-World Sleep Day pays attention to insomnia
Jiang Changqing, Department of Clinical Psychology, Beijing Anding Hospital
Usually, people are used to thinking that adults should have 8 hours of sleep every day, but the actual individuals are very different. Some people may sleep for 4-6 hours to meet their physiological needs. About 10% of healthy people belong to this situation, and 15% of them sleep for more than 8 hours or more. The average sleep time of the total population is about 7.5 hours.
Some people sleep for a short time, but feel comfortable and satisfied after waking up. Others sleep for a long time, but they are either dreamy or easy to wake up. After sleeping all night, I always feel sleepy and abnormal. Therefore, when judging a person's sleep quality in clinic, we should consider both sleep time and sleep quality.
Sleep stage and rhythm
Sleep is divided into five periods. During the 8-hour sleep every night, cycle the sleep cycle every 90 minutes or so. The first four stages are non-rapid eye movement sleep (NREM) or slow wave sleep (SWS), and the last stage is rapid eye movement sleep (REM).
SWS is the whole process from hazy sleep to deep sleep. The EEG at this stage is slow wave and there is no eye movement, so it is called non-rapid eye movement sleep. According to the EEG pattern during sleep, this period is divided into four periods.
Sleep period: it is a transitional period between waking and sleeping, and people are easy to wake up, accounting for about 10% of the total sleep time.
Shallow sleep period: it is easy to wake up during this period, and those who have difficulty falling asleep often wake up on their own, accounting for about 50% of the whole sleep period.
Mid-sleep: during this period, consciousness disappears and it is not easy to wake up, and each sleep cycle lasts about 1 hour.
Deep sleep period: during this period, the sleep is deep and it is quite difficult to wake up. Each sleep cycle lasts about 30 minutes, and then you enter REM sleep.
In the whole sleep cycle, SWS and REM appear alternately regularly, and each of the two kinds of sleep at different times has a sleep period. Each cycle lasts 70 ~ 90 minutes, and you must go through SWS stage to enter REM.
Sleep deprivation experiment
Sleep deprivation experiment is actually a special kind of artificial insomnia. Understanding the adverse effects of sleep on human body, including psychological and physiological dysfunction, is helpful to understand the consequences of lack of sleep in clinic.
There is a true story: there is a biologist abroad, because he has been sleeping less, so he thinks that sleep is not a physiological need of the human body, but a habit of human beings. In order to prove his point of view is correct, he designed an experiment, taking himself as the research object, and asked several assistants to closely monitor him and prevent him from sleeping or taking a nap. Remind him immediately when he wants to sleep. The experiment lasted 10 days and nights. The biologist insisted on staying up for 240 hours. During the experience, although no physical illness was found, the mental state changed obviously. It's hard to concentrate, and my temper has become very grumpy. The experimental results strongly show that if a person does not sleep, his physical and mental health will be seriously affected.
A further experiment is selective sleep deprivation. When the observer finds eye movements or EEG changes, he can selectively terminate REM by waking the sleeping subjects. Deprivation of REM will not cause serious adverse reactions in a short time, and the subjects may have slight anxiety, impatience and irritability, but when deprived for a long time, hallucinations and terror will occur.
How to judge insomnia
Insomnia is a condition that the quality and quantity of sleep are not satisfactory for a long time. Among insomniacs, difficulty in falling asleep is the most common, followed by shallow sleep and early awakening, some of which are manifested as lack of sleep sensation, and usually the above situations coexist.
The duration of insomnia has important diagnostic significance. Short-term insomnia for only a few days is normal and should not be enlarged. The following are the specific criteria for insomnia diagnosis for reference:
1. Insomnia is almost the only symptom, including difficulty in falling asleep, lack of deep sleep, easy awakening, dreaminess, early awakening, or difficulty in falling asleep after waking up, feeling unwell during the day, fatigue or drowsiness.
2. Have the advantage of insomnia, and pay great attention to the results of insomnia.
3. Insomnia causes significant distress or mental activity efficiency decline, or hinders social function.
4. The above-mentioned sleep disorder occurs at least three times a week and lasts for more than 1 month.
It is not a part of any physical illness or mental illness.
Insomnia and sleeping pills
The use of sleeping pills is extremely extensive and random, and this tendency is increasing at present.
The EEG study on drug-induced sleep caused by sleeping pills proves that drug-induced sleep is different from physiological sleep, in which the proportion of REM is obviously reduced. Drug-induced sleep caused by sleeping pills, on the surface, seems to satisfy the sleep time, but in fact, it makes patients suffer from severe REM deprivation in the case of long-term insomnia, and REM is irreplaceable to the human body. The self-feeling of users of sleeping pills also illustrates this situation. Although they fell asleep all night after taking the medicine, they were seriously short of rapid eye movement, so they woke up in the morning still groggy, as if they didn't have enough sleep. For ordinary insomnia, although sleeping pills are helpful to sleep, they should not be used routinely, and the use period should not exceed 2 1 ~ 28 days. Drugs with short half-life or intermittent administration (2 ~ 4 times a week) should be selected to reduce the sedative effect during the day.
Taking sleeping pills for a long time will make the body dependent. Drug addicts will have withdrawal symptoms once they can't get the drugs that cause drug dependence. Among the hypnotics, the dependence caused by fast sleep, metoprolol and methaqualone is more serious, especially the abuse of methaqualone has caused serious consequences around the world. Therefore, clinicians and insomnia patients must re-recognize sleep and insomnia, re-evaluate the role of sleeping pills, and use sleeping pills carefully.
Psychological and behavioral intervention of insomnia
Treatment of insomnia should first emphasize sleep hygiene, especially one-time or short-term insomnia is expected to be solved through these measures, the specific methods are as follows:
1. Keep a regular work and rest system, go to bed and get up on time, and do not take a nap during the day (including holidays).
2. Don't spend more time in bed than before sleep disorder.
3. Stop drinking substances that stimulate the central nervous system, such as coffee, strong tea and alcohol.
4. Eat regularly and don't be too full for dinner.
5. Avoid reading stimulating books and periodicals before going to bed.
6. Do relaxation activities before going to bed, such as massage, massage and meditation.
7. The bedroom environment should be comfortable, the temperature should be appropriate, and noise and light should be avoided.
8. I can't sleep in bed for 20 minutes. If I want to sleep, I will get up and sleep.
9. Stick to physical exercise after getting up in the morning.
The most prominent feature of insomniacs is that they are easily afraid of sleeping. When the night comes, they try their best to find out how to fall asleep as soon as possible, and at the same time they are afraid of insomnia, which will lead to inner conflicts, thus forming a vicious circle. One way to break this vicious circle is to let nature take its course and take the attitude of sleeping as much as possible.
Special psychotherapy methods also include relaxation therapy, biofeedback technology, cognitive-behavioral therapy and other therapies, which can be carried out under the guidance of clinicians and psychologists.
Psychological adjustment methods to overcome insomnia;
First, keep a good attitude of optimism and contentment. Have a full understanding of social competition and personal gains and losses. To avoid psychological imbalance caused by setbacks.
Second, establish a regular daily life system and maintain a normal sleep-wake rhythm.
Third, create a conditioned reflex mechanism conducive to falling asleep. Such as taking a hot bath, soaking feet and drinking a glass of milk half an hour before going to bed. As long as you persist for a long time, you will establish a "sleep conditioned reflex."
Fourth, moderate physical exercise during the day will help you fall asleep at night.
Fifth, develop good sleep hygiene habits, such as keeping the bedroom clean and quiet, away from noise and light stimulation; Avoid drinking tea and alcohol before going to bed.
Six, self-regulation, self-suggestion. You can play some relaxing activities, or count them repeatedly. Sometimes a little relaxation can accelerate your sleep.
Seven, limit the sleep time during the day, in addition to the elderly can take a nap or nap during the day, should avoid taking a nap or nap, otherwise it will reduce the sleepiness and sleep time at night.
In addition, for some critically ill patients, under the guidance of a doctor, sleeping pills or small doses of anti-anxiety and antidepressants should be given in a short time. This may lead to faster and better treatment results.
What about insomnia? Here are some tapping methods for you to try.
1. Three teaspoons of apple juice and a cup of honey (be careful)
2. Carefully rub your fingers one by one, which has a calming effect.
3. Eat some bread (be careful of getting fat)
4. A tablespoon of vinegar and a cup of cold water.
5. Take a hot bath one and a half hours before going to bed (pay attention to safety)
6. Drink a cup of hot milk (beware of getting fat)
Seven ... When it is difficult to sleep because of noise, you can dissolve a tablespoon of lettuce juice in a glass of water.
8 ... Drinking a glass of sugar water will make the body produce a lot of serotonin, which can inhibit the cerebral cortex and cause drowsiness.
9 ... Eat some bread, the pancreas will secrete insulin in the body and metabolize the amino acids contained in the bread, thus calming the nerves.
10 ... clench your fist, and then slowly release it, so that your mind can relax between holding and releasing.
1 1 ... Wash your feet alternately with hot and cold water before going to bed to dredge the blood.
12 ... Never force your brain to think about all kinds of things, or you will be more nervous.
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