A 78-year-old man with an 18-year history of coronary heart disease has been taking medication and is in stable condition.
However, during this period, the family quarreled over the property. The old man was angry and could not sleep at night. One day, when I got up at 2 a.m. to go to the toilet, I suddenly felt a tight feeling in my throat, sweating all over my body, and angina! Quickly stay in bed and take 2 tablets of nitroglycerin for 10 minutes before you can relax. At 5 a.m., I went to sleep and smoked twice more during sleep and after waking up, and both contained 2 tablets of nitroglycerin for several minutes to relieve it. In this way, the old man lived in the hospital.
In hospitalization, blood pressure was 120/70 mmHg and heart rate was 68 beats per minute; ECG had complete right bundle branch block and T wave changes.
After being admitted to the hospital, after active treatment, angina did not recur.
On the 5th day of hospitalization, the family visited and raised the property again. The old man was angry again and had not fallen asleep all night. The next morning at 6:00 a.m. when I got up, I felt that my throat was tight, dry mouth, squeezing in the middle and lower sternum, sweating profusely, and the doctors and nurses arrived and found that the patient was pale, the blood pressure dropped to 100/60mmHg, the heart rate slowed down to 30 times per minute, and the ELECTROCARDI also appeared "complete atrioventricular block, myocardial damage ischemic changes", which is the rhythm of the heart to stop beating. Hurry to rescue, the condition finally stabilized.
As cardiovascular physicians, outpatients often encounter patients who complain of palpitations, increased premature beats, or increased blood pressure due to poor sleep.
The reason for not sleeping well is that some changes have occurred in life, which are called "life events" in medicine. For example, because of schoolwork, physical examinations, and examinations, young people are working overtime and internal volumes, and many middle-aged and elderly people are because of raising the third generation, supporting the elderly, as well as changes in the family, the death of relatives, suffering from malignant diseases and so on.
Because of these changes in life, these events have an impact on people's mental emotions, which affect sleep. Sleep disorders and the decline in sleep quality will affect the patient's body and affect the spirit and emotions, which in turn can affect sleep.
Sleep disorders, the decline in sleep quality, can cause emotional disorders, depression and anxiety, patients can appear all kinds of physical discomfort, because psychological problems will cause physical performance. Patients with pre-existing cardiovascular disease may have fluctuations, aggravation, and even cause acute onset, just like the old man in front of him. In medicine, this is called "double heart disease", and heart disease and mental illness coexist.
To say that people have seven emotions and six desires, it is also a normal reaction to encounter emotional changes in things. However, if this effect continues for a long time, it has always affected people's mental emotions and affected people's sleep, there will be problems. If it lasts for 3 months and half a year, it may be planted with "heart disease".
"Heart disease" is depression and anxiety.
Depression and anxiety are closely related to sleep. With depression or anxiety, sleep problems will occur, it is difficult to fall asleep, wake up early, sleep time changes, and patients will have "can't sleep" and "wake up early". Sleep disorders can aggravate depression and anxiety, which is a two-way regulatory relationship.
Depression and anxiety and cardiovascular disease also have a mutually influencing, mutually causal relationship, and will also aggravate each other.
When studying "double heart disease", some teachers have summarized the relationship between sleep, depression and anxiety, "Not being able to sleep is anxiety, waking up early is depression." Clinically, it seems to make sense.
How to initially screen for mental and psychological problems? Experts give the "three-question method".
Ask three questions:
1. Is there a poor sleep that has affected the daytime state or needs medication?
2. Are you upset and lose interest in something you were previously interested in?
3. Is there any obvious physical discomfort that has not been found after multiple examinations and cannot be explained?
If two of the three questions answer "yes," then the eight achievements are problematic.
If you have a problem, you need to see a psychologist or mental health department.
Earlier, if I had said depression and anxiety and looked at the psychology department, many people would have resisted in their hearts, thinking that people said that they were "thinking wrong". Not really. Depression and anxiety are all disease states, and the reason for the onset of the disease is also based on material basis. Now under research, it is the neurotransmitters in the brain, the chemicals such as dopamine and serotonin secreted by nerve cells, which are unbalanced and out of balance; some examinations also find that some brain cells have problems, so there are mental emotions and sleep abnormalities.
If you have a problem with depression and anxiety and can't sleep well, then taking "sleeping pills" alone may not work well. Such patients need to see psychology and psychiatry to test, diagnose, and treat. Of course, the treatment is not all medication, but also "speech therapy", biofeedback, exercise and other treatment methods.
Therefore, for sleep disorders that cause patients to have symptoms of the cardiovascular system, or because of sleep disorders that cause instability and aggravation of the original cardiovascular disease, it is necessary to pay attention to the detection and treatment of mental and psychological diseases.
Blocking the influence of bad psychological behavior can not only alleviate the symptoms of patients, but also prevent the occurrence and development of cardiovascular disease.
(All rights reserved, may not be reproduced without my authorization!) ）