designed not only to save the patient from suffering, but also to preserve his vital activity for as long as possible.

Every year, up to 7 million people worldwide die from cancer, and this pain syndrome worries about a third of patients in the first stages of the disease and almost everyone in advanced cases. Dealing with such pain is extremely difficult for a number of reasons, but even those patients whose days are numbered and whose prognosis is extremely disappointing need adequate and correct pain relief.

Painful sensations bring not only physical suffering, but also disrupt the psycho-emotional sphere. In patients with cancer, due to the pain syndrome, depression develops, suicidal thoughts appear and even attempts to die. At the present stage of development of medicine, such a phenomenon is unacceptable, because in the arsenal of oncologists there are a lot of drugs, the correct and timely administration of which in adequate doses can eliminate pain and significantly improve the quality of life, bringing it closer to that of other people.

Difficulties in pain relief in oncology are associated with a number of reasons:

• Pain is difficult to correctly assess, and some patients themselves cannot localize it or describe it correctly;
• Pain is a subjective concept, so its strength does not always correspond to what the patient describes - some minimize it, others exaggerate it;
• Refusal of patients to receive pain relief;
• Narcotic analgesics may not be available in required quantities;
• Lack of special knowledge and a clear scheme for prescribing analgesics on the part of oncology clinic doctors, as well as neglect of the patient’s prescribed regimen.

Sick oncological processes- a special category of people to whom the approach should be individual. It is important for the doctor to find out exactly where the pain comes from and the degree of its intensity, but due to different pain threshold And subjective perception negative symptoms Patients can evaluate pain of the same severity differently.

According to modern data, 9 out of 10 patients can completely get rid of pain or significantly reduce it with a well-chosen analgesic regimen, but for this the doctor must correctly determine its source and strength. In practice, things often happen differently: drugs that are obviously stronger than necessary at this stage of the pathology are prescribed, and patients do not comply with their hourly regimen and dosage.

Causes and mechanism of pain in cancer

Everyone knows that the main factor in the appearance of pain is the growing tumor itself, but there are other reasons that provoke and intensify it. Knowledge of the mechanisms of pain is important for the doctor in the process of choosing a specific therapeutic regimen.

Pain in a cancer patient may be associated with:

1. Actually a cancerous tumor that destroys tissues and organs;
2. Concomitant inflammation, provoking muscle spasm;
3. The operation performed (in the remote education zone);
4. Concomitant pathology (arthritis, neuritis, neuralgia).

Based on the degree of severity, there are mild, moderate, and intense pains, which the patient can describe as stabbing, burning, or pulsating. In addition, the pain can be either periodic or constant. In the latter case the risk is highest depressive disorders and the patient’s desire to give up his life, while he really needs strength to fight the disease.

It is important to note that cancer pain can have different origins:

• Visceral - bothers for a long time, is localized in the abdominal cavity, but the patient himself finds it difficult to say what exactly hurts (pressure in the abdomen, distension in the back);
• Somatic - in the structures of the musculoskeletal system (bones, ligaments, tendons), does not have a clear localization, continuously grows and, as a rule, characterizes the progression of the disease in the form of metastasis to bone tissue and parenchymal organs;
• Neuropathic - associated with the effect of a tumor node on nerve fibers, can occur after radiation or surgical treatment as a result of nerve damage;
• Psychogenic is the most “complex” pain, which is associated with emotional experiences, fears, exaggeration of the severity of the condition on the part of the patient, it is not relieved by analgesics and is usually characteristic of people prone to self-hypnosis and emotional instability.

Given such versatility of the pain syndrome, it is easy to explain the lack of a universal pain reliever. When prescribing therapy, the doctor must take into account all possible pathogenetic mechanisms of the disorder, and the treatment regimen can combine not only drug support, but also the help of a psychotherapist or psychologist.

Scheme of pain therapy in oncology

Today, a three-stage pain treatment regimen is recognized as the most effective and appropriate, in which a transition to the next group of drugs is possible only if the previous one is ineffective in maximum dosages. This scheme was proposed by the World Health Organization in 1988, is used everywhere and is equally effective for lung, stomach, breast cancer, soft tissue or bone sarcomas and many other malignant neoplasms.

Treatment of progressive pain begins with non-narcotic analgesics, gradually increasing their dose, then move on to weak and strong opiates according to the scheme:

1. Non-narcotic analgesic (non-steroidal anti-inflammatory drug - NSAID) with adjuvant therapy (mild to moderate pain).
2. Non-narcotic analgesic, weak opiate + adjuvant therapy (moderate to severe pain).
3. Non-narcotic analgesics, strong opioid, adjuvant therapy (for persistent and severe pain in stage 3-4 cancer).

If the described sequence of pain relief is followed, the effect can be achieved in 90% of cancer patients, while mild and moderate pain disappears completely without the use of narcotics, and severe pain is eliminated by narcotic drugs opioid series.

Adjuvant therapy is the use of drugs with their own beneficial properties - antidepressants (imipramine), corticosteroid hormones, anti-nausea drugs and other symptomatic drugs. They are prescribed according to indications separate groups patients: antidepressants and anticonvulsants for depression, neuropathic pain mechanism, and for intracranial hypertension, bone pain, compression of nerves and spinal roots by a neoplastic process - dexamethasone, prednisolone.

Glucocorticosteroids have a strong anti-inflammatory effect. In addition, they increase appetite and improve emotional background and activity, which is extremely important for cancer patients, and can be prescribed in parallel with analgesics. Use of antidepressants anticonvulsants, hormones allows in many cases to reduce the dose of analgesics.

When prescribing treatment, the doctor must strictly adhere to its basic principles:

• The dosage of painkillers for oncology is selected individually based on the severity of pain, it is necessary to achieve its disappearance or an acceptable level for advanced cancer with minimal possible quantity medication taken;
• The drugs are taken strictly in time, and not as the pain develops, that is, the next dose is administered before the previous one stops working;
• The dosage of drugs is increased gradually, only if the maximum amount of a weaker drug is ineffective, a minimum dosage of a stronger one is prescribed;
• Preference should be given to dosage forms taken orally, used in the form of patches, suppositories, solutions; if ineffective, a transition to the injection route of administering analgesics is possible.

The patient is informed that the prescribed treatment should be taken hourly and in accordance with the frequency and dose specified by the oncologist. If the medicine stops working, it is first changed to an analogue from the same group, and if it is ineffective, they move on to stronger analgesics. This approach allows you to avoid an unreasonably rapid transition to strong drugs, after starting therapy with which it will no longer be possible to return to weaker ones.

The most common mistakes that lead to the ineffectiveness of a recognized treatment regimen are considered to be an unreasonably rapid transition to stronger drugs, when the capabilities of the previous group have not yet been exhausted, prescribing too much high doses, causing the likelihood of side effects to increase sharply, while the pain is not relieved, as well as non-compliance with the treatment regimen with skipping doses or increasing the intervals between doses of drugs.

I stage of analgesia

When pain occurs, non-narcotic analgesics are first prescribed - non-steroidal anti-inflammatory, antipyretic:

1. Paracetamol;
2. Aspirin;
3. Ibuprofen, naproxen;
4. Indomethacin, diclofenac;
5. Piroxicam, movalis.

These drugs block the production of prostaglandins that cause pain. The peculiarity of their action is that the effect ceases upon reaching the maximum permissible dose; they are prescribed independently for mild pain, and for moderate and severe pain - in combination with narcotic drugs. Anti-inflammatory drugs are especially effective when tumors metastasize to bone tissue.

NSAIDs can be taken either in the form of tablets, powders, suspensions, or by injection in the form of painkillers. The route of administration is determined by the attending physician. Considering the negative effect of NSAIDs on the mucous membrane of the digestive tract when administered enterally, it is advisable for patients with gastritis, peptic ulcers, and people over 65 years of age to use them under the cover of misoprostol or omeprazole.

The drugs described are sold in pharmacies without a prescription, but you should not prescribe or take them yourself, without the advice of a doctor, due to possible side effects. In addition, with self-medication, the strict analgesia regimen changes, drug intake may become uncontrolled, and in the future this will lead to a significant decrease in the effectiveness of therapy as a whole.

As monotherapy, pain treatment can be started by taking analgin, paracetamol, aspirin, piroxicam, meloxicam, etc. Combinations are possible - ibuprofen + naproxen + ketorolac or diclofenac + etodolac. Considering the possible adverse reactions, it is better to take them after meals with milk.

Injection treatment is also possible, especially if there are contraindications to oral administration or the effectiveness of the tablets is reduced. Thus, pain-relieving injections may contain a mixture of analgin with diphenhydramine for mild pain; if the effect is insufficient, the antispasmodic papaverine is added, which is replaced by ketane in smokers.

The addition of analgin and diphenhydramine with ketorol can also enhance the effect. It is better to eliminate bone pain with NSAIDs such as meloxicam, piroxicam, xefocam. Seduxen, tranquilizers, motilium, and cerucal can be used as adjuvant treatment at the 1st stage of treatment.

II stage of treatment

When the analgesic effect is not achieved maximum doses means described above, the oncologist decides to proceed to the second stage of treatment. At this stage, progressive pain is relieved with weak opioid analgesics - tramadol, codeine, promedol.

Tramadol is recognized as the most popular drug due to its ease of use, because it is available in tablets, capsules, suppositories, and oral solution. It is characterized by good tolerability and relative safety even with long-term use.

Appointment possible combined agents, which contain non-narcotic painkillers (aspirin) and narcotics (codeine, oxycodone), but they have a final effective dose, after which further use is not advisable. Tramadol, like codeine, can be supplemented with anti-inflammatory drugs (paracetamol, indomethacin).

Painkillers for cancer at the second stage of treatment are taken every 4-6 hours, depending on the intensity of the pain syndrome and the time that the drug works in a particular patient. Changing the frequency of taking medications and their dosage is unacceptable.

Anesthetic injections at the second stage may contain tramadol and diphenhydramine (simultaneously), tramadol and seduxen (in different syringes) under strict blood pressure control.

III stage

A strong pain reliever for oncology is indicated in advanced cases of the disease (stage 4 cancer) and when the first two steps of the analgesic regimen are ineffective. The third stage includes the use of narcotic opioid drugs - morphine, fentanyl, buprenorphine, omnopon. These are centrally acting drugs that suppress the transmission of pain signals from the brain.

Narcotic analgesics have side effects, the most significant of which is considered to be addiction and a gradual weakening of the effect, requiring an increase in dose, so the need to move to the third stage is decided by a council of specialists. Only when it becomes clear that tramadol and other weaker opiates are no longer effective is the prescription of morphine justified.

The preferred routes of administration are orally, subcutaneously, into a vein, or as a patch. It is extremely undesirable to use them in a muscle, as this will cause the patient to experience severe pain from the injection itself, and active substance will be absorbed unevenly.

Narcotic painkillers can disrupt the functioning of the lungs and heart, and lead to hypotension, so if you take them constantly, it is advisable to keep an antidote in your home medicine cabinet - naloxone, which, if adverse reactions develop, will quickly help the patient return to normal.

Morphine has long been one of the most prescribed drugs, the duration of its analgesic effect reaches 12 hours. The initial dose of 30 mg is increased to 60 mg as pain increases and effectiveness decreases, administering the drug twice a day. If the patient received painkilling injections and switches to oral treatment, then the amount of medication increases.

Buprenorphine is another narcotic analgesic that has less severe side effects than morphine. When applied under the tongue, the effect begins after a quarter of an hour and becomes maximum after 35 minutes. Buprenorphine lasts up to 8 hours, but must be taken every 4 to 6 hours. When starting drug therapy, the oncologist will recommend bed rest for the first hour after taking a single dose of the drug. When taken above the maximum daily dose At 3 mg, the effect of buprenorphine does not increase, which the attending physician always warns about.

At constant pain high intensity, the patient takes analgesics according to the prescribed regimen, without changing the dosage on his own and skipping the next dose of medication. However, it happens that during treatment the pain suddenly intensifies, and then prompt treatment is indicated. active remedies- fentanyl.

Fentanyl has several benefits:

Fentanyl can be injected or used in patches. The pain-relieving patch lasts for 3 days, when fentanyl is slowly released and enters the bloodstream. The effect of the drug begins after 12 hours, but if the patch is not enough, then additional intravenous administration is possible until the effect of the patch is achieved. The dosage of fentanyl in the patch is selected individually based on the treatment already prescribed, but older cancer patients require less of it than younger patients.

The use of the patch is usually indicated at the third stage of the analgesic regimen, and especially in case of swallowing problems or problems with the veins. Some patients prefer the patch as a more convenient way taking medication. Fentanyl has side effects, including constipation, nausea, vomiting, but when using morphine they are more pronounced.

In the process of dealing with pain, specialists can use the most different ways administration of drugs, in addition to the usual intravenous and oral ones - nerve blockade with anesthetics, conduction anesthesia of the growth zone of neoplasia (on the limbs, pelvic structures, spine), epidural anesthesia with the installation of a permanent catheter, administration of drugs into myofascial spaces, neurosurgical operations.

Pain relief at home is subject to the same requirements as in the clinic, but it is important to ensure constant monitoring of treatment and correction of doses and names of medications. In other words, you should not self-medicate at home, but you should strictly follow the oncologist’s prescriptions and ensure that the medicine is taken at the prescribed time.

Folk remedies, although very popular, are still not able to relieve the severe pain that accompanies tumors, although there are many recipes on the Internet for treatment with acid, fasting and even poisonous herbs, which is unacceptable for cancer. It is better for patients to trust their doctor and recognize the need drug treatment, without wasting time and resources on the obviously ineffective fight against pain.

Sleep problems (insomnia) with cancer

Insomnia is a situation in which a person is unable to fall asleep or stay asleep at all at night. This situation can cause problems throughout the day, such as fatigue, low energy, poor concentration, and irritability. Most people experience insomnia at least once in their lives, but the risk of insomnia increases with age and with serious illnesses such as cancer.

In one study, 44% of people with breast and lung cancer had trouble sleeping. In another study, insomnia in cancer affected more than half of the patients, although they had metastatic cancer. Insomnia can lead to other cancer-related conditions and worsening symptoms, such as pain, fatigue, or anxiety. It can also reduce a person's ability to cope and cause feelings of isolation. It is no coincidence that one of the conditions leading to recovery from cancer is proper sleep, which allows you to regain strength for the further battle for your life.

Diagnosis of insomnia

Understanding what causes insomnia is important in developing strategies to treat it. To find the causes of insomnia, your doctor will ask you about the following symptoms:

• History of sleep disorder
• Depression, anxiety, or delirium
• Pain, shortness of breath, cough, nausea, or itching
• Use of caffeine, alcohol, or tobacco
• Exit from treatment of the disease
• Side effects of other medications
• Sleep deprivation habit
• Emotional distress or anxiety
• Unfamiliar, noisy, or uncomfortable sleeping environment

Treatment of insomnia in cancer

The goal of managing insomnia in cancer is to achieve good sleep and improving overall quality of life as much as possible during cancer treatment and rehabilitation. Medications may help relieve insomnia, but they should only be used in the short term unless other treatments are ineffective.

The following suggestions may be helpful in treating insomnia:

• Sleep and wake at the same time every day.

Additionally, the following approaches may help:

• Relaxation techniques, which may include music, prayer or meditation, breathing exercises, or professional therapy to obtain biofeedback or hypnosis

Perhaps these articles will be useful to you

Depression in cancer

Shark cartilage in thought

In China, shark cartilage has been a delicacy for centuries. The Chinese consume it in the form of soup.

Cure for cancer

Oncology treatment. Need vigilance

While exploring the possibilities of obtaining reliable information on the issue of oncology treatment, I talked with.

Copyright ©17 Cancer is curable

Sleep is the best medicine! Any person forced to fight an illness needs to sleep well, soundly and long enough. It is important both in the treatment of colds and in the treatment of cancer.

Unfortunately, not all diseases can be cured without help. medications and doctor's help. The immune system doesn't always cope. But he needs help. Even if we are talking about a disease like cancer.

Any doctor will tell you what happens to the immune system during cancer. Cells responsible for the destruction of foreign or own, but diseased cells, are sent to fight the tumor. The patient is already more difficult to tolerate infectious diseases and poisoning: the strength of the immune system goes to fight cancer. The body itself becomes depleted, and the immune system loses its “strength” over time. There are only two ways to restore it - ensure good, healthy sleep and proper diet. Physical activity and fresh air are also necessary.

What should a cancer patient's sleep be like?

First of all, complete. Its duration should be at least 8 hours, and preferably more. Some patients oncology clinics sleep 14-16 hours a day.

Secondly, natural. You should not use sleeping pills and tranquilizers - such artificial sleep doesn't bring much benefit. It is worth taking medications only in extreme cases, when a person cannot fall asleep for many days.

How to ensure healthy sleep?

But this question is more complicated. A person who has just learned of his diagnosis is most likely depressed. This condition also affects the quality of sleep. It is quite possible that this is why doctors do not advise relatives to reveal the diagnosis to the patient and talk about the real state of affairs. Excitement doesn't help good sleep and leads to insomnia and nervous breakdowns.

It is impossible to force anyone to sleep, but it is quite possible to make sure that the patient can fall asleep on time and sleep well.

First, prepare a place to sleep. It is best if it is a separate room, where no one will disturb a person from getting a good night's sleep. The room must be completely silent - the screams of children, the noise of cars and other too loud sounds must be excluded.

The room should be clean and bright. There should be curtains to block light that can be closed if necessary. It is necessary to ventilate the room. Ideally, in summer it is better to sleep with open windows. If the air outside is polluted, it is better to install an air conditioner with a filter.

Secondly, prepare a daily routine. It is important that the regimen does not go astray and the patient sleeps well at night. You should not plan an evening of too long walks or watching long films.

Thirdly, walk more. A walk is not only fresh air and physical activity that is acceptable for any person, but also a great way to spend time and an alternative to watching TV.

Pharmacology and traditional medicine offer many recipes for insomnia. But it is important to understand that you need to fight the problem, and not its consequences. One of the main tasks of a person is to find out the reason that prevents normal sleep and eliminate it. If you can’t do this on your own, you need to consult a therapist or neurologist.

If insomnia is caused by pathologies of the nervous system or diseases, it is necessary integrated approach. Drugs that eliminate neurosis or are aimed at treating pathologies are added to the means for improving sleep.

Difficulty falling asleep is often combined with shallow sleep, accompanied by nightmares and constant awakenings. This does not allow the brain to rest and does not bring the necessary relief. The next morning the person will feel exhausted, the desire to sleep continues throughout the day. In the evening, history repeats itself, and, despite being tired, it takes a long time to fall asleep.

The main causes of insomnia during menopause are:

• tides;
• increased nervousness;
• frequent urge to go to the toilet.

For prolonged insomnia, hormone therapy with estrogen may be required to eliminate the main manifestations of menopause. Additionally, the doctor may prescribe sedatives.

How to prevent insomnia: prevention

Regular insomnia can be controlled with simple rules:

• Don't go to bed too early. According to experts, the most suitable time is 22–23 hours.
• For a good night's sleep, daytime sleep is completely excluded.
• You should not go to bed in a state of irritation. Before going to bed, you need to relax properly: read, listen to music or take a warm shower.
• Intense physical activity in the evening is excluded, but a quiet jog or a short warm-up is welcome.
• The last meal should be at least three hours before bedtime.
• In the evening you should not drink coffee or strong tea.
• A clear schedule is necessary: ​​it is advisable to go to bed at approximately the same time.

Some people have the habit of drinking alcohol-containing drinks before bed, believing that they have a sleeping effect. Light alcohol intoxication can indeed speed up the process of falling asleep, but this is an imaginary improvement: sleep becomes superficial and shallow, fragmented, and is accompanied by frequent waking up.

In addition, alcohol has a delayed effect: within next day a person experiences a hangover syndrome – headaches, a feeling of exhaustion, decreased performance. All this aggravates insomnia.

Creating conditions for falling asleep

To organize the “correct” sleep, you need to take care of suitable conditions for falling asleep. Each person has his own concept of comfort, but there are general rules, recommended for everyone. First of all, this concerns the environment.

• In order for the brain to be able to rest normally, without being distracted by outside stimuli, you need to stop falling asleep while watching TV. It is also not recommended to watch dynamic films before bed that cause vivid emotions - action films, thrillers, horrors and melodramas.
• The bedroom should be cool and fresh. In the warm season, it is advisable to leave the window slightly open; in the cold season, ventilate the room in advance. It is better not to use incense: any “unnatural” smells can become an irritant to the brain, distracting it from sleep.
• The ideal mattress is orthopedic; it should not be too soft or hard. It is recommended to purchase a pillow that is dense and small in size. The best bedding for sleeping is hypoallergenic or made from natural materials.

Drug therapy

For symptomatic treatment, medications are used that speed up the process of falling asleep and reduce the likelihood of frequent awakenings. Can be appointed:

• Z-hypnotics;
• barbiturates;
• benzodiazepines;
• tranquilizers;
• other sleeping pills and sedatives.

The preferred option is Z-group medications: they work quickly and effectively, are not addictive, and have almost no side effects. Your doctor will decide what you can take for insomnia in a particular case. The drugs are sold primarily by prescription.

Benzodiazepines speed up sleep, but have a pronounced sedative effect. Throughout the day, a person feels drowsiness and lethargy, coordination, attention and memory suffer. Suitable for use for insomnia after a stroke.

Large quantities Barbiturates have side effects. They are prescribed only if other drugs do not bring the desired effect.

Tranquilizers calm the central nervous system and have an anti-anxiety and muscle relaxant effect. Prescribed for insomnia caused by anxiety, depression, neurotic conditions, psychosis, fears.

The most famous drug is Phenazepam. Drugs from this group are prescribed only to adults.

Contraindicated during pregnancy, children and adolescents, drivers, and people whose work requires quick and accurate reactions.

Sleeping pills, such as Donormil, speed up falling asleep and increase sleep duration. Prescribed for insomnia of various origins, including:

• V old age;
• with alcoholism;
• for neuroses;
• with ARVI.

Recipes with honey

Some sleep medications are relatively safe and have few side effects. You can take them without medical supervision. But for maximum therapeutic effect, consultation with a specialist is necessary.

If you are not allergic to bee products, a person suffering from insomnia can eat a little natural honey before going to bed. It is also used to prepare special sedatives and healthy mixtures.

You can prepare one of the following:

1. Mix 0.2 kg of liquid honey and three teaspoons apple cider vinegar. You need to take the mixture half an hour before your planned bedtime.
2. Half a medium lemon is finely chopped, combined with a tablespoon of thick honey and mineral water. Everything is thoroughly mixed and infused overnight. Take a teaspoon of syrup in the morning.
3. To two tablespoons of honey add the juice of three lemons and 400–500 g of chopped walnut. Drink a tablespoon half an hour before bedtime.

The simplest option is boiled water or warm milk with honey: a tablespoon per glass of liquid. This remedy works especially well on young children.

Insomnia and alcohol

If we are talking about sleep disturbances after an alcoholic comes out of a binge, you need comprehensive treatment under the supervision of a narcologist.

Even after a short binge, periodically drinking man Self-administration of medications is strictly prohibited. The consequences are the most serious, up to fatal outcome.

To eliminate withdrawal syndrome and normalize sleep, you need:

• reduce alcohol intoxication by lavaging the stomach;
• restore electrolyte balance. A traditional cucumber or cabbage pickle, containing dissolved salts;
• put the nervous system in order. This is facilitated by a calm environment, a ventilated dark room, and safe sedatives - herbal decoctions, which will be discussed below.

Relaxing baths

Warm baths with essential oils, salt or decoctions should help you get rid of stress and get into the right frame of mind.

1. About 200 hop cones are poured into 0.2 l cold water, everything is put on low heat. After boiling, the broth is left on the stove for another 20 minutes. The liquid is filtered.
2. 50 g of mint, calendula and spruce needles are poured into 3 liters of boiling water and infused for an hour.
3. Add 50 g of valerian root to boiling water (3 l), leave for 4–5 hours.

You can also add a few drops of natural lemon balm or mint essential oil to your bath water. A test is done first: 4-5 drops are enough. If no allergic reaction occurs, the number of droplets increases to 15–20.

It is recommended to take baths “with additives” every other day; the course consists of 10 procedures. Duration – no more than 15 minutes. At this time, a person relaxes as much as possible. After finishing bathing, it is advisable not to dry yourself, but simply pat your skin dry with a soft towel.

Ways to combat intoxication of the body due to cancer

In recent years, cases of cancer have increased so much that it can be compared to an outbreak of plague. With each disease, at a certain stage of progression, intoxication of the body occurs. In the case of oncology, a similar phenomenon occurs when running forms cancer.

There are two options for intoxication:

1. Self-poisoning. When a person is poisoned by the decay products of a malignant cancer, which, thanks to the circulatory system, spread throughout the body, infecting and infecting everything in its path.
2. Poisoning as a result of cancer treatment. This happens when undergoing chemotherapy. Its main components are poisons and toxins that inhibit the growth and development of cancer cells. But, unfortunately, they accumulate in the body, adversely affecting and poisoning it.

Signs of intoxication in oncology mainly depend on a number of factors:

• from the location of the cancer;
• forms and stages of flow;
• the scale of the lesion and the size of the oncology;
• presence of metastases;
• age of the patient;
• adaptive abilities of the body and much more;

Symptomatic signs have a wide variety of manifestations, since cancer can settle in absolutely any organ of the human body. But, in medicine, a general list of symptoms has been drawn up, which is usually present in every cancer disease:

In addition to constant drowsiness, patients suffer from insomnia, they often feel dizzy, and experience feverish symptoms. There are symptoms of reduced immunity: poor resistance to temperature changes, rapid acquisition of infectious diseases, long and difficult recovery with various complications.

With cancer, patients constantly complain of aching pain in the joints and muscles. They feel depressed emotional state, absolute indifference to what is happening around, the desire to cry, constant irritability, feelings of anxiety and restlessness.

Along with all the visible factors and symptoms, obvious changes occur inside the body. The main blood parameters change: the erythrocyte sedimentation rate, the total number of leukocytes increases, the protein level decreases, the level of red blood cells decreases and other differences from the norm.

If oncology is not treated in a timely manner, symptoms of anemia, dystrophic manifestations in the myocardium, and renal and pulmonary failure appear.

Since cancer affects each body differently, the severity of symptoms differs for everyone. Some people suffer more from insomnia, while others have a constantly rising temperature. Along with all this, concomitant chronic diseases and acquired complications play an important role.

The main attention should be paid to the choice therapeutic therapy, based on the results obtained upon its completion. A disease such as cancer requires permanent job over yourself and over your body, as well as strong desire live and fight for life with all your strength.

Before carrying out measures aimed at removing intoxication from cancer, it is necessary to understand that poisoning of the body occurs due to the entry of metabolic products and the breakdown of cancer formations into the bloodstream. And in order to relieve the symptoms of intoxication, it is necessary to cleanse the blood of toxins and poisons.

There are several medical methods aimed at combating such poisonings:

• peritoneal dialysis;
• forced diuresis;
• enterosorption;

Peritoneal dialysis

Peritoneal dialysis is a procedure whose actions are aimed at cleansing the blood of toxic and poisonous substances. The technique of such manipulation is based on the use of drainage systems that are installed in abdominal cavity sick.

Injected into the upper tubules special solution– dialysate, it absorbs toxic substances in the abdominal region, and independently exits through the lower tubes. On the first day of the procedure, approximately 20 liters of cleaning solution are administered.

In total, therapeutic procedures last from 2 to 3 days. Dialysis is contraindicated in people with cancer who have adhesions abdominal wall, infectious and purulent processes, too much weight.

Forced diuresis

Forced diuresis. This is a method of detoxification that cleanses the body by increasing the amount of urine.

During the procedure, the total blood volume increases, which reduces the concentration of toxins, and is eliminated during urination. To carry out this manipulation, a special solution is injected into the patient’s vein: glucose, albumin, sodium bicarbonate or another substance.

After this, he is given an injection of Furosimide (a diuretic). It is strictly forbidden to do forced diuresis in case of renal and heart failure, pulmonary and cerebral edema, internal hematoma, vascular thrombosis, increased blood pressure and diseases of the pericardium.

Enterosorption

Enterosorption. This is perhaps the most effective way getting rid of intoxication of the body, which has no contraindications.

The whole process consists in the fact that the patient simply takes a sorbent, the main function of which is to absorb toxic and harmful substances. This drug can be taken either orally or through a tube.

The treatment period for cancer poisoning lasts within five days.

We continue to publish chapters from the book “Palliative Care for Cancer Patients” edited by Irene Salmon (beginning - see “SD” No. 1’2000).

Weakness due to cancer

64% of cancer patients suffer from this unpleasant symptom. With advanced stage cancer, weakness is the most common symptom.

Drowsiness, tiredness, lethargy, fatigue and weakness are experienced differently by each patient. In some cases the situation may be uncontrollable. However, the causes of weakness may be treatable. A thorough examination of the patient and assessment of the situation is the first step towards solving this problem.

A person's life journey ends with his death. You need to be prepared for this, especially if there is a bedridden patient in the family. The signs before death will be different for each person. However, observational practice shows that it is still possible to identify a number of general symptoms that portend the approach of death. What are these signs and what should you prepare for?

How does a dying person feel?

A bedridden patient usually experiences mental anguish before death. In a sane mind there is an understanding of what is to be experienced. The body undergoes certain physical changes, this cannot be ignored. On the other hand, the emotional background also changes: mood, mental and psychological balance.

Some people lose interest in life, others completely withdraw into themselves, and others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his own dignity, more often thinks about the emergency and easy death, asks for euthanasia. These changes are difficult to observe and remain indifferent. But you will have to come to terms with this or try to alleviate the situation with medications.

As death approaches, the patient sleeps more and more, showing apathy towards the world around him. In the last moments, there may be a sharp improvement in the condition, reaching the point that the patient, who has been lying down for a long time, is eager to get out of bed. This phase is replaced by subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.

Bedridden patient: ten signs that death is near

In conclusion life cycle old man or a bedridden patient increasingly feels weak and tired due to lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or a slumber through which voices are heard and the surrounding reality is perceived.

A dying person can see, hear, feel and perceive things and sounds that do not actually exist. In order not to upset the patient, you should not deny this. Loss of orientation is also possible and the Patient becomes more and more immersed in himself and loses interest in the reality around him.

Due to kidney failure, urine darkens to an almost brown color with a reddish tint. As a result, swelling appears. The patient's breathing quickens, it becomes intermittent and unstable.

Under pale skin, as a result of impaired blood circulation, dark “walking” venous spots appear that change location. They usually appear first on the feet. In the last moments, the limbs of a dying person become cold due to the fact that the blood, flowing from them, is redirected to more important parts of the body.

Failure of life support systems

Distinguish primary signs, appearing on initial stage in the body of a dying person, and secondary, indicating the development of irreversible processes. Symptoms may be external or hidden.

Gastrointestinal tract disorders

How does a bedridden patient react to this? Signs before death associated with loss of appetite and changes in the nature and amount of food consumed, manifested by problems with stool. Most often, constipation develops against this background. It becomes increasingly difficult for a patient to empty his bowels without a laxative or an enema.

Patients spend the last days of their lives completely refusing food and water. Don't worry too much about this. It is believed that when dehydrated, the body increases the synthesis of endorphins and anesthetics, which to some extent improve overall well-being.

Functional disorders

How does the condition of patients change and how does a bedridden patient react to this? Signs before death associated with weakening of the sphincters in the last few hours of a person's life include fecal and urinary incontinence. In such cases, you must be prepared to provide him with hygienic conditions by using absorbent linen, diapers or nappies.

Even with an appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may lead to aspiration.

With severe exhaustion, when the eyeballs are severely sunken, the patient is unable to completely close the eyelids. This has a depressing effect on those around you. If the eyes are constantly open, the conjunctiva must be moisturized with special ointments or saline solution.

and thermoregulation

What are the symptoms of these changes if the patient is bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - heard against the background of frequent respiratory movements death rattles. This is due to the movement of mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to place the patient on his side, wheezing will be less pronounced.

The beginning of the death of the part of the brain responsible for thermoregulation is manifested by jumps in the patient’s body temperature in the critical range. He may feel hot flashes and sudden cold. The limbs are cold, the sweating skin changes color.

Road to Death

Most patients die quietly: gradually losing consciousness, in their sleep, or falling into a coma. Sometimes in such situations they say that the patient passed away along the “usual road.” It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.

A different picture is observed with agonal delirium. In this case, the patient’s movement towards death will take place along a “difficult road”. Signs before death in a bedridden patient who has taken this path: psychosis with excessive excitement, anxiety, disorientation in space and time against a background of confusion. If there is a clear inversion of the cycles of wakefulness and sleep, then for the patient’s family and relatives this condition can be extremely difficult.

Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere or run. Sometimes this is speech anxiety, manifested by an unconscious flow of words. A patient in this state can only perform simple actions, without fully understanding what he is doing, how and why. The ability to reason logically is impossible for him. These phenomena are reversible if the cause of such changes is identified in time and treated with medication.

Painful sensations

Before death, what symptoms and signs in a bedridden patient indicate physical suffering?

In general, uncontrollable pain rarely worsens in the last hours of a dying person's life. However, it is still possible. An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain even in such cases causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.

If, when examining an unconscious patient, there is evidence of developing pain, the doctor usually prescribes opiates. You should be careful, as they can accumulate and over time aggravate the already existing problem. serious condition due to the development of excessive overexcitation and seizures.

Providing assistance

A bedridden patient may experience significant suffering before death. Symptom relief of physiological pain can be achieved drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying person.

Experienced doctor at assessment stage general condition the patient can recognize the initial symptoms of irreversible pathological changes cognitive processes. This is primarily: absent-mindedness, perception and understanding of reality, adequacy of thinking when making decisions. You can also notice disturbances in the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.

The choice of methods to relieve suffering, the process of assessing chances and possible outcomes in the presence of the patient, in some cases can itself serve as a therapeutic tool. This approach gives the patient a chance to really realize that he is sympathized with, but is perceived as a capable person with the right to vote and choose possible ways to resolve the situation.

In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertensive drugs. They will only aggravate the suffering and cause inconvenience to the patient. Painkillers, anticonvulsants, antiemetics, and tranquilizers should be left.

Communication with a dying person

How should relatives who have a bedridden patient behave?

Signs of approaching death can be obvious or conditional. If there is the slightest prerequisite for a negative forecast, you should prepare in advance for the worst. By listening, asking, trying to understand the patient’s non-verbal language, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.

Whether the dying person knows about it is not so important. If he realizes and perceives, it makes the situation easier. You should not give false promises and vain hopes about his recovery. It is necessary to make it clear that his last will will be fulfilled.

The patient should not remain isolated from active cases. It’s bad if there is a feeling that something is being hidden from him. If a person wants to talk about the last moments of his life, then it is better to do this calmly than to hush up the topic or accuse him of stupid thoughts. A dying person wants to understand that he will not be alone, that they will take care of him, that suffering will not affect him.

At the same time, relatives and friends need to be prepared to show patience and provide all possible assistance. It is also important to listen, let them talk, and offer words of comfort.

Doctor's assessment

Is it necessary to tell the whole truth to relatives whose family has a bedridden patient before death? What are the signs of this condition?

There are situations when the family of a terminally ill patient, being unaware of his condition, literally spends their last savings in the hope of changing the situation. But even the best and most optimistic treatment plan may not produce results. It may happen that the patient will never get back on his feet or return to an active life. All efforts will be in vain, expenses will be useless.

Relatives and friends of the patient, in order to provide care in the hope of a speedy recovery, quit their jobs and lose their source of income. Trying to ease the suffering, they put the family in a difficult situation. financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.

Knowing the symptoms of inevitably approaching death, seeing irreversible signs physiological changes, an experienced doctor is obliged to inform the patient’s family about this. Aware, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.

Palliative care

Do relatives whose family has a bedridden patient need help before death? What patient symptoms and signs indicate that she should be seen?

Palliative care for a patient is not aimed at prolonging or shortening his life. Its principles include the affirmation of the concept of death as a natural and natural process in the life cycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options have been exhausted, the question of medical and social assistance is raised.

First of all, you need to apply for it when the patient no longer has the opportunity to lead an active lifestyle or there are no conditions in the family to ensure this. In this case, attention is paid to alleviating the suffering of the patient. At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind of the patient and his family.

A dying patient needs not only attention, care and normal living conditions. Psychological relief is also important for him, the relief of experiences associated, on the one hand, with the inability to independently care, and on the other, with the awareness of the fact of his inevitably approaching imminent death. Prepared nurses and master the subtleties of the art of alleviating such suffering and can provide significant assistance to terminally ill people.

Predictors of death according to scientists

What should relatives who have a bedridden patient expect?

Symptoms of the approaching death of a person “eaten” by a cancerous tumor were documented by the staff of palliative care clinics. According to observations, not all patients showed obvious changes in their physiological state. A third of them did not show symptoms or their recognition was conditional.

But in most terminally ill patients, three days before death, a noticeable decrease in response to verbal stimulation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them. The “smile line” in such patients was lowered, and an unusual sound of the voice was observed (groaning of the ligaments).

Some patients also had hyperextension neck muscles(increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids tightly. Of the obvious functional disorders, bleeding was diagnosed in the gastrointestinal tract (in the upper sections).

According to scientists, the presence of half or more of these signs may most likely indicate an unfavorable prognosis for the patient and his sudden death.

Signs and folk beliefs

In the old days, our ancestors paid attention to the behavior of a dying person before death. The symptoms (signs) of a bedridden patient could predict not only his death, but also the future wealth of his family. So, if in the last moments a dying person asked for food (milk, honey, butter) and relatives gave it, then this could affect the future of the family. There was a belief that the deceased could take wealth and good luck with him.

It was necessary to prepare for imminent death if the patient obvious reasons shuddered violently. It was believed that she looked into his eyes. Also a sign of imminent death was a cold and pointed nose. There was a belief that it was for him that death kept the candidate in last days before his death.

The ancestors were convinced that if a person turns away from the light and most of the time lies facing the wall, he is on the threshold of another world. If he suddenly felt relief and asked to be shifted to his left side, then this is a sure sign of imminent death. Such a person will die without pain if the windows and doors in the room are opened.

Bedridden patient: how to recognize the signs of impending death?

Relatives of a dying patient at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen. Not all of the symptoms and signs described above may be present before the death of a bedridden patient.

The stages of dying, like the processes of the birth of life, are individual. No matter how hard it is for relatives, you need to remember that it’s even harder for a dying person. Close people need to be patient and provide the dying person with the best possible conditions, moral support and attention and care. Death is an inevitable outcome of the life cycle, and this cannot be changed.

This is 12-25% of the total about the world, the world, and other things. Ó 45% of the country's borders. About the forms of the world as well as in other countries from the outside world. What's more, this is what you're talking about. we are the faktorovs, the syskas with the yakka y/yy ryak. The same is the same, the following is the following ò Ýôôåêòû ðîñòà îïóõîëè è ëå÷åíèÿ ðàêà, êîòîðûå ìîãóò âûçâàòü íàðóøåíèå ñíà — òðåâîãà, äåïðåññèÿ, áîëü, íî÷íîå ïîâûøåíèå òåìïåðàòóðû, êàøåëü, íàðóøåíèå ïðîõîäèìîñòè äûõàòåëüíûõ ïóòåé, çóä, óñòàëîñòü, ïðèñòóïû æàðà, ãîëîâíûå áîëè, íî÷íûå ïîòû, äèàðåÿ, çàïîð, òîøíîòà, ÷àñòûå ïîçûâû ê ìî÷åèñïóñêàíèþ è íåñïîñîáíîñòü óïðàâëÿòü â ïîëíîì îáúåìå àêòàìè ìî÷åèñïóñêàíèÿ è äåôåêàöèè . Ëåêàðñòâåííûå ïðåïàðàòû, èñïîëüçóåìûå äëÿ ëå÷åíèÿ ðàêà, ìîãóò ÿâëÿòüñÿ ïðè÷èíîé íàðóøåíèé ñíà. Ñòèìóëÿòîðû ÖÍÑ (àìôåòàìèíû, êîôåèí, ïèùåâûå äîáàâêè êîòîðûå ïðèíèìàþò äëÿ ñíèæåíèÿ âåñà è àïïåòèòà), óñïîêîèòåëüíûå ñðåäñòâà è ñíîòâîðíûå ñðåäñòâà (ãëþòåòèìèä, áåíçîäèàçåïèíû, ïåíòîáàðáèòàë, õëîðàëãèäðàò), ïðåïàðàòû äëÿ õèìèîòåðàïèè ðàêà (îñîáåííî àíòèìåòàáîëèòû), àíòèêîíâóëüñàíòû (íàïðèìåð, ôåíèòîèí), àäðåíîêîðòèêîòðîïèí, îðàëüíûå ïðîòèâîçà÷àòî÷íûå ñðåäñòâà, èíãèáèòîðû ìîíîàìèíîêñèäàçû, ìåòèëäîïà, ïðîïðàíîëîë, àòåíîëîë ìîãóò íàðóøàòü ñîí. Êðîìå òîãî, ïðåêðàùåíèå ïðè¸ìà óñïîêîèòåëüíûõ ñðåäñòâ (íàïðèìåð, áàðáèòóðàòîâ, îïèàòîâ, ãëþòåòèìèäà, õëîðàëãèäðàòà, àíòèãèñòàìèííûõ ïðåïàðàòîâ) ìîæåò âûçâàòü íàðóøåíèÿ ñíà. Ðåçêîå èçúÿòèå ñíîòâîðíûõ è óñïîêîèòåëüíûõ ñðåäñòâ ìîæåò ïðîÿâëÿòüñÿ ïîÿâëåíèåì ðàçäðàæèòåëüíîñòè, òðåâîãè, äèñôîðèè, àïàòèè, çàìåäëåíèåì ìûøëåíèÿ, ñèìïòîìàìè îòìåíû è íàðóøåíèåì öèêëîâ ñíà. Ó òàêèõ ïàöèåíòîâ óäëèíÿåòñÿ ôàçà áûñòðîãî äâèæåíèÿ ãëàç, è îíè ÷àùå ïðîñûïàþòñÿ â ýòó ôàçó. Ó íèõ óâåëè÷èâàåòñÿ ÷àñòîòà ïðîáóæäåíèé íî÷üþ ñ ïîâûøåíèåì èíòåíñèâíîñòè âîñïîìèíàíèé î ñíàõ â áîëüøèíñòâå ñëó÷àåâ êîøìàðàõ. Ïðîáóæäåíèå â ôàçó áûñòðîãî äâèæåíèÿ ãëàç ìîæåò áûòü îïàñíî äëÿ áîëüíûõ ñ ñîïóòñòâóþùèìè ÿçâîé æåëóäêà è ñåðäå÷íî-ñîñóäèñòîé ïàòîëîãèåé .  ñòàöèîíàðå ó áîëüíûõ ñ âèçóàëèçèðîâàííûìè ôîðìàìè çëîêà÷åñòâåííûõ íîâîîáðàçîâàíèé íàðóøåíèÿ ñíà ñâÿçàíû ñ íî÷íûìè ïðîáóæäåíèÿìè â ðåçóëüòàòå îñîáåííîñòåé ëå÷åíèÿ ðàêà, øóìà â áîëüíèöå (áîëüíûå íî÷üþ ñòîíóò è êðè÷àò îò áîëè), àêòèâíîñòè ñîñåäåé ïî ïàëàòå. Ñòåïåíü íàðóøåíèé ñíà çàâèñèò îò èíòåíñèâíîñòè øóìà, âîçðàñòà áîëüíîãî, òåìïåðàòóðû â ïàëàòå, óäîáñòâà ïîñòåëè, à òàêæå áîëè è òðåâîãè êîòîðûå èñïûòûâàåò áîëüíîé. Íî ãëàâíûå ôàêòîðû — äåïðåññèÿ, òðåâîãà, ñèìïòîìû, ñâÿçàííûå ñ ðîñòîì ðàêà è ïîáî÷íûìè ýôôåêòàìè õèìèîòåðàïèè è ëó÷åâîé òåðàïèè . Òðåâîãà ìîæåò áûòü âûçâàíà ó äàííûõ áîëüíûõ âîëíåíèÿìè î ïîñëåäñòâèÿõ äèàãíîçà ðàêà, î îïàñíîñòè õèðóðãè÷åñêîãî ëå÷åíèÿ è î ïîáî÷íûõ ýôôåêòàõ õèìèîòåðàïèè è ëó÷åâîé òåðàïèè. Êîãäà ëå÷åíèå çàêîí÷åíî òðåâîãà âîçíèêàåò ïîä âëèÿíèåì ìûñëåé î ïîâòîðíîì âîçíèêíîâåíèè ðàêà. Ïîñëå ñåàíñîâ ëó÷åâîé òåðàïèè áîëüíûå ÷óâñòâóþò óñòàëîñòü, ïîýòîìó ìíîãî âðåìåíè ïðîâîäÿò â ïîñòåëè äíåì, ÷òî âåäåò ê íàðóøåíèþ íî÷íîãî ñíà è èíâåðñèè ñíà. Ãîðìîíàëüíàÿ òåðàïèÿ ìîæåò âûçûâàòü ïðèñòóïû æàðà â òå÷åíèè íî÷è ÷òî íàðóøàåò ñîí. Òàêæå õèìèîòåðàïèÿ ìîæåò âûçâàòü ïðåæäåâðåìåííóþ ìåíîïàóçó èëè ïðè å¸ ïðîâåäåíèè ïîÿâëÿþòñÿ ñèìïòîìû, êîòîðûõ ðàíåå íå áûëî ó áîëüíûõ â ìåíîïàóçå. Ýòî ìîãóò áûòü ïðèñòóïû æàðà êîòîðûå íàðóøàþò ñîí. Õèìèîòåðàïèÿ òàêæå ìîæåò âûçûâàòü òîøíîòó, è ïðåïàðàòû, êîòîðûå ïàöèåíòû ïðèìåíÿþò äëÿ êóïèðîâàíèÿ òîøíîòû, íàðóøàþò ñîí . Ó ïàöèåíòîâ ïðåêëîííîãî âîçðàñòà ÷àñòî íàáëþäàþòñÿ íàðóøåíèÿ ñíà èç-çà âîçðàñòíûõ èçìåíåíèé. Ñîí ó íèõ ïîâåðõíîñòíûé, îíè ÷àñòî ïðîáóæäàþòñÿ, è â ñèëó ýòîãî ó íèõ óìåíüøàåòñÿ îáùàÿ ïðîäîëæèòåëüíîñòü ïîëíîãî âðåìåíè ñíà. Áåñïîêîéñòâî, äåïðåññèÿ, ïîòåðÿ ñîöèàëüíîé ïîääåðæêè, è äèàãíîç ðàêà — ôàêòîðû íàðóøàþùèå ñîí ó ïîæèëûõ ïàöèåíòîâ ñî çëîêà÷åñòâåííûìè íîâîîáðàçîâàíèÿìè . Ó 55% of the total price in other words, this is not the case. These are the synonyms and the other forms. Remarks about the world this is the case with this world. Îäíà èç ïrè÷èí vògî – kîrîòkîå vðåìÿ ïðè¸ìà vâðà÷îî. The ÷ ÷ ÷ ery ï ï ï ä ä ä ery The same, of the same. All the different sides of the world with each other synonymous form: áíîñòü çàñíóòü è ñïòòü (áåññîíèöà) (èíñîìíèÿ); íàðóøåíèÿ öèkëîâ ñía; íaðóøåíèÿ fàç ñía, èëè ÷àñòè÷íûå ïrîáóæäåíèÿ (ïàðîîñîíèÿ); and the meaning of the word. About the forms of the world in Russia, in Russia with all this information. The same is the name of the time for the first time èé ï is the same for the following. Ñåé÷àñ êàê îáúåêòèâíûé èíñòðóìåíò äëÿ äèàãíîñòèêè íàðóøåíèé ñíà ó ïàöèåíòîâ ñ ðàêîì ïðèìåíÿþò àïïàðàò «Ïîëèñîìíîãðàì» ñ åãî ïîìîùü â ïåðèîä ñíà èññëåäóþò ýëåêòðîýíöåôàëîãðàììó, êàðäèîãðàììó, ýëåêòðîìèîãðàììó, ñïèðîãðàììó è îêóëîãðàììó è îöåíèâàþò ìîçãîâûå âîëíû, äâèæåíèÿ ãëàç, òîíóñ ìûøö, äûõàòåëüíóþ è ñåðäå÷íóþ àêòèâíîñòü è èçìåíåíèÿ ïîëîæåíèÿ òåëà â òå÷åíèå ñíà. «Ïîëèñîìíîãðàì» — ãëàâíûé äèàãíîñòè÷åñêèé èíñòðóìåíò ïðè íàðóøåíèÿõ ñíà è ïðèìåíÿåòñÿ ïðè íåâîçìîæíîñòè âûÿâèòü ïðè÷èíû íàðóøåíèé ñíà äðóãèìè ñïîñîáàìè . Ïîñëåäñòâèÿ íàðóøåíèÿ ñíà âëèÿþò íà ïðîãíîç ëå÷åíèÿ è ýôôåêòèâíîñòü ðåàáèëèòàöèè ó ïàöèåíòîâ ñî çëîêà÷åñòâåííûìè íîâîîáðàçîâàíèÿìè. Ïàöèåíòû ñ õðîíè÷åñêèìè íàðóøåíèåì ñíà èñïûòûâàþò ðàçäðàæèòåëüíîñòü, íàðóøàåòñÿ èõ ñïîñîáíîñòü êîíöåíòðèðîâàòüñÿ, ýòî ìîæåò ïðîÿâèòüñÿ îòêàçîì îò ïðîäîëæåíèÿ ëå÷åíèÿ, êîíôëèêòàìè ñ îêðóæàþùèìè, ñíèæåíèåì ñïîñîáíîñòè ïðèíèìàòü îáäóìàííûå ðåøåíèÿ Äåïðåññèÿ è òðåâîãà òàêæå ìîãóò âîçíèêàòü êàê ðåçóëüòàò õðîíè÷åñêèõ íàðóøåíèé ñíà. Íàðóøåíèÿ ñíà êîððåëèðóþò ñ êà÷åñòâîì æèçíè ïàöèåíòîâ ñî çëîêà÷åñòâåííûìè íîâîîáðàçîâàíèÿìè ñíèæàÿ èõ àêòèâíîñòü è íàñòðîåíèå . Âàæíî êàê ìîæíî ðàíüøå íà÷èíàòü ëå÷åíèå íàðóøåíèé ñíà, ÷òîáû îíè íå ïðèîáðåëè õðîíè÷åñêèé õàðàêòåð. Íàðóøåíèÿ ñíà ó áîëüíûõ ñ âèçóàëèçèðîâàííûìè ôîðìàìè çëîêà÷åñòâåííûõ íîâîîáðàçîâàíèé íèâåëèðóþòñÿ â ïðîöåññå ëå÷åíèÿ ðàêà è óñòðàíåíèÿ ïîáî÷íûõ ýôôåêòîâ õèìèîòåðàïèè è ëó÷åâîé òåðàïèè . The same is the same to be the following òühny About the world and the world this is the case with the “legal sons”. Propositions of the “global sys” of the world: the world of the world the form of the syska of the yaya sya, in the world in the world in the world ; between the two countries and the Russian Federation more information; The formula is the same as the alias; this is the case; fäåæäà ía ïàöèåíòå äîëæíà áûtü ñâîáîäíàÿ è ìÐãêàÿ; this is the case with this system; in other words in other words); in other words, in this case regalia; in other words, in the same way Ð ñíà; in other words; about the yurts, and the systs of the yurts çà 4 - 6 episodes more information; çà äâà ÷àñà äî äðåmåíè ñía ìmîæíî óïîtòðåáèò ïðîäóêkò ñ ñ âûñîêèñîî åðæàíåm tòrðètofàíà (íàïrèmåð, ìmîloîka, èíäåékè); in the center of the world about 4 - 6 hours about the world; fig. o sina; this is the world of the world. The same is the following Ø ø ø ø ø ø ø ø þù í ñ ñіcl. Áîëüøîå çíà÷åíèå äëÿ áîëüíîãî ñ âèçóàëèçèðîâàííîé ôîðìîé çëîêà÷åñòâåííîãî íîâîîáðàçîâàíèÿ èãðàåò ýìîöèîíàëüíàÿ ïîääåðæêà. Ïîýòîìó íåîáõîäèìî ïðîâîäèòü ñåàíñû ñåìåéíîé ïñèõîòåðàïèè ñ ðîäñòâåííèêàìè áîëüíûõ, íà êîòîðûõ ïñèõîòåðàïåâò ïîìîãàåò ïîíÿòü, ÷òî ÷óâñòâóåò áîëüíîé ñ ðàêîì è â êàêîé ïîääåðæêå îí íóæäàåòñÿ. Åñëè áîëüíîé íå èìååò ðîäñòâåííèêîâ èëè äðóçåé, êîòîðûå ìîãóò îêàçàòü èì ýìîöèîíàëüíóþ ïîääåðæêó îíè å¸ ìîãóò ïîëó÷èòü â ãðóïïàõ ïîääåðæêè, êîòîðûìè ÿâëÿþòñÿ êëóáû áîëüíûõ ñ îíêîïàòîëîãèåé. ×åì áîëüøàÿ ïñèõîëîãè÷åñêàÿ è ýìîöèîíàëüíàÿ ïîääåðæêà îêàçûâàåòñÿ òàêèì áîëüíûì, òåì ëó÷øå îíè ñïÿò íî÷üþ . Ïñèõîòåðàïèÿ èìååò áîëüøîå çíà÷åíèå â ñíÿòèè òðåâîãè ñâÿçàííîé ñ äèàãíîçîì ðàêà, ãîñïèòàëèçàöèåé è îñíîâíîå ¸¸ çíà÷åíèå èçìåíèòü óñòàíîâêè áîëüíîãî (äàòü ïîíÿòü, ÷òî äèàãíîç çëîêà÷åñòâåííîãî íîâîîáðàçîâàíèÿ íå âñåãäà îçíà÷àåò ñìåðòü) è íàöåëèòü áîëüíîãî íà òî, ÷òî óñëîâèåì åãî èçëå÷åíèÿ íàðÿäó ñ îïåðàòèâíûì ëå÷åíèåì, õèìèîòåðàïèåé è ëó÷åâîé òåðàïèåé ÿâëÿåòñÿ îòñóòñòâèå òðåâîãè, ñíÿòèå ìûøå÷íîãî íàïðÿæåíèÿ è íîðìàëèçàöèÿ ñíà. Áîëüíîé îáó÷àåòñÿ óïðàæíåíèÿì, êîòîðûå ïîìîãàþò ñíÿòü ìûøå÷íîå íàïðÿæåíèå (àóòîãåííàÿ òðåíèðîâêà ïî Äæåêîáñîíó) è äëÿ íåãî ñîçäàþòñÿ èíäèâèäóàëèçèðîâàííûå ôîðìóëû ñàìîâíóøåíèÿ (àóòîãåííàÿ òðåíèðîâêà ïî Êóý) êîòîðûå áîëüíîé ðåãóëÿðíî ïîâòîðÿåò â ñîñòîÿíèè ðåëàêñàöèè. Ïîâòîðåíèå ýòèõ óïðàæíåíèé ïåðåä âðåìåíåì îòõîäà êî ñíó âåäåò ê çàñûïàíèþ â ïðîöåññå èõ ïðîâåäåíèÿ. Ïîçíàâàòåëüíî-ïîâåäåí÷åñêàÿ ïñèõîòåðàïèÿ íàïðàâëåíà íà èçìåíåíèÿ öåëè ó áîëüíîãî îò «ïîòðåáíîñòè ñïàòü» ê ïîòðåáíîñòè «òîëüêî, ñíÿòü ìûøå÷íîå íàïðÿæåíèå» ïåðåä îòõîäîì êî ñíó, ÷òî ñíèìàåò «òðåâîãó îæèäàíèÿ íàðóøåíèé ñíà» è íîðìàëèçóåò ïðîöåññ çàñûïàíèÿ. Òàêæå çàäà÷åé ïñèõîòåðàïèè ÿâëÿåòñÿ îáó÷åíèå áîëüíîãî îòêðûòîìó âûðàæåíèþ ñâîèõ ýìîöèé è ïîòðåáíîñòåé ÷òî ïîìîãàåò â íîðìàëèçàöèè âçàèìîîòíîøåíèé ñ ñîöèàëüíûì îêðóæåíèåì áîëüíîãî è ñïîñîáñòâóåò ñíÿòèþ ýìîöèîíàëüíîãî íàïðÿæåíèÿ . In this regard, in the same way to the other side, the meaning of the word. BALANCES OF SYSTEM ON SYSTEM in the context of the world That's it. In this case, in this case, in the Russian Federation däçàõ - synítovîîîå. It is possible to have the same time The most of the time is the same of the ø ö ñ ñ ä ä ä ñ ñ ï ï ï orth. BALANCED IMAGES AND FASHIONS kek. The reference of the work of the following The most of the time is to On the other hand, in Russia in other words, and in the same way. BIOGRAPHICAL AFFAIRS 24 cases, facsimiles, facsimiles in other words, in other words this is the case with the other countries. This is the same thing. The question of the world's information with the help of other countries, and yellow ones. More information about the world about the world and the world and the world moreover, this is the case. This is the same as the other one, or the other. That's the difference between this and the other side. The most importantly, (permissions), the same ’ The truth about this issue information about the world in the world with the other side and with the other side å ìmîîtåràïèè. The following is the same of the following The following is a matter of the following The same, the following, is the same, the following. About the same and the same way about the other countries. Ìàëûå íåéðîëåïòèêè (íàïðèìåð, òèîðèäàçèí), îêàçûâàþò õîðîøèé ýôôåêò ó áîëüíûõ ñî çëîêà÷åñòâåííûìè íîâîîáðàçîâàíèÿìè ïðè íàðóøåíèÿõ ñíà ñâÿçàííûõ ñ íåâðîçàìè, êîòîðûå ñîïðîâîæäàþòñÿ ñòðàõîì, òðåâîãîé, âîçáóæäåíèåì, íàïðÿæåíèåì, ïîäàâëåííûì íàñòðîåíèåì, íàâÿç÷èâûìè ñîñòîÿíèÿìè à òàêæå ïðè ïñèõîòè÷åñêèõ ðàññòðîéñòâàõ, êîòîðûå ñîïðîâîæäàþòñÿ ãèïåððåàêòèâíîñòüþ è âîçáóæäåíèåì. Ìàëûå íåéðîëåïòèêè ãðóïïû ôåíîòèàçèíà ñ îñòîðîæíîñòüþ íàçíà÷àþò ïðè ðàêå ìîëî÷íîé æåëåçû, âñëåäñòâèå èíäóöèðîâàííîé ôåíîòèàçèíîì ñåêðåöèè ïðîëàêòèíà âîçðàñòàåò ïîòåíöèàëüíûé ðèñê ïðîãðåññèðîâàíèÿ çàáîëåâàíèÿ è ðåçèñòåíòíîñòü ê ëå÷åíèþ ýíäîêðèííûìè è öèòîòîêñè÷åñêèìè ïðåïàðàòàìè . Áàðáèòóðàòû íå ðåêîìåíäóþòñÿ íàçíà÷àòü ïðè õðîíè÷åñêèõ íàðóøåíèÿõ ñíà ó áîëüíûõ ñ âèçóàëèçèðîâàííûìè ôîðìàìè çëîêà÷åñòâåííûõ íîâîîáðàçîâàíèé, òàê êàê ïîñëå ïðåêðàùåíèÿ äëèòåëüíîãî ëå÷åíèÿ âîçíèêàåò ñèíäðîì îòìåíû, ïðîÿâëÿþùèéñÿ áåññîííèöåé, ãîëîâíîé áîëüþ, áåñïîêîéñòâîì. Áîëüøèíñòâî ñíîòâîðíûõ ñðåäñòâ ýôôåêòèâíî â íà÷àëå ëå÷åíèÿ, íî ïðè ðåãóëÿðíîì èõ ïðèìåíåíèè èõ ýôôåêòèâíîñòü ñíèæàåòñÿ, ïðîÿâëÿþòñÿ èõ ïîáî÷íûå ýôôåêòû è îíè ìîãóò ñòàòü ïåðâè÷íîé ïðè÷èíîé íàðóøåíèé ñíà . Àâòîð: Âðà÷-ïñèõîòåðàïåâò, Îäåññêîãî îáëàñòíîãî îíêîëîãè÷åñêîãî äèñïàíñåðà, ê.ìåä.í. Ñóøêî Âÿ÷åñëàâ Âèêòîðîâè÷

Insomnia

The alarm clock has been set for a long time, it’s almost time to get up, and you haven’t slept a wink yet? Insomnia is a fairly common problem for modern people. You don’t have to worry if this problem rarely bothers you. Most likely, in such cases, sleep does not come because you have had a busy day, or you are worried about an upcoming event. When insomnia becomes your frequent guest, you should think about the possible causes and take action.

There are 2 types of insomnia: primary and secondary. The most common type is secondary insomnia; according to various studies, it affects 7 out of 10 people. The causes of secondary insomnia are called various diseases: heart disease, stomach disorders, alcohol, lung disease, stress and depression.

Also, causes of secondary insomnia can be caffeine abuse, change of environment and emotional distress.

Treating secondary insomnia is quite difficult. This is due to the fact that the body has become accustomed to lack of sleep and has learned to cope with it. Those. in fact, you want to sleep, you can say you fall asleep while walking, but you still can’t fall asleep.

Primary insomnia does not depend on any third-party diseases. This is a sleep disorder that needs treatment. Without treatment, it can last more than 1 month. Women and older people are most susceptible to this type of sleep disorder. The causes of primary insomnia can be long-term depression, long trips and frequent change time zones, as well as night work. It is advisable to exclude from life all factors that contribute to the development of insomnia so that it does not become chronic.

Insomnia definitely needs to be treated. You cannot expect this disease to go away on its own. You risk getting even more problems and sleep disturbances.

There are 2 main methods of treatment. The first is to take medications that normalize sleep, and the second is to eliminate the causes of insomnia. Of course, the second path is longer and more difficult. It is not always possible to get rid of insomnia by stopping, for example, drinking coffee in the evenings. But still, before resorting to pharmaceutical methods, we recommend that you work with the causes of your sleep disturbance. If you cannot solve the problem on your own, be sure to consult a doctor, he will be able to choose an adequate treatment plan for you.

Next - Self-treatment of varicose veins
Go to section menu
On this topic, see the article - Why is it difficult to fall asleep?
Tip of the day:
You need to quit smoking. But how? In order to quit smoking, you first need to understand the harm caused to the body by smoking.

What to do if you have insomnia? Elimination of causes

Pharmacology and traditional medicine offer many recipes for insomnia. But it is important to understand that you need to fight the problem, and not its consequences. One of the main tasks of a person is to find out the reason that prevents normal sleep and eliminate it. If you can’t do this on your own, you need to consult a therapist or neurologist.

Various factors can trigger insomnia, including:

If insomnia is caused by pathologies of the nervous system or diseases, an integrated approach is necessary. Drugs that eliminate neurosis or are aimed at treating pathologies are added to the means for improving sleep.

Difficulties falling asleep are often combined with shallow sleep, accompanied by nightmares and constant awakenings. This does not allow the brain to rest and does not bring the necessary relief. The next morning the person will feel exhausted, the desire to sleep continues throughout the day. In the evening, history repeats itself, and, despite being tired, it takes a long time to fall asleep.

How to prevent insomnia: prevention

Regular insomnia can be brought under control with simple rules:

• Don't go to bed too early. According to experts, the most suitable time is 22–23 hours.
• For a good night's sleep, daytime sleep is completely excluded.
• You should not go to bed in a state of irritation. Before going to bed, you need to relax properly: read, listen to music or take a warm shower.
• Intense physical activity in the evening is excluded, but a quiet jog or a short warm-up is welcome.
• The last meal should be at least three hours before bedtime.
• In the evening you should not drink coffee or strong tea.
• A clear schedule is necessary: ​​it is advisable to go to bed at approximately the same time.

Some people have the habit of drinking alcohol-containing drinks before bed, believing that they have a sleeping effect. Light alcohol intoxication can indeed speed up the process of falling asleep, but this is an imaginary improvement: sleep becomes superficial and shallow, fragmented, and is accompanied by frequent waking up.

In addition, alcohol has a delayed effect: over the next day, a person experiences a hangover syndrome - headaches, a feeling of exhaustion, and decreased performance. All this aggravates insomnia.

Creating conditions for falling asleep

To organize the “correct” sleep, you need to take care of suitable conditions for falling asleep. Each person has his own concepts of comfort, but there are general rules recommended for everyone. First of all, this concerns the environment.

• In order for the brain to be able to rest normally, without being distracted by outside stimuli, you need to stop falling asleep while watching TV. It is also not recommended to watch dynamic films before bed that cause vivid emotions - action films, thrillers, horrors and melodramas.
• The bedroom should be cool and fresh. In the warm season, it is advisable to leave the window slightly open; in the cold season, ventilate the room in advance. It is better not to use incense: any “unnatural” smells can become an irritant to the brain, distracting it from sleep.
• The ideal mattress is orthopedic; it should not be too soft or hard. It is recommended to purchase a pillow that is dense and small in size. The best bedding for sleeping is hypoallergenic or made from natural materials.

If a person who has previously suffered from insomnia has already practiced aromatherapy and knows which herbs have a calming effect on their body, you can make a custom pillow with natural ingredients. Will help you sleep:

• chamomile;
• pine needles;
• small hop cones;
• hazel.

These plants are rich in essential oils that have a calming and soporific effect. The main thing is that you like the smells and evoke positive emotions.

Drug therapy

For symptomatic treatment, medications are used that speed up the process of falling asleep and reduce the likelihood of frequent awakenings. Can be appointed:

• Z-hypnotics;
• barbiturates;
• benzodiazepines;
• tranquilizers;
• other sleeping pills and sedatives.

The preferred option is Z-group medications: they work quickly and effectively, are not addictive, and have almost no side effects. Your doctor will decide what you can take for insomnia in a particular case. The drugs are sold primarily by prescription.

Benzodiazepines speed up sleep, but have a pronounced sedative effect. Throughout the day, a person feels drowsiness and lethargy, coordination, attention and memory suffer. Suitable for use for insomnia after a stroke.

Barbiturates have a large number of side effects. They are prescribed only if other drugs do not bring the desired effect.

Tranquilizers calm the central nervous system and have an anti-anxiety and muscle relaxant effect. Prescribed for insomnia caused by anxiety, depression, neurotic conditions, psychosis, and fears. The most famous drug is Phenazepam. Drugs from this group are prescribed only to adults. Contraindicated during pregnancy, children and adolescents, drivers, and people whose work requires quick and accurate reactions.

Sleeping pills, such as Donormil, speed up falling asleep and increase sleep duration. Prescribed for insomnia of various origins, including:

• in old age;
• with alcoholism;
• for neuroses;
• with ARVI.

Drugs without a prescription

Some sleep medications are relatively safe and have few side effects. You can take them without medical supervision. But for maximum therapeutic effect, consultation with a specialist is necessary.

You can buy synthetic or herbal sedatives without a prescription, which include:

Important! Take any medications only as directed, duration treatment course determined individually. Over time, the body gets used to the medications and the effectiveness decreases. Because of this, it is necessary to take intervals between courses, the average duration of which is 1–2 months.

Cancer and insomnia are frequent companions. The reasons for this are as follows:

• Sleep disturbances can be symptoms of the disease itself.
• A person cannot sleep normally due to increased anxiety and shock that developed after the terrible diagnosis was made.
• In oncology treatment, insomnia is pronounced during chemotherapy.

You need to solve the problem with the help of specialists:

• an oncologist who will prescribe gentle drugs;
• a psychologist who will help restore peace of mind;
• chemotherapist, who will adjust the treatment regimen if necessary.

What to do for insomnia during menopause

The main causes of insomnia during menopause are:

• tides;
• increased nervousness;
• frequent urge to go to the toilet.

For prolonged insomnia, hormone therapy with estrogen may be required to eliminate the main manifestations of menopause. Additionally, the doctor may prescribe sedatives.

Insomnia and alcohol

If we are talking about sleep disturbances after an alcoholic comes out of a binge, you need comprehensive treatment under the supervision of a narcologist.

Even after a short binge in a periodically drinking person, self-administration of medications is strictly prohibited. The consequences are the most serious, including death.

To eliminate withdrawal symptoms and normalize sleep, you need to:

• reduce alcohol intoxication by lavaging the stomach;
• restore electrolyte balance. A traditional cucumber or cabbage brine containing dissolved salts will help here;
• put the nervous system in order. This is facilitated by a calm environment, a ventilated dark room, and safe sedatives - herbal decoctions, which will be discussed below.

Decoctions for sound sleep

If you don’t want to resort to using medications, prescriptions will help traditional medicine. Decoctions, tinctures and relaxing teas that can be easily made at home will improve the quality of sleep and give you the opportunity to get enough sleep. Ready-made preparations can be purchased at the pharmacy.

The following recipes are suitable for combating insomnia:

Important! When choosing a remedy for insomnia, take into account individual characteristics body. Any component of the decoction can be an allergen or cause rejection. If negative reactions appear after using the mixture, stop taking it.

Recipes with honey

If you are not allergic to bee products, a person suffering from insomnia can eat a little natural honey before going to bed. It is also used to prepare special sedative and beneficial mixtures.

You can prepare one of the following:

Mix 0.2 kg of liquid honey and three teaspoons of apple cider vinegar. You need to take the mixture half an hour before your planned bedtime.

Half a medium lemon is finely chopped, combined with a tablespoon of thick honey and mineral water. Everything is thoroughly mixed and infused overnight. Take a teaspoon of syrup in the morning.

Add the juice of three lemons and 400–500 g of chopped walnuts to two tablespoons of honey. Drink a tablespoon half an hour before bedtime.

The simplest option is boiled water or warm milk with honey: a tablespoon per glass of liquid. This remedy works especially well on young children.

Relaxing baths

Warm baths with essential oils, salt or decoctions should help you get rid of stress and get into the right frame of mind.

About 200 hop cones are poured into 0.2 liters of cold water, everything is placed on low heat. After boiling, the broth is left on the stove for another 20 minutes. The liquid is filtered.

50 g of mint, calendula and spruce needles are poured into 3 liters of boiling water and infused for an hour.

Add 50 g of valerian root to boiling water (3 l), leave for 4–5 hours.

You can also add a few drops of natural lemon balm or mint essential oil to your bath water. A test is done first: 4-5 drops are enough. If no allergic reaction occurs, the number of droplets increases to 15–20.

It is recommended to take baths “with additives” every other day; the course consists of 10 procedures. Duration – no more than 15 minutes. At this time, a person relaxes as much as possible. After finishing bathing, it is advisable not to dry yourself, but simply pat your skin dry with a soft towel.

Types of intoxication

Intoxication of the body due to oncology

In recent years, cases of cancer have increased so much that it can be compared to an outbreak of plague. With each disease, at a certain stage of progression, intoxication of the body occurs. In the case of oncology, a similar phenomenon occurs in advanced forms of cancer.

There are two options for intoxication:

Self-poisoning. When a person is poisoned by the decay products of a malignant cancer, which, thanks to the circulatory system, spread throughout the body, infecting and infecting everything in its path.

Poisoning as a result of cancer treatment. This happens when undergoing chemotherapy. Its main components are poisons and toxins that inhibit the growth and development of cancer cells. But, unfortunately, they accumulate in the body, adversely affecting and poisoning it.

Signs of intoxication in oncology mainly depend on a number of factors:

• from the location of the cancer;
• forms and stages of flow;
• the scale of the lesion and the size of the oncology;
• presence of metastases;
• age of the patient;
• adaptive abilities of the body and much more;

How does intoxication manifest in a cancer patient?

Symptomatic signs have a wide variety of manifestations, since cancer can settle in absolutely any organ of the human body. But, in medicine, a general list of symptoms has been drawn up, which is usually present in every cancer disease:

In addition to constant drowsiness, patients suffer from insomnia, they often feel dizzy, and experience feverish symptoms. There are symptoms of reduced immunity: poor resistance to temperature changes, rapid acquisition of infectious diseases, long and difficult recovery with various complications. With cancer, patients constantly complain of aching pain in the joints and muscles. They experience a depressed emotional state, absolute indifference to what is happening around them, a desire to cry, constant irritability, a feeling of anxiety and restlessness.

Along with all the visible factors and symptoms, obvious changes occur inside the body. The main blood parameters change: the erythrocyte sedimentation rate, the total number of leukocytes increases, the protein level decreases, the level of red blood cells decreases and other differences from the norm. If oncology is not treated in a timely manner, symptoms of anemia, dystrophic manifestations in the myocardium, and renal and pulmonary failure appear.

Since cancer affects each body differently, the severity of symptoms differs for everyone. Some people suffer more from insomnia, while others have a constantly rising temperature. Along with all this, concomitant chronic diseases and acquired complications play an important role.

The main attention should be paid to the choice of treatment therapy, based on the results obtained after its completion. A disease like cancer requires constant work on yourself and your body, as well as a strong desire to live and fight for life with all your strength.

Ways to combat intoxication of the body due to cancer

Before carrying out measures aimed at removing intoxication from cancer, it is necessary to understand that poisoning of the body occurs due to the entry of metabolic products and the breakdown of cancer formations into the bloodstream. And in order to relieve the symptoms of intoxication, it is necessary to cleanse the blood of toxins and poisons.

There are several medical methods aimed at combating such poisonings:

• peritoneal dialysis;
• forced diuresis;
• enterosorption;

Peritoneal dialysis

Peritoneal dialysis

Peritoneal dialysis is a procedure whose actions are aimed at cleansing the blood of toxic and poisonous substances. The technique of such manipulation is based on the use of drainage systems that are installed in the patient’s abdominal cavity. A special solution, dialysate, is injected into the upper tubes; it absorbs toxic substances in the abdominal area and exits independently through the lower tubes. On the first day of the procedure, approximately 20 liters of cleaning solution are administered. In total, therapeutic procedures last from 2 to 3 days. Dialysis is contraindicated for people with cancer, who have adhesions in the abdominal wall, infectious and purulent processes, and too much weight.

Forced diuresis

Forced diuresis. This is a method of detoxification that cleanses the body by increasing the amount of urine. During the procedure, the total blood volume increases, which reduces the concentration of toxins, and is eliminated during urination. To carry out this manipulation, a special solution is injected into the patient’s vein: glucose, albumin, sodium bicarbonate or another substance. After this, he is given an injection of Furosimide (a diuretic). It is strictly forbidden to do forced diuresis in case of renal and heart failure, pulmonary and cerebral edema, internal hematoma, vascular thrombosis, high blood pressure and pericardial diseases.

Enterosorption

Enterosorption. This is perhaps the most effective way to get rid of intoxication from the body, which has no contraindications. The whole process consists in the fact that the patient simply takes a sorbent, the main function of which is to absorb toxic and harmful substances. This drug can be taken either orally or through a tube. The treatment period for cancer poisoning lasts within five days.

We continue to publish chapters from the book “Palliative Care for Cancer Patients” edited by Irene Salmon (beginning - see “SD” No. 1’2000).

Weakness due to cancer

64% of cancer patients suffer from this unpleasant symptom. With advanced stage cancer, weakness is the most common symptom.

Drowsiness, tiredness, lethargy, fatigue and weakness are experienced differently by each patient. In some cases the situation may be uncontrollable. However, the causes of weakness may be treatable. A thorough examination of the patient and assessment of the situation is the first step towards solving this problem.

First of all, you should find out whether the patient is experiencing local weakness or general weakness. Local weakness can be caused by cerebral neoplasms (monoparesis, hemiparesis), compression spinal cord(mostly bilateral), damage brachial plexus, recurrence of cancer in the axillary region, damage to the lumbosacral plexus, lateral popliteal nerve palsy; as well as muscle weakness in the proximal limb (corticosteroid myopathy, paraneoplastic myopathy and/or neuropathy, paraneoplastic polymyositis and Lambert-Eaton myasthenic syndrome).

Lambert-Eaton myasthenic syndrome (autoimmune syndrome) is a paraneoplastic deviation of the neuromuscular transmission pathway that occurs in 3% of cancer patients with small cell cancer lung and in a few isolated cases in patients with other types of cancer, such as breast cancer and lymphoma. Clinical manifestations of the syndrome include weakness of the legs (25% of patients may also experience weakness of the arms), temporary diplopia (double vision), dysarthria, dysphonia, dysphagia, dry mouth, constipation.

General, progressive weakness may indicate that the patient is close to death. But there are others worth taking into account possible reasons. Causes of general weakness may include anemia, hypercalcemia, adrenal hyperfunction, neuropathy, myopathy and depression. General weakness can be caused by the consequences of surgical treatment, chemotherapy and radiation therapy, as well as the use of medications (diuretics, antihypertensive drugs, hypoglycemics), hyperkalemia, insomnia, fatigue, pain, shortness of breath, general malaise, infection, dehydration, malnutrition.

Depending on the situation, the patient should be prescribed appropriate treatment.

Nursing care for a frail patient should focus on helping the patient to be as active as possible during the day, which will give him a sense of independence. The nurse must monitor and evaluate the effectiveness of the prescribed treatment, report to the doctor about changes in the patient’s condition, teach the patient to lead a correct lifestyle; provide him with support and instill a sense of self-confidence.

The nurse should help the patient observe the rules of personal hygiene, monitor the condition of the skin and oral cavity to eliminate possible complications.

The patient should be convinced of the need to eat and drink (food should be as high-calorie as possible), and also help him eat if the patient is too weak. A weakened patient should not be left unattended when eating or drinking hot food. It is also necessary to assist him when going to the toilet, while ensuring sufficient privacy.

The nurse should provide the patient with psychological support, show friendly concern in order to increase his self-esteem and promote interest in life. The patient should be encouraged, but not forced.

Feelings of weakness and inability to perform usual actions can cause stress in the patient. In this case, a calm discussion of the situation helps. For example, a nurse might tell a patient: “Yes, you are now unable to do many of the things you could do before. But if we try to do it together or put it off until you feel a little better, then we can do it.”

Nursing care should be aimed at preventing possible complications or discomfort associated with the patient's limited mobility. Thus, to prevent painful contractures, massage the limbs and recommend passive exercises to the patient, and correctly positioning weak limbs will help prevent damage to the joints.

Spinal cord compression

This symptom appears in 3% of patients with advanced cancer. Moreover, more than 40% of cases of spinal cord compression occur in patients with breast, bronchial and prostate cancer, the remaining 60% of cases - in patients with kidney cancer, lymphoma, myeloma, sarcoma, head and neck cancer.

Compression of the spinal cord in 85% of cases is caused by the spread of metastases to the vertebral body or pedicle, in 10% by the spread of a tumor through the intervertebral foramen (especially with lymphoma), in 4% by an intramedullary primary tumor.

Most often (in 90% of cases), compression of the spinal cord leads to pain, in 75% of cases - to weakness, in half of the cases - to sensory impairment, and in 40% of cases - to dysfunction of the sphincter.

The onset of pain usually occurs several weeks or months before the onset of other symptoms and signs of spinal cord compression. The occurrence of pain can be caused by metastases in the spinal cord, compression of the nerve root, compression of the long nerve tract of the spinal cord.

The most pessimistic prognosis occurs in patients with rapidly developing complete paraplegia (within 24-36 hours); it is almost always caused by spinal cord infarction due to tumor pressure and thrombosis vertebral artery. Loss of sphincter function is also a bad sign. IN better position there are patients with paraparesis.

The main therapeutic measures in the event of spinal cord compression are the appointment of corticosteroids, which can quickly reduce peri-tumor inflammation, and radiation therapy, which leads to a reduction in the tumor, but over a fairly long period of time.

Surgery is indicated in cases where there is no improvement after steroid and radiation therapy, when there are single metastases in the spine, or when the diagnosis is in doubt.

A nurse, when caring for a patient with spinal cord compression, must provide him with psychological support, since the patient, as a rule, experiences fear, anxiety, and a depressed state due to forced dependence on other people. The nurse must help the patient adapt to a new lifestyle and provide him with the necessary equipment.

Nursing care also includes a number of measures to prevent complications (bedsores, problems with the urinary and digestive systems, etc.), teaching the patient self-help techniques, and teaching his family members how to care; selection and dispensing of medications, as well as analysis of their effect on the patient’s body.

Confusion

Confusion is a human condition that is characterized by disorientation in time, space and the people around him, as a result of which the patient is confused, embarrassed, his thoughts are disordered, and his actions are indecisive. Typically, this condition is caused by some organic disorder, and can also be a consequence of severe emotional stress and various types of mental and psychiatric disorders.

When confusion occurs, first of all, it is necessary to analyze the reasons for the occurrence of such a patient’s condition.

Common causes of confusion include Alzheimer's disease, cerebral atherosclerosis, neoplasms, biochemical changes, organ dysfunction, AIDS, multiple sclerosis, certain medications, environmental changes, depression, fatigue, pain, constipation, urinary retention, infection, dehydration, vitamin deficiency, use of alcohol or psychotropic drugs, smoking.

Causes of acute confusion terminal stage There are quite a lot of oncological diseases (see table). In this case, two main causes (acute and chronic brain syndromes) usually appear in combination with secondary ones.

It is also necessary to carefully analyze the patient’s medical history and obtain as much information as possible from the patient’s relatives. It should be established whether the patient has any damage to the sensory organs, such as deafness, loss of vision, whether there have been long periods in the past when the patient was not fully conscious, what was the mental state of the patient before the onset of the symptom of confusion, whether any - changes in the regimen of taking medications. It is also necessary to find out the patient’s level of knowledge about his diagnosis, whether he has any vascular or infectious diseases, intestinal condition and bladder whether he experiences pain, etc.

When caring for a cancer patient with confusion, special attention should be paid to the environment around him. The room of such a patient should be quiet and well-lit, and all objects that could disturb his peace should be removed from it. The number of staff caring for such a patient should be reduced to a minimum to help him quickly settle down and get used to the people around him. You should also ask one of the patient's family members to stay and help care for him (this is especially important on the first night after hospitalization).

A patient with a disordered thinking process must be shown the same respect and attention as other patients - he deserves it no less than them. It should also be taken into account that the occurrence of confusion in a patient with severe cancer can cause deep psychological trauma to members of his family. For them, having already come to terms with the idea that a person close to them is dying, it can be unbearable to see how he loses his personality, ceases to be the one they knew and loved. In this situation, they also need attention and support.

A nurse caring for a confused patient should act with confidence and kindness. She needs to use all her knowledge, all her experience to find the right tactics for communicating with the patient. Those patients who previously occupied a leadership position in society often perceive information better and make contact more easily than those who have an indecisive character.

The nurse should orient the patient in time and space, share the latest news with him, talk, periodically reminding him of his name, constantly explain and comment on his actions. It will be helpful if the patient's room contains up-to-date newspapers, a clock and a calendar. The nurse should communicate as much as possible with the patient's relatives in order to better know and understand him.

It is very important to keep daily records of observations and assessments of the patient’s condition, which should reflect as fully and in detail as possible everything that happened to him during the day.

Factors that could worsen the situation should be constantly monitored. If the patient's body is dehydrated, he needs to drink constantly; medications that cause negative influence on the patient’s body, it is necessary to fight the infection, if necessary (as prescribed by the doctor and depending on the situation), treat constipation, and, if possible, correct metabolic/biochemical abnormalities.

In terminal agitation/activation, a rare condition that sometimes precedes death (several days or hours before death), when the patient exhibits uncharacteristic restlessness that he cannot control because he is unconscious, administering a sedative is often the only option help.

CAUSES OF CONFUSION

ACUTE BRAIN SYNDROME (DELIRIUM) severe impairment of memory and brain activity relief phenomenon (loss of control over certain aspects of personality) paranoia, hallucinations autonomic sensitivity (sensations related to the autonomic nervous system): restless behavior, sweating, dry mouth, tachycardia some causes of acute brain syndrome may be treatable	Restless/agitated behavior before death	Anxiety	State of detachment	Intoxication	CHRONIC BRAIN SYNDROME (DEMENTIA) slowly developing memory disorder (this process may go unnoticed) insomnia - early symptom. Hence the agitated/restless state at night consciousness is pure, clear
	TERMINAL / END STAGES OF MALIGNANT DISEASE
	Psychosis	Hallucinosis	Rave	Amnesia