Problems with sleep: causes, symptoms

Sleep is an important element of human life. And although we do not sleep for 16 hours a day, like a coteyki, we need no less a dream. During those 6-9 hours, which are given to sleep by the average person, the body has enough time to rest and recover for fruitful work during the day. Such a rest is necessary for the body to improve mental processes, restore energy and strength, stabilize protective functions, so when there are problems with sleep, we do not just feel sleepy and broken during the day, our health suffers.

Do not think that during the night sleep the body completely turns off. Its organs and systems continue to function, but are already less active, which makes it possible to save and accumulate the energy necessary to work during the day. Quiet work without loads - this is a complete rest for our bodies, which they really need, otherwise it wears out and gradually begins to fail. Is this not the reason to think about the quality of your sleep and about what it is for the body: rest or an additional, exhausting force load?

[1], [2], [3], [4], [5]

Causes of the problems with sleep

Without being distracted by the whole variety of sleep disorders, let's try to determine the main pathological and physiological causes that can cause such violations:

• Mental disorders. Probably, many immediately in front of him are schizophrenic or paranoid, who, of course, are characterized by sleep disorders. In fact, we are talking about more everyday pathologies, such as stresses, neuroses, depression, strong emotional experiences, phobias.
• Exertion of the body and brain in particular as a result of excessive physical or mental stress.
• Non-compliance with sleep and wakefulness (conscious or unconscious).
• Neurological and other syndromes, manifested in increased unconscious physical activity or breathing disorders at night.
• Abuse of alcohol, taking drugs, smoking.
• Intoxication of an organism of any etiology.
• Abuse of heavy fatty and sweet food in the evening, overeating, late dinner.
• Active therapy with psychotropic drugs and drugs that stimulate or vice versa depress the activity of the central nervous system, the uncontrolled use of hypnotics.
• Acute and chronic diseases of internal organs.
• Metabolic disorders, hormonal imbalance due to disruptions in the endocrine system.
• Organic pathologies of the brain, including benign and malignant neoplasms.
• Pain syndrome of different localization.

[6], [7], [8], [9], [10]

Risk factors

Risk factors for the appearance of various sleeping problems include unfavorable conditions for night rest: uncomfortable bed, extraneous annoying smells, intense light, loud noises, unsuitable temperature regime and humidity in the room. Problems with sleep can be expected if one strains the brain on the eve of going to bed, which is the case with evening work with a computer, reading, watching TV, etc.

At school age, a habit of doing homework late at night can cause insomnia and sleep disturbances, after which the brain remains awake for a long time. Older students and students can observe pre-examination insomnia or sleep disorders on the basis of love experiences.

[11], [12], [13], [14], [15], [16], [17], [18], [19]

Pathogenesis

Problems with sleep - this is a general concept, which combines various violations of night recreation of a person. The most common problem is, of course, insomnia. According to statistics, 10 to 20% of the population have difficulty falling asleep. And then it is only about this complaint. And in fact, insomnia means not only problems with falling asleep, but also early awakenings well before the appointed hour, episodes of interruption of sleep in the middle of the night, half asleep. That is all that does not allow the body to fully rest during the night.

This is one side of the coin. And on the other hand, we see only those cases when a person really turned to specialists for sleep disorders. But most of us do not hurry to visit doctors with such a problem, considering it temporary and not dangerous. It turns out that if you dig a little deeper, the statistical picture turns out to be completely different, but even less comforting.

In addition to insomnia, which is scientifically called "insomnia," there are other sleep disorders:

• Hypersomnia (by analogy with insomnia, you can understand that it is an excess of sleep or increased sleepiness),
• Parasomnia (in this case, imply violations in the work of various organs, occurring only during sleep),
• Violation of biological rhythms.

Consider these pathologies of sleep in more detail, proceeding from the fact that each of them has its own psychological and pathological causes.

Insomnia

Insomnia (insomnia) is understood as a violation of sleep, sleep and awakening processes, as a result of which the total number of hours of sleep during the night is not sufficient for proper rest. A person either does not sleep at night, or sleep takes from 0.5 to 4 hours, although normal recovery usually requires 6 to 9 hours of sleep for recovery.

It is clear that all these figures are approximate, because each person is individual. Someone can have enough and 4 hours of deep quiet sleep to have a good rest, and another and after a 9-hour rest will feel overwhelmed.

The time that we need for proper rest depends:

• from age (for children who grow and grow up in a dream, and also for old people, whose body is worn out and needs a long rest, it takes more time than young adults)
• from a way of life (an active way of life with a large expenditure of energy requires more time to rest and restore the body than a sedentary one),
• from the type of activity (occupations with heavy physical or intellectual labor should be compensated by 8-9 hours of normal sleep, so that labor productivity lasts for a long time)
• from the state of health, etc.

But the question now is not so much about the time of sleep, but about the fact that a person can not use the time allotted for sleep to the destination. He can not fall asleep, wakes up in the middle of the night or early in the morning, although there is no need for an early rise.

We used to think that insomnia is the result of our intense psycho-emotional state. There is some truth in this. If a person is overly excited by thoughts or memories of an important event, it is very difficult to fall asleep in this state. In this case we are talking about psychosomatic insomnia, which can have both a temporary and a permanent nature. In the first case, we have episodic (situational) insomnia, associated with a certain event. In the second case, it is a question of sleep disturbance in people with increased nervous excitability or depressed-minded individuals.

In healthy people, the cause of insomnia can become, as an excited state of the nervous system (vivid memories, exciting thoughts, dreams, etc.), and the conventions that we ourselves put in relation to sleep. For example, it is commonly believed that:

• To sleep it is necessary at the closed curtains,
• with the TV turned off,
• You need to go to bed at 9 o'clock,
• get up at 6,
• Sleep should be at least 8 hours and only in silence, etc.

But by whom is this accepted, and on what grounds? Forcing ourselves to act according to such rules, we only break our sleep. Try to sleep at 9 o'clock in the evening, if you do not want to sleep at all. The result will be 2-3 hours of drinking in bed before falling asleep, restless sleep and shabby in the morning.

Adhering to the rule of sleeping in silence and darkness, we only accustom the body to the fact that we will rest only in such conditions. It is only necessary to be at night somewhere on the road or in a room near it, and we can not fall asleep because of the noise. The same applies to illuminated rooms (for example, some people can relax at the train station in anticipation of the train, and others will not let the light fall off in the hall).

Identical situation and with a ban on food before going to bed or at night, because the digestive system should also rest. But you can not simply fall asleep on an empty stomach, and you can not dream of a peaceful dream. And is it worth it to limit yourself so much by sacrificing a full-fledged holiday?

Night is a time for rest, not for violence against oneself. Therefore, in bed, you do not need to think about the number of hours for sleep, about suitable and undesirable conditions, about the consequences of lack of sleep, about possible insomnia or fighting with it with the help of hypnotics, etc. Otherwise, even 8-9 hours sleep-deprived will not be enough, because such thoughts only aggravate our senses, so it starts to irritate everything that can interfere with normal, in our opinion, sleep: smells, noises, the sound of the clock, hard or too a soft pillow, snoring behind a wall, etc.

But insomnia is not always the product of our thoughts and prejudices. The cause of insomnia can be taken before bedtime a plentiful portion of food or an invigorating drink (for example, coffee or energy). Insomnia can be the result of regular abuse of alcohol or taking medications that have a stimulating or inhibitory effect on the central nervous system. Sleep disorders can also cause a sharp withdrawal of drugs with a sedative or hypnotic effect.

Insomnia can be a symptom of various diseases of the psyche, restless legs syndrome, respiratory disorders (sleep apnea, alveolar ventilation decline syndrome). In the restless legs syndrome, a person can not fall asleep due to unpleasant sensations in the legs, with respiratory distress, the cause of insomnia can be the fear of the appearance of symptoms of the illness (stopping breathing), thoughts about it, breathing disorders themselves.

It is clear that problems with sleep in the form of insomnia can occur during periods of exacerbation of various diseases, metabolic disorders affecting the work of the brain and the central nervous system, pain syndrome.

[20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30]

Hypersomnia

This is the opposite of insomnia, as a result of which people constantly want to sleep, even if they sleep at least 9 hours a day. The psychophysiological variety of hypersomnia, which can also be episodic or permanent, is associated with overstrain, both physically and psycho-emotionally. In this case, there is a decline in strength, which requires more time to restore the body's functions. Hypersomnia on an ongoing basis can be associated with the physiological characteristics of a particular individual.

Like insomnia, hypersomnia can be caused by the use of alcoholic beverages or certain medications, whose side effects indicate such a symptom as drowsiness, mental illness and breathing disorders in sleep (in this case, lack of rest at night, which manifests itself in the form of daytime sleepiness) .

To the category of hypersomnia there is also such a neurological pathology as narcolepsy, in which a person can "turn off" several times during the day for a short time. This supposedly hereditary disease has specific symptoms:

• sudden falling asleep, awakening, accompanied by paralysis of muscles (consciousness is activated earlier than the capacity for motor activity, in the first instants after awakening only the eyes and eyelids move)
• a sharp weakness of the muscles due to the impact of bright emotions (cataplexy), which causes falls and injuries,
• waking dreams that appear even before a person falls asleep, or immediately after awakening (visions are bright, can be accompanied by sounds and sensations, so they are difficult to differentiate from real ones).

It is clear that increased drowsiness can occur with various health problems, both acute and chronic, indicating weakness due to illness.

Parasomnia

This concept denotes not a specific disease, but a whole list of pathologies in which during sleep or awakening there are failures in the work of various organs and systems. The most common in this list are: somnambulism (sleepwalking), nightmares and horrors, bruxism associated with increased activity in the brain sleep, as well as enuresis, which everyone knows as incontinence at night.

Sleepwalking is a disease in which the motor activity of a person during sleep does not actually differ from that during periods of wakefulness. A person can walk, navigating well enough in space, doing the usual household chores, answering questions without waking up. Despite the fact that the eyes of the sleepwalker during the movement are usually open, and his actions and answers seem quite meaningful, after awakening he can not remember anything.

Sleepwalking is an episodic phenomenon. A person does not walk at night regularly. Attacks of sleepwalking can cause a lack of sleep, inadequate night rest, the intake of certain medicines, the abuse of alcohol and drugs, stress, neurosis, epilepsy, anxiety. Episodes of somnambulism can be observed during a fever during illness.

Nightmares and horrors - this is what at least once chased each of us in a dream. This awakening did not promise anything pleasant. And although there were no clear memories of what he saw in a dream after awakening, anxiety and despair were felt in his soul.

Nightmares - this is a kind of ordinary dreams, appearing in the phase of fast sleep. After them, only heavy emotions remain. But the horrors - it's something atypical, because they appear in the phase of deep sleep, which in itself is abnormal. Awakening from horrors is considered even more difficult, because a person can not immediately understand where the dream is, and where reality is.

Why are there such dreams that interrupt a full sleep and do not allow them to quickly and safely fall asleep after them? It is likely that previously a person experienced a strong mental shock, which the subconscious subsequently converted into fairy-tale images, elements of fantasy, etc. The same nightmarish dreams can be a signal from the subconscious about the onset of the disease. But they can also be the result of a frenetic fantasy after reading books, watching movies or participating in computer games that contain elements of horror.

It is clear that such dreams can pursue a person whose mind is occupied by troubling thoughts. Such sleep disorders are characteristic of depression and can cause insomnia. Nightmares can often dream of those who already have certain fears (phobias). At the same time, they seem to stimulate such mental disorders from the inside.

Night terrors can be a side effect of some drugs: antidepressants and drugs from pressure.

Bruxism, or involuntary gnashing / tapping with the teeth in a dream, is already a problem not so much for the asleep person as for those around him. Episodes of pathology can be single or repeated several times a night. The person usually does not wake up, mostly teeth and jaws, because the sleeper does not control the force of pressure on them. But people who sleep in the same room with such a person have a hard time.

There are several other types of parasomnia:

• night myoclonia, which includes restless legs syndrome, nocturnal cramps, rhythmic limb movements,
• night epileptic seizures,
• nocturia or frequent urination at night,
• hereditary pathology, characterized by paralysis of the muscles of the limbs with a sharp awakening (sleep paralysis).

Earlier it was believed that the cause of this problem with sleep are helminths, but this theory has not found its scientific justification. Most likely, the provoking factor is still stress, great excitement, great mental stress, a state of mental fatigue after the experience of grief. This pathology is typical for people with an incorrect bite.

Behavioral fast-sleep phase disorder is another pathology in which a person starts actively moving in a dream. But if somnambulism, such movements are unhurried and meaningful, then with this violation they are spontaneous and sharp. And the motor activity is observed only in the phase of fast sleep.

In a normal person, the phase of fast sleep is characterized by active brain work, the appearance of dreams, while only the muscles of the heart and respiratory system can be reduced. The tone of the remaining muscles is reduced, so the person remains immovable.

When the phase of rapid sleep is broken, muscle paralysis does not occur. On the contrary, a person reacts actively to his dreams, as a result of which he can shout, cry, jump out of bed, wring his hands, swing arms and legs, etc. This behavior not only prevents others from sleeping, but can also cause injuries, both for the patient himself and for the people around him.

The reasons for this violation are for certain unknown. The connection of the disorder of the phase of fast sleep with some severe neurological pathologies, including parkinsonism and senile dementia, can be traced. But statistics show that this disorder often accompanies the reception of alcoholic beverages and antidepressants.

Violations of the rhythm of sleep and wakefulness

Here we are talking not so much about a separate pathology, as about the development of syndromes that ultimately lead to the emergence of insomnia (syndromes of delayed and premature sleep, a syndrome not twenty-four-hour cycle of sleep and wakefulness).

The states of sleep and wakefulness (circadian rhythms) are regulated by our biological clock, which are time-oriented. The impetus to the production of melatonin (a sleep hormone) is considered a decrease in illumination in the evening. It starts to get dark, and we tend to sleep, because the brain gives the signal to go out. Light is an irritant to the sense organs, which leads to the awakening of the brain, and after him and all other organs.

Problems with sleep begin when the circadian rhythms are violated. This is facilitated by:

• change of time zones,
• work on shifts (the body is difficult to get used to get up and go to bed at different times, it's unnatural for him to sleep when it's light outside and stay awake in the dark)
• changes in the work schedule,
• excessive physical and especially mental stress, slowing the production of the sleep hormone,
• the translation of the clock in the spring and autumn (many people for a month or more have problems with sleeping precisely on this basis).
• the absence of the regime of the day when a person himself breaks circadian rhythms, on weekends going to bed at another time (usually later than on weekdays),
• creative insomnia (the situation is similar to the previous one, but the person regularly postpones retreat at a later time, arguing that it works better at night)
• adverse environmental conditions (sharp odors, strong noise, bright lighting in the evening, too high or low air temperature, high or very low humidity).

At the same time, sleep disorders can be both temporary (they pass after the microclimate in the room is normalized or the body loads are reduced), and permanent (for example, if a person regularly travels and the body has to adjust to changing time zones).

To avoid such disruptions, you should always go to bed and get out of bed at the same time. Then you do not have to force yourself to sleep, which is impossible in principle.

Symptoms of the problems with sleep

The clinical picture of various problems with sleep is always unique, how unique is the organism of each of us. Sometimes patients' complaints about difficulties with falling asleep and restless sleep speak for themselves, and it is not difficult for the doctor to decide on the diagnosis. In other cases, a person simply does not suspect what the deterioration of his state of health is due to, therefore the topic of sleep does not even affect.

But in any case, problems with sleep can not go unnoticed, because they negatively affect not only the ability of a person to work productively mentally and physically, but also on the general condition, causing irritability, headaches, constant fatigue, drowsiness, apathy.

The symptomatology of various sleep disorders should be considered not only with respect to a particular pathology, but also taking into account the causes that caused it. In this case, the clinical picture of the same pathology can have its own distinctive features, which is especially noticeable in the case of insomnia.

Psychosomatic insomnia

Insomnia against the background of strong experiences is most often a temporary phenomenon and lasts no more than three weeks. If the problem remains and further, although the experiences are not so acute, it is better not to postpone the trip to a specialist.

A person with psychosomatic insomnia complains that for a long time he can not fall asleep while in bed, then more than once wakes up in the middle of the night and again falls asleep with difficulty. In the morning, such patients usually wake up long before the alarm clock rings, but not because the body has rested enough. During the day they feel that they have not had enough sleep, they want to sleep, everything is annoying.

According to the patients, the time of night wakefulness is too slow, which makes it even more tiring. A person waits until a dream comes or the morning comes to interrupt these tortures. Everything is complicated by the fact that in a person's mind, the situations related to the lack of sleep begin to recur: he calculates the time before recovery, thinks how he will feel after a sleepless night, experiences about fulfilling his labor duties and the impossibility to rest during working hours, plans for the future, providing for early retirement. This causes the brain to work even harder, and there can not be any talk about a full rest.

But these are only the first signs of pathology. Further, the person develops chronic fatigue, which greatly affects the productivity of labor. A person can feel weakness and weakness during the day, he has headaches, drowsiness. But despite the strong desire to sleep, it can not be done during the day because of the tension of the nervous system, which reacts to the slightest stimuli.

Patients become emotionally unstable, which is accompanied by a violent reaction to any stimuli. As a result, we have conflicts at work and at home, non-fulfillment of professional duties, demotion, depression, etc.

Usually situational depression does not have serious consequences. Sleep comes to normal as soon as the psycho-emotional state of a person is normalized. Alas, this is not always the case. There is a certain percentage of cases when for help restoring a normal night rest you have to turn to specialists, because insomnia turns into a permanent form, which is fraught with various complications.

Drug and alcohol insomnia

Insomnia against the background of taking medications for their symptoms is similar to insomnia with prolonged use of alcoholic beverages. At the same time, the person seems to fall asleep normally, but the phase of fast sleep becomes shorter, and the dream is constantly interrupted.

Problems with sleep after drinking are characteristic for both men and women. After all, the reason for such disorders is the toxic effect of alcohol on the nervous system. Nerve cells suffer, which turns into an inability to carry out impulses, circadian rhythms are broken, the sleep phases are lubricated.

Insomnia can be the result of drinking a lot of alcohol. But in this case, it only drags on for a couple of days. In chronic alcoholism, intoxication in any case leads to failure of biological rhythms (alcoholics often confuse night and day, so they are difficult to bed in the evening and wake up in the morning), which is harder to correct and can lead to constant insomnia.

Symptoms of alcohol insomnia:

• a person does not get enough sleep regularly,
• feels tired (even in the morning),
• sleep, although deep, but short or intermittent,
• the appearance of nightmares and anxious feelings on awakening,
• there are symptoms of behavioral disorder of the phase of rapid sleep in the form of screams and sudden movements in a dream.

Treatment for insomnia with alcoholism is possible only after getting rid of alcohol dependence. Usually, as soon as a person ceases to poison himself with alcohol, the dream gradually improves within 2-3 weeks.

An identical picture is also observed during the administration of sedatives, hypnotics or antidepressants. If such medications take a long time to become addicted to them, which significantly reduces the effect of taking medication. As a result, it is necessary to increase the dose, which also leads to intoxication and complication of the condition. So drugs for insomnia can only worsen the situation if taken long and without the supervision of a doctor.

Problems with sleeping in adults are usually reduced to insomnia or hypersomnia. And one usually follows from the other. It is clear that if a person does not sleep normally at night, then during the day he feels tired and sleepy, and if after that he can rest in the daytime, there can be difficulties with falling asleep at night.

[31], [32], [33], [34], [35]

Smoking and insomnia

But there are adults, aggravated by multiple bad habits, and such a mystery: quit smoking, there were problems with sleep. It would seem, why the refusal of alcohol contributes to the normalization of sleep, and the rejection of cigarettes, on the contrary, causes insomnia, although previously this person did not have such a problem? In this case, insomnia manifests itself mainly in the fact that a person can not fall asleep without first lighting a cigarette. If you do not smoke, sleep will be restless, perhaps an early awakening, caused by the same desire to get a sip of nicotine.

It must be said that insomnia in quitting smoking is a fairly common problem. 95-97% of those who quit smoking, face sleep disorders. Man and so difficult to get rid of addiction, and then there are problems with sleep, only increasing irritability. But what is the relationship between nicotine and normal sleep?

First, nicotine reduces the production in the body of a neurotransmitter neurotransmitter, acetylcholine, because it acts in the same way. The brain begins to experience dependence on nicotine to begin to work actively, so there is an uncontrollable desire to smoke, not allowing the nervous system to relax, which helps to fall asleep.

Secondly, smoking before going to bed or in the morning became a kind of ritual for many smokers. Smoking cigarettes on an adult has an effect similar to a pacifier, which helps to calm down and fall asleep to the child. It is psychologically difficult for a former smoker to give up the opportunity to calm nerves in such a pleasant way for him. Moreover, he simply does not remember other ways to relieve the stress accumulated over the day to quickly turn into sleep.

It should be understood that nicotine, like alcohol or drugs, negatively affects the nervous system, causing an increase in blood pressure, a decrease in working capacity, the appearance of headaches, disruption of many organs and systems, including circadian rhythms. Those. Sleep disturbances could appear in humans before, but this smoker became especially acute only after he decided to abandon the addiction.

"Pathological" insomnia

If the cause of insomnia is serious mental disorders, including depression, sleep disturbance will consist in a constant nightly anxiety, a sensitive dream, which can be called half asleep, and frequent awakenings. The next morning the patient becomes apathetic, tired, inhibited.

Insomnia on the background of nocturnal apnea arises from the sudden cessation of breathing. A person begins to snore or restlessly move in a dream, and from this to wake up. It is clear that the difficulty of breathing and the danger of suffocation can sow fear in the soul of the patient, because of which he will be afraid to fall asleep and die in a dream. Over time, the problem of awakening in the middle of the night grows into difficulties with falling asleep.

Insomnia against the background of restless legs syndrome is manifested in the fact that a person can not fall asleep at first because of the unpleasant sensation that causes him to move his legs (but this sensation passes only when a person gets out of bed and walks), and then in revivals in the middle of the night same reason. Only now the involuntary flexion movements of the feet, feet or fingers of the lower limbs a man wakes himself up. He again has to get up to get rid of an unpleasant feeling.

And now let's talk a little about the symptoms of other sleep disorders.

Hypersomnia

The first signs of increased sleepiness is, of course, a constant desire to go to bed, so they look sluggish and uninformative (especially in the mornings and in the evening when it gets dark). Such people usually fall asleep quickly (they are told that they turn off instantly, only laying their head on the pillow) and sleep for a long time (9-12 hours a day, and sometimes more). Exceptions are situations that cause great excitement. But here the process of falling asleep will not be too long.

Sometimes hypersomnia is a sign of body fatigue when overexertion or illness, but very often physicians are faced with a physiological feature of the body, which does not make sense.

An interesting form of hypersomnia is narcolepsy. Scientists believe that the cause of the pathology is the inadequate production of the oroxine hormone in the patient's body, which is responsible for the wakefulness of the organism. Thus, a person even during the day needs a dream, he seems sleepy and can fall asleep at any moment, and not just fall asleep, but relax to such an extent that it just falls to the floor.

Episodes of sudden falling asleep during narcolepsy happen not only during rest or monotonous work. A person does not interfere with disconnection during a trip in transport (even while driving) or other active activities. At the same time he can sit or stand, and the next minute to be on the floor. This often happens against a background of intense excitement (fear, joy, anger, etc.).

Disorders of circadian rhythms

Problems with sleep on the background of changing time zones or the transfer of hours are manifested in the difficulties of adapting to a new time. If a person is used to falling asleep at 10 o'clock in the evening, then at 8-9 o'clock he still does not feel the need for rest, and falling asleep for obvious reasons will be prolonged. But if the shift in time will be in the opposite direction, then in the evening the person will feel sleepy, and in the morning he will wake up earlier than the local time and will feel sleepy.

Particularly hard is for people who often travel to other countries, where the difference in time zones is 3 hours or more, as well as those who work in shifts. The body simply ceases to understand when it's time to sleep, and when to stay awake. A person will simply fall asleep in the daytime, and experience problems with falling asleep at night. It is not excluded and awakening in the middle of the night, and sleep a second time a person will be very problematic.

The syndrome of delayed sleep is a violation, in which it is difficult for a person to fall asleep at the right time. Until 12 at night, such people feel very cheerful, so there can not even be a talk about going to bed. After 12, the activity is somewhat reduced, but a person can fall asleep not earlier than 1-2 hours of the night, and even later. It is clear that such people can not wake up on time in time, so they get enough sleep on weekends, when there is no need to adhere to the regime.

The syndrome of premature sleep is a condition opposite to that described above. People with this syndrome go to bed early and also wake up early, which is typical of most old people. They are quite cheerful during the day and reduce their activity when it starts to get dark. In principle, the problem of lack of sleep does not arise here, therefore, specialist assistance and correction of the regime of the day is not required.

Syndrome, in which the biological clock of a real person is not 24 hours, but more, is characterized by constant shifts in the phases of sleep and wakefulness. Most often, this pathology occurs in the blind, because their brain does not receive a command to produce a sleep hormone about the eyes, so the body measures the time approximately, which causes malfunction. A similar situation can be observed in personality disorders.

[36], [37], [38], [39], [40], [41], [42]

Parasomnia

This combination of sleep disorders and disorders of various organs and systems. We have already mentioned somnambulism in all its details. This pathology is characterized by sleep walking, unconscious movements that seem to be fully conscious until they become dangerous for the person himself, conversations in a dream, the eyes are often open, the ability to answer questions (usually monosyllabic). In this case, the person seems quite calm, but putting him back in bed will not be so easy.

Night terrors and nightmares rarely arise in the middle of the night or in the morning. Most often a person wakes up from them shortly after falling asleep. A single glance at him is enough to understand the reason for such a sharp awakening: the face is frightened and panicked, the eyes are wide open, the pupils are dilated, the body is covered with sweat, breathing and pulse are rapid. The patient can scream at awakening from fear, sit in bed or grab onto his feet.

Usually, in a few minutes, when it comes to understanding that it was just a dream, the person calms down and quickly falls asleep. In the morning, he can not remember anything about a nightmare or remember only a few moments.

Night enuresis has only one symptom - involuntary urination during sleep, which affects mostly babies. In this case, the patient may not even wake up. For babies who do not yet know how to walk on a pot, this is normal. In older children, this condition is often associated with mental disorders that occur and against a background of stress or nervous shock. And the older the child becomes, the more problems arise on this basis. Fearing condemnation on the part of adults or peers, a child or teenager is afraid to sleep in a common room with other children, because he can not control the discharge of urine in a dream, and the next morning to hide the traces will be even more problematic.

Sleep problems in different groups of people

I must say that sleep disorders are equally characteristic for people of different sex and age. The reasons and types of such violations can differ. For example, old people usually suffer from increased drowsiness and disturbances in biological rhythms, which is understandable against the background of age-related physiological changes in various organs and systems. Young people and middle-aged people, mired in domestic problems, complexities of relationships and professional tasks, are more prone to insomnia, while many teenagers and schoolchildren may suffer from hypersomnia due to early upsurge and high physical activity.

Problems with sleeping during pregnancy  - one of the most common problems in expectant mothers. This is mainly about insomnia, the reasons for which in the delicate period is increasing with each new day.

About 80% of pregnant women suffer from sleepless nights. Most often this condition is a direct evidence of pregnancy, because it occurs already in the first months after conception of the baby. The cause of sleep problems during this period are hormonal changes that prepare a woman's body for hard work. Progesterone and other hormones simply do not allow the future mother to relax, recalling that her task is to endure and give birth to a healthy baby.

Problems with sleep can begin already from the moment when the woman learns about her pregnancy. For someone, this is an incredible joy, for others - a terrible tragedy, requiring as soon as possible to make a choice: leave the child or have an abortion. In any case, the body experiences emotional overload, which does not allow a woman to sleep peacefully.

Then follows the hormonal changes and a whole bunch of problems that plague the pregnant woman at every step:

• the stomach grows and it becomes more difficult to choose the posture in which it is possible to fall asleep and have a restful sleep (we all get used to sleeping in our own way, someone on the stomach, others on the side or back, and it will be difficult to change the position in any case)
• there are pains in the back and lower back that do not rush to subside, even when a woman is resting,
• the baby in the womb starts to move, so it can easily wake his mother in the middle of the night (he can not be seen, day in the street or night),
• it is often necessary to go to the toilet for a small need, including night hikes, and all because the growing uterus begins to squeeze the bladder, which now has a smaller capacity,
• there are problems with the digestive system, which also does not have the best effect on the night rest,
• when pregnancy is not uncommon occurrence of cramps in the legs, especially if Mom wants to pull in her toe socks, it is clear that the appearance of seizures leads to a sharp awakening, which aggravates further falling asleep,
• in the abdomen, many pregnant women note annoying itching, which does not cease even at night, preventing sleep,
• a growing abdomen is a pressure not only on the bladder, but also on the lungs, resulting in shortness of breath and problems with breathing in a dream,
• the body of a pregnant woman works for two, so it's not surprising that over time a young mother begins to experience chronic fatigue, which on the one hand causes drowsiness, but on the other - does not allow you to normally rest at night,
• a woman during the whole pregnancy experiences not only joy, but also excitement for her unborn baby. Fear of harming a child in a dream, thoughts about the upcoming birth and future life in a new quality so absorb the woman, which leads to a nervous overstrain leading to insomnia. And if there are still some complications and there is cause for concern, nightmares can join the insomnia, which further exhausts the woman who is ready to become a mother.

As we see, there are more than enough reasons for sleep disorders during pregnancy, but the lack of sleep can not but affect the health of the future mother, while the health and life of the child in her womb directly depends on this point. Lack of proper sleep in conditions of increased work of the body can lead to premature birth or weak labor.

Alas, the problems of young mothers usually do not end with childbirth. Seven to nine months of waiting and unrest are not in vain. The nervous system of the woman has already become quite dirty during this time, so any irritant is now perceived with hostility. Fatigue after childbirth, the need for every minute care for the baby, worry about his health against a weakened nervous system naturally cause sleep problems.

Despite the fatigue, literally dumping the newly mamma in the evenings, she can not fall asleep easily. The thing is that the nervous and physical overexertion plus the well-known suspiciousness of young mothers who are afraid of not hearing in a dream how the baby coughs, registers or God forbid it stops breathing, does not give the tired woman a normal sleep. And over time, fatigue only accumulates.

You can not get anywhere, pregnant women and young mothers are characterized by an increased suspiciousness, conditioned by the maternal instinct to protect their child from all adversity. Help can only support and care of relatives, as well as training techniques of self-control and self-control.

Childbirth is hard work and possible damage to body tissues. A newly mum needs time to get the body back to normal. In the early days, it may be painful in the lower abdominal pain associated with contraction of the uterus and return to the previous state. Severe discomfort can also be caused by aching sutures after caesarean section. These inconveniences against the backdrop of hormonal changes are not the best way to affect the night rest of a woman who at first can not fall asleep, and then grasps in the middle of the night as if on a signal.

Another problem is the fear of the fact that after the period of gestation and childbirth the figure of a woman became less attractive. A young woman worries that her husband can cool to her and seek pleasure on the side.

The most common problems with sleep after childbirth occur in women with the first child. The desire to succeed everywhere and do everything to "excellent" encounters a lack of experience. The young mother is upset and very tired of the tasks she has put out, which affects the quality of her sleep.

In young families with the advent of the first child often begin and the first quarrel. A man can make claims to a lack of affection and attention, lack of sex, appearance of a woman who is so deeply entangled. There is controversy over who should get up at night to a child. All this further shakes the nervous system of the woman after childbirth, which negatively affects the process of falling asleep and the quality of sleep.

But with the need for night feeding and lifting from bed at the first call of a baby who has not yet adapted in this world, so he can be disturbed literally by everyone, moms are faced with both the first, and second, and subsequent children. Caring for a newborn is not limited to day time only, so Mommy can only dream about a full night's sleep if her family does not help her.

The task of the woman is not only to endure and give birth, but also to feed the newborn as much as possible with mother's milk for at least a year, so that he has strong immunity, which protects him in the future on various diseases. And that mommy was able to breastfeed, she should eat well and have enough rest, which will allow her to be less nervous. After all, everyone knows that the nerves most often lose milk from lactating women.

But during the lactation period, women besides the causes of sleep disorders, which were characteristic of the postpartum period, also appear new, making the problem worse, and thus representing an additional danger of loss of milk. So, problems with sleeping in a nursing mother can be caused by:

• unpleasant sensations in the chest, until she gets used to the new quality (the breast is poured, becomes heavy and slightly aches a bit, the milk can leak, which requires additional measures to avoid wetting and hypothermia of the mammary glands, etc.)
• overeating in the evening (on the one hand, a woman needs to eat a lot, so that the baby has enough milk for night feeding, but on the other hand a late or thick dinner negatively affects sleep)
• various neurological and mental disorders reminiscent of themselves after childbirth,
• taking various medications (if they are prescribed by a doctor).

Again, you have to look for a comfortable posture, because lying as before on the stomach or back becomes uncomfortable and even painful, but some women even during pregnancy and can get used to sleep in an unusual posture for them.

Pregnancy, childbirth, the need to feed and take care of a newborn baby - all this does not contribute to a calm sleep of a woman, which she simply needs in the face of an increased burden on the body. And the task of the family to help the young mother successfully survive this difficult period, so that chronic fatigue and malaise do not overshadow the joy of motherhood and do not become an obstacle to the full development of the child.

Complications and consequences

Even single cases of insomnia can knock us out of the rut for a whole day, not to mention the constant problems with sleep. And if till 10 o'clock in the morning the person still can somehow become harsh, then further terrible fatigue begins to pile on him, he wants to lie down and rest, and in the absence of such an opportunity episodes of drowsiness and sluggishness are periodically replaced by irritability and anger.

Moreover, a body that has not rested for a night starts to fail. There are headaches, weakness, increased fatigue. On the day off, you can afford to rest for a while in the morning or at lunch, but again it's worth a little sleep, and anticipating a night's sleep will be long minutes of vigil in bed with your eyes open or forcibly closed. And on the other hand, if the body does not get rest at night or day, severe fatigue begins to manifest itself with the same insomnia.

But how can you rest on working days? Very few people get to sleep at lunch time, and night problems with sleep in the afternoon usually result in a noticeable decrease in efficiency. If this happens once or twice, the management of the enterprise will at best make a comment. But a constant lack of sleep and bad work will be an unconditional reason for dismissal without discussing the reasons.

Lack of night sleep and the associated deterioration of well-being very often cause domestic scandals and conflicts at work. All this only complicates the situation, and a person begins to experience chronic fatigue from everything, and this is the direct way to depression.

Chronic fatigue always causes a decrease in the body's internal forces, which becomes harder to deal with negative environmental factors. A malfunction in the work of the immune system will lead to the fact that a person (an adult or a child) will begin to suffer more often from infectious diseases, he can manifest until now dormant hereditary pathologies, metabolism is disrupted. And these are only the consequences that a healthy person can have.

But after all, problems with sleep and themselves can be a consequence of various diseases. Do not pay attention to them, then give the disease to develop further, causing various complications, affecting the well-being and mood of a person.

[43], [44], [45], [46]

Diagnostics of the problems with sleep

When a person has a disturbance of falling asleep and sleep it is very difficult to immediately tell what exactly they are caused. After all, even stresses and experiences, which are the strongest causative agents for the nervous system, affecting the quality of sleep, do not exclude the development of a pathology in the body, which can also negatively affect the night rest. That is, a person can take soothing infusions and drink sleeping pills, but the problem with sleep will remain, causing more and more difficulties.

If a person sleeps only 6 hours a day, and at the same time feels well, retains enough activity and performance during the day, there is no reason to consult a doctor. Each organism is individual. Therefore, one is enough and a six-hour sleep, and another and after 8-9 hours of full sleep can feel not slept well. By the way, the latter should be alarming, especially if the drowsy state persists after awakening for more than half an hour, creating difficulties in the work, communication, perception of information.

What other symptoms are considered alarming and require more thorough research than the analysis of flights with friends and friends? Difficulty breathing during sleep and snoring, nighttime apnea, frequent nightmares, unreasonable awakenings at night - all this is an occasion for consultation with a doctor. But somnambulism and conversations in a dream, gnashing of teeth, involuntary urination in bed (nocturnal enuresis), sudden episodes of falling asleep (narcolepsy), which also require detailed study and revealing the causes of pathology, can be no less a problem.

Diagnosis should be done if insomnia occurs in the absence of causes for anxiety and distress and is not associated with physical fatigue, and if taking sedatives does not help to solve the problem. The doctor should also visit those people who have insomnia caused by pathological causes (night cramps, pains, phobias, fears, etc.).

If it concerns a child, it is necessary to seek help from specialists (pediatrician, somnologist, psychologist) if the lack of sleep begins to affect the state of health of a small person, his academic performance at school, mental and physical abilities, and the psychoemotional state. In principle, you can apply to a psychologist before. Especially those parents who themselves can not solve the problems of sleep disorders in their child, which themselves and provoked excessive care or connivance.

But if a visit to the therapist or pediatrician, neurologist, cardiologist, endocrinologist and even psychologist in most cases does not present difficulties, the diagnosis of a doctor specializing specifically on sleeping problems (somnology) may not be available in the absence of such a specialist in the clinic. In small towns, district centers, villages such specialists can not be found, so you will have to rely on the knowledge and experience of existing doctors, as well as on the usual diagnostic procedures:

• laboratory tests of urine and blood, which will tell you about the state of the body as a whole and its individual organs,
• measurement of blood pressure and pulse,
• ECG,
• Ultrasound,
• radiography and other possible studies,
• examination of an ophthalmologist, cardiologist, urologist, endocrinologist and other specialist doctors.

Such diagnostics can be quite tiring, because it is not so easy to find out the cause of sleep disorders to the layman. Probably, it is necessary to pass set of inspections and to wait their results that after carrying out of differential diagnostics it was possible to count on more or less concrete diagnosis. So it is better to find an opportunity to still visit a somnologist and undergo specialized studies (polysomnography and SLS).

And even here hypersomnia, for example, will have to differentiate from asthenic syndrome, depression, chronic fatigue. In addition, it is always important to understand what causes the occurrence of sleep disorders: with a psychoemotional state or with organic pathologies of health.

Polysomnography is a study that helps to understand the causes of insomnia and other sleep disorders. It can be performed by a doctor in a special room or at home in a patient (especially if the patient is a child). It does not need to perform any complicated tasks, the only task of the researcher is sleep.

The study is conducted at night. A different sensor is connected to the human body, each of which registers certain parameters. As a result, the doctor has EEG information (brain research), cardiograms (heart work), a chart of chest movement, information on the volume of inhaled and exhaled air, oxygenation of the blood, etc.

During the study, a video is recorded, but the doctor on duty also constantly monitors the patient's condition, noting any changes in it. As instrumental diagnostics are carried out continuously throughout the night, the somnologist gets the opportunity to track the readings of the instruments and the video camera at all stages of sleep, which makes it possible to more clearly determine the cause of the problems with sleep.

The method of SLS (determining the average latency of sleep) is of great value in hypersomnia, in particular for the diagnosis of narcolepsy. It helps to determine the causes of increased drowsiness.

During the day, the patient will need to try to fall asleep 5 times. The duration of immersion in sleep is 20 minutes, the interval between attempts is 120 minutes. The time during which the patient manages to fall asleep is recorded.

A healthy person without sleep disturbances falls asleep for 10 minutes or more. If the result is between 5 and 10 minutes, this condition is considered borderline. If the examinee took less than 5 minutes to drown in the arms of Morpheus, it is a question of pathological drowsiness (hypersomnia).

Diagnosis of failures of human biological rhythms and related sleep disorders is carried out using a special device - an actigraph. The patient with a device on his arm in the form of a clock walks for 1-2 weeks, the device during this time captures all of its movements. Do not try to fall asleep and wake up at the specified time. The patient should sleep and stay awake when he wants it.

Diagnosis of parasomnias is carried out using polysomnography. But only this research is not limited. The patient gives a general and biochemical blood test, undergoes various examinations from different doctors. The final diagnosis is usually put on a consultation, in which different specialists participate.

[47], [48], [49], [50]

Prevention

As for the prevention of sleep disorders, everything here is extremely simple. To sleep well, you need:

• create comfortable conditions for rest: a comfortable bed, soothing aroma in the bedroom, a switched off computer and telephone, weak soft lighting, natural bedding, no loud noises and noises, etc.
• daily active walks in the fresh air, but not right before bed, and in the afternoon or at least a couple of hours before going to bed,
• in bed, try to forget about all the daily problems and worries, about past troubles and failures, not to try to make plans for the future; help in this can special breathing techniques, relaxation, yoga,
• to find soothing nerves that can be pampered at bedtime: knitting, embroidery, listening to pleasant slow music, reading lyrical works, etc., but all these activities need to be done outside of bed (bed is needed only for sleep and making love!),
• if the nerves are overstrained and you can not relax, you should take a plant sedative drops (for example, motherwort tincture),
• before bedtime, always ventilate the room and create in it suitable conditions for sleeping: the appropriate temperature and humidity, oxygenated air, the absence of irritating smells of cigarette smoke, perfume, fried food, etc.
• pay attention to bedding, which must be clean and with a pleasant scent,
• to observe a mode of sleep and wakefulness: to try to go to bed every day and get up at the same time, to develop certain settings, according to which the body will understand that it is time to sleep (for example, we make lighting in a room less intense half an hour before bedtime)
• do not eat later than 2 hours before going to bed, but do not go to bed hungry (if necessary, you can have a snack with apples, croutons or ½ cup of kefir)
• for half an hour and an hour before otboem take a warm, relaxing bath,
• Do not engage in activities that can exert a stimulating effect on the nervous system (active games, watching TV, especially news, thrillers, detectives, working at a computer, communicating online, etc.) on the eve of sleep,
• when symptoms of ill health appear, seek medical advice, because this can help prevent the development of diseases in which there are problems with sleep.

[51], [52], [53], [54], [55], [56]

Forecast

Let's talk first about what patients with sleep disturbances can expect after treatment. We must immediately say that any problems with sleep is not a reason for panic. Almost all of them are solved, and the conducted course of treatment allows to restore the normal functioning of regulatory systems.

The prognosis of primary sleep disorders is generally favorable. States are considered temporary and easily amenable to correction. The most difficult to deal with parasomnia. And although they themselves do not affect the health of the patient very much, a phenomenon such as somnambulism can be dangerous for patients, since they do not control their night movements.

Dangers of the patient may also be presented with narcolepsy attacks. After all, a person can "disconnect" in the middle of the road, in the workplace (and it's good if he works in the office, and not at the machine tool or in the hot shop), at the wheel of the car, which means he can die himself or ruin those who happened to be around.

In principle, with the help of therapeutic and psychotherapeutic techniques, it is possible to improve the sleep of patients who have problems with falling asleep and early awakenings associated with various diseases. But, for example, such hereditary pathology, as a carotid paralysis, gives in to treatment with great difficulty. And in the treatment of bruxism, along with the above methods are used and dental procedures, because the disease is fraught with spoilage of teeth.

In the treatment of adult patients, it is especially important that a person himself realizes his problem and wants to solve it, so drug treatment is almost always combined with psychological help.

[57], [58], [59]