For quotation: Kovrov G.V., Lebedev M.A., Palatov S.Yu., Merkulova T.B., Posokhov S.I. Sleep disturbances in anxiety and anxiety-depressive disorders // RMJ. Medical Review. 2015. No. 10. P. 530

In clinical practice, sleep disorders are usually combined with anxiety and depression. Existing research shows a close relationship between sleep disorders and anxiety and depressive disorders. A clear dependence of the severity of both groups of diseases on concomitant sleep disorders has been shown. In general somatic practice, the prevalence of insomnia reaches 73%, in borderline psychiatry, clinically defined insomnia occurs in 65%, and changes in night sleep according to polysomnography are observed in 100% of cases.

Combination of sleep disorders and anxiety disorders

It is known that the relationship between sleep disorders and anxiety disorders is observed, on the one hand, when sleep disorders can provoke the development of anxiety disorders, and on the other hand, when the onset of an anxiety disorder precedes the onset of sleep disorders. Complaints about problems related to sleep are typical for patients with all diseases included in the group of anxiety disorders. In the case of major generalized disorder and post-traumatic stress disorder (PTSD), sleep disturbances are one of the criteria necessary for diagnosis. There are objective reasons for the development of sleep disorders within the framework of anxiety disorders, namely: anxiety is manifested by increased cortical activation, which entails difficulty falling asleep and maintaining sleep.

In the clinic, anxiety manifests itself as restlessness, irritability, motor agitation, decreased concentration, and increased fatigue.

The most striking manifestation of anxiety disorders is generalized anxiety disorder (GAD), which is diagnosed based on the presence of at least 3 of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. The duration of the disease must be at least 6 months, the symptoms must cause psychosomatic discomfort and/or social maladjustment.

Sleep disturbances in this situation are one of the 6 diagnostic criteria for GAD. The main symptom of GAD is excessive, persistent anxiety, which is the main factor predisposing to the development of insomnia. Insomnia and GAD are closely related, usually comorbid, disorders. The difference between insomnia due to an anxiety disorder and primary insomnia not associated with other diseases is the nature of the experience during the process of falling asleep. In the case of GAD, the patient is worried about current problems (work, study, relationships), which interferes with the process of falling asleep. In the case of primary insomnia, it is the disease itself that causes concern.

A polysomnographic study can reveal changes characteristic of insomnia: increased time to fall asleep, frequent awakenings, decreased sleep efficiency, and a decrease in its total duration.

Another striking example of anxiety disorders is panic disorder, which is manifested by recurrent states of severe anxiety (panic). The attacks are accompanied by phenomena of depersonalization and derealization, as well as severe autonomic disorders. The patient's behavior shows avoidance of situations in which the attack first occurred. Fear of loneliness and a recurrence of the attack are possible. A panic attack occurs spontaneously, outside of formal situations of danger or threat.

Panic disorder is more common in women and usually begins around age 20. A distinctive feature of panic disorder is spontaneous episodes of panic attacks, characterized by attacks of fear, anxiety and other vegetative manifestations. About 2/3 of patients suffering from this disorder experience some kind of sleep disturbance. Patients complain of difficulty falling asleep, non-restorative sleep, as well as characteristic nocturnal panic attacks. It should be noted that the presence of certain sleep-related problems can lead to worsening anxiety disorders, including panic disorder.

A polysomnographic study may reveal frequent awakenings, decreased sleep efficiency, and a reduction in overall sleep duration. It is not uncommon to observe a combination of depression and anxiety disorders, and therefore there is a possibility that the presence of other changes in sleep structure in patients with panic disorder is associated with comorbid depression, therefore it is necessary to exclude the diagnosis of depression in patients with similar sleep disorders.

Sleep paralysis, a characteristic of narcolepsy, can also occur with panic disorder. It is a motor paralysis that occurs when falling asleep or waking up, during which patients experience fear, a feeling of tightness in the chest and other somatic manifestations of anxiety. This symptom also occurs in patients with post-traumatic stress disorder.

Nighttime panic attacks are a common occurrence with this disease. They manifest themselves with a sudden awakening and all the symptoms characteristic of panic attacks. Awakening occurs during the slow-wave sleep phase, which most likely excludes their connection with dreams. It was also found that night attacks are an indicator of a more severe course of the disease. It must be remembered that patients, fearing a repetition of such episodes, deprive themselves of sleep, which leads to more serious disorders and generally reduces the quality of life of these patients.

PTSD is a disease from the group of anxiety disorders in which sleep disturbances are a diagnostic criterion. Sleep disturbances in this disease include 2 main symptoms: nightmares and insomnia. Other phenomena inherent in PTSD and associated with sleep are: somnambulism, sleep talking, hypnagogic and hypnopompic hallucinations. The changes detected by polysomnography are not specific and in some cases may be absent. Possible changes include: an increase in the representation of the 1st stage of sleep, a decrease in the representation of the 4th stage of sleep. Also, with PTSD, breathing disorders during sleep are often found.

Agoraphobia, which is defined as anxiety that arises in response to situations from which, in the patient’s opinion, is difficult to escape, can also be a manifestation of anxiety disorders. In the clinical picture, as a rule, there is a persistent fear of the patient being in crowded places, public places (shops, open squares and streets, theaters, cinemas, concert halls, workplaces), fear of independent long trips (on various types of transport). The situational component of agoraphobia syndrome is expressed in the confinement of phobic experiences to certain situations and in the fear of getting into situations in which, according to patients, a repetition of painful sensations is likely. Often agoraphobic symptoms cover many fears of various situations, forming panagoraphobia - fear of leaving the house with the development of deep social maladaptation. The patient's attempts to overcome his own experiences are observed; in unfavorable cases, social activities are limited.

Specific phobias are characterized by the connection of anxiety with certain situations (air travel, contact with animals, the sight of blood, etc.), also accompanied by an avoidance reaction. Patients are critical of their experiences, however, phobias have a significant impact on various areas of the patients’ activities. The following forms are found: cardiophobia, cancerophobia, claustrophobia, etc. Sleep disturbances in these patients are nonspecific, and from the patient’s point of view they are a minor manifestation of the disease.

In general, the most common manifestations of sleep disorders in anxiety states are presomnia disorders. The initial phase of sleep consists of 2 components: drowsiness, a kind of desire to sleep, and falling asleep itself. Often, patients have no desire to sleep, no desire to sleep, muscle relaxation does not occur, and they have to perform various actions aimed at falling asleep. In other cases, the desire to sleep is present, but its intensity is reduced, and drowsiness takes on an intermittent, wave-like character. Drowsiness occurs, muscles relax, perception of the surroundings decreases, the patient takes a comfortable position for falling asleep, and a slight drowsy state appears, but soon it is interrupted, disturbing thoughts and ideas arise in the mind. Subsequently, the state of wakefulness is again replaced by slight drowsiness and superficial drowsiness. Such changes in states can be repeated several times, leading to emotional discomfort that prevents the onset of sleep.

In a number of patients, worries about disturbed sleep can acquire an overvalued-hypochondriacal coloring and, according to the mechanisms of actualization, come to the fore; often an obsessive fear of insomnia arises - agripnophobia. It is usually combined with an anxious and painful expectation of sleep, certain demands on others and the creation of the special conditions noted above for sleep.

Anxious depression is characterized by the patient's constant experience of anxiety, a sense of impending threat and uncertainty. Anxious experiences change: worry about your loved ones, fears about your condition, your actions. The structure of anxious depression, as a rule, includes anxious fears, feelings of guilt, motor restlessness, fussiness, fluctuations in affect with worsening in the evening hours, and somatovegetative symptoms. Anxious and melancholy affects often occur simultaneously; in many cases it is impossible to determine which of them is leading in the patient. Anxious depression most often occurs in people of involutionary age and occurs in protracted phases. In addition, it is actually the leading type of neurotic level depression.

The patient exhibits a variety of symptoms of anxiety and depression. Initially, one or more somatic symptoms may be detected (for example, fatigue, pain, sleep disturbances). Further questioning reveals depression and/or anxiety.

Signs of anxious depression:

• low mood;
• loss of interests;
• pronounced anxiety.

The following symptoms are also often detected:

• sleep disorders;
• physical weakness and loss of energy;
• fatigue or decreased activity;
• difficulty concentrating, fussiness;
• impaired concentration;
• agitation or inhibition of movements or speech;
• appetite disorders;
• dry mouth;
• tension and anxiety;
• irritability;
• tremor;
• heartbeat;
• dizziness;
• suicidal thoughts.

Often with anxious depression, variants of presomnia disorders are observed, in which the desire to sleep is pronounced, drowsiness increases quickly, and the patient falls asleep relatively easily, but after 5–10 minutes he suddenly wakes up, drowsiness completely disappears, and then for 1–2 hours he does not can fall asleep. This period without sleep is characterized by unpleasant ideas, thoughts, fears, reflecting, to a greater or lesser extent, the experienced conflict situation and the reaction to the inability to sleep. Hyperesthesia to sensory stimuli is also observed. Those suffering from this form of sleep disorder react extremely painfully to the slightest sensory stimuli, even outbursts of passion.

Disturbed sleep patterns are characterized by a prolongation of the drowsy period. This drowsy state is often accompanied by motor, sensory and visceral automatisms, sharp shudders, vivid perceptions of sounds and visual images, palpitations, and sensations of muscle spasms. Often these phenomena, awakening the patient, cause various painful ideas and fears, sometimes acquiring an obsessive character.

Sleep disorders and their polysomnographic manifestations among mental illnesses have been most studied for depressive disorder. Among the sleep disorders associated with depressive disorder, the most common is insomnia. The severity and duration of insomnia are manifestations of a more severe depressive disorder, and the appearance of insomnia during remission indicates the imminent occurrence of a repeated depressive episode. In addition, sleep disorders in this disease are the most persistent symptom. The close relationship of this disorder with sleep disorders is explained by the biochemical processes characteristic of depression. In particular, in depressive disorder there is a decrease in the level of serotonin, which plays a role in initiating REM sleep and organizing delta sleep. Depressive disorder is characterized by the following manifestations of sleep disturbances: difficulty falling asleep, non-restorative sleep, as a rule, reduced total sleep time. The most specific symptoms for depression are frequent awakenings at night and early terminal awakening. Complaints of difficulty falling asleep are more common in young patients, and frequent awakenings are more common in older patients.

With masked depression, complaints of sleep disturbances may be the only manifestation of the disease. With depression, in contrast to primary insomnia, there are complaints of sleep disturbances typical of this disease: frequent awakenings, early morning awakening, etc.

In a polysomnographic study, the following changes are observed: an increase in the time it takes to fall asleep, a decrease in sleep efficiency. The most common symptoms specific to depressive disorder are shortened REM sleep latency and decreased delta sleep. It has been found that patients with a higher proportion of delta sleep remain in remission longer compared to patients who experience a decrease in the proportion of delta sleep.

Attempts have been made to explore the possibility of using depression-specific sleep disturbances as markers of depressive disorder. Due to the heterogeneity of the manifestations of sleep disorders, this issue remains not fully resolved.

The characteristics of sleep disturbances in various types of depression were also highlighted. Patients with a predominance of the anxiety component are more likely to have difficulty falling asleep and early awakenings. With this type of depression, dream plots are associated with persecution, threats, etc. In addition, these patients generally had a high level of wakefulness before falling asleep. For depression with a leading affect of melancholy, early morning awakenings and dreams of static types of gloomy content are most characteristic. Depression with apathy affect is characterized by early awakenings and rare, unsaturated dreams. Also typical for depression with apathetic affect is the loss of the sense of boundaries between sleep and wakefulness. Patients with bipolar disorder have a similar polysomnographic pattern.

Features of sleep disturbance in bipolar disorder are a significant decrease in sleep duration during a manic episode and a greater tendency of patients to hypersomnia during depressive episodes compared to the unipolar course of the disorder. There are usually no complaints of sleep disturbances during manic episodes.

Treatment

For the treatment of anxiety and depressive disorders, drugs of various pharmacological groups are used: tranquilizers (mainly long-acting or short-acting benzodiazepine drugs), selective serotonin reuptake inhibitors, selective serotonin reuptake stimulants, tricyclic antidepressants. All of these drugs, to one degree or another, affect a person’s sleep, making it easier to fall asleep, reducing the number and duration of night awakenings, thereby affecting the recovery processes that occur during night sleep. When developing tactics for treating sleep disorders combined with anxiety and depressive symptoms, it is important to remember that insomnia itself can increase anxiety, worsen well-being, and mood, usually in the morning after poor sleep. In this regard, the use of hypnotics in treatment may be promising if insomnia symptoms are predominant in the clinical picture in order to prevent exacerbation of anxiety and depressive disorders. In this regard, the most effective assistants can be hypnotics that affect the GABAergic (GABA - γ-aminobutyric acid) system - histamine receptor blockers (Valocordin®-Doxylamine) and melatonin preparation. The most convenient to use in the treatment of insomnia is Valocordin®-Doxylamine, which is available in drops, which allows you to select an individual dose of the drug.

Valocordin®-Doxylamine is a unique drug used as a hypnotic. Most of the known hypnotic drugs (benzodiazepines, cyclopyrrolones, imidazopyridines, etc.) act on the GABAergic complex, activating the activity of somnogenic systems, while histamine receptor blockers act on the waking systems, not sleep, reducing their activation. A fundamentally different mechanism of hypnotic action allows Valocordin®-Doxylamine to be used more widely: when changing one drug to another, reducing the dosage of “habitual hypnotics,” as well as when it is necessary to discontinue hypnotics.

A study of the drug in healthy subjects showed that doxylamine succinate leads to a decrease in the duration of night awakenings and stage 1 sleep and an increase in stage 2 sleep without a significant effect on the duration of the 3rd and 4th stages of sleep and REM sleep. There was no significant subjective effect on the reports of healthy volunteers, however, compared with placebo, doxylamine increased the depth of sleep and improved its quality.

In Russia, one of the first studies was carried out under the leadership of A.M. Veyna. It has been shown that under the influence of doxylamine, such subjective characteristics of sleep as the duration of falling asleep, the duration and quality of sleep, the number of night awakenings and the quality of morning awakening improve. Analysis of objective sleep characteristics showed that while taking doxylamine, there is a reduction in the time of wakefulness during sleep, a decrease in the duration of falling asleep, an increase in sleep duration, REM sleep phase time, and the sleep quality index. It was also shown that doxylamine did not reduce the effectiveness of the use of other drugs in patients, such as antihypertensive, vasoactive, etc. The results of a study of the effect of doxylamine on patients with insomnia indicate the effectiveness of this drug in these patients. Subjective feelings of a positive effect are confirmed by objective studies of the structure of sleep, which is undergoing positive changes, which affect indicators such as sleep duration, duration of falling asleep, REM sleep phase. Of great importance is also the absence of any changes in the results of questionnaire data regarding drowsiness and sleep apnea syndrome, which indicates the absence of an aftereffect of the drug in relation to the worsening of obstructive apnea syndrome. However, if obstructive sleep apnea is suspected, doxylamine should be prescribed with caution.

Modern clinical studies do not reveal serious side effects when treated with therapeutic doses of the drug, but it is always necessary to remember the possible appearance of symptoms arising due to the individual characteristics of the body and contraindications (glaucoma; difficulty urinating due to benign prostatic hyperplasia; age under 15 years; increased sensitivity to the drug).

Simultaneous use of the drug Valocordin®-Doxylamine and sedatives that affect the central nervous system (CNS): antipsychotics, tranquilizers, antidepressants, hypnotics, analgesics, anesthetics, antiepileptics, may enhance their effect. Procarbazines and antihistamines should be combined with caution to minimize CNS depression and possible drug potentiation. During treatment with Valocordin®-Doxylamine, alcohol should be avoided as it may unpredictably interfere with the effects of doxylamine succinate.

While using this drug, it is recommended to avoid driving a car and operating machinery, as well as other activities accompanied by an increased risk, at least in the first stage of treatment. It is recommended that the attending physician evaluate the individual reaction rate when choosing a dose. These features of the drug’s influence are important to consider when treating patients with insomnia in order to increase the effectiveness of the drug Valocordin®-Doxylamine and eliminate possible undesirable effects.

Conclusion

When diagnosing the disease, it is important to remember that, as a rule, problems falling asleep indicate the presence of severe anxiety, early awakenings are a manifestation of depression. When choosing treatment tactics at all stages of the development of anxiety-depressive syndrome (ADS), the prescription of modern sleeping pills at the stage of unexpressed ADS is a promising tactical approach aimed at reducing the risk of further increase in symptoms of anxiety and depression.

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Sleep is a complex physiological act, during which a “reboot” of the basic processes of the nervous system occurs. Daily rest is necessary for the normal functioning of the body. Restless sleep is a pathological condition in which a person sleeps, but his brain continues to be active. Why does this happen and what consequences can it lead to: let's figure it out.

Restless sleep in an adult: causes of the condition

The main factors causing restless sleep in adults include:

• unfinished business that causes anxious thoughts;
• increased nervous excitability, excessive emotionality or, on the contrary, an attempt to always control one’s emotions (see);
• stress (death of a loved one, dismissal from work, divorce);
• uncontrolled intake of stimulants (coffee, alcohol, drugs, etc.);
• regular violations of the daily routine due to frequent flights, night shift work;
• exacerbation of bronchial asthma (shortness of breath in patients with chronic respiratory diseases increases, usually at night);
• arthritis, rheumatism, and other diseases of the musculoskeletal system, manifested by pain;
• gastrointestinal disorders;
• cardiovascular diseases (see);
• neurological and mental disorders (see).

Restless sleep in an adult, the causes and treatment of which are discussed in this article, is a fairly common pathology. Up to 75% of the planet's population has encountered it at least once.

How does restless sleep manifest?

Restless sleep in an adult, depending on the cause, can manifest itself as:

• shuddering, twitching - involuntary muscle work caused by the presence of active, “non-sleeping” areas in the brain;
• bruxism - unpleasant grinding of teeth, which can impair breathing;
• night terrors, nightmares. A person wakes up in a cold sweat, his heart rate is rapid, and his breathing is intermittent.

The nature of the dream itself also changes:

• a person cannot fall asleep for a long time, tosses and turns in bed, and hundreds of thoughts appear and then end in his head;
• the dream is very disturbing, sensitive: awakening occurs at the slightest sound;
• after normal falling asleep, very early wakefulness may occur (at three to four o'clock in the morning). Afterwards, sleep either does not come at all, or becomes exhausting, intermittent, filled with disturbing dreams;
• severe weakness during the daytime: no energy for work or study, chronic fatigue, constantly want to sleep;
• negative emotions before a night's rest, fear that you won't be able to get enough sleep again.

Why is there no strength in the body? The fact is that restless sleep can hardly be called complete, and it does not provide the need for rest that is so necessary for every person. All systems, especially the nervous system, work hard, and sooner or later they will fail.

Restless sleep: principles of treatment

The body's powerlessness during restless sleep is a signal for help. What to do when you have no strength and weakness interferes with normal life and work? To normalize sleep, it is important to identify and eliminate the cause of sleep disturbance:

• try to forget about everything when you cross the threshold of the bedroom. The ability to “switch” is an important point in the health of the nervous system;
• You can't always cope with stress on your own. Don’t avoid the problem, seek help from a specialist (psychologist or psychotherapist);
• try to adjust your daily routine. If sleep problems are caused by constant business trips and frequent night shifts, you may need to change jobs;
• all chronic diseases accompanied by pain, shortness of breath and other unpleasant symptoms, which usually worsen at night, require timely diagnosis and treatment. Be sure to contact a therapist with your complaints.

1. Make your bed a place for sleeping only. Don't spend much waking time lying down.
2. Create a rough daily routine and try to go to bed at approximately the same time.
3. Avoid daytime naps, no matter how much you want to rest.
4. Put the clock away in the bedroom.
5. Do not watch TV, avoid noisy active activities at least 2 hours before going to bed. Devote the evening to reading and communicating with loved ones.
6. Avoid alcohol, coffee and tobacco. But warm milk will help you relax and get ready for sleep.
7. Don't pass it on. But don’t go to bed hungry: if you’re hungry, drink a glass of kefir or nibble on an apple.
8. Create a pleasant, relaxing atmosphere in your bedroom.

Traditional methods will also help you cope with the problem of falling asleep.

Milk-honey drink

Ingredients:

• honey – 1 tsp;
• dill juice – 1 tsp;
• milk – 1 glass.

Pour warm milk over honey and fresh dill juice and take it in the evening if you have problems falling asleep.

Pumpkin decoction

Ingredients:

• fresh pumpkin – 200 g;
• honey – 1 tsp.

Peel the pumpkin, cut into small cubes, pour 250 ml of boiling water and cook over low heat for a quarter of an hour. Strain, add honey and take half a glass before bed.

We figured out the causes and symptoms of the condition, as well as why restless sleep causes impotence in the body, and what to do to improve night's rest. In addition to identifying the main cause of the problem, which is not always hidden in disorders of the nervous system, it is important to pay attention to the environment at home and establish a bedtime routine. A psychotherapist studies sleep problems. It is worth turning to him for long-term insomnia and restless, disturbing sleep.

Sleep disturbance is a serious problem that deprives many people suffering from such disorders of vitality and reduces their performance. The importance of the sleep cycle cannot be underestimated, as it is dangerous to health and even life.

Sleep is a vital cycle that repeats itself day after day. It is characterized by a state of rest, physical inactivity, lasting on average about 8 hours. During this period, the body rests. The body's systems are restored, information received during the day is processed and stored, and the immune system's resistance to infectious agents increases.

Various external and internal factors can affect the sleep cycle. As a result, various types of sleep disorders develop. Why do sleep cycle disorders occur? What diseases is this associated with? How to restore sleep patterns? How to deal with sleep disorders? The answers to these important questions will be discussed in the article below.

Types of sleep cycle disorders

There is a special classification of sleep cycle disorders. The main types of pathologies of the sleep cycle are the following conditions:

1. Insomnia is a type of pathological condition that is characterized by problems with the process of falling asleep. At the same time, the sleep cycle itself is short-term, very sensitive. Insomnia develops against the background of mental illnesses of the nervous system, or as a result of prolonged use of alcohol or certain medications.
2. Hypersomnia is a type of sleep pathology characterized by a state of constant drowsiness. People suffering from this disorder can sleep up to 20 hours a day. It develops as a result of deep depression and chronic lack of sleep. There are such forms of hypersomnia:

• – a type of hypersomnia characterized by a sudden attack of drowsiness, causing a person to fall asleep on the spot. The main symptom of this disease is cataplexy - loss of muscle tone while awake (a person freezes in a certain position, without loss of consciousness);
• – excessive sleepiness during the daytime;
• a type of hypersomnia associated with alcohol dependence.

1. Parasomnia is a sleep disorder that is characterized by disruptions in the phases of the sleep cycle, as a result of which a person often wakes up at night. Restless sleep develops against the background of enuresis (urinary incontinence during night rest), various forms of sleepwalking, and epilepsy (bursts of electrical activity in the brain). May be associated with night terrors and nightmares.
2. in a dream - disruption of the pulmonary ventilation process. As a result of such a failure, an adult develops hypoxia - oxygen starvation of tissues, which leads to impaired concentration and daytime sleepiness. Apnea is accompanied by snoring, which makes it difficult for close family members and the sufferer to rest.
3. Ordinary insomnia is the most common sleep cycle disorder, which can be caused by various factors.
4. Sleep paralysis is a common phenomenon in which, at the stage of falling asleep or waking up, a person is aware of everything, but cannot move or speak. enough.
5. Bruxism - . It appears in both adults and children.

Causes of sleep disturbances. Symptoms

The normal sleep cycle is characterized by a process of quickly falling asleep, after which awakening occurs after a certain period of time (depending on how much time a person needs to rest). On average, an adult's nightly rest should be at least 8 hours.

However, due to certain factors, sleep cycles and quality may be disrupted. This is due to health status, the presence of chronic diseases and the negative influence of the external environment. So, the main causes of sleep disturbance in adults are:

• emotional excitement, shock. Such conditions can develop due to frequent stress, prolonged depression, aggression, severe shock associated with illness, or the death of loved ones. Also, sleep disturbance in adults can occur due to upcoming exciting events: student session, wedding, childbirth, divorce, job loss;
• daily use of substances that excite the nervous system before bedtime, overeating. These can be drinks containing caffeine (strong tea, coffee), as well as alcohol, energy drinks, and in worst cases, drugs. Some medications can negatively affect the quality of the sleep cycle;
• disruption of the endocrine system, thyroid disease. Poor sleep is observed in women during menstruation, when the level of female sex hormones increases, or during menopause. Sleep disturbance, insomnia is observed with hyperthyroidism - excessive release of thyroid hormones into the blood, which activate metabolism in the body;
• diseases of internal organs: asthma, arthritis, coronary heart disease, kidney failure, Parkinson's disease and similar mental illnesses. As a result of such diseases, a person experiences enormous physical discomfort, debilitating pain, which makes it difficult to sleep.
• disturbance of sleep patterns, uncomfortable conditions for rest: the presence of unpleasant odors, too high or low room temperature, light, extraneous noise, unusual surroundings.

These are the main reasons that lead to short-term or long-term disruption of the sleep cycle. The following symptoms may indicate this condition: a long period of falling asleep, constant changes in body position, very frequent awakenings at night, restless sleep, getting out of bed early in the morning. After such a dream, a person feels exhausted, tired, concentration and memory processes decrease.

The consequences of sleep disturbance can be very dire. So, for those who regularly lack sleep or sleep poorly, the risk of developing cardiovascular diseases and diabetes increases. Poor sleep leads to obesity, immunodeficiency, and breast cancer in women.

Causes and treatment of sleep cycle disorders. Diagnostics

The problem of poor sleep cannot be neglected. If a person daily has complaints like:

• “I can’t sleep for a long time.”
• “I often wake up at night.”
• “I wake up very early, I can’t get enough sleep,” this eloquently indicates a disruption in the sleep cycle. In this case, he simply needs to contact a treating specialist and undergo a full medical examination. You cannot hesitate, as accumulating fatigue can lead to irreparable health problems.

Who to contact?

To diagnose sleep cycle disorders, people consult a somnologist who specializes in dreams, problems, and diseases associated with the sleep cycle. If such a specialist is not available in the medical institution, then you can consult a therapist, psychotherapist, or neurologist. They will tell you how to restore sleep. If there is a serious problem, you will have to contact a somnologist.

Remember, a person who sees a doctor on time avoids many health problems!

Sleep disorders are diagnosed in a special laboratory. The following methods are used for this:

Polysomnography

It is carried out in a special laboratory where the necessary equipment is available. During this procedure, the patient must be under the supervision of doctors during the night's rest.

A person is connected to various sensors that measure respiratory rate, heartbeat, pulse, and electrical activity of the cerebral cortex. Based on these indicators, a somnologist can determine the real problem of poor sleep, tell you what to do, and prescribe appropriate therapy.

SLS method - study of average sleep latency

This technique is carried out in cases where the doctor suspects that the patient has hypersomnia (excessive sleepiness), especially narcolepsy.

During this procedure, the suffering person is given 5 attempts to fall asleep, each of which lasts about 20 minutes, the interval between them is 2 hours. If the patient falls asleep in more than 10 minutes, then he has no disturbances, within 5-10 minutes - borderline range, in less than 5 minutes - a clear sleep disorder.

How to restore sleep patterns?

This is a vital question. The listed diagnostic methods will help the doctor create a complete picture of what is happening to the human body during a night's rest. After diagnosing the disease, the doctor will prescribe treatment. Sleep disturbances and severe insomnia are treated by taking medications such as:

• sleeping pills of varying strength;
• antidepressants (if the cause of sleep cycle disturbance is a severe form of depression);
• antipsychotics with a calming effect, psychotonics are prescribed to patients with severe sleep disorders;
• sedative (calming) drugs can be taken by anyone who is nervous before a night's rest or is in an excited state;
• drugs with a vasodilating effect in combination with mild types of sleeping pills are intended for elderly patients whose poor sleep cycle is caused by arrhythmia or angina pectoris.

It is important to remember that self-prescribing treatment with sleeping pills is very dangerous, since in most cases, long-term use of such medications causes various types of addiction, leading to a malfunction of the central nervous system and its organs, aggravating the problem of sleep disorders. Only a qualified doctor should prescribe a course of treatment.

If poor sleep at night is associated with worries before an important event, old age, troubles at work, etc., then you can drink a soothing tea, decoction, or herbal infusion half an hour before rest. For these purposes, chamomile tea made from its flowers, or mint, lemon balm, and their leaves is well suited. After this tea, you will fall asleep better, you will sleep soundly.

You can saturate your bedroom with the pleasant smell of lavender from an aroma lamp. Its pleasant aroma calms and relaxes. The smell of lavender will make a woman wake up joyful and full of strength. You can also place a bag of dry herbs of jasmine and lavender near the pillow.

At the pharmacy you can buy an alcohol tincture of motherwort, which is an excellent remedy for insomnia and its other manifestations. At home, you can prepare a decoction from this plant and drink throughout the day.

For older people whose sleep cycle is disrupted, a decoction of lily of the valley herb is well suited, which normalizes heart function and eliminates arrhythmia. Regular use of this decoction will restore the sleep cycle.

Sleep problems. What to do?

However, sleep problems in adults and insomnia are often associated with the most seemingly insignificant factors, such as: overeating, intense physical activity, a cup of strong coffee or black tea. Therefore, in order to normalize the sleep cycle, we first need to prevent sleep disorders, which includes following these simple rules:

• create all the conditions for a comfortable rest: make the bed with a clean sheet, ventilate the room, if necessary, install an aroma lamp;
• take a contrast shower before bed;
• let a loved one give you a light restorative massage;
• do not eat 2 hours before bedtime;
• do not engage in activities that can overstimulate the nervous system;
• before going to bed, drink a glass of warm milk with honey, or soothing tea;
• If you wake up at night, it is better not to get up, not to start doing active things. You need to lie down for a while, after a while you will fall asleep again.
• always remember, if you often wake up at night, especially at an early age, then you need to see a doctor. The sooner you get rid of the problem of poor sleep, the more you can avoid many diseases.

The above tips will relieve fatigue after a hard day, help you relax and calm down. In such an environment it will be easy to fall into a deep, sweet sleep.

Poor and weak sleep affects your well-being throughout the day. A nightmare can ruin your mood for a long time. A bad dream causes fears, anxiety, physical and emotional fatigue. A person begins to think more about its meaning than about the reason that caused such a dream. In order for nightmares to stop tormenting you at night, it is important to find the reasons for their occurrence, and only then decide how to improve the quality and duration of sleep.

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Nightmares

When you have bad dreams, sometimes a person does not wake up immediately and continues to experience unpleasant moments. Psychology defines a nightmare as a dream of a frightening nature, memorable for a long time. After waking up, there is weakness, headache and concern about your sleep.

1. 1. REM sleep phase. If you have nightmares during this period, a person wakes up faster and immediately understands that this did not happen in reality. This option is easier to experience and it takes less time to forget it.
2. 2. Phase of deep slow sleep. The awakened one does not immediately understand that this is all unreal. He experiences severe drowsiness, he breaks out in a sweat, his breathing becomes impaired and his pulse quickens. Blood pressure may rise and memory may be temporarily impaired. This is the most difficult and long-remembered dream.

But nightmares also have some advantages - they help get rid of some problems and pay attention to your well-being. If they are repeated often, a person needs rest and working through problematic situations.

The human brain receives psychological overload and gets rid of it with the help of dreams. If the same dream is constantly repeated, this is a signal from the subconscious that there is a serious and unresolved problem that needs to be worked out. For example, a bad dream about a guy or girl speaks of problems in relationships, especially if it repeats itself almost every night. Until young people sort things out among themselves, the nightmare will appear again and again.

Causes of poor sleep

Several factors influence the quality of your night's rest. All of them are quite obvious and can be explained logically. Here are the reasons why a person often suffers from nightmares:

• overwork;
• frequent stress;
• unresolved internal conflicts;
• negative impressions of the day;
• suppression of one's own feelings.

Scary dreams also happen for medical reasons.. They are caused by poor health or high temperature, cardiovascular diseases, mental illnesses that are known or that are just beginning and make themselves felt in this way, as well as taking certain medications.

Dreams of an unpleasant nature are disturbing for many other reasons. Among them:

1. 1. Stuffy room. Uncomfortable temperatures and lack of oxygen lead to poor sleep.
2. 2. Uncomfortable bed. A hard or soft mattress, a bad pillow, a thin or too warm blanket can make it difficult to simply fall asleep.
3. 3. Overeating. The last meal should be light and easily digestible.
4. 4. Watched a horror movie before bed. The brain replays plots or develops events in its own way under the impression of violent scenes seen in the film.
5. 5. Alcohol or drinks containing caffeine taken at night. It is not for nothing that doctors do not recommend drinking coffee late at night. Milk or fermented milk drinks are more suitable for this.
6. 6. New place. Change of environment is one of the causes of nightmares.

Nightmares during pregnancy happen for several reasons. The expectant mother is concerned about her well-being and the health of the baby and often worries about this. A woman’s hormonal levels change and there are sharp fluctuations, which cause an increased feeling of anxiety. Low blood pressure and hemoglobin are the reasons why you have bad dreams. Due to the displacement of the diaphragm, the heart rate increases, which makes it difficult to fall asleep. Obstetricians recommend that pregnant women sleep on their sides rather than on their backs, especially later in pregnancy.

How to get rid

To avoid nightmares, you need to figure out the reasons and start eliminating them. If you cannot relieve your anxiety on your own and avoid stressful situations, you should consult a specialist and accept his help. Some medications have the necessary calming effect and relieve stress.

But we must not forget about rest and useful physical activity. Walking before bed or during the day helps you relax and set yourself up for a good night's sleep. You can’t constantly be tense, expect trouble and be nervous about every occasion. Relaxing in nature solves the problem of nightmares well. A weekend trip to the forest solves this problem perfectly.

If everything is going well in a person’s life, the reason is not a bad mood. It may be necessary to air for a longer time or increase the room temperature if the bedroom is cold. These changes will improve your night's sleep:

1. 1. Changing blankets and bed linen to lighter, better quality or more comfortable ones.
2. 2. Meditation to calm music puts you in the appropriate mood and has a relaxing effect.
3. 3. You can’t drink coffee and tea at night. The caffeine contained in these drinks has an invigorating effect on the body. Chamomile tea or warmed milk with honey is recommended.
4. 4. A warm bath with essential oils helps.
5. 5. Alcohol and nicotine should be avoided, as they have a bad effect on blood vessels.

Poor sleep is a consequence of daytime experiences and the cause of increased fatigue, poor health and nervous disorders. Few people know that sleep disturbance can lead to very serious consequences for the body. Among them are malfunctions in the functioning of organs and systems, the development of dangerous diseases, including cancer, the occurrence of depression, and decreased performance.

Manifestation of poor sleep

Poor sleep can manifest itself in different ways. A person cannot fall asleep for a long time in the evening and often wakes up during the night. During sleep, internal tension and a state of anxiety are felt, which intensifies on the eve of any significant events. Insomnia is a disease without age or gender. It is generally accepted that more than 30% of men and 35% of women worldwide have experienced this disease. This problem is known to representatives of the older generation, middle-aged people and even young children.

Possible causes of poor sleep

Bad sleep does not happen without a reason. This is a dangerous sign, which indicates that a person’s “biological clock” has malfunctioned. As a rule, it is caused by a whole complex of prerequisites. Among them is a disruption in the passage of biochemical reaction cycles. Normally, our body at a certain time produces a whole complex of hormones and enzymes that trigger the mechanisms of “falling asleep” - the speed of reactions decreases, mental and physiological processes slow down, blood pressure decreases, and the production of adrenaline goes to zero. The body falls into a sound and healthy sleep. However, if these mechanisms fail, then everything goes differently: “activity hormones” continue to be released into the blood, neural connections are disrupted, and the person experiences serious problems because he cannot fall asleep.

Treatment for poor sleep

If problems of this kind are the rule rather than the exception, then drastic measures must be taken. Treatment of poor sleep is carried out comprehensively. Increasing physical activity and physical activity during the day, following a routine, and changing your diet helps a lot. Scientists have proven that a lack of certain components can worsen insomnia. So, for example, deficiency of vitamin B6, which is known as pyridoxine, has a detrimental effect on the course of many reactions in organs and tissues, including nerves.

Vitamin deficiency

Due to vitamin B6 deficiency, a person will eventually face the problem of insomnia. The nervous system will become unstable and will need strengthening. In addition to physiological procedures, the use of appropriate medications will be useful. Thus, treatment of poor sleep should begin with taking vitamins containing beneficial substances that stabilize the nervous system.

In addition to pyridoxine, when treating poor sleep, it is necessary to use drugs containing magnesium and calcium. These microelements, in combination with B6, have a positive effect on the higher parts of the central nervous system, helping the body cope with emotional stress, depression, and neuroses, which are often the causes of insomnia.

If the quality of sleep is disturbed, it is recommended to take vitamin B6 and magnesium in combination, 1 tablet 1 time per day with meals. Calcium and magnesium restore the balance of these minerals in the body, thereby improving well-being and normalizing sleep.

• Vitamin B-6. Pyridoxine;
• Magnesium complex;
• KALMAG.

INTERMITTENT SLEEP:

Interrupted sleep takes a toll on your mental and physical health. Find out how you can effectively deal with this problem.

Adequate sleep is one of the most important components of a healthy human life. Depending on physiological characteristics, a person’s sleep should last from 6 to 8 hours. Doctors do not recommend deviating from these parameters, since the body is harmed not only by lack of sleep, but also by excessive sleep.

Unfortunately, today, in the hustle and bustle of the city, few people can boast of good sleep. Frequent problems and conflicts at work and in the family, responsibilities that need to be dealt with on time and countless everyday problems take their toll. Some people do not have enough time for proper sleep because they are too busy, and many suffer from various sleep disorders.

THE PROBLEM OF INTERRUPTED SLEEP

One of the forms of insomnia that is often encountered, mainly by city residents, is interrupted sleep. People suffering from this disease can fall asleep without problems in a relatively short time after going to bed, but in the process their sleep becomes very light and restless. For no apparent reason, a person wakes up in the middle of the night (usually at the same time), while feeling tense, as if those few hours of sleep had never happened. The state of wakefulness can last from several minutes until the morning, when you need to get ready for work. Often this condition is accompanied by a feeling of anxiety and excitement. A person is nervous due to his inability to sleep normally, and negative thoughts are swarming in his head. In some cases, such awakenings occur several times a night, which does not allow a person to properly rest and regain his strength. As a result, we wake up already tired and get out of bed simply because we need to go to work.

WHAT DOES INTERRUPTED SLEEP THREATEN?

Intermittent sleep, as well as insomnia, in the traditional sense of the word, does not allow a person to get enough sleep. As you know, sleep is the time when the body intensively processes the information received during the day and harmonizes the work of all body systems. If you deprive the body of quality sleep, then the entire body is disabled. People suffering from certain sleep disorders (including interrupted sleep) may experience deterioration in cardiovascular activity, nervous disorders, and a decrease in immune defense, as a result of which the body becomes more vulnerable to viral diseases. In the autumn-winter period, such people are more likely than others to suffer from ARVI, and their recovery period lasts longer due to the body’s low compensatory capabilities.

According to medical observations, people suffering from interrupted sleep are more susceptible to sleepwalking. One of the components of the treatment of such patients is maintaining regular, adequate sleep, which significantly reduces the frequency of sleepwalking attacks. In addition, recent research shows that interrupted sleep negatively affects a person's memory, as well as the ability to think clearly.

HOW TO SOLVE A PROBLEM?

If you are concerned about the problem of interrupted sleep, then first of all you should adjust your lifestyle. Try to go to bed at the same time every day. At first, you won’t be able to do this well; you won’t be able to fall asleep for a long time, tossing and turning in bed, but over time, your body will get used to the new regime. The last meal should be no later than 2 hours before bedtime.

Evening walks and airing the room have a positive effect on sleep. If the weather permits, then leave the window open at night, so your sleep will be stronger and healthier.

Treatment of insomnia with folk remedies

Treatment of insomnia with folk remedies. If you have poor sleep, you are tormented by insomnia, you toss and turn in bed for a long time and cannot fall asleep - folk recipes for good sleep will help you. Insomnia can also occur in healthy people due to overwork or mental agitation. Insomnia is more common among people who do mental work. If insomnia caused by any serious illness, you should consult a doctor to eliminate the cause of the sleep disorder.

If sleep problems are associated with nervous excitement, you can use traditional medicine. It is better to sleep on your stomach, with your hands under a low pillow (if you do not have hypertension), and your face turned to the left. Relaxation in this position is more effective, probably because it is the natural position in which children sleep. It is also useful to sleep on the left side - to improve the functioning of the gastrointestinal tract. In order to be healthy, a person must rest well.

Due to everyday stress, which has already become a habit, our sleep cannot be called healthy. More than 25% of our planet's population complains of insomnia and chronic fatigue, regardless of where they work and live. There are many ways to keep the nervous system in good shape - from coffee to energy drinks, but the best medicine was and remains sleep, during which the body recovers and replenishes energy reserves.

Solving a problem with the help of drugs is not a method, but a trap that causes dependence and addiction, and further destroys the nervous system.

To fall asleep quickly you need develop a certain bedtime ritual and stick to it: ventilate the room, take a shower, go to bed at the same time, etc.

Diet and daily routine are excellent remedies for insomnia

The main means by which you can get rid of insomnia, are daily routine and proper nutrition. By adhering to a routine, we get closer to natural biological rhythms, and the process of falling asleep at the allotted time is much easier. American scientists have discovered that people suffering from insomnia have lower levels of tryptophan, an amino acid that promotes the production of hormones necessary for falling asleep - melatonin and serotonin. These substances help relieve nervous tension and relax muscles.

Turkey meat contains the most tryptophan, and if you do not mix it with carbohydrates, it will be a wonderful dinner, after which it will be easier to fall asleep. Oatmeal for dinner will make you feel full and warm; it contains a lot of melatonin, which is called the sleep hormone. To enhance the effect, you can add milk and honey. Milk contains a lot of tryptophan, and honey is an excellent folk sedative. A piece of wholemeal bread will increase the production of insulin, which helps convert tryptophan into serotonin. Very calming: baked potatoes, broccoli, wild or brown rice, bananas and kiwi for dinner. As for the daily routine, it is better to go to bed no later than 22:00 and get up before sunrise.

Folk remedies for insomnia

• Fill the pillow with mint, geranium, oregano, fern, laurel, hazel leaves, pine needles, rose petals.
• Eat 1 onion at night. Onions are considered a sedative with hypnotic properties.
• Mix 1 tablespoon of honey in 1 glass of warm water and drink at night.
• Before going to bed, apply lavender oil to your whiskey.
• Place 3-5 drops of lavender oil on a piece of sugar and suck before bed.
• Hot foot baths at night relieve fatigue and calm the nervous system.
• Take pine baths or baths with infusions of calendula, mint, oregano, lemon balm; the duration of the procedure is 10 minutes.
• Grind 2 tablespoons of hop cones and pour 0.5 liters of boiling water, leave for 1 hour, strain. Drink 0.25 glasses 3 times a day 20 minutes before meals.
• Pour 2 tablespoons of crushed rhizomes with valerian roots with 1 glass of boiling water, leave. Take 2 tablespoons 4 times a day.
• Inhale the scent of valerian or valerian root infusion.
• Take pharmaceutical tincture of peony root 3 times a day, 1 teaspoon.
• Pour 4 tablespoons of dried motherwort herb into 1 cup of boiling water and leave in a thermos for 2 hours. Drink 0.3 cups warm 30 minutes before meals.
• Pharmacy tincture of Manchurian aralia, take 40 drops 3 times a day.
• Finely crush 2 tablespoons of hemp seeds, sift, add 1 glass of hot boiled water. Leave, wrapped, for 30-40 minutes. Drink 0.5 glass 2 hours before bedtime. Then, after 1 hour, the rest along with the sediment (necessarily warm). The course of treatment is 2 weeks. Can also be taken for occasional insomnia.

• Pour 100 g of crushed hawthorn fruits with 2 glasses of water, simmer over low heat for 30 minutes, cool, strain. Take 50-100 ml 3 times a day after meals.
• Mix hawthorn tincture with 20% alcohol tincture of propolis. Take 20 drops 2-3 times a day 20 minutes before meals.
• Take rhizomes with valerian roots and hop cones in equal proportions, pour 1 glass of boiling water, leave. Drink like tea with honey at night.
• Take equal parts of rhizomes with valerian roots, motherwort herb, dill seed and caraway seed. Pour 2 tablespoons of the mixture with 1 cup of boiling water. Leave for 30 minutes. Drink 0.5 cups 2-3 times a day. This tea has a calming effect.
• Mix 1 teaspoon lemon balm herb and 1 teaspoon orange peel. Pour 1 cup of boiling water over this mixture and close tightly. Leave for 10 minutes, strain, add 1 teaspoon of valerian tincture. Take 1 glass 2-3 times a day along with natural honey (eat the honey without dissolving it in the tincture). This tea has a calming effect.
• Take lemon balm herb, mint leaf, and oregano herb in equal parts. Pour 3 tablespoons of the mixture into 0.5 liters of boiling water and leave in a thermos for 8 hours. Take 1 glass 3 times a day.
• Take 2 parts of three-leaf leaves, 1 part of rhizomes with roots of valerian officinalis and a peppermint leaf. Pour 2 tablespoons of the dry crushed mixture into a thermos with 0.5 liters of boiling water, leave for 30 minutes, strain. Drink 0.5 glasses 2-3 times a day for nervous overexcitation and insomnia.
• Take equal parts by weight of veronica herb, fragrant violet herb, lavender flowers, lemon balm leaf, barberry fruits. Pour 1 tablespoon of the mixture into 1 cup of boiling water and leave until cool. Take 1-2 glasses of infusion in the evening for insomnia.
• Take in equal parts blood-red hawthorn flowers, rhizomes with roots of valerian officinalis, peppermint leaf, white mistletoe herb, motherwort herb. Pour 1 tablespoon of the mixture with 1 glass of water, bring to a boil, leave for 30 minutes, strain. Drink 1 glass in the morning and at night for increased irritability and insomnia.
• Take 20 g of coriander fruit, lemon balm leaf, peppermint leaf. Infuse the entire amount of raw material in a mixture of 100 ml of pure alcohol and 20 ml of water. Strain after 24 hours and squeeze out the raw materials; Apply a handkerchief moistened with tincture to the temples and the back of the head for insomnia and headaches.
• Take by weight 2 parts each of peppermint leaf and water trefoil leaf, 3 parts each of angelica root and rhizomes with valerian roots. Brew 1 tablespoon of the mixture in 1 glass of boiling water, strain after 1 hour and drink 0.3 glasses 3 times a day.
• Take equal parts by weight of fennel fruits, caraway fruits, motherwort herb and rhizomes with valerian roots. Brew 1 tablespoon of the mixture in 1 glass of boiling water, strain after 1 hour and drink 0.3 glasses 3 times a day.
• Take hop cones, rhizomes with valerian roots, lemon balm leaf, juniper fruits, horsetail herb in equal parts by weight. Pour 1 tablespoon of the mixture into 1 cup of boiling water and leave until cool. Take 1-2 glasses of infusion in the evening.
• Take by weight 1 part each of hop cones and peppermint leaves, 2 parts each of lemon balm leaf, chamomile flowers, buckthorn bark, rhizomes with valerian roots. Prepare a decoction of 1 tablespoon of the collection in 1 glass of cold water. Take 1-2 glasses at night.
• Take by weight 1 part of hop cones and rhizomes with valerian roots, 2 parts of peppermint leaf and water trefoil leaf. Brew 1 tablespoon of the mixture in 1 glass of boiling water, strain after 1 hour and drink 0.3 glasses 3 times a day.
• Mix 3 tsp. herbs thyme, motherwort and oregano and 2 tsp. valerian root. Then 1 tbsp. l. collection, pour a glass of boiling water, leave for 15 minutes. Strain and drink 1/3 cup before meals throughout the day.
• Tea with oregano, mint, and hawthorn soothes the nervous system. You can make a tincture from these same herbs. Fresh herbs are torn and kneaded by hand.
• Fill a liter jar with them to the middle. Then fill it to the top with vodka and leave for two weeks. Take 1 tsp. an hour before meals. Course -1 week

For those who have frayed nerves and suffer from insomnia and hypertension, there is the following folk recipe: You should buy alcoholic tinctures of valerian, motherwort, hawthorn and Corvalol (the same number of milliliters) at the pharmacy and pour them into one dark glass bottle. The potion is ready! Directions: dilute a teaspoon in 1/3 glass of warm water and take 3 times a day for a month. Then rest for a month and repeat twice more.