One of the reasons for poor sleep is related to the characteristics of diabetes, one of which is polyuria. Diabetic patients often have increased nocturia and always go to the toilet at night, which seriously affects the continuity of sleep.
In addition, some complications caused by diabetes will also affect sleep, such as peripheral neuropathy, arteriosclerosis occlusion of lower limbs, autonomic neuropathy, skin itching and so on.
How to judge insomnia?
Although there are suitable sleeping opportunities and sleeping environments, they are still dissatisfied with sleeping time and/or sleeping quality, which affects social activities during the day. Can be expressed as:
1, it is difficult to fall asleep, and I can't sleep in bed for 30 minutes;
2. After falling asleep, you will wake up frequently (more than 2 times) for more than 30 minutes, or it is difficult to fall asleep again after waking up;
3, wake up early, if you plan to get up at 6 o'clock, but wake up earlier than this expected time (1 hour or more);
4, wake up feeling tired, like lack of sleep;
5, the next day, the whole body is uncomfortable, inattention, forgetfulness, irritability, excitability, lethargy, affecting work and life.
Insomnia symptoms are less than three times a week or less than three months, which is short-term insomnia and lasts for more than three months, which is chronic insomnia.
Why am I prone to insomnia?
Clinically, the causes of insomnia in diabetic patients are as follows:
1, diabetes, diabetes, diabetes: "three more and one less" is the most common clinical manifestation of diabetes, one of which is polyuria. Diabetic patients often have increased nocturia and always go to the toilet at night, which seriously affects the continuity of sleep.
2. Chronic complications of diabetes: unspeakable pain.
1) Peripheral neuropathy: numbness of both feet, needle-like pain, burning sensation, etc. And the symptoms often get worse at night, leading to uncomfortable legs and uncomfortable sleep.
2) Arteriosclerosis and occlusion of lower limbs: Ischemia of lower limbs can lead to resting pain, which is often unbearable at night and even wakes up after falling asleep.
3) autonomic neuropathy: often accompanied by abnormal sweating, sweating at night, and five-heart irritability.
4) Skin itching: Hyperglycemia can promote the growth of fungi, destroy the skin defense barrier, cause skin itching and affect sleep.
Who can solve my troubles: anxiety and depression.
Effective control of blood sugar requires scientific management of diet and exercise. Diabetes itself brings some pressure to people who love sugar and can't eat too many things they like. The limitations of life and the troubles of complications are easy to make people suffer, anxious, depressed and even depressed.
4. Others: In addition to the influence of diabetes, it is necessary to inquire about the medical history in detail, identify insomnia through blood drawing, polysomnography and body movement recorder, and exclude diseases such as hyperthyroidism and respiratory sleep apnea syndrome.
What should I do?
1. Control primary disease: actively control blood sugar to reach the standard, treat diabetic complications, and seek help from doctors to improve physical discomfort symptoms.
Enhance the confidence to overcome the disease, correctly face and accept the state of living with the disease, and tell myself that although I have diabetes, I can control it like a normal person.
2. Non-drug therapy:
Relax, don't stay up late, don't stay in bed, and avoid taking an excessive nap. Appropriate physical activities during the day can not only regulate the functions of various organs of the body, but also improve attention, relieve tension and bring pleasure and a sense of accomplishment. Don't drink before going to bed. Drinking alcohol will fragment sleep, reduce deep sleep and affect sleep quality. It is not advisable to overeat or eat indigestible food before going to bed.
3. Drug therapy: In some cases, taking drugs can make patients rest, and changes in habits and lifestyles can improve sleep quality for a long time. It is recommended to take medicine occasionally or for a short time.
1) Non-benzodiazepine drugs, such as zopiclone and zolpidem tartrate, take effect quickly and for a short time. They are suitable for people with difficulty in falling asleep and sleep interruption, and are relatively safe, and generally do not cause daytime sleepiness.
2) Benzodiazepines, such as estazolam, can increase the total sleep time, but have adverse reactions such as daytime sleepiness and dizziness. Like non-benzodiazepines, both drugs can have a short-term insomnia rebound after sudden withdrawal, and they are both prescription drugs, so they must be used under the guidance of a doctor, and alcohol should be avoided during medication.
3) Melatonin and melatonin receptor agonists: It can be used to treat sleep disorders such as difficulty in falling asleep and circadian rhythm disorder.
4) Antidepressants: Some antidepressants have a calming effect, which is more effective when insomnia is accompanied by depression and anxiety.
Go to the doctor.
If long-term insomnia affects daily life and work, please seek medical advice in time. Doctors will ask about medical history, physical examination and blood tests, and in some cases, they will conduct sleep research to find out the health problems that lead to insomnia. If the patient's symptoms indicate mental health problems, such as depression or anxiety, the doctor may refer the patient to a psychological clinic for treatment.
Tips to help sleep:
1) Have a tryptophan-rich dinner (such as warm milk).
2) Insist on soaking feet with warm water before going to bed, or you can also cooperate with foot massage at the same time.
3) Choose pillows and bedding that suit you and change your sleeping position frequently.
4) Create a quiet, comfortable and dimly lit sleeping environment, and do relaxation exercises: meditation, gradually relax completely from head to toe, and relax breathing. You can choose soothing music and Sanskrit to help calm your mind.
5) Chinese herbal medicine pillow and massage instruction.
6) Maintaining family harmony is an important way to relieve mental stress and avoid unpleasant events affecting sleep.
Have a good sleep tonight.
Authors: Ma, Deputy Chief Physician, Department of Endocrinology, Beijing Geriatric Hospital.
He is good at the diagnosis, syndrome differentiation, prevention and treatment of diabetes and its acute and chronic complications, thyroid diseases, hyperuricemia, osteoporosis and water and electrolyte disorders. He has been engaged in the management of senile diseases for a long time and has rich clinical experience in the prevention and treatment of chronic diseases and metabolic syndrome in the elderly.