In the meantime, there is no need to know about it. ”
Depending on the duration, insomnia can be divided into:
1. Acute (short-term) insomnia – lasts up to 3 months.
Reasons: interpersonal conflict, work stress, change of environment (moving, hospitalization, etc.); events with a positive emotional sign (wedding, successful exam, etc.). With the termination of the trigger factor or as adaptation to it, a decrease in the severity of sleep disorders is observed. It occurs at any age (including infants) with a prevalence of 15-20% in the general population.
In the meantime, there is no need to know about it. ”
2. Chronic insomnia – lasts more than 3 months.
There are separate subtypes of chronic insomnia. Previously, they were considered as separate clinical forms, however, due to the common development mechanisms, they were combined into one category. “Pure” forms of these subtypes are rare, most often the patient can find signs of several of them.
a) Psychophysiological insomnia is characterized by an increase in the level of internal stress and anxiety of the patient regarding his sleep disorders, which manifest themselves in the evening and / or at night and prevent falling asleep. These sleep disorders can start suddenly (due to a provoking event) or develop slowly over several years. Patients with this type of insomnia are characterized by “fixation” on the issue of their sleep. They believe that not getting enough sleep can cause most problems the next day, leading to fatigue and reduced performance. They develop a “fear of bed”: in the evening, when it’s time to sleep, there is an anticipation of failure, which increases internal tension and further prevents falling asleep. As a result, a strong association of insomnia with a place to sleep is formed. Such patients often sleep better in a new place than at home, as negative associations are broken.
In the meantime, there is no need to know about it. ”
b) Idiopathic insomnia is characterized by sleep disturbance throughout a person’s life. This disorder begins in early childhood or school years and continues without periods of improvement. The examination fails to identify medical (mental, behavioral, medication) or other causes of insomnia. It is assumed that there is a genetic predisposition to the development of this type of insomnia, but there is no evidence of this at the moment. Previously, this form of insomnia was called “primary insomnia.”
c) Paradoxical insomnia (or “pseudo-insomnia”) is characterized by a discrepancy between the patient’s complaints of a significant sleep disorder and the objective picture of sleep detected by polysomnography. Usually, there is more than 50% discrepancy between the duration of sleep according to the patient’s own feelings and objective indicators. It is these people who often claim that they do not sleep for several nights in a row, which is associated with the formation of the “phenomenon of sleep disturbance” in them.
In the meantime, there is no need to know about it. ”
d) Insomnia due to poor sleep hygiene is a common form of sleep disorders in children, adolescents and the elderly. The main reasons for the development of this type of insomnia are considered to be non-compliance with the rules of sleep hygiene: irregular laying time, prolonged naps, drinking alcohol, caffeine-containing products, smoking before going to bed, physical or mental stress, etc. With its normalization, sleep improves.
In the meantime, there is no need to know about it. ”
e) Children’s behavioral insomnia is characterized by the dependence of the child falling asleep on the presence of certain conditions – motion sickness in the arms, feeding, the presence of parents in the immediate vicinity. The most typical manifestations of this type of insomnia are frequent night awakenings with the requirement of parental approach, picking up and motion sickness or feeding. In older children, this insomnia is manifested by the “call from behind the door” syndrome, when the child, who does not agree with the time to go to bed, finds various reasons to prolong communication with the parents.
In the meantime, there is no need to know about it. ”
f) Insomnia in mental disorders occurs against the background of a current mental illness. Sleep disorders usually occur with the onset of the disease and worsen as it progresses. Currently, this form of insomnia is considered not as one of the symptoms of mental illness, but as a concomitant condition that requires separate treatment. It has been shown that the normalization of sleep is accompanied by an additional improvement in the condition of patients with depressive disorder.
In the meantime, there is no need to know about it. ”
g) Insomnia when taking medications or other substances occurs both against the background of taking and after the cancellation of certain substances. Most patients with this form of insomnia are elderly people who are unable to independently endure withdrawal symptoms when the drug is discontinued [most often benzodiazepines (Phenazepam) and barbituric acid preparations (Corvalol, Valocardin, Valoserdin), which are often prescribed for insomnia]. The effects of alcohol on sleep are also considered in the context of this form of insomnia.
h) Insomnia with somatic diseases accompanies various diseases of internal organs. For a long time, the leading somnologist in Russia, Roman Vyacheslavovich Buzunov, in his lectures and books, divided insomnia into primary and secondary. He believed that in general therapeutic practice, up to 80% of cases of insomnia are secondary and identified more than 50 causes of secondary insomnia.
Indeed, any disease from this list and not only is a biological stress for the body and a factor provoking sleep disorder. And in some cases, by successfully curing or transferring to the stage of remission, a particular disease can improve sleep. However, this does not always happen, especially when the disease is chronic or difficult to correct. Why is this happening? Because insomnia has its own mechanism of development (the so-called pathogenesis – like any disease) and it does not depend on the presence of other diseases in a person. That is, an acute illness or exacerbation of a chronic process is only a trigger for the development of insomnia, and then insomnia lives its own life and requires its own specific treatment, and not just the correction of the condition that caused it.
In the meantime, there is no need to know about it. ”