Insomnia And Excessive Daytime Sleepiness (Ets)

Many sleep disorders are manifested in insomnia and excessive daytime sleepiness usually (ETS). Insomnia refers to difficulty falling or staying asleep, early awakening or a feeling of non-recuperative sleep. ETS is the tendency to fall asleep during normal waking hours. Sleep disorders can be caused by factors within the body (intrinsic) or outside the body (extrinsic). Inadequate sleep hygiene Sleep is affected by certain behaviors. These include: consumption of caffeine or other stimulants or sympathomimetic drugs (typically just before bedtime, but in sensitive patients even in the afternoon) movement or agitation (for example, an exciting TV show.) Late in the evening An irregular sleep-wake scheme patients who compensate for their lack of sleep by long rest or nap, further fragment the night sleep. Patients with insomnia should maintain a regular wake-up time and avoid regardless of the amount of nighttime sleep, naps. Adequate sleep hygiene can improve sleep (see table: sleep hygiene). Anpassungsinsomnie acute emotional stress (eg., Loss of a job, hospitalization) can cause insomnia. The symptoms typically form shortly after the disappearance of the stressor back; the insomnia is usually temporary and short. Nevertheless, short-term treatment with hypnotics is appropriate, as long as daytime sleepiness and fatigue develop, v. a. if they interfere with the functioning of the day. Persistent symptoms of anxiety can make a specific treatment necessary. Psychophysiological insomnia Whatever the cause, the insomnia on the elimination of triggering factors also may persist, usually because patients feel an anticipatory anxiety with regard to the prospect of another sleepless night and the following day with fatigue. Patients usually spend hours in bed and focus on and ponder about their insomnia, and they have in their own bedroom more asleep than elsewhere. Optimal therapy combines cognitive-behavoristische strategies hypnotics Although cognitive-behavioral strategies are more difficult to establish and take longer, so the effects are yet more durable and last up to about 2 years of post-treatment. These strategies include sleep hygiene (especially restriction of time in bed-see table: sleep hygiene) reconnaissance relaxation training stimulus control Cognitive behavioral therapy hypnotics are suitable for patients requiring rapid relief and their insomnia already affecting the day such. B. as ETS and fatigue. These drugs may be used only a limited time in most cases. Physical sleep disorders Physical disorders can disrupt sleep and cause insomnia and ETS. Disorders that cause pain or discomfort (eg. As arthritis, cancer, herniated discs) cause, v. a. if they become worse when moving, transient wake and poor sleep quality. Nocturnal seizures can also disrupt sleep. The treatment is determined by the underlying disorder and is aimed at relieving symptoms from (z. B. with nightly analgesics). Mental sleeping Most of the major mental disorders can cause insomnia and ETS. Approximately 80% of patients with major depression report these symptoms. Conversely, 40% of patients with chronic insomnia a significant mental disorder, most commonly a mood disorder. Patients with depression may have trouble falling asleep or sleep disorders. Sometimes in the depressive phase in bipolar disorder and not interrupted when seasonal affective disorders of sleep, however, the patients complain of daytime sleepiness insurmountable. If the depression is accompanied by insomnia, antidepressants with predominantly sedative component (z. B. citalopram, paroxetine, mirtazapine) can help the patient to sleep. These drugs are added to the regular, rather than in low, dosages, in order to ensure an improvement of depression. However, the physician should be aware that these drugs are unpredictable sedative and may have activating properties. Moreover, given sedation may outlast the benefits and lead to ETS, and these drugs may have other undesirable effects such as weight gain. Alternatively, any antidepressant can be used together with a hypnotic. When a depression of ETS is accompanied, antidepressants can be selected by activating component (for. Example, bupropion, venlafaxine or certain SSRI such as fluoxetine and sertraline). Sleep deprivation syndrome (sleep deprivation) Although they had the opportunity to sleep patients with this syndrome at night not enough to stay awake when they are awake. The cause various social or job-related obligations in general. This syndrome is probably the most common cause of ETS. It disappears when the sleep time is extended (eg. As on weekends or on holidays). After extended periods of sleep deprivation for weeks or months are needed with longer sleep to daytime restore alertness. Drug-induced sleep disorder insomnia and ETS can by the chronic use of CNS stimulants (eg., Amphetamines, caffeine), hypnotics (z. B. benzodiazepines), other sedatives, antimetabolic chemotherapy, anticonvulsants (eg., Phenytoin), oral contraceptives , methyldopa, propranolol, alcohol and thyroid hormone preparations are caused (see table: drugs that interfere with sleep). Usual manner prescribed hypnotics can cause irritability and apathy and reduced mental alertness. Many psychoactive drugs can induce abnormal movements during sleep. A insomnia may also during withdrawal from CNS depressant drugs (eg. As barbiturates, opioids, sedatives), tricyclic antidepressants, monoamine oxidase inhibitors or illegal drugs (eg. As cocaine, heroin, marijuana, phencyclidine) develop. The abrupt withdrawal of hypnotics or sedatives can cause nervousness, tremors and seizures.

Health Life Media Team

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