How long have you not slept well?
I lay down at 10:30, and the surrounding area was quiet, but after two or three hours, my head was still awake.
Mortgages, car loans, and jobs all went through my head and stayed up until dawn with my eyes closed.
(Image source: soogif)
Unable to sleep, it has become a knife hanging over the head of modern people.
Can't sleep all the time, is it a disease? To what extent should I go to the hospital for insomnia?
Let's take a comprehensive introduction this time. (Insomnia is severe, you can jump directly to the second part)
Many people sleep less than 7 hours at night and begin to be anxious and think that they have insomnia.
In fact, "how long to sleep" is not the criterion for judging insomnia.
According to the Guidelines for the Diagnosis and Treatment of Insomnia in Adults in China (2017 Edition)[1] definition:
Insomnia refers to a subjective experience that, despite the right opportunity and sleep environment, is dissatisfied with the time and/or quality of sleep and affects daytime social functioning.
Sounds a bit complicated?
To put it simply: insomnia is a subjective experience, which cannot be judged simply by looking at the time of sleep, but also depends on whether it affects the daytime study and work, whether there are accompanying health problems, etc. [2, 3].
This effect includes: feeling tired and uncomfortable; inattention or not being able to remember things; short temper; easy agitation, etc...
Some people are born with a buff that sleeps less, or sometimes even if they sleep less, but the quality of sleep is high, and the next day the spirit is very full, which is not insomnia.
Many times, because you have important tasks the next day (interview, debriefing, exam, etc.), you occasionally lose sleep once or twice, or work overtime or stay up late to cause poor sleep, which is not insomnia.
These situations do not need to be overly nervous, adjust your work and rest, and generally sleep well.
If you are in this situation of occasionally not sleeping well, give you 7 tips to help you sleep:
1. Sleepy and then go to bed, establishing psychological cues between "bed" and "sleeping".
2. Don't drink tea, drink coffee or eat before going to bed, and try not to think about complicated things or brush drama.
3. Wake up in the morning.
4. Even if the previous day's sleep is not good, the next day's sleep time should not be too long (try to be within 30 to 40 minutes), and at night, you should maintain the usual sleep time.
5. Do not bring a mobile phone to bed, and even recommend not to bring it into the bedroom, so that the brain and body will form a memory of playing with the mobile phone in bed.
6. Moderate exercise (150 to 300 minutes of moderate-intensity aerobic activity per week, such as brisk walking, dancing, etc.), but not too late, do not do strenuous exercise before going to bed [4,5].
7. Meditation, reading is more conducive to sleep, do not believe you take a book to read, within half an hour you may be sleepy.
How does mindfulness meditation work?
If you can't sleep for a long time, and you have physical discomfort, which seriously disrupts the rhythm of life, don't carry it yourself, you can seek the help of a doctor.
This is not a fuss.
Insomnia, like colds and fevers, requires the help of a doctor if necessary. Only by obediently treating can we heal as soon as possible.
Mild insomnia can be adjusted according to their own situation, moderate to severe insomnia (15 points and above) and obviously affect daily life, remember to go to the hospital in time.
This scale is one of the most commonly used sleep self-assessment scales and is highly credible [6,7]. However, it is not the gold standard for diagnosis and can be used as a reference.
Doctors treat insomnia, not as scary as you might think.
Doctors will decide how to treat insomnia based on the severity of insomnia and different causes, commonly:
1. Psychotherapy [1,8]
(1) Cognitive behavioral therapy:
Insomnia mentioned earlier is actually a subjective feeling, if you are too worried about the impact of insomnia because of severe insomnia, often feel anxious about it, the doctor will help you establish a correct and rational attitude, change the perception of insomnia.
(2) Stimulation control therapy:
Through some guidance, help patients establish a regular biological clock. For example: do not lie in bed if you are not sleepy, do not sleep during the day; get up when you wake up, do not lie in bed and think blindly; no matter how late you sleep, you must maintain a regular wake-up time.
(3) Relaxation therapy:
Listen to music, take a deep breath, massage, etc.
In addition, doctors will also guide the improvement of some bad sleep habits, such as drinking coffee before going to bed, brushing drama and so on.
2. Take medicine
In order to allow patients to recover as soon as possible, doctors will also prescribe some drugs.
It mainly plays a role in calming and aiding sleep, relieving anxiety, and improving sleep structure [9,10].
Many people are worried that sleeping pills have side effects, which will lead to mental and neurological problems, and may also form dependence, so they would rather carry them than eat them.
Don't worry about it.
Sleeping pills, like other drugs, do have some side effects (e.g., dry mouth, lack of strength) [11].
Under the guidance of a doctor, the side effects on the body are definitely less than the damage of insomnia to the body (long-term insomnia may induce a series of disorders, such as anxiety, depression, migraines, etc.).
Just like taking some fever-reducing drugs, you may want to sleep because of side effects, but the body will also win the hard battle of fever with the help of drugs, which is more beneficial than harmful.
There are also many people who are worried about the dependence of drugs.
In fact, as long as it is not a long-term large number of drugs, follow the doctor's advice, generally will not become addicted.
However, such sleep aids cannot be bought and used by themselves!
Small reminder:
There are many over-the-counter drugs or nutritional supplements for insomnia on the Internet, such as melatonin and folk remedies, which have limited authoritative evidence on their efficacy and safety [12], and are recommended for consultation with a doctor.
Finally, I wish you all a good night's sleep today, tomorrow, and the day after tomorrow!
Contributing Author: Hu Qiuhui
Zhejiang University
Review expert: Song Chongsheng
Deputy Chief Physician of the Department of Psychiatry, Beijing Huilongguan Hospital
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[10] HISHIKAWA Y. Appropriate use of benzodiazepines in insomnia: clinical update [J]. J Clin Psychiatry, 1991, 52 Suppl: 10-3.
[11] SULLIVAN S S. Insomnia pharmacology [J]. Med Clin North Am, 2010, 94(3): 563-80.
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Review: Zhao Yanan, Zhang Jie, Zhang Liang
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Wu Wei