Most often, patients complain of early waking up (at 4-5 am) with the impossibility of falling asleep again. On awakening, they note an almost instantaneous “turning on” of the brain and a hard-to-stop stream of negative thoughts. Sometimes the phenomenon of disturbed perception of sleep develops, when the patient feels a complete lack of sleep for several days, weeks, or even months. Sleep disturbance may be the first symptom of a depressive state, developing before the onset of the classic symptoms of depression: a reduced background mood, lack of feelings and desires, apathy, guilt, etc.
As a rule, patients complain of difficulty falling asleep. Anxiety can be situationally conditioned (against the background of stress), and not having external causes (endogenous).The main symptoms of anxiety are a feeling of internal tension, agitation, nervousness, palpitations, tingling in the region of the heart, a feeling of a lump in the throat, a feeling of dissatisfaction with inhalation.
If insomnia due to psychological or mental problems is detected , it is advisable to refer the patient to a psychotherapist or psychiatrist for consultation.