Sleeping disorders
Sleep is a period that is very important for the rest and renewal of the body.
Sleep disorders cause deterioration of physical and mental health and decrease quality of life. It is an important public health problem because it can cause accidents. Sleep disorders can be asleep, difficulty in maintaining, problems with the body's biological clock or excessive daytime sleepiness, walking in sleep, wetting diapers, nightmares.
Many medical problems and psychiatric disorders can disturb sleep
It is quite common in patients with early waking, insomnia, or depression asleep. Treatment of the underlying disease may help to improve your sleep.
Periodic Leg Movements: Leg splashes occur during sleep for one to two seconds. Constant nightly splashing of the legs causes sleep interruptions and restless sleep. It can become more severe with age. Treatments are provided with medications, evening exercises and hot baths. If the iron level is low, iron treatment is beneficial.
Gastro-esophageal reflux: There is pain and stiffness in the middle of the chest and is called heartburn. During sleep, the stomach contents come back to the throat and awaken the person many times with a coughing and choking sensation. If you have reflux, raise the head of the bed 15-20 cm or lift your head with pillows. If it still persists, the appropriate medication is given to treat reflux.
Sleep Respiratory Disorders: The most common symptom in this group of diseases is snoring caused by narrowing of the throat during sleep. This disturbs individuals sharing the same bed. In addition to the causes of narrowing of the throat, excessive weight, alcohol intake, fatigue also increases the snoring conditions. When the narrowing of the throat increases, it causes complete blockage and stops breathing. Stopping breathing (above 10 seconds) among noisy snores, followed by breathing again and continuing with noisy snoring is called obstructive sleep apnea syndrome. . Sleep disturbance affects the metabolism, the rate of oxygen in the blood, the heart and vessels, sexual functions. The person wakes up in the morning not resting, not resting. Due to insomnia, attention deficit disorder, forgetfulness, sleepiness may develop during the day. Therefore, it is an important health problem affecting all physical and mental activities. The use of unprescribed medication and the use of sleep-related medications without knowing the underlying problem may be harmful. For the diagnosis of 'obstructive sleep apnea syndrome', sleep and breathing recordings and examination are required in the sleep laboratory. Obstructive sleep apnea syndrome is a treatable disease. The aim of treatment is to keep the upper airway open by giving positive pressure from outside, which has an increased tendency to close during sleep. For this purpose, pressure therapy is applied through the nose through the mask. Surgical treatment may be appropriate in patients with anatomic stenosis of the upper airway and moderate disease. The other treatment method that can be selected in these patients is the intraoral device placed in the mouth which is arranged by dentistry. Treatment with psychological support can reduce and eliminate negative outcomes.
Insomnia
It is an important health problem seen in one out of three people in case of difficulty falling asleep or maintaining sleep. It is seen at any age. It is most commonly seen in women and older people.
Insomnia due to adjustment disorder
It is a problem of falling asleep or sustaining for several nights due to excitement or tension. It takes less than three months. For example, when you are away from home, journeys beyond the time frame are often seen before starting a new job, before an important exam or sports activity, before an important business meeting or after a discussion. Sleep returns to normal when the stressful situation ceases or the person begins to adapt.
Chronic Insomnia
It takes at least a month. Mostly people are worried about their sleep. With psychological support, identifying and eliminating the underlying problem provides treatment.
Learned Insomnia
If you cannot sleep during stressful periods and are trying hard to sleep at night, it may become increasingly learned. Things done before going to bed remind you of sleeping problems and suddenly make you more alert. However, when they are not in bed, they easily sleep on the couch, reading newspapers and watching television. Treatment is provided by "not learning" things that remind you of stressful sleep and learning new sleeping habits.
Life style
If you drink coffee or cigarettes at night, it may prevent you from falling asleep or your sleep will be less relaxing. Weight loss medications, allergy and asthma medications, cold medicines contain stimulants and can disrupt sleep.
It is generally thought that a glass of wine before bedtime helps to sleep. However, although alcohol allows to fall asleep, it causes awakening during sleep for short periods.
In shift workers, sleep disturbances are common. This also occurs in people whose working hours are constantly changing. Programming to sleep at certain times and stay awake at other times helps a good sleep. Waking up at the same time every morning is a way to fix the way you sleep.
Regular exercise provides better sleep. The best time to exercise is in the afternoon. Do not exercise near bedtime.
Sleeping pills should be used under medical supervision. Some sleeping pills become useless if they are used for a long time. If you stop using it all of a sudden, it may break your sleep. Reducing need to cut.
Environmental Factors
The bedroom should be as quiet as possible. The noisy environment causes disruptions in falling asleep and disrupt sleep during sleep.
It is necessary to keep the bedroom dark. You can use thick curtains for this.
Treatment
Insomnia due to bad sleep habits can only help in providing information and training.
Insomnia should first be recognized correctly and treatment options discussed with a specialist.
If medication is required, talk to your specialist to determine which is the best treatment and medicine. 'Jet lag' develops with flight over many time periods. It can trigger both insomnia and excessive daytime sleepiness. An appropriate sleeping medication that allows you to sleep on a plane during a night flight can reduce your excessive daytime sleepiness by regulating your sleep. Shift workers can sometimes be given medication to help them fall asleep. This can reduce daytime sleepiness and help adapt to the new program. Appropriate drug use during stressful periods may prevent sleep problems in people with insomnia.
Those with insomnia spend more time in bed, which interrupts sleep and creates frustration. Sleep restriction reduces the time spent in bed and makes sleep more effective.
Sometimes the bedroom becomes the place where things are done or where sad thoughts and discussions take place. These activities and thoughts often prevent sleep as a stimulus. Controlling and removing stimuli makes it easier to fall asleep. So try to sleep only when you feel sleepy. If you're not feeling sleepy and can't fall asleep in 20 minutes, get out of your bedroom and start a quiet activity elsewhere. Read books and listen to light music. Go back to your bedroom only when you feel sleepy. Keep a regular wake-up time even on holidays and weekends. Use your bedroom only for sleep and sexual intercourse. Before you go to bed every night, do some activities that help you relax, such as a warm bath or reading. Avoid heavy exercise, alcoholic beverages, cigarettes or other nicotine-containing foods six hours before bedtime. Do not be hungry, but do not eat heavy meals. Share your concerns with a family member or friend. Express your feelings in a diary. Share your feelings with your specialist.
Avoid sleeping during the day. However, take a nap for half an hour after lunch.
Try to focus on pleasant thoughts in a tranquil setting for relaxation and relaxation.
COGNITIVE THERAPY for the purpose of correcting information and correcting thoughts facilitates the initiation of sleep and helps to reduce anxiety during the day, thus helping to relieve insomnia
Excess Daytime Sleepiness
The main symptom of the disease is a short period of unbearable sleep attacks and a constant feeling of sleeplessness when awake.
Although excessive daytime sleepiness is a common symptom for many diseases, one of the most important diseases to remember is "Narcolepsy". In narcolepsy there may also be a loss of muscle power in the form of collapsing where excessive excitement occurs, such as laughing, surprise, fear, so-called 'cataplexy'. The other symptoms of the disease are the inability to move any organs for a short period of time, feeling like a paralysis while awakening from sleep, despite being in place of consciousness. The exact cause of narcolepsy is unknown. In recent years, a hormone called "Hypokretin" has been found to be low and the genetic structure secreting this hormone has been found to be defective. The patient who is thought to have narcolepsy is called "sleep test" called polysomnography. This test is expected to be normal. Daytime sleepiness has subjective (with questionnaires such as the "Epworth sleep scale") and objective (with tests such as MSLT or MWT). The day after the night of the sleep test, the so-called MS MSLT gündüz helps to make a diagnosis. In narcoleptic patients, MSLT test, which takes about 4-5 times 20 minutes of sleep at 2 hour intervals, shows the sleep phase called REM sleep much earlier than normal people in the first 5-10 minutes of sleep.
It is most often confused with the disease called "Idiopathic Hypersomnia". There are no signs and symptoms such as hallucinations, cataplexy and sleep paralysis observed in narcolepsy.
Kleine - Levin Syndrome, a rare disease, should not be forgotten. In this disease, it may show symptoms like sleeping more than 16 hours a day (3 to 15 days), eating too much or being overly eager for sexuality. It is expected to occur at a younger age, after stress or after an infection.
Specialist psychiatry and neurology physician follow-up is important in treatment. 10 - 20 mg / day Clomipramine treatment is used to correct conditions such as cataplexy, hallucinations and sleep paralysis, while Modafinil 100 - 400 mg / day is the most effective treatment for daytime sleepiness.
Also recommendations on sleep hygiene are useful.
parasomnia
Sleep freezes are observed with abnormal behavior during sleep. Sometimes it becomes more frequent, its intensity increases and requires treatment.
Confused awakening, sleepwalking and sleep terror are the most common parasomnias among the wakefulness disorders. It is mostly in the deepest part of sleep, not seen in dreams. Although one can do some complicated behavior, he is actually asleep and does not remember what he has done. It is common in children. Sometimes it can cause fatigue, febrile illness or some medications.
Crying and wandering in sleep are common in infants and children. Sometimes it can be in adults. It is difficult to wake up at this time, it may take up to half an hour. Often when he wakes up, he doesn't remember what happened and wants to go back to sleep.
Sleepwalking is common in older children. Sometimes he just gets out of bed and takes a few steps. But sometimes they can even go outside. Sometimes they talk, but they can do things that are incomprehensible, complicated. It may be necessary to take precautions to avoid injuries. Mostly it does not require treatment. It is not a symptom of a serious disease, it can cause tension or fatigue at the time. In children, the frequency decreases with age.
Eating is a rare form of sleepwalking. It is more common in young women.
Sleep Terror: Sleep begins with intense fear and a creepy scream. Pupils are enlarged, breathing is accelerated, sweat and very mobile. Horses from the bed; wanders around the room and even inside the house like crazy. This can harm both themselves and others. Terrified people around him. The person is unaware, he does not remember anything when he wakes up. This is the biggest difference from nightmares or bad dreams, so the event is not related to the dream.
Hypnagogic hallucination is a state of dreaming while awake just before falling asleep. These dreams can be scary because they are real.
Sleep paralysis (nightmare) is the inability to move the arms and legs as if paralyzed when awakened. Mostly after a dream.
Hypnagogic hallucinations and sleep paralysis may occur together. It is common in narcolepsy. There may also be people who have not been able to sleep.
REM Sleep Behavior Disorder: During most of our dreams, during Quick Eye Movements sleep, normally all muscles except the respiratory muscles are paralyzed. When this paralysis is not fully realized, the person plays in a sense the things they do in their dreams. This situation can harm both himself and his relatives. Treatment is done with drugs.
Startled during sleep: Sudden startle occurs as the whole body falls asleep. Sometimes it may also be sudden light or sound detection. Mostly harmless.
Tooth Grinding (Bruxism): In severe cases, some instruments may need to be inserted into the mouth. The underlying causes of tension for treatment should be eliminated.
Rhythmic Movement Disorder: Mostly seen in children. Shaking the head or body or turning the head to the left or right. It occurs just before or during sleep. In some severe cases, treatment may be required.
In case of dangerous situations that may cause harm to oneself or others, eating excessively or disturbing the people around them, excessive sleepiness during the day and if these complaints persist after childhood, treatment should be done with the help of an expert.
Simple measures should be taken to prevent injury to the person with alertness. Preventing injuries in the bedroom, closing the windows, doors, installing a lock or alarm are the precautions that can be taken.
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