Causes and treatment methods for chronic insomnia. Insomnia is a complex neurological disorder. Insomnia treatment

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According to medical criteria, a diagnosis of chronic insomnia is made when sleep efficiency falls below 85% and falls asleep for more than half an hour. This clinical picture should persist for at least a month. To determine sleep efficiency, you need to evaluate the ratio of time spent sleeping to time spent in bed. According to statistics, such a pronounced disorder is present in 10-15% of the world's population. Women of childbearing age, older people and people with mental illness are more likely to suffer from it. Usually the disease is preceded by several isolated cases of episodic or short-term insomnia, to which there was no adequate response.

Types and features of chronic insomnia

The diagnosis of chronic insomnia is not made if the disorder occurs as a result of a disruption in the daily routine due to a night or shift work schedule.

Situations where sleep deficiency does not lead to dissatisfaction with this fact are not considered a problem.

Delayed sleep syndrome, when falling asleep occurs 2 hours later than usual, is also not directly related to the pathological condition.

Chronic insomnia comes in several types:

primary – an independent disease, the cause of which is not always obvious;

adaptation – the result of stress and experiences. Symptoms occur against the background of increased pathological activity of certain parts of the brain. With proper treatment, the situation quickly normalizes, the clinical picture lasts no longer than three months;
psychophysiological – the causes of sleep disorders are initially unclear, and the problem persists for a long time. Symptoms are soon supplemented by psychological disorders. The patient begins to feel afraid of falling asleep, which only increases agitation nervous system and aggravates the situation;
pseudo-insomnia is the result of a distortion in the perception of the sleep process. It seems to the patient that he did not manage to sleep at all during the night, although in fact the duration of rest exceeded 6 hours. This occurs due to a heightened perception of moments of awakening and wakefulness, and a negative internal mood.

secondary – the result of a somatic disease, neurological or mental disorder. Most often, sleep problems occur against the background of depression, neurosis, diabetes mellitus, hypertension, liver or kidney damage.

The adaptive type of deviation is the result of stress.

Symptoms of chronic insomnia are conventionally divided into several groups. Presomnia includes difficulty falling asleep, due to which this process takes more than 20 minutes. Intrasomnia symptoms are characterized by night awakenings, after which it is difficult to fall back to sleep. Post-somnia symptoms manifest themselves in the form of an early rise, after which fatigue, weakness, and lack of feeling of freshness occur.

Causes of chronic insomnia

All factors provoking the primary form of the disorder have not yet been identified. The basic causes remain stress, physical or psycho-emotional overload, disruption of the daily routine, and ignoring the rules of sleep hygiene.

Secondary chronic insomnia is recorded much more often. Sometimes it occurs against the background of physiological changes in the body, for example, during pregnancy, menopause, and puberty.

The main causes of chronic sleep disorders:

pathologies that are accompanied by persistent pain;
shortness of breath due to heart disease, respiratory failure;
damage to the urinary system;
previous TBI, organic or functional brain diseases;
hormonal disorders;
taking medications - psychotropics, theophyllines, hormones, anticonvulsants, non-steroidal anti-inflammatory drugs, alpha and beta blockers.

Shortness of breath may be the cause of the deviation.

Often a pathological chronic condition is associated with an unhealthy lifestyle. Smoking, alcohol abuse, physical inactivity, and obesity cause disruption of natural processes in the body, which manifests itself in the form of insomnia.

Treatment methods

Pharmacies offer sleeping pills various types, which promise to give you a sound sleep. Doctors do not recommend taking the medicine until less aggressive approaches have been tried.

In situations where insomnia is not caused by mental disorders or somatic diseases, it can be eliminated through lifestyle adjustments.

Treatment of chronic insomnia will give maximum effect with an integrated and professional approach to combating the problem.

Sleep hygiene

Often, lack of sleep is caused by neglecting the daily routine and ignoring the rules for organizing rest. To quickly fall asleep after going to bed, it is enough to develop the appropriate habit in your body and eliminate the influence of irritants on it.

To fall asleep quickly, you need to eliminate the influence of irritants.

Basic rules for organizing healthy sleep and proper rest:

going to bed and waking up at the same time, no exceptions on weekends;
refusal to try to take a nap during the day;
physical activity up to 16-17 hours, contributing to the development of pleasant fatigue;
avoiding heavy dinners, snacks, and drinking liquids right before bed;
exclusion of stimulants in the form of coffee, alcohol, nicotine from the routine or their use before 17:00;
providing the body with comfortable conditions for rest;
walks on fresh air in the evening.

You should also accustom yourself and your body to the fact that the bed is a place for sleeping, not eating, watching TV, solving important issues, or working with gadgets. The latter should generally be removed from the bedroom if possible so that they do not create temptation and do not become a source of radiation.

It is not advisable to drink liquids before going to bed.

How to get rid of chronic insomnia using drug therapy

Medication for insomnia is a radical method of combating the problem, which is used only by doctors. Classic sleeping pills and sedatives can be addictive and provoke mental and physical dependence. As a result, the harm they cause often outweighs the benefits received from therapy. In many cases, taking medications of this type does not provide any positive effect at all. This especially often occurs when trying to relieve symptoms without identifying the cause of the disorder. Modern products “Sleep Formula”, “Melaxen”, “Donormil”, which are available without a doctor’s prescription, are relatively safe.

Melaxen is a relatively safe drug.

How to cure chronic insomnia with folk remedies

The approach will help if night wakefulness is provoked by overstrain of the nervous system, bad mood, negative thoughts, and inability to relax. A good effect is achieved by consuming decoctions, infusions or teas based on chamomile, oregano, thyme, peppermint, motherwort or hop cones. Aromatherapy, which uses essential oils of lavender, chamomile, and lily of the valley, provides lasting positive results.

Herbal infusions can also be added to warm bath water to enhance the therapeutic results of the physiotherapy procedure. If you don’t want to waste time preparing medicinal products, you can purchase them in ready-made form at the pharmacy.

Prevention

The risk of developing chronic insomnia will decrease significantly if you initially follow a daily routine, lead a healthy lifestyle, and play sports. It is necessary to develop a number of habits, thanks to which the body will receive the maximum effect from a night's rest and fully recover. At a minimum, you should always go to bed at the same time, trying to fall asleep immediately after getting into bed. After waking up, it is not recommended to lie for a long time, get enough sleep, or do any business in bed. If you can’t fall asleep right away, it’s better to get up, wait for a new wave of drowsiness and try again.

Chronic insomnia requires treatment, regardless of the severity of the problem. If you ignore the disorder, the situation will worsen, provoking personality changes, stimulating the development of somatic and mental illnesses.

Have you ever noticed that, being very tired and exhausted, you experience an irresistible desire to fall asleep, and as soon as you get into bed, sleep simply disappears? Or do you experience itching on your skin and discomfort throughout your body before falling asleep, or maybe you are unable to find a comfortable position? If so, then most likely these are symptoms of a common disease called insomnia.

Despite the unfamiliar term, everyone has encountered insomnia and its symptoms. For example, apnea syndrome, accompanied by snoring during sleep, is the cause of insomnia. And insomnia is nothing more than a sleep disorder, the timely treatment of which does not cause any particular difficulties.

Causes of insomnia

Sleep disorders are observed in people of any gender, age, and different professions. Sleep disturbance is considered to be a pathological process (deviation from the normal state) only when sleep problems occur more than 3 times a week.

At risk are people whose work involves constant stress and night shifts. And also people who lead a sedentary lifestyle have bad habits. Sleep disturbances cause serious negative consequences in the professional (a person’s performance decreases) and social spheres (becomes irritable, “lethargic”). If you are in a high-risk group, be careful and consult a doctor at the first symptoms to avoid unpleasant consequences.

Insomnia is pathological condition characterized by a sleep disorder. Depending on the form, the patient experiences disturbances before sleep, during and after waking up. Often patients without medical education called insomnia. This is not entirely correct, because insomnia is a complete lack of sleep.

Classification of insomnia

Depending on the cause that caused sleep disorders, insomnia is divided into:

primary;
secondary.

Primary insomnia is diagnosed if it is an independent disease. Secondary insomnia is a pathological condition that appears as a consequence of another disease (primary diseases). But the pathology may also have an unclear origin (unexplained etiology). Then it is called idiopathic.

There are three types of pathology:

acute (transient);
subacute (short-term);
chronic.

Acute insomnia lasts up to 1 week, subacute lasts from 1 to 6 months, chronic - over 6 months.

Depending on how often insomnia bothers a person and the level of inconvenience caused, the following are distinguished:

mild;
moderate;
expressed.

Mild insomnia does not bother the patient every night, and the consequences of the sleep disorder are almost invisible to life. Moderate sleep disturbance occurs every night, and the consequences of sleep deprivation cause enough inconvenience to the patient that it interferes with work and personal life. With severe insomnia, a person constantly experiences serious problems with sleep, and normal life activities become impossible.

What causes insomnia?

The causes of this disease are various. Primary insomnia develops due to the psychophysiological characteristics of a person (psychophysiological insomnia). A secondary pathological condition occurs as a consequence of other diseases:

mental illness;
diseases of the central and peripheral nervous system (neurological diseases);
bodily diseases not related to human mental activity (somatic diseases): diseases of the lungs, heart.

In addition to the diseases described above, insomnia appears after consuming psychotropic drugs, as well as drinks containing alcohol and caffeine. Living in a big city (the presence of noise, vibrations, toxic compounds and other unpleasant factors), excessive stress, shift work, and time zone changes also become causes of sleep disorders.

Signs of insomnia

Symptoms of the pathology depend on the form of insomnia (presomnic, intrasomnic and postsomnic). They are observed in humans both individually and together. Presomnia symptoms include difficulty falling asleep. Healthy people fall asleep within 10 minutes, and patients suffering from presomnia insomnia need from half an hour to 4 hours. A person experiencing drowsiness loses the desire to sleep after he gets into bed.

The appearance of causeless itching throughout the body is observed, and the thought process (various kinds of memories, images) is activated. He is unable to find a comfortable position, which is why he constantly turns over from one side to the other. The process of falling asleep is so long that a person perceives it as a state of wakefulness.

A patient experiencing intrainsomia often wakes up due to lack of deep sleep. Night rest is disrupted by things that cannot wake up a healthy person (low sound, lights on). Patient wakes up feeling full bladder, scary dreams, breathing disorders, tachycardia. A healthy person also sometimes wakes up during sleep, but he quickly falls asleep (sometimes without even noticing the awakening). The patient experiences twitching of the limbs and apnea syndrome.

The post-somnia form is characterized by the severity of awakening. So, a person, having slept enough time, feels drowsy throughout the day. There is a loss of strength, decreased performance, sudden mood swings (not for the better). Upon waking up, the patient experiences discomfort in the body, headaches, and sometimes appears (high blood pressure).

This disease leads to loss of performance, impairment of memory and attentiveness, and circadian rhythm (sleep, wakefulness). In people suffering from secondary insomnia, the course of the underlying disease worsens.

How to detect insomnia

A doctor diagnoses insomnia by taking a medical history, examining the patient, and assessing his physical condition. There are two criteria that help identify this pathology:

The period of falling asleep increases to half an hour or more.
Deterioration in sleep quality to 85% or less (the ratio of the time a person sleeps and stays in bed).

In some situations, the patient is referred for consultation to a somnologist, and a procedure called polysomnography (a complete detailed examination of a person during sleep) is performed. In addition to diagnosing insomnia, the cause of its occurrence is determined. To do this, you will need to consult other doctors, undergo additional tests, tests.

Treatment methods for insomnia

Acute insomnia usually goes away on its own. Other types require therapy after identifying the cause. Insomnia can be treated with medications (medication) or without medications.

Non-drug methods include physiotherapy (acupuncture, light therapy) and psychotherapy sessions. Patients are increased in physical activity, avoid daytime naps, and are advised to maintain sleep hygiene (a set of rules that help improve the efficiency of falling asleep).

Using medication, the patient is prescribed:

sedative herbal remedies (mint, motherwort, oregano);
sleeping pills;
antidepressants.

Find out why it appears: causes, consequences.

Read how it helps with insomnia: instructions for use of the drug.

Everything about it, symptoms, treatment.

Prevention of insomnia development

The best prevention of the disease is a healthy lifestyle. In order to reduce the risk of various sleep disorders, you must adhere to the following recommendations:

do not consume alcoholic beverages and tobacco products;
limit intake of caffeinated drinks;
do not take medications without consulting a doctor;
lead an active lifestyle, avoid sleeping during the daytime;
try to go to bed (no later than ten o’clock in the evening) and wake up at the same time;
Do not overwork yourself with unnecessary loads, try to avoid stressful situations.

If you discover symptoms of the disease, you should not delay visiting a specialist, since acute and subacute forms can be treated without any particular difficulties. But if you delay and do not consult a doctor in a timely manner, chronic insomnia develops. It is quite difficult to cure it. Untimely treatment of secondary insomnia poses a great danger. Since it complicates the course of the underlying disease.

For last decades Sleep disorders have become so widespread that experts have created a separate branch of medicine that deals exclusively with solving this problem and developing methods for its treatment. Relatively recently, the World Health Organization published data from a survey of residents of more than 15 countries. Insomnia (the scientific name for a similar illness is insomnia) was the reason 27% visited a doctor, but the real numbers are still unknown.

According to doctors, we can talk about sleep disorders if one (or more) of the following signs are present:

a person cannot fall asleep after being in bed for 30 minutes or more;
characterized by frequent awakenings at night, not associated with external stimuli (noise, crying of a child, etc.);
reduction in the duration of night sleep;
feeling weak and tired after waking up.

Sleep is one of the ways our body interacts with environment Moreover, the correct biorhythm is the key to a person’s full health and adequate resistance to infections and other diseases. Roughly speaking, during wakefulness, certain information is accumulated, and it is consolidated at night during the deep sleep phase.

According to experts, when the human body is resting, the brain analyzes the received information and “develops” a further strategy for constructing responses. At the same time, secondary data is excluded, and what remains outside the scope of attention due to external stimuli comes to the fore. It is these processes that explain the improvement of memory, the inspiration that comes to people of a creative mind, and even such a phenomenon as intuition.

In addition, during sleep, the functioning of the nervous system, endocrine glands, and, consequently, hormonal levels is regulated. In addition, insomnia significantly increases the risk of damage to the corneal vessels, myocardial infarction, strokes and other disorders of the cardiovascular system.

With a lack of sleep, the level of one of the main markers of the inflammatory process, C-reactive protein, increases in the body. During a clinical study, experts noted that people who had full rest 4 hours less than normal for just three nights had impaired tissue tolerance to glucose. After 5 days, pronounced disorders of the psychoemotional state were noted, which manifested themselves in the form of attacks of irritability, anxiety and other neurological disorders. Stress resistance is also noticeably reduced.

How to improve your sleep yourself

Their range is quite wide:

antidepressants;
blockers of histamine receptors type H1;
neuroleptics;
anticonvulsants;
melatonin-based preparations.

However, the most widely used medications are those that the patient can purchase at the pharmacy independently without a prescription.

One such drug is the antihistamine doxylamine, which is sold in pharmacies under the trade names:

Valocordin - Doxylamine;
Reslip;
Donormil.

Take the medicine 15 mg per day half an hour before bedtime. Among the advantages are the possibility of use during pregnancy (in any trimester), the absence of withdrawal syndrome. But Doxylamine is contraindicated in:

lactation;
in children's and adolescence;
glaucoma;
hypertrophy of prostate tissue;
urinary disorders.

Also included as over-the-counter medications are medications containing melatonin. This substance is synthesized in the human body (epiphysis, retina and intestines). Its concentration increases significantly in the dark, which is manifested by a decrease in temperature, depression of emotional activity, and the functions of the gonads. In this way, the body “prepares” for the upcoming sleep.

This group of medications includes:

Melaxen;
Sonnovan;
Melarithm.

In addition to the hypnotic effect, melatonin also has antidepressant, antioxidant, and immunomodulatory effects. It is also prescribed to restore daily biorhythms when changing time zones. The recommended dosage is from 2 to 6 mg.

If there is no effect from over-the-counter drugs, doctors switch to strong sleeping pills.

Most of them are well tolerated by patients, but the likelihood of complications is quite high. Such medications include:

Zolpidem (Ivadal, Nitrest, Sanval, Snovitel), prescribed 10 mg;
Zopiclone (Imovan, Somnol, Relaxon, Thorson), take 7.5 mg;
Zaleplon (Andante), drink 10 mg;
Clonazepam, take 2 mg;
Trazodone (Trittiko), prescribed 75 - 150 mg.

Good results can be achieved using various methods of physiotherapy. Unlike medicines they are safe and do not cause any consequences.

Thus, patients are offered:

Phototherapy. This treatment technique involves the influence of light impulses on the visual organ system, and through them on certain structures of the brain, which makes it possible to normalize and restore biorhythms.
Encephalophonia. This is a relatively new method of physiotherapy, which consists of processing the bioelectrical activity of the brain during relaxation and wakefulness. The received signals are converted into music, which the patient is offered to listen to. This leads to the gradual restoration of normal sleep and proper rest.

To solve problems with falling asleep and staying asleep, they often resort to other methods. Meditation and auto-training programs and yoga classes in the afternoon help a lot. Massage of reflex biologically active points located on the feet, face and ears is also very effective. To overcome insomnia, some resort to relaxing music, recorded sounds of nature, sea surf, etc.

Sleep disorder: features in different categories of patients, physiotherapy and other treatment methods

Doctors pay special attention to sleep disorders in certain categories of patients. Representatives of the fair sex often experience insomnia during menopause. This is associated with hormonal fluctuations, deterioration of well-being, and depressive mood. Treatment of this condition is carried out comprehensively. From the neurological side, insomnia is corrected with the help of mild herbal sedatives. Additionally, hormonal medications may be prescribed.

In old age

After 40 years, the incidence of sleep disorders increases significantly. In older people, sleep is “blurred” throughout the day; many prefer to rest during the day, which negatively affects the quality of night sleep. Lack of physical activity and social communication also plays a role.

30% of elderly patients experience disturbances in sleep biorhythms (early falling asleep and early awakening). Sometimes they complain of difficulty falling asleep and decreased depth of sleep. This irreversibly entails daytime sleepiness and deterioration of well-being, weakness. In addition, with the onset of certain age-related diseases, many are prescribed medications that can cause insomnia.

For this category of patients, behavioral therapy for insomnia comes first. It is recommended to refrain from napping during the day and go for a walk in the evening. Reviewing the list of accepted medicines and adjust assignments if necessary.

Children's

IN early age Primary behavioral insomnia is often diagnosed. As a rule, it occurs when certain associations or attitudes are formed when falling asleep. For example, the habit of motion sickness, sleeping in the parent’s bed, at the mother’s breast, etc. Therefore, when trying to change such habits, the child actively resists, which leads to sleep disorders.

In older children, their academic performance deteriorates and constant conflicts with friends and parents begin. A tendency to hysterics and tearfulness is often noted. However, for the treatment of insomnia at an early age, medications are prescribed only as a last resort in the absence of results from other treatment methods. Parents are advised to strictly observe the daily routine and adhere to the rules of sleep hygiene. A variety of herbal baths and massages are also useful.

The effect of alcoholic drinks on sleep

Often, a heavily drunk person completely falls asleep, reacting poorly to external stimuli. Ethyl alcohol and its metabolic products inhibit the functional activity of the central nervous system, but this will not help solve the problem of insomnia. Under the influence of alcohol, sleep is superficial, and proper rest and restoration of the body does not occur. That is why drinking alcohol shortly before bed is not recommended.

Homeopathy

Sleep disturbances can be gently corrected using safe medications that are suitable for long-term use and practically do not cause unwanted reactions. This:

Ignacy - Gummacord;
Nervoheel;
Gelarium Hypericum.

Alternative Therapies

Water procedures have a positive effect on the process of falling asleep and quality of sleep. But their effectiveness can be increased by using decoctions of medicinal herbs. Suitable:

valerian;
mint;
Melissa;
series;
hop cones;
pine or fir needles.

Prepare a steep decoction (200 - 300 g per two liters of boiling water), which is poured into the finished bath. Instead of medicinal plants, you can use essential oils(sandalwood, orange, mint).

Music plays a special place in the treatment of insomnia. A lullaby sung by a mother is known to calm a crying baby. But certain melodies have a similar effect on an adult. There are enough collections of various music on the Internet for relaxation and relaxation, but classical works work best.

Sanatorium-resort treatment provides excellent results. A clear daily routine, physical therapy, a change of environment, abstraction from work problems, and walks in the fresh air work wonders. In general, health, sleep and wakefulness biorhythms are restored.

Consequences of insomnia and prevention of disorders

Without appropriate treatment, sleep disorders are dangerous with severe and often fatal consequences for a person:

risk mental disorders increases by 2.5 times;
the likelihood of depressive disorders increases 4 times;
dependence on taking strong sleeping pills;
various psychosomatic pathologies;
immunity disorders;
metabolic disorders;
impact on driving (lack of sleep during the day is comparable to 0.1% blood alcohol concentration);
productivity and efficiency halved.

In many cases, this can all be prevented. It is enough to follow a daily routine, limit your time in front of the computer, use of a smartphone and tablet, especially in bed. Attention should also be paid to diet and physical activity. Doctors recommend giving up bad habits, limit coffee consumption, strictly plan your work schedule.

Antidepressants that have a sedative effect: Tryptisol, Remeron, . They are used mainly in the elderly and those who have anxiety chronic pain and depression. The effect of antidepressants is milder than that of benzodiazepines.

In the most extreme cases, antipsychotics are used.

Many older people are bothered by itching, which makes it difficult to sleep. If there are no dermatological problems, then best effect give Hydroxyzine and Alimemazine. These are mild tranquilizers with additional antiemetic activity and have antihistamine and anticholinergic effects. Relief from itching occurs within 1 hour. The drugs do not cause mental or physical dependence. Alimemazine also has a pronounced hypnotic effect.

Diphenhydramine is considered a “folk” sleeping pill. It is undesirable to use it, since the controversial hypnotic effect is incomparable with the complications that the drug causes - urinary retention, constipation and vascular delirium.

Impact on the underlying disease

All causes that are caused by diseases of the body require prompt treatment. It is useless to treat insomnia in isolation if a person has a chronic disease that leaves him short of breath, swollen, or in constant pain.

Qualified treatment is required for the following diseases:

The need for sleep hygiene

To fall asleep normally, you need to follow a number of mandatory rules:

do not sleep during the day;
engage in physical activity in the first half of the day and spend quiet time in the evening;
take care of the comfort of the sleeping place - change the bed, purchase an orthopedic mattress and pillow, attractive bed linen;
keep the bedroom clean and well ventilated;
you can’t overeat at night;
do not drink coffee, strong tea or alcohol at night;
go to bed and get up at the same time;
avoid strong or exciting experiences at night;
ensure darkness in the bedroom;
in the bedroom only to sleep, and not to watch TV, read or “lounge around”.

Rituals that a person creates on his own help a lot. It could be a hot bath before bed, warm milk in your favorite cup, beautiful soft pajamas, an aromatic pillow, quiet music - whatever you like. Such rituals are developed individually through experience.

It is important to spend just enough time in bed to fall asleep. If you can’t fall asleep, there’s no point in torturing yourself. You need to get up and do something calm until you want to sleep again.

Explanatory psychotherapy

The most important part of psychotherapeutic work in the elderly. Aged patients are concerned about the changes occurring in the body, primarily the reduction in the duration and depth of sleep. Insomnia in the elderly is not so much a disorder as an adaptive reaction, a response to neuro-endocrine changes that are inevitable with aging.

An elderly person needs to be explained that everything that happens has natural causes, that with age the need for sleep decreases, and this is not a sign of illness. In addition, older people can afford more time for rest, and the rhythm of life can be adjusted to individual characteristics. For many older people, a gentle restructuring of stereotypes is healing; this phenomenon ceases to be frightening for them.

It is useful to master relaxation techniques, when simple muscle relaxation leads to calm and a gentle fall into sleep.

Psychotherapy of acute adaptation insomnia

This is a type of insomnia that affects the vast majority of the population. This is a stressful reaction to unfavorable life circumstances or events - interpersonal conflict, family discord, failure at work.

The psychotherapist begins treatment by accelerating adaptation to stress. Already during the period of clarification of specific circumstances, many “skeletons in the closet” are revealed that require further elaboration. This could be low self-esteem, incorrect life prospects, problems stemming from childhood, or an inability to make compromise decisions.

In many cases, behavioral therapy or behavior modification helps. Today, this concept unites a group of techniques based on teaching socially acceptable behavior patterns. It all starts with an analysis of the patient’s behavior in a traumatic situation. After analyzing the errors, they move on to model learning, when the therapist presents a model of behavior leading to a clear benefit for the patient and offers to follow it.

This method is indicative for families with constant existing conflict or employees who regularly fail in the professional sphere. The transfer method is used when the behavior of dolls, rather than specific people, is discussed. This approach allows patients to recognize typical situations of conflictual interpersonal communication and recognize the true, and not ostentatious, goals of those who are up to intrigue at home and at work.

Elimination methods are used when inappropriate behavior is “disassembled” into its components. The patient is taught to overcome fear by muscle relaxation, make lists of basic fears and work through them sequentially.

Biological methods complement psychotherapy feedback, when, with the help of acoustic or optical signals, the patient learns to recognize the state of his body and correct it.

Cognitive psychotherapy

The most important non-drug treatment for insomnia, helping to break the vicious cycle of fear that sleep will not come. The technique is aimed at changing thinking, namely at changing incorrect beliefs and prejudices that are firmly rooted in the mind. This kind of work takes a lot of time, but the result is new behavioral skills that improve adaptation to society.

Cognitive therapy is valuable because it discusses the patient's problems in the here and now. The therapist shows the patient how to think and act in harmony with the real circumstances of his life, and not with fictitious stereotypes.

The psychotherapist is often the only person who is interested in the patient’s feelings and desires. The therapist can gently change pathological attitudes that have been poisoning the patient’s life for a long time.

An important part is the discussion of fantasies, in which many unrealized possibilities are expressed. The therapist helps the patient return “from heaven to earth,” realistically assess threats and opportunities, find the best way out of a conflict, or come to terms with what cannot be changed.

Open cooperation between patient and doctor always leads to overcoming insomnia.

Difficulty falling asleep and waking up at night occurs predominantly in adults, with the majority of patients being elderly. And at least a tenth of people suffering from insomnia need special drug treatment.

Insomnia: what is it and how is it dangerous?

First of all, you need to understand what is meant by this term. Insomnia is not complete insomnia (although this is what is most often called any sleep disorder), but partial. That is, a person sleeps regularly, but restlessly, often waking up at night, or has difficulty going to bed.

This disorder of the “wake-sleep” cycle affects the quantity and quality of night rest. The patient is either unable to fall asleep for a long time, at least half an hour, or is sensitive to external stimuli and periodically awakens.

Why do sleep disorders occur?

The pathogenesis of the pathology has not been fully studied; neurologists do not have a complete understanding of the mechanisms of insomnia development. However, it was empirically possible to establish that in all patients, brain activity during sleep remains at the same level as during wakefulness. In addition, the metabolism of people suffering from insomnia is accelerated, and the concentration of certain hormones (adrenocorticotropic and cortisol) is increased.

If it is not yet entirely clear how exactly insomnia develops, its causes have been fully elucidated:

Strong emotions (both negative and positive), stress, worries, and other similar phenomena that have a stimulating effect on the nervous system.
Physiological predisposition, which consists in the innate characteristics of the body.
Psychogenic disorders - depression, various psychoses, neuroses, panic attacks.
Diseases of some internal organs or the nervous system, including its organic lesions. The pathology in this case causes pain at night and makes breathing difficult until it stops for a short time (apnea). Nighttime insomnia is often observed with hypertension, epilepsy, schizophrenia, atherosclerosis, pneumonia, and other diseases.
Eating behavior (the habit of overeating at night, for example), abuse of alcoholic and tonic drinks.
Features of lifestyle, profession, such as regular changes in time zones or a shift schedule (involving work at night). In this case, as in the previous paragraph, so-called behavioral insomnia is formed.
Taking certain medications, especially psychotropics. Such drugs stimulate the central nervous system, therefore, a full night’s rest is not possible.