Verification expert: @ Neurology Dr. Wang 丨 Attending Physician of the First Affiliated Hospital of Xinxiang Medical College
Sleep is the most basic physiological needs of the human body, about 1/3 of a person's life is spent in sleep, the old saying is good: "Go to bed early and get up early, no disease provokes you." ”
It can be seen how important high-quality sleep is to the body.
In life, many people have a lot of misunderstandings about "insomnia", and they always feel that insomnia is not to be able to sleep, not to cure diseases.
But in fact, this is a wrong perception.
Insomnia should not only be treated, but also treated in time.
Many people have experienced insomnia in their lifetime.
Foreign studies have shown that only 12% of people without any sleep problems [1], insomnia is the most common type of sleep disorder, and its harm to the human body may be far beyond your imagination.
First of all, we must first clarify the definition of insomnia.
"Insomnia ≠ can't sleep"
Insomnia is a sleep disorder characterized by frequent and persistent difficulty falling asleep and/or difficulty maintaining sleep, and leading to unsatisfactory sleep sensations.
To put it simply, when you can't sleep for a period of time, you can't sleep, you can't wake up easily when you fall asleep, and you always feel that you don't sleep well, you have to pay attention, it is likely to be "insomnia".
The most important feature of insomnia is that it is frequent and persistent, so if you have difficulty falling asleep 1 to 2 times, you don't have to worry too much.
"Insomnia is a complex disease that should not be taken lightly"
The most common symptoms in people with insomnia include:
Difficulty falling asleep (time required to fall asleep for more than 30 minutes) is often accompanied by a precarious awakening at night;
Long-term awakening, insufficient sleep time and poor sleep quality[2];
Therefore, the types of insomnia are basically divided into difficulty falling asleep, early awakening, sleep-wake disorders, poor sleep quality and so on.
Among them, difficulty falling asleep and waking up early may account for the largest proportion.
Therefore, many people think that insomnia is just not being able to sleep, no big deal.
In fact, insomnia is a very complex disease, and long-term non-attention to insomnia may cause serious diseases.
There are many studies in this regard, such as insomnia may be a trigger for cardiovascular disease, cardiovascular disease can also aggravate sleep disorders [3], and the length of sleep is also an important indicator of cardiovascular disease prognosis [4].
Long-term insomnia also increases the risk of Developing Alzheimer's Disease (Alzheimer's Disease) in old age.
Studies have shown that insomnia is closely related to Alzheimer's disease, and pathological changes such as aβ deposition, neurotransmitter system imbalance, and circadian rhythm disturbances may be involved [5].
Insomnia and hypertension, diabetes, and depression are also mutually causal.
Many patients with chronic diseases themselves have the problem of insomnia, and worse, long-term insomnia will make these chronic diseases more serious.
Therefore, we must face insomnia scientifically, and do not delay treatment because of contempt.
Why do people have insomnia?
The answer given by many people is: think too much.
For such an answer, it cannot be said that it is all wrong, and some people's insomnia is indeed a psychological factor.
But the causes of insomnia are far from simple.
Some people have a harmonious family, a smooth job, and a cheerful personality, and they also suffer from insomnia. Why?
"Causes of Insomnia"
At present, there are four mainstream theories about the pathogenesis of insomnia:
1. Hyper-arousal mechanism;
2. Neurotransmitter mechanisms;
3. Neuro-endocrine-immune mechanisms;
4. Psycho-environmental factors;
Let's talk about them one by one.
The hyper-arousal mechanism provides an important theoretical basis for the mechanism of insomnia occurrence and maintenance.
Experts and scholars have emphasized the close connection between over-arousal and insomnia through 3p models, psychophysiological models, and neurocognitive models.
This mechanism is complex, and to put it bluntly, insomniacs have excessive arousal both night and day [6] (both day and night).
The neurotransmitter mechanism is relatively simple.
That is, the patient's neurotransmitters associated with sleep are disturbed, which leads to the occurrence of insomnia.
There is a two-way information transmission between the nerve-endocrine-immune network, which regulates the sleep rhythm through hormones, neurotransmitters, immune factors, etc., and maintains homeostasis.
But there is still relatively little research on this aspect, which may provide some new ideas for the treatment of insomnia in the future.
Finally, the most familiar psychological-environmental factors.
Excessive stress, a discordant family environment, or emotional disorders such as anxiety and depression can lead to insomnia.
In this way, a little insomnia is indeed not a simple thing.
You've all heard it. In the face of such a person to debunk rumors, jun can only say young too simple.
Earlier we said that insomnia is not only a disease, but also a serious disease that may lead to cardio-cerebral system diseases.
Therefore, we should pay attention to insomnia.
There are many ways to treat insomnia, and the following methods are commonly used:
"Non-Pharmacological Treatment"
The most important thing about non-pharmacological treatment is to establish a healthy lifestyle:
Improve the sleep environment and adhere to regular sleep time;
Exercise appropriate activities during the day, control nap time, but avoid excessive exercise 3 hours before bedtime;
Pay attention to a reasonable diet, dinner is best done 3 hours before bedtime, avoid drinking alcohol or caffeinated drinks before going to bed;
Cognitive behavioral therapy: Common include music therapy, light therapy, sleep restriction, stimulation control therapy, and progressive relaxation training.
"Medication"
If non-pharmacological therapy is ineffective, drug therapy is recommended, and commonly used drugs include benzodiazepines, antidepressants, orexin receptor antagonists, etc.
Benzodiazepines are the most common "sleeping pills", which can directly inhibit the central nervous system, shorten the sleep latency, reduce the number of nighttime awakenings, and sedative hypnosis.
Now some new benzodiazepines have the advantages of short half-life and few side effects, and are used more and more clinically.
Antidepressants For patients with cognitive impairment with symptoms of depression and anxiety, a new generation of antidepressants, such as mirtazapine and trazodone, may be considered.
Appetite receptor antagonist – Suvolesin is effective in treating insomnia and is the first orexual receptor antagonist. It is a new type of drug for the treatment of insomnia.
However, the rumor-busting Jun reminds everyone that after insomnia, they should go to a regular hospital for treatment, and under the guidance of professional doctors, they should carry out targeted treatment for the symptoms. Drugs are a double-edged sword, do not use them yourself.
Regarding sleeping pills, you can also click to see this article written by the rumor-busting jun before: "Often take sleeping pills when you can't sleep? Taking sleeping pills indiscriminately, the consequences are more serious than you think].
I hope that today's article can help you establish a correct understanding of insomnia, and you can't take insomnia lightly in the face of insomnia, nor do you have to be like a big enemy.
As long as everyone responds scientifically, it will no longer be difficult to get a comfortable and high-quality sleep.
bibliography WANG Tong, DONG Jiaqi, SONG Yan, WU Yue. Research progress on influencing factors related to sleep disorders in the elderly[j]. Geriatrics and Health Care, 2021, 21(1):197-199. Hu Hua, Wu Yonghua. Sleep disorders and Alzheimer's disease[j]. Chinese Journal of Geriatrics Research Electronics, 2020, 7(3):41-47. Cao Yuan, Xu Yanmin. Effects of sleep disorders on cardiovascular disease[j]. Chinese Journal of Cardiovascular, 2020, 25, (1):86-88. [4] cappuccio fp，cooper d，d'elia l，et al. sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies［j. eur heart j, 2011, 32 (12):1484-1492. doi:10. 1093/eurheartj/ehr007. [5] spira ap, gottesman rf. sleep disturbance: an emerging opportunity for alzheimer's disease prevention[j] int psychogeriatr, 2017, 29(4):529-531. [6] riemann d，spiegelhalder k，feige b,et al.the hyperarousal model of in-somnia:a review of the concept and its evidence[j].sleep med rev,2010,14(1):19-31． Han Muzhen. More traditional medical methods for improving sleep[j]. Jiangsu Health Care, 2021,(02):42.