Sleep disturbance manifests itself in subjective feeling lack of rest. This illness consists of prolonged falling asleep, disruption of sleep depth and time of awakening. More than 30% of the world's population are diagnosed with such disorders. The phenomenon often occurs in old age, but can also be a problem in the younger generation. The etiological factors for each disease differ significantly.

Etiology

The causes of sleep disturbances in a child arise from excessive excitability of the nervous system. Even a little stress can lead to illness. In adults, sleep disturbances can be caused by somatic problems. These indicators include:

• cardiovascular pathologies;
• endocrine diseases;
• disorders of the neuropsychic system;
• wrong exchange substances.

Sleep disturbances occur only in those people who are highly susceptible and hypersensitive to various situations. It is psycho-emotional stress that can lead to a person beginning to develop insomnia.

Another reason is taking medications. The disorder also manifests itself when consuming caffeinated drinks, drug or alcohol abuse.

During pregnancy, women especially often experience difficulty falling asleep. The disease can be caused by both physiological and pathological problems. The first category includes the following reasons:

• difficulty in finding an acceptable pose;
• all over the back;
• fetal movement;
• itching in the abdominal area;

During pregnancy, pathology can develop due to exacerbation of such factors - fatigue, stressful and nervous tension, nightmares and fears.

Classification

Clinicians have determined that sleep disturbance has various reasons manifestations that can be classified according to different criteria. The disease itself also manifests itself in several forms. Thus, based on the duration of the illness, doctors determined:

• short-term insomnia;
• chronic.

By etiological factor There are primary and secondary, which are caused by early mental disorders, diseases or medications.

To diagnose a disease, it is very important for the doctor to determine the type of disease according to the classification presented below. Therefore, sleep disorders have the following types:

• insomnia – difficulty falling asleep. Manifests itself from mental illness, from taking medication or alcoholic drinks, from respiratory problems, from nocturnal myoclonus and “ restless legs»;
• – pathological drowsiness. Develops from the above factors;
• temporary disturbance of sleep and periods of wakefulness;
• parasomnia - manifests itself in a violation of the functional spectrum, which is associated with sleep, determination of sleep phases, and defective awakening. They are formed from movement during night rest, fears and anxieties, epileptic seizures and other functional failures.

Symptoms

Symptoms of sleep disorders in children and adults can manifest themselves in general clinical picture, characterized by various manifestations:

• feeling of lack of sleep;
• it is impossible to fall asleep at the usual time, which is accompanied by anxiety, fear and obsessive thoughts;
• restless rest with frequent awakenings;
• when falling asleep, the time of wakefulness comes earlier than usual and the person cannot fall asleep a second time, or sleep may be too restless (such sleep disturbances appear in older people and in depression);
• lack of restored strength after rest;
• and naps during the day;
• fatigue;
• anxiety before falling asleep.

When the patient suffers from insomnia, he falls asleep too late, he is tormented by strange thoughts and it is difficult to find a comfortable position.

If the illness is formed from the abuse of alcoholic beverages or medications, sleep becomes small phases, since everything fast periods are significantly shortened and the patient wakes up at night. After a person stops taking too much alcohol, the restoration of the regime begins within a week.

With a disorder from, a person complains of constant uncontrolled movements of the legs, feet, or thumb. They last only 2 seconds, but can be repeated frequently.

Violation of the regime manifests itself in falling asleep during attacks during the day. This disorder manifests itself when traveling, eating, monotonous work or an overly active process.

Disruption of normal sleep patterns and wakefulness occurs from moving to different time zones or changing work schedules. Adaptation in this case occurs in 2–3 days. Sleep disturbance in adults is characterized by the following manifestations:

• hard to fall asleep in certain time;
• falling asleep early in the evening or getting up too early;
• non-24-hour sleep-wake syndrome.

If the patient develops against a background of fears, then such panic attacks may be accompanied by strong discharge sweat, dilated pupils. A few minutes later, normal condition is restored and the person falls asleep.

In infants, bedwetting is also a manifestation of sleep disorder. Often in a newborn, such a symptom manifests itself as physiological reasons, because it is not yet developed enough urinary system. It may also be a sign of a violation of the regime in older children who have learned to go to the toilet on their own. In the second case, the symptom is pathological.

Patients may also exhibit the following additional indicators:

• with apnea – snoring, drowsiness, difficulty concentration, ;
• with –, pain in the facial muscles, temples, jaw, decrease hard tissue teeth, appearance.

Diagnostics

To determine how to treat a sleep disorder, the patient first needs to consult a doctor. WITH similar problem a person should consult a somnologist.

For examination, doctors prescribe polysomnography with cardiorespiratory analysis - special sensors record a person’s sleep and all manifestations. After completion of the experiment, data on electroencephalography, electrooculography, electromyography, electrocardiography, respiration, and blood oxygen saturation are analyzed.

Such an examination makes it possible to determine the following nuances as accurately as possible:

• cycle ratio;
• their change;
• other factors affecting sleep.

The disorder can be diagnosed in another way - by identifying average latency. This method will allow the physician to determine the root cause of drowsiness and identify narcolepsy if it has developed in the patient. The experiment is carried out on the basis of 5 attempts to fall asleep while awake. Each time a person has 20 minutes to fall asleep. A second attempt is made two hours later. The average sleep latency is revealed over all attempts of a person. If the indicator is more than 10 minutes, then this is normal; within 5–10 minutes is an extreme indicator of the norm; less than 5 is abnormal drowsiness.

Treatment

After diagnosing a sleep disorder, the treating doctor prescribes treatment. There are many ways in medicine to treat this pathology. However, if the symptoms turned out to be insignificant, the person does not develop serious complications, then you can get by with simple rules:

• go to bed at your usual time and familiar surroundings, before going to bed, it is advisable to ventilate the room, you can walk a little outside, take warm bath or read a book;
• distribute time for work and rest;
• use sedatives from natural ingredients;
• It is recommended to exclude all caffeine-containing drinks;
• Avoid alcohol 6 hours before bedtime.

Drug treatment of sleep disorders is based on taking the following drugs:

• sedatives;
• antidepressants;
• sleeping pills.

In addition to drugs and general rules conducting healthy way life, what else can be done to eliminate the disease? Doctors advise people with this problem to resort to physiotherapeutic procedures. Therefore, the patient is prescribed:

• pine baths;
• electrophoresis;
• electrosleep;
• hypnotherapy;
• autogenic training.

The drugs allow you to cope perfectly with the pathology, but you can also use non-drug methods. Often patients are prescribed acupuncture. It helps normalize all phases of sleep, reduce latent sleep, restore normal duration and depth of rest, reduce the manifestation of neuropathic symptoms.

To eliminate sleep disturbances in children, parents need to strictly follow the recommendations of doctors. To do this, you need to carry out the following activities:

• keep a sleep diary in which you record the time of falling asleep and waking up, night wakefulness, and the child’s behavior during the day;
• walk on fresh air, feed correctly and at the same time;
• ventilate the child’s room, observe temperature regime and humidity;
• reduce the activity of the baby or older child in the evening;
• maintain a calm and loving family environment.

During pregnancy, women also have special treatment rules, namely:

Sleep disorders are among the most common clinical problems arising in medicine and psychiatry. Insufficient or poor quality sleep can significantly worsen a patient's quality of life.

The sleep disorder may be primary or may result from various psychiatric and medical conditions.

Primary sleep disorders typically result from an endogenous disruption of sleep-wake mechanisms, often complicated by behavioral conditioning. All sleep disorders can be divided into the following two broad categories:

• Parasomnias are unusual experiences or behaviors that occur during sleep. These include nightmares and sleepwalking, which occur during stage 4 sleep, as well as nightmares that occur during rapid eye movement.
• Dyssomnia is characterized by deviations in the quantity or quality of sleep. Disorders include primary insomnia and somnolence, narcolepsy, breathing disorders (sleep apnea), and circadian rhythm sleep disorders.

It is important to distinguish these primary sleep disorders from secondary sleep disorders. Sometimes, anxiety and depression cause problems with sleep or, conversely, these phenomena are secondary to the problem of night rest.

Since sleep quality and quantity requirements vary from individual to individual, insomnia is considered clinically significant if the patient perceives sleep loss as a problem.

Types and Types of Sleep Disorders

Under one general definition a fairly large set of different sleep disorders may be hidden, manifesting themselves according to their type and individual manifestation in the patient.

The most common types of sleep disorders include:

• Bruxism is the involuntary grinding or clenching of teeth during sleep.
• Delayed sleep phase is the inability to wake up and fall asleep an acceptable number of times, but this disorder is not a sleep problem or a circadian rhythm disorder.
• Hypopnea syndrome is abnormally shallow breathing or slow breathing during sleep.
• Idiopathic somnolence has a primary neurological cause long sleep, which has much in common with narcolepsy.
• Primary insomnia is chronic difficulty falling asleep or staying asleep when these symptoms are not detected.
• Klein-Levin syndrome is characterized by persistent episodic hypersomnia along with cognitive or affective changes.
• Narcolepsy, including excessive daytime sleepiness, often involves falling asleep spontaneously bad time. It is also often associated with cataplexy, a sudden motor weakness in the muscles that can lead to falls.
• Nightmares or fear of falling asleep.
• Nocturia - frequent urination during the night period. The disorder is different from enuresis, or urinary incontinence, in which a person urinates without waking up.
• Parasomnia, or disruptive sleep, is associated with the involvement of inappropriate behaviors during sleep, such as sleepwalking or a reaction to night terrors.
• Periodic limb movement disorder is sudden, involuntary movement of the arms or legs during sleep, such as kicking. The disorder is also known as nocturnal myoclonus.
• Rapid eye movement during sleep leads to uncontrolled aggression and frequent harm to the health of oneself and the sleeping person nearby.
• Restless legs syndrome is an irresistible urge to move your legs while you sleep.
• Sleep pattern shift is a situational circadian rhythm sleep disorder. Often observed when changing time zones.
• Sleep apnea, obstructive sleep apnea. Obstruction respiratory tract during sleep, resulting in a lack of sufficient deep sleep often accompanied by snoring. Other forms of sleep apnea are less common. When air is blocked in the lungs, a person subconsciously increases the rhythm of breathing and sleep is disturbed. Stopping breathing for at least ten seconds and 30 times during eight hours of sleep is classified as apnea. Other forms of sleep apnea include central apnea and hypoventilation.
• Sleep paralysis is characterized by temporary paralysis of the body shortly before or after sleep. Paralysis may be accompanied by visual, auditory, or tactile hallucinations. Often considered as part of narcolepsy.
• . Vigorous activity, without the effect of waking up - walking or eating.
• Somniphobia - fear of sleep. One of the causes of sleep deprivation is the fear of falling asleep. Signs of illness include anxiety and panic attacks before and while trying to fall asleep.

Types of sleep disorders:

• Primary hypersomnia is of central origin.
• Narcolepsy - chronic neurological disorder, caused by the inability of the brain to control periods of sleep and wakefulness.
• Idiopathic hypersomnia - chronic neurological disease, similar to narcolepsy, but characterized by an increased feeling of tiredness during the day. Patients who suffer from idiopathic hypersomnia are unable to get a healthy amount of sleep to ensure productivity during the day.
• Periodic drowsiness, including Klein-Levin syndrome.
• Post-traumatic drowsiness.
• Menstrually-related drowsiness.
• Breathing disorders during sleep.

Medical or psychiatric conditions that may cause sleep disturbances:

• psychoses and more complex psychopathological conditions, for example, schizophrenia;
• mood disorders;
• depression;
• anxiety;
• panic;
• alcoholism.

Diagnosis of sleep disorders and possible complications

Insomnia can be expressed as a decrease in sleep efficiency or a decrease in the total number of hours of sleep, which is associated with a decrease in productivity or overall quality of life. Because sleep requirements vary from person to person, quality of sleep is more important than total quantity. The total number of hours spent sleeping should be compared with the average nightly sleep duration for each person.

Depending on clinical manifestations There are several types of insomnia:

• Initial insomnia is characterized by difficulty falling asleep and an increase in period latent phase sleep - the time between sleep and falling asleep. Initial insomnia is often associated with anxiety disorders.
• Mid-sleep insomnia is characterized by difficulty maintaining sleep. Reduced efficiency is present along with fragmented restless sleep and frequent awakenings during the night. This type of sleep disorder may be associated with medical illness, pain syndromes or depression.
• Terminal insomnia. Patients constantly get up earlier than they should. This symptom is often associated with major depression.

Some additional clinical characteristics sleep disorders:

• Changes in your sleep-wake cycle may be a sign of circadian rhythm disorder.
• Hypersomnia, or excessive daytime sleepiness, is often associated with ongoing sleep deprivation or poor sleep quality due to reasons ranging from sleep apnea to substance abuse or medical diagnoses;
• With delayed sleep phase syndrome, the patient is unable to fall asleep until the morning. Over time, the onset of sleep gradually delays.
• Nightmares repeat awakenings again and again, caused by vivid and painful feedback real life. Nightmares usually occur in the second half of the sleep period. Night terrors, caused by recurrent episodes of abrupt awakening from sleep, are characterized by panicked screams and strong fear against the background of vegetative arousal.

Signs of a sleep disorder include the following:

• hypertension, which may be caused by sleep apnea;
• loss of coordination due to sleep deprivation;
• drowsiness;
• poor concentration;
• slower reaction time;
• weight gain.

Mood disorders and anxiety disorders may develop with sleep disorders not affected by therapeutic effects. Current medical research support the theory that these changes mental state brain, are risk factors for morbidity and mortality due to the development of secondary medical conditions, e.g. cardiovascular diseases.

Correction and treatment of sleep disorders

Patient education proper hygiene sleep is the cornerstone of treatment:

• The sleeping bed should only be used for its intended purpose. It is not advisable to use it for watching TV or reading, especially before bed.
• Caffeine and activities that stimulate an adrenaline rush should be avoided, especially later in the day. Relaxation methods before bed are highly recommended.
• Light to moderate physical exercise every day is the key to good sleep.
• Maintaining a regular sleep and wake schedule. Dozing should be avoided daytime.
• Don't look at your watch at night, it's better to put it away.

Other interventions:

• Sleep apnea can be relieved by weight loss, continuous positive airway pressure, and special methods and hardware, and sometimes surgical treatment.
• Sleepwalking and other manifestations of nocturnal activity must be combated in all possible ways.
• Light therapy is useful for sleep disorders associated with circadian rhythm disorders. Patients may be exposed to bright light, such as natural light sunlight, which can help normalize your sleep patterns.
• Cognitive behavioral therapy is effective means for the short-term treatment of insomnia, like sleeping pills, but some patients can achieve complete remission with one of these treatments.

Diversity computer programs are commercially available that use wristbands or motion detection technologies built into smartphones to detect and record a patient's sleep cycles and nocturnal behavior. This information is then used to assess sleep duration and quality and make suggestions on how he can get more consistent and refreshing sleep.

Pharmacological therapy

Many drugs are really useful. Short term drug therapy is preferred to restore normal structure sleep. In general, sleeping pills are approved for two weeks or less of continuous use. At chronic insomnia, longer courses may be prescribed that require long-term monitoring to ensure continued appropriate use of the medications.

Barbiturates and chloral hydrate are rarely used nowadays, due to safety concerns associated with their undesirably low therapeutic indices.

Diet and activity

Not required special diet for the treatment of insomnia, but eating excessive amounts of food and spicy foods should be avoided at least three hours before bedtime.

In addition, it is necessary to exclude alcohol, nicotine and caffeine. Alcohol creates the illusion of good sleep, but this negatively affects its architecture. Nicotine and caffeine stimulate the central nervous system and should be avoided in the afternoon.

Consuming tryptophan-containing foods can help induce sleep, a classic example being warm milk.

Serious physical activity during the day can help improve sleep, but the same exercise three hours before bed can cause initial insomnia. Intense movies, novels, exciting television shows, challenging arguments and vigorous exercise are detrimental to healthy sleep.

They are a fairly common problem. Frequent complaints of poor sleep are reported by 8-15% of the total adult population globe, and 9-11% use various sleeping pills. Moreover, this figure among older people is much higher. Sleep disorders occur at any age and for everyone age category are characterized by their own types of violations. Thus, bedwetting, sleepwalking and night terrors occur in childhood, and pathological drowsiness or insomnia is more common in older people. There are also sleep disorders that, starting in childhood, accompany a person throughout his life, for example, narcolepsy.

As drug therapy For sleep disorders, benzodiazepine drugs are more often used. Preparations with short time actions - triazolam and midazolam are prescribed for disorders of the process of falling asleep. But when taking them there are often adverse reactions: agitation, amnesia, confusion, and impairment morning sleep. Long-acting sleeping pills - diazepam, flurazepam, chlordiazepoxide - are used for early morning or frequent awakenings at night. However, they often cause daytime sleepiness. In such cases, medium-acting drugs are prescribed - zopiclone and zolpidem. These drugs have a lower risk of developing dependence or tolerance.

Another group of drugs used for sleep disorders are antidepressants: amitriptyline, mianserin, doxepin. They are not addictive and are indicated for elderly patients, patients with depressive states or those suffering from chronic pain syndrome. But a large number side effects limits their use.

In severe cases of sleep disturbance and in the absence of results from the use of other drugs in patients with confused consciousness, antipsychotics with a sedative effect are used: levomepromazine, promethazine, chlorprothixene. In cases of pathological drowsiness mild degree weak central nervous system stimulants are prescribed: glutamine and ascorbic acid, calcium supplements. For severe disorders, use psychotonics: iproniazid, imipramine.

Treatment of sleep rhythm disturbances in elderly patients is carried out comprehensively using a combination of vasodilator drugs ( nicotinic acid, papaverine, bendazole, vinpocetine), central nervous system stimulants and mild tranquilizers plant origin(valerian, motherwort). Reception sleeping pills can only be carried out as prescribed by a doctor and under his supervision. After completing the course of treatment, it is necessary to gradually reduce the dose of the drug and carefully reduce it to nothing.

Forecast and prevention of sleep disorders

As a rule, various disorders dreams are cured. Treatment of sleep disorders caused by a chronic somatic disease or occurring in old age presents difficulties.

Compliance with sleep and wakefulness, normal physical and mental stress, correct use drugs that affect the central nervous system (alcohol, tranquilizers, sedatives, sleeping pills) - all this serves to prevent sleep disorders. Prevention of hypersomnia consists of preventing traumatic brain injury and neuroinfection, which can lead to excessive drowsiness.

Kalinov Yuri Dmitrievich

Reading time: 7 minutes

Sleep disturbance in adults is the scourge of our time. Often problems with night rest, insomnia and other disorders cause serious illnesses. Why do they appear and how to get rid of them?

Sound, healthy sleep allows a person to rest and recharge with energy for the whole day. The modern rhythm of life and constant stress lead to the fact that about a third of the population suffers from insomnia, or insomnia. Defective night rest leads to a deterioration in the quality of life and increases the likelihood of developing dangerous diseases. Therefore, it is important to identify the cause of the problem in time and begin treatment.

Types and symptoms of sleep disorders (insomnia)

Rest needs vary from person to person. For some, six hours is enough to fully restore strength, while others need to sleep at least eight to nine. Problems due to lack of sleep at night can occur periodically or be chronic. There are several types of deviations with different symptoms:

1. Presomnia disorder, or difficulty falling asleep. A person may toss and turn in bed for hours trying to fall asleep. This is usually accompanied by obsessive thoughts and anxiety.
2. Intrasomnic. A person wakes up many times a night without obvious reason, after which it is difficult for him to fall asleep again. Sleep is often accompanied by nightmares.
3. Post-somnia – short nap, early awakening. Many people dream of learning to get up early, but in this case the person does not feel that he got enough sleep because the amount of rest was insufficient. This is a reason to think about your health and eliminate sleep disturbances.

Another sign of somnological problems is the constant feeling that night rest even with normal duration does not give the required effect. The person feels “broken” and tired.

If these symptoms do not go away long time, it is recommended to seek help from a specialist. Frequent awakenings at night may have serious consequences for health: immunity decreases, the risk of developing cardiovascular diseases, diabetes, breast cancer, and obesity increases significantly.

How would you characterize the sleep disorder that is bothering you?

Poll Options are limited because JavaScript is disabled in your browser.

Difficulty falling asleep: I can toss and turn in bed for several hours. 39%, 312 votes

I constantly wake up in the middle of the night, and then it is difficult to fall back to sleep. 29%, 236 votes

Sleep does not bring a feeling of rest, regardless of the number of hours spent in bed. I always want to sleep! 18%, 142 vote

I wake up too early in the morning, regardless of my bedtime. 14%, 111 votes

12.03.2018

A very common problem in modern world. Similar complaints come from approximately 10-15 percent of the adult population, about 10% of people on the planet use various sleeping pills. Among older people, this figure is higher, but violations occur regardless of age, and certain age categories are characterized by their own types of violations. For example, night terrors and urinary incontinence occur in children, insomnia or pathological sleepiness in older people. There are disorders that, having appeared in childhood, accompany a person throughout his life. For example, narcolepsy.

Primary and secondary disorders

Sleep disorders are classified into primary and secondary. The former are not associated with the pathology of any organs, but the latter arise as a consequence of various diseases.

Sleep disorders can also often occur with problems with the central nervous system or mental disorders. With many somatic diseases a person suffers from pain, shortness of breath, cough, and does not sleep at night.

Drowsiness often occurs in cancer patients due to intoxication. Pathological sleepiness may be a symptom hormonal disorders for tumors, encephalitis.

Classification of sleep disorders

Doctors identify several main types of such disorders. Let's look at the most common ones.

Insomnia is a disorder that occurs during the process of falling asleep, causing prolonged insomnia. They are often associated with therefore can occur temporarily as well as permanently.

Often, insomnia is caused by such causes of sleep disturbance as taking medications or alcohol. Insomnia is provoked by: chronic alcoholism, long-term use of drugs that depress the central nervous system. nervous system, abrupt withdrawal of sedatives or sleeping pills.

Another type is called hypersomnia. This is increased sleepiness. Psychophysiological may be associated with psychological state may be caused by drinking alcohol or medications, mental illness, narcolepsy, and other pathological conditions.

Sleep disturbances are caused by disruptions in wakefulness and sleep patterns. Parasomnia is also widespread, that is, a malfunction in the functioning of human systems and organs associated with awakening or sleep. Causes of sleep disturbances: somnambulism, night terrors, urinary incontinence, epileptic seizures happening at night.

Symptoms

Symptoms vary and depend on the type of sleep disorder in adults or children. It is worth noting that any problems with sleep can soon lead to changes in emotional state, decreased attentiveness and performance. Schoolchildren may have problems with studying and mastering the material. Often, a patient turns to a doctor for help, not suspecting that the reasons lie precisely in insomnia.

Let us now analyze the symptoms in more detail, considering what consequences they lead to. or insomnia can be considered non-chronic if it lasts less than three weeks. People who suffer from sleep disorders - insomnia, first cannot fall asleep, and then constantly wake up in the middle of the night. They often wake up early in the morning in a broken state, without enough sleep, and this leads to emotional instability, irritability, and chronic fatigue.

The situation is aggravated by the fact that patients with these problems wait with increasing anxiety every night, imagining what it will lead to. Time passes much slower at night, especially when a person suddenly wakes up and then cannot fall asleep. His emotional state suppressed under the influence of various psychological factors.

Often after stress subsides, sleep also normalizes. Often, problems with falling asleep become a habit, the situation only gets worse, and constant insomnia develops.

Insomnia, which is caused by alcohol or medications, often leads to a phase REM sleep is reduced, because of this the patient begins to wake up regularly at night. If long-term use stop drinking alcohol, the body will return to normal rhythm in about two weeks.

When sleep disturbance in adults occurs as a consequence of taking potent drugs that affect the nervous system, the effect of such a drug decreases over time, and increasing the dose may only lead to a temporary improvement in the situation. Sleep problems may worsen even as your dosage increases. In such a state, a person often wakes up, and a clear boundary between sleep phases disappears.

At mental illness insomnia is accompanied by a feeling of severe restlessness at night, as well as a superficial and very light sleeper. A person often wakes up and feels tired and apathetic during the day.

The diagnosis of sleep disturbance is made with the so-called sleep apnea syndrome. At this time, the flow of air in the upper respiratory tract temporarily stops; such a pause may be accompanied by motor restlessness or snoring. Doctors distinguish obstructive apnea, which occurs due to the closure of the upper respiratory tract during inspiration, and central apnea, which is usually associated with disorders in the respiratory center.

Restless legs syndrome can also often lead to insomnia. It arises in the depths calf muscles, constantly requiring the body to move its legs. This uncontrollable desire often occurs before bedtime.

Another reason for sleep disturbance lies in involuntary flexion movements in the leg that occur at night, and sometimes in thumb or foot. This bending can last about two seconds and be repeated after half a minute.

Narcolepsy

In narcolepsy, disorders are characterized sudden attacks falling asleep during the daytime. Such disturbances are usually short-lived and may occur during a trip to public transport, after eating, due to monotonous work, and sometimes due to prolonged physical activity.

In this case, narcolepsy is often accompanied by attacks of cataplexy. This is the name given to a sudden loss of muscle tone, which can even cause the patient to fall. The attack is usually associated with severe emotional reaction, for example, laughter, anger, surprise or fear.

Insomnia is often caused by disturbances in wakefulness and sleep patterns. This occurs when changing time zones or a constant schedule of intense shift work. Such problems disappear after two to three days.

IN medical practice Delayed sleep syndrome also occurs, which is characterized by the physical inability to fall asleep at certain hours. Because of this, it is not possible to establish a normal schedule of rest and work on weekdays. Patients with this disorder manage to fall asleep no earlier than two o’clock in the morning or even by the morning. Only on weekends or on vacation do they not have problems sleeping.

Rarely do they consult a specialist when premature sleep syndrome is detected. Although outwardly he may not bother them at all. The patient falls asleep quickly, has a good night, but wakes up too early and then goes to bed early. Such disorders usually occur in people old age and do not cause them any particular discomfort.

Rarely, but still, non-24-hour sleep syndrome occurs, due to which a person cannot live in a normal day. The biological day of such patients increases to 25-27 hours. Such disorders are popular among people with personality disorders and the blind.

Sleep disturbances during menopause are common. It is during menopause that restless legs syndrome manifests itself. During this period, the level of the main female sex hormone, estrogen, sharply decreases. This is what causes insomnia and other sleep problems. Doctors advise going to bed early during menopause, eliminating all unnecessary sources of light, and starting to prepare the body for sleep as early as 7 pm. If you still need to work in the evening, then try to use directional light by turning off the central lighting in the room.

Children's problems

Sleep disorders in children are most often caused by several diagnoses. One of them is somnambulism, which, having manifested itself in childhood, can accompany the patient throughout his life.

The essence of the disease lies in the unconscious repetition of certain actions during sleep. Such people can get up at night, walk around the room, perform some actions, without realizing it at all. At the same time, they do not wake up, and attempts to wake them up can lead to actions that are dangerous to their life and health. Most often, this condition lasts no more than a quarter of an hour. After this, the person returns to bed and continues to sleep or wakes up.

Often they occur in the first hours of the patient's sleep. He may wake up in a panic in the middle of the night. Such conditions are accompanied by rapid breathing, tachycardia (strong heartbeat), sweating, and the pupils are dilated. Only after calming down and coming to his senses can the patient fall asleep. In the morning, there may be no memories of the nightmare at all.

Nocturnal urinary incontinence occurs during the first third of sleep. Such sleep disturbance in children is classified as physiological if they are very young, and pathological if the child has learned to go to the toilet on his own.

Diagnosis of insomnia

In order to find out what to do about sleep disorders, it is important to make a correct diagnosis. Polysomnography remains one of the most common research methods. It is carried out in a special laboratory in which the patient remains overnight.

A somnologist conducts the examination. Now it’s clear which doctor treats sleep disorders. If you have such problems, you need to contact a specific specialist.

During the diagnostic process, the patient sleeps in a special laboratory, and his sleep is monitored large number sensors that record cardiac activity, bioelectrical activity of the brain, breathing movements chest, inhaled and exhaled during sleep air flow, the process of saturating the blood with oxygen.

Everything that happens in the ward is recorded on a video camera, and the doctor on duty is always nearby. So detailed and detailed examination makes it possible to thoroughly study the state of the brain, how all body systems function at each of the five stages of sleep, determine what deviations from the norm exist, and, accordingly, find the causes of your problems.

Another diagnostic method is called average sleep latency testing. It is usually used for excessive sleepiness and is extremely important in determining narcolepsy.

The essence of the study is five attempts to fall asleep, which must be carried out during the person’s normal waking hours. Each attempt is given 20 minutes, with a break between them of two hours.

Particular attention with this method is paid to average sleep latency - this is the time it takes the patient to fall asleep. The norm is 10 minutes. If it is in the range from 5 to 10 minutes, then this is a borderline value, and less than 5 minutes is already pathological drowsiness.

Treatment of insomnia and its consequences

Another doctor who deals with sleep problems is a neurologist. The treatment he prescribes for the sleep disorder will depend on the identified causes. If a somatic pathology is identified, therapy will be aimed at combating the underlying disease.

If the depth of sleep and its duration decrease due to the patient’s age, then this process is considered natural and usually requires only an explanatory conversation with the patient.

If you can't sleep

It is important to ensure that the patient follows the general rules healthy sleep before starting treatment with sleeping pills. A person should not try to sleep when overexcited or when he is angry, do not eat a lot before going to bed and do not drink alcohol at night, do not drink alcohol several hours before going to bed strong tea and coffee, don't sleep during the day. Maintain good physical fitness, exercise, but do not do any exercise at night. Keep your bedroom clean and tidy.

If you have problems sleeping, then it is recommended to go to bed and get up at approximately the same time, and if you still cannot fall asleep within half an hour, then you should get up and do distracted activities. The desire to sleep should appear on its own. Nightly calming treatments are recommended, e.g. warm bath or a walk. Relaxation methods and psychotherapy help to cope with insomnia.

Drugs against insomnia

Tablets for sleep disorders are often benzodiazepine drugs. When the process of falling asleep is disrupted, medications with a short duration of action are prescribed. These include "Midazolam" and "Triazol". Taking them increases the likelihood side effects- amnesia, confusion, excessive agitation.

To medications long acting include "Flurazepam", "Diazepam", "Chlordiazepoxide". They are taken when waking up frequently and can cause drowsiness during the day. Zolpidem and Zopiclone, which are believed to have an average duration of action, will help cope with this. The risk of becoming dependent on them is much lower.

For insomnia, antidepressants are often taken. They are not addictive and are good for older people suffering from chronic pain or depression. These are Mianserin, Amitriptyline, Doxepin. They also have plenty of side effects.

In severe cases of sleep disorders, antipsychotics with a sedative effect are used. These are "Promethazine", "Levomepromazine", "Chlorprothixene". Elderly people are often prescribed vasodilators. Papaverine, nicotinic acid, and Vinpocetine can help you fall asleep. Remember that any sleeping pills can only be taken as prescribed by a doctor, and after completing the course, the dose should be gradually reduced to get rid of addiction.

There are also over-the-counter sleeping pills that can help with insomnia. But it also needs to be taken with caution. Donormil, which will prolong the period of sleep, and Melaxen, which will compensate for the lack of the hormone melatonin in the body, can help. "Sonylux" is produced in the form of drops, which has a sedative effect. This is also a sleeping pill without a prescription. Helps overcome anxiety and feelings of aggression.

One of the most popular and widespread means is Valocordin. Although it is sold over the counter, it contains a barbiturate. Helps cope with painful sensations in the heart, psychomotor overexcitation.

Prevention of insomnia

It is not easy to cure insomnia, so it is effective to prevent sleep disorders.

To do this, you need to scrupulously follow a routine, go to bed on time and get up in the morning, give the body moderate physical and mental stress. Carefully use drugs that affect the central nervous system, and also monitor the intake of alcohol, sleeping pills and sedatives.

Prevention of hypersomnia will include the prevention of traumatic brain injuries, as well as neuroinfections, which can cause excessive drowsiness.