The clinical signs of insomnia, depending on the time of their manifestation, are divided into groups: presumptive, intrasomal and post-somnolent disorders. Disorders before, after and during sleep can manifest separately and in combination. All 3 types of disorders are observed in only 20% of middle-aged patients and in 36% of elderly patients with insomnia.
Insomnia leads to daytime activity, memory impairment and attentiveness. In patients with mental pathology and somatic diseases, the course of major illnesses is aggravated. Insomnia can cause a slow response, which is especially dangerous for drivers and workers serving industrial machines.
Patients complain of problems with the onset of sleep. Usually the stage of falling asleep lasts 3-10 minutes. A person suffering from insomnia can spend 30 to 120 minutes or more to fall asleep.
The increase in the period of the onset of sleep may be the result of insufficient body fatigue when the baby is raised late or when it is too early to sleep; pain reaction and itching of a somatic nature; reception of drugs that excite the nervous system; arising during the day of anxiety and fear.
As soon as a person is in bed, the desire to fall asleep instantly disappears, the state of heavy thoughts, memory recalls painful memories. At the same time there is some motor activity: a person can not find a comfortable posture. Sometimes there is an unreasonable itch, unpleasant sensations on the skin. Sometimes, falling asleep is so imperceptible that a person perceives it as a wakefulness.
Problems with falling asleep can form strange rituals before going to bed, unusual for healthy people. Perhaps the appearance of fear of non-occurrence of sleep and fear of bed.
The patient complains of the absence of deep sleep, even a minimal stimulus causes awakening followed by a prolonged falling asleep. The slightest sound, switched on the light and other external factors are especially acute.
The cause of spontaneous awakening can be terrible dreams and nightmares, a feeling of filling the bladder (repeated urge to urinate), vegetative dyspnea, heart palpitations. A healthy person who does not suffer from insomnia, can also wake up, but the threshold of awakening is noticeably higher, the subsequent falling asleep is not problematic, the quality of sleep does not suffer.
Intrasomal disorders also include increased motor activity, manifested by the syndrome of “restless legs”, when a person in a dream makes shaking movements with his feet. The cause of the “sleep apnea” syndrome, which is often observed with insomnia, is the inclusion of an arbitrary mechanism of regulation of respiration. It usually occurs during animation and is accompanied by snoring.
Insomnia manifests itself in the waking state after awakening. It is difficult for a person to wake up early, he feels broken in the whole body. Drowsiness and reduced performance may accompany the patient all day. Often there is a non-operative daytime sleepiness: even with all the conditions for a good sleep, a person can not fall asleep.
There are sharp mood swings, which adversely affects the communication with other people, often exacerbating psychological discomfort. Some time after awakening, a person complains of headaches, there may be a rise in pressure (hypertension). This is characterized by a more pronounced increase in diastolic pressure.