▲The insomnia of melancholic patients is often insomnia of early waking up. When they wake up, they can’t fall asleep. They toss and turn, and can’t wait until dawn, which is extremely painful.

(Photo credit: shutterstock)

Text / Lin Jinjia

According to statistics from the National Health Insurance Administration, 4.41 million people used sleeping pills last year, which is equivalent to 1 in every 5 people. The annual consumption of sleeping pills has exceeded 1 billion, which is quite amazing.

The annual consumption of sleeping pills exceeds 1 billion

In psychiatry clinics, insomnia is a common complaint of patients.

However, the reasons behind the insomnia of different patients may be different; different patients often have different expectations for insomnia treatment.

The treatment of insomnia is simple, but not easy.

Please read on...

Insomnia trouble, usually has 5 kinds of conditions: 1. Occasional insomnia or poor sleep; 2. Primary insomnia; 3. Originated from mental illness; 4. Originated from physical disease; 5. Originated from drugs.

Clinically, when a patient suffers from insomnia, the first thing to judge is 1. Has the diagnosis of insomnia been reached?

2. It is simple insomnia or other reasons (3-5 above).

The International Classification of Diseases (ICD-10) diagnostic criteria for "primary insomnia" are: 1. Difficulty falling asleep, maintaining sleep, or getting up early, and unable to restore healthy sleep; 2. Insomnia at least 3 nights per week for one month The above; 3. Insomnia has caused daytime dysfunction; 4. It is not caused by organic reasons.

Some people do not sleep well once or twice, and they have not reached the diagnosis of "insomnia" at all. In fact, there is no need to worry and no need to see a doctor.

It’s just that some people have emotional reactions to this occasional insomnia, worrying that insomnia will affect their spirit during the day and be bad for their health. This kind of worry and cognition is likely to turn “occasional insomnia” into persistent insomnia, meeting the diagnostic criteria of 1-3 above.

Next, we have to judge, is this "primary insomnia"?

Or is it caused by other organic factors (physical illness, mental illness, drugs)?

Mental Illness Can Cause Insomnia

Most insomnia is one of the symptoms of mental illness, such as anxiety disorders and depression can cause insomnia.

Typically, anxiety sufferers suffer from insomnia, which is often difficult to fall asleep. The patient thinks a lot before going to bed, and the more he thinks, the more awake he becomes. Sometimes he wants to sleep hard, but the harder he tries, the less he can fall asleep, and he may finally start to worry before going to bed. , so a vicious circle; insomnia in patients with depression, often early awakening insomnia, can not sleep, tossing and turning, can not wait until dawn, extremely painful.

Of course, in clinical practice, many patients have difficulty falling asleep and early awakening insomnia.

Insomnia is also one of the common symptoms of mental illness (such as schizophrenia, delusional disorder, bipolar disorder, etc.), and patients with dementia will also.

If a patient suffers from insomnia due to delusions and hallucinations, it is difficult to effectively treat insomnia with sleeping drugs alone.

The sleep disorder of manic patients is quite special, "sleep less than usual but feel full and full of energy"; in addition to being affected by hallucinations and delusions, the sleep disorder of dementia patients is more commonly disturbed by the sleep-wake cycle ( Do not sleep at night, sleep during the day), caregivers often take care of crazy.

(The author is the attending physician of the psychiatry department of Chi Mei Hospital)

▲The insomnia of anxiety patients is often difficult to fall asleep. Before going to bed, they will think wildly, and the more they think, the more awake they become. The picture is a situational photo, and the characters in the picture have nothing to do with this article.

(Photo provided / Lin Jinjia)

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keywords

• depression

• Insomnia

• anxiety

• sleeping pills

• health care

• sleep quality

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