Sleep disorders and insomnia (insomnia)

One third of human life is spent in sleep. Sleep is one of the important physiological functions of a person’s daily life (such as eating, drinking). The average daily sleep requirement of an adult is 7-8 hours. However, this requirement differs from person to person. Sleep time is much longer in childhood and infancy. Sleep is not a passive slowing down in the functions of the organism and a transition to silence. During its normal duration, sleep is cyclical. There are two types of sleep states, REM (Rapid Eye Movements) and non-REM (Non-REM) periods, which repeat 4-5 times at regular intervals and have separate features. An adult’s sleep may have as many as ten brief awakenings during the night. These awakenings are not remembered and are considered normal. After the age of 50, REM sleep begins to decline. After the age of 60-70, the duration of deep sleep decreases.

Sleep is a requirement for the body to collect itself. It is also an important indicator of being healthy. It is essential that sleep is of sufficient duration and of sufficient quality. When this cannot be achieved, it can lead to physical symptoms such as tiredness, fatigue, and weakness during the day (or during the waking hours), as well as drowsiness, inability to concentrate, irritability, and various types of accidents, especially traffic accidents. It is one of the most common complaints in people with impaired physical and mental health. Just as physical and mental disorders cause sleep disorders, sleep problems can also cause mental disorders. If sleep disorders continue, the susceptibility to various physical diseases increases.

The duration of adequate sleep varies from person to person. For some people, very little sleep may be enough to rest. Most of the sleep should be of sufficient depth. Constantly restless sleep does not provide adequate rest.

Impairment of sleep quality;

a) Sleeping Breathlessness (apnea) disease table*

b) Wandering in sleep,

c) Night fears (the person is in a panic as if he has had a nightmare, does not respond easily to waking efforts, there is a disorientation that lasts for minutes even if he wakes up, it lasts for 1-10 minutes, in the morning he does not remember what he experienced at night)

d) Depressive dreams (when recurring frequently, it means a sleep disorder. Frequent bad dreams lead to recurring awakenings, shortening the sleep time. The difference from night fear is that the person is aware of his surroundings when he wakes up, he is aware that he is dreaming)

e) It can be observed in cases such as not being able to sleep at a sufficient depth due to another mental or physical disorder.

In some sleep disorders, there may be a (organic) disorder related to brain functions that can be detected by EEG (electroencephalographic) examination. The situation can be corrected with appropriate treatments.

Major sleep problems:

Insomnia

Excessive Sleeping (Hypersomnia)

Sleep-wake Disorder

Sleep Problems in Mental Disorders

parasomnias

Insomnia

Insomnia is the most common sleep disorder. In these cases, there is usually a deterioration in sleep habits. For diagnosis, insomnia must last for at least a month and be at least 3 times a week. These patients worry about not being able to sleep, and they worry that they will not be able to sleep at night. His mind is constantly busy with daily tasks. The patient tries various sleeping methods. But as long as he tries, he does not sleep; therefore it becomes more restless.

A physical illness (such as Parkinson’s disease, heart pain, breathing difficulties, asthma, arthritis) or amphetamine, steroid, antidepressant, excessive tea, coffee intake or alcohol, etc. Quitting habit-forming substances can also cause insomnia.

When there is no obvious psychological or organic cause in insomnia, it is necessary to pay attention to sleep hygiene, especially before treatment with medication.

For healthy sleep;

• Try to get into the habit of always going to bed at the same time and getting up at the same time in the morning.

• Even if you go to bed late at night for any reason, get into the habit of getting up at a certain time in the morning. When you get into this habit (when you get up at a certain time every morning and you don’t sleep or doze during the day), it will be easier for you to fall asleep at night after a while.

Avoid strenuous activities in the few hours just before sleep.

Do not use the bedroom for activities other than sleep (such as working, watching TV).

Do not eat excessive and heavy meals at dinner.

Avoid alcohol, cola drinks, coffee, tea and cigarettes that have stimulating effects at night. Do not drink alcohol as it is thought to have a sleep-inducing effect.

Avoid smoking in the bedroom.

If you’re having trouble falling asleep, don’t force yourself to go to sleep, get out of bed after twenty-twenty-five minutes and go to another room and do something that is relaxing, not distracting, and more or less monotonous. Avoid newspapers, magazines or exciting TV shows, movies and books.

In the meantime (linden, milk, ayran, etc.) for something warm. It may be beneficial to do light exercise such as walking and gymnastics that will not make you sweat too much.

Practice breathing and relaxation exercises before turning to medication.

You should see a doctor if the insomnia persists for several weeks despite doing all these things.

You should know that,

Insomnia Doesn’t Make You Crazy.

Excessive Sleeping (Hypersomnia)

Too much sleep is sometimes a complaint in itself. It both reduces the performance of the person and weakens his ties with life. The main symptom of this disorder is excessive daytime sleepiness despite normal sleep at night. Daytime sleepiness may occur at work, while driving, or falling asleep in meetings. The desire to sleep continues throughout the day. Disorders such as narcolepsy*, myoclonus with involuntary contractions in a part of our body, and some medications (hypertension, allergies, antipsychotics, etc.) can cause daytime sleepiness.

Medication may be required in cases of excessive sleepiness, narcolepsy and myoclonus.

obey ku-wakefulness disorder

In some people, the day-night pattern is disrupted for a long time. The person falls asleep in the morning and wakes up towards noon or in the afternoon. It can be very difficult for a person who is used to this to change their sleep-wake pattern. It can be seen in youth confusion, personality disorders, schizophrenia, shift workers.

The sleep-wake pattern of the person depends on the biological rhythms (circadian rhythm), also known as the body clock, and shows a more or less certain structure throughout life. There may be a temporary disruption of sleep-wake order (jet-lag) during flight trips where the day-night pattern will make a difference of more than 4 time zones.

Sleep Problems in Mental Disorders

Sleep disorders such as sleeping too much or sleeping less can be seen in mental disorders. For example, sleep is decreased in mania, acute phases of psychosis, depression, anxiety disorder, and there may be a constant need for sleep in some types of depression. In sad and anxious situations, it is difficult to fall asleep or wake up many times during the night and/or wake up earlier in the morning.

Patients with schizophrenia have difficulty falling asleep and waking up frequently, and sometimes excessive sleepiness. One of the most difficult problems of schizophrenia patients to isolate themselves from daily life is that they fall asleep at night and sleep until late in the day. Sleeping during the day and not sleeping at night is the subject of complaints of families rather than patients, and it is an important area of ​​conflict between the patient and the family.

In depression and similar situations, excessive sleep can be a passive coping mechanism. Apart from depression, excessive sleep can be seen in some physical ailments.

parasomnias

Here is an abnormal event in normal sleep.

Depressed Dreams (Night Nightmare)

Asleep Fear Seizure (Pavor Nocturna)

Sleepwalking (Somnambulism)

Sleep-Related Movement Disorders

Depressed Dreams (Night Nightmare); The person wakes up with fearful dreams, which are usually seen towards the end of the night’s sleep. It may recur several times during the night. On waking, the dream is remembered, but the person may be afraid to go back to sleep. Everyone can have nightmares and wake up from time to time. In order to call this condition a disorder, it must be repeated at least a few times a week. Depressive dreams may be due to medications or drug discontinuation. It appears in childhood and is temporary. Although rare, it can be a persistent condition in adults.

Sleep Fear Seizure (Pavor Nocturna) is the state of waking up screaming with great fear, without dreaming, usually in the first few hours of sleep. There are deep fear, panic and related autonomic symptoms. It begins at the age of 4-12 and gradually disappears as childhood ends. It can be seen in adults with generalized anxiety disorder.

Sleepwalking (Somnambulism) It is a sleep disorder characterized by automatic behaviors such as sitting in bed, making repetitive movements, getting up and walking around, dressing, opening doors, and eating during the non-REM period, usually in the first few hours of sleep. During the seizure, the person’s face is dull; acts by looking at a single point, does not respond to the surroundings; it’s hard to wake up. It is common in childhood; is rare in adults.

Sleep Related Movement Disorders;Restless legs syndrome, periodic limb movements during sleep, cataplexy*, REM sleep behavior disorders, teeth grinding (bruxism) fall into this group.

* Sleeping Breathlessness (apnea) disease table : It is the cessation of breathing in recurrent seizures during sleep. The actual diagnosis of these is made in the sleep laboratory. Clinically, these people have an excessive tendency to sleep during the daytime and loud snoring during sleep.

* In narcolepsy, there are excessive drowsiness and sleep attacks during the day.

* Cataplexy (short-term atony-slackness in the muscles), inability to move suddenly while waking up or falling asleep, inability to speak, and certain sleep paralysis and hallucinations while falling asleep.

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