One-third of a person’s life is spent in sleep. Sleep is extremely important for all of us. A good sleep can also protect a good body. However, as the pace of life accelerates, the pressure of work and life is increasing, and sleep problems are becoming more and more prominent.
2020 is an even more special year. The new crown epidemic is coming fiercely. The persistent epidemic continues to fiddle with our sensitive nerves. Anxiety, panic, difficulty falling asleep, and awakening from nightmares make us more tossed and turned.
What are your confusions about insomnia? We invited Professor Zhang Wenjing, the chief physician of the Department of Mental Diseases, Shanghai University of Traditional Chinese Medicine Affiliated City Hospital of Traditional Chinese Medicine, to give us detailed answers──
Q1: Affected by the new crown epidemic, many professionals will face the crisis of layoffs and salary cuts. Under pressure, many people cannot sleep or sleep well all day long. Is this insomnia in the usual sense?
Poor sleep is a common problem encountered by modern people. There are many manifestations of poor sleep. Some people may have difficulty falling asleep, some people have insufficient sleep time, and some people have difficulty falling asleep and have enough sleep time, but the quality of sleep is poor, such as a lot of dreams, or even nightmares. Repeatedly or very easily to wake up and wait. Because of stress or a bad mood, not sleeping well for just one or two nights cannot be judged as “insomnia”. Every disease has a clear medical diagnosis, and insomnia is no exception.
According to the diagnostic criteria of the American Diagnostic and Statistical Manual of Mental Disorders (DSM-V), when the aforementioned sleep disorder/dyssomnia occurs at least 3 times a week and lasts for more than 1 month, we can only be diagnosed as “primary Insomnia”. Since it is called primary insomnia, it is necessary to exclude many other mental and psychological diseases or secondary insomnia caused by physical diseases.
In general, insomnia is a very complicated problem. It may be the primary disease of the body, or it may be secondary to other diseases, and may even appear as a symptom in the course of many other diseases. For different types of insomnia, treatment methods are also very different.
Once you feel bad sleep in your life, and it has seriously affected your normal life, work and study, you should go to the relevant specialists of the hospital in time and ask a doctor to make a clear diagnosis to confirm whether you are insomnia and what type of insomnia. For insomnia, treat the symptoms again.
Q2: What are the characteristics of people with insomnia? Do people of different ages have different characteristics of insomnia?
According to clinical manifestations, people who are usually more sensitive, people with greater mood swings, people who work more carefully or sometimes are more likely to suffer from mental illness are relatively more likely to suffer from mental illness. Then, insomnia as a physical and mental illness is relatively common among such people.
People of different ages have different characteristics of insomnia. We first simply divide the population into children, adults, and the elderly, and then analyze them one by one.
There are many categories of children’s sleep disorders, such as insomnia, drowsiness, parasomnia, etc. Insomnia is a common disease among them, and most of them are school-age children, especially teenagers. Irregular sleep time, hunger or fullness when falling asleep, and poor sleeping environment are common causes of sleep disorders in infants and young children. In addition to the above reasons, insomnia in older children is often related to psychological stress and anxiety caused by factors such as study and exams; or drinking certain central nervous-exciting beverages at night, such as drinking some cola and other caffeine before going to bed Related to the drink. Insomnia in children is mainly manifested as difficulty falling asleep and sleep maintenance disorders. Insomnia in children is often accompanied by symptoms such as dream terrors, teeth grinding, and enuresis.
Insomnia in the elderly is related to a variety of factors. In addition to primary insomnia, it is usually secondary to physical, mental illness, psychosocial or drug factors. Traditional Chinese medicine believes that elderly people’s body failure, thinking, fatigue, heart and spleen are easy to cause deficiency of the heart and spleen, and the biochemical source is insufficient, so it is easy to cause insomnia. Compared to when they were young, the sleep time of the elderly is relatively short, and insomnia is more likely to occur. Insomnia in the elderly is mainly manifested as light sleep at night and easy to wake up. From the perspective of sleep medicine, this is a kind of “advance of the sleep phase”, that is, early going to bed and early awakening or multiple short-term early awakenings during sleep And wake up.
Adult insomnia is more complicated, and there are many reasons. Adults have insomnia and “gender orientation”. The probability of women suffering from insomnia in their lifetime far exceeds that of men. This is mainly related to women’s multiple menstrual periods. To put it simply, women have significant cycles of physiological changes such as menstrual cycle, pregnancy, lactation, and menopause in their life. These cyclical changes often have a greater impact on women with more sensitive physiques and can easily cause sleep disorders. For example, menstrual tension syndrome has manifestations of insomnia. Clinically, some women have obvious difficulty falling asleep or anxiety and insomnia symptoms one week before menstruation; there are also perimenopausal (commonly known as “menopausal”) women who have obvious insomnia, including falling asleep Difficulty, frequent awakening or early awakening, and the symptoms of insomnia are often intertwined with the typical menopausal heat, sweating, and anxiety, which affect each other and seriously damage women’s quality of life.
Q3: What are the abnormal reactions of the body caused by long-term insomnia? To what extent should I get medical attention as soon as possible if I suffer from insomnia?
Insomnia is called “insomnia” in Chinese medicine. It is mainly related to factors such as emotional disorders, improper eating, tiredness, excessive thinking, after illness or old age and physical weakness. Under the action of many predisposing factors, it leads to restlessness and unwillingness to stay away. , It will continue to be insomnia.
The harm of insomnia to the body is very significant. Take the most intuitive feeling, if you always do not sleep well, you will lose energy the next day, and your study and work will definitely be affected. People who do not sleep well will also experience dizziness, hair loss, low mood or emotional anxiety. Easy to lose temper etc. If long-term insomnia is not effectively managed and treated, it may cause the decline of the body’s immunity and the impairment of cognitive functions (such as memory and concentration, which will be affected). Of course, continuous insomnia will increase many chronic diseases. The risk of underlying diseases. Medical research has found that insomnia is related to obesity, cardiovascular and cerebrovascular diseases, diabetes, and even cancer. If your insomnia has seriously affected your normal work and life, you should seek medical treatment in time to improve your sleep problem as soon as possible.
Q4: What are the methods of modern medicine to treat insomnia? Is there a direct relationship between insomnia and anxiety?
Clinically, there are two main methods of modern medicine to treat insomnia, one is sedative and sleeping medicine, and the other is psychotherapy.
Sedative and sleeping drugs are very effective, but they have potential side effects, mainly dependence and tolerance. For example, some patients will feel dizzy and feel weak when stepping on cotton when they get up the next day, and some patients will have dry mouth, bitter mouth, or even nausea, and there is a certain dependence on these drugs, so they will rebound after stopping the drug. The phenomenon is obvious. The most widely used psychotherapy is cognitive behavioral therapy, but it has the disadvantages of slow onset, long treatment cycle, and high cost.
In recent years, because drugs have side effects and psychotherapy has certain limitations, more and more people have begun to seek the help of Chinese medicine. There are many methods of Chinese medicine for insomnia. In addition to Chinese medicine, there are also acupuncture, massage, ear acupoints, foot baths and other therapies, and the effect is better when used together. Traditional Chinese medicine therapy is safer, has no obvious side effects, and patients do not need to worry about dependence.
For patients with a short course of insomnia, we recommend that you use traditional Chinese medicine to intervene first; for patients who have a long course of insomnia or are taking western medicine and have more serious insomnia, we recommend a combination of Chinese and Western medicine therapy, which is based on the use of western medicine. At the same time, the two-pronged approach of traditional Chinese medicine was added at the same time. After the quality of sleep was significantly improved, the dosage of western medicine was gradually reduced.
Regarding the relationship between insomnia and anxiety, we often compare it to “brothers”, who accompany each other and influence each other. Insomnia may induce or aggravate anxiety, and anxiety may also induce or aggravate insomnia. Therefore, in the process of treating insomnia and anxiety with traditional Chinese medicine, it is also necessary to comprehensively consider the joint regulation of mood and sleep.
Q5: Under the epidemic situation, the pressure of life is even greater. When the psychological pressure is too great, what methods can be adopted to help sleep?
In my opinion, the most important thing is to develop good sleep hygiene habits. If you do not have good sleep hygiene habits, it is easy to suffer from insomnia. Even if you take more drugs or receive more treatments, it will be a drop in the bucket for improving insomnia.
So, what are good sleep hygiene habits? For example, many people will be anxious in response to the epidemic, and their anxiety will affect their sleep. So, first, we must maintain a good mood and a positive attitude. Second, have regular sleeping habits, go to bed regularly, wake up regularly, and don’t stay up late. Third, maintain a good sleeping environment and do not use electronic products (such as mobile phones, tablets, etc.) while lying in bed. Fourth, eat a balanced diet, do not eat too many spicy foods, and try not to drink strong tea or caffeinated or alcoholic beverages after 5 pm. Fifth, if you feel tired from work, you can take a short break at noon, but the nap should not exceed half an hour, otherwise it may affect the quality of sleep at night.
Q6: What kind of confusion do patients have during the consultation process? What are the instructions for patients with insomnia?
In many cases, insomnia and a variety of physical and mental illnesses will occur together. Such as insomnia with anxiety, insomnia with depression, insomnia with menopausal syndrome, insomnia with cognitive impairment, etc. It should be said that there are many types of our patients. In clinical practice, we follow the principle of “differentiation and treatment based on syndrome differentiation, one person and one party” in TCM, considering the type of insomnia, predisposing factors, physical characteristics of the body, and whether there is a primary disease or complication for different patients. The specific situation, Specific analysis and specific medication. Every time a patient comes to follow-up, we will adjust the medication and treatment methods according to the actual situation of the patient.
What needs special reminder is that if insomnia has seriously affected daily life and the patient’s mood, seek medical attention in time, instead of blindly taking medicines and health care products by yourself, let alone some so-called “remedies”, so as not to cause Further harm to the body and mind.
Q7: When encountering insomnia, many young people think of taking health products for the first time, such as melatonin, which is sought after by young people. Do these health products really help sleep?
Melatonin is one of the hormones secreted by the pineal gland of our brain, so it is also called pineal hormone. After being synthesized by the human body, melatonin is stored in the pineal gland, and sympathetic nerves excite the pineal gland cells to release melatonin. The secretion of melatonin has an obvious circadian rhythm, the secretion is inhibited during the day, and the secretion is active at night.
Nowadays, the melatonin taken by many people is an exogenous melatonin, which can be understood as a health product. The well-known function of this health product is to improve sleep. So, is melatonin useful? I personally think that it is necessary to “divide the conversation into two parts”. First of all, as a health product, melatonin does not work for everyone. It can only be said that for some people, take it once or twice when they have poor sleep. Some melatonin health products can improve sleep. And to treat melatonin as a kind of “sleeping medicine” to treat insomnia, it definitely won’t work. After all, health products are not drugs.
Q8: Insomnia is bad for your health, too much sleep is also bad for your health. What is the best sleep time? What kind of sleep can be called “healthy sleep”?
There is no clear conclusion on this issue. Because everyone has different needs for sleep, some people get energetic after 6 hours of sleep, but feel dizzy if they sleep too much; some people have to sleep for 8 hours to cope with the normal life of the next day. Obviously 6 hours of sleep is not enough for him.
So, what kind of sleep can be called good sleep, healthy sleep, or satisfactory sleep? Simply put, it means that night sleep is comfortable and satisfying. It can completely eliminate the fatigue of the day through night sleep, so that the tired body and mind can be completely released, and after waking up the next day, it is energetic and can cope well with the second. Days of work and study are a good, healthy sleep.