Sleep Does Not Mean Sleep

Sleep does not mean sleep

Russians are tortured by insomnia - every fifth inhabitant of the country suffers from various sleep disorders. As a result, labor productivity decreases, chronic fatigue and serious diseases develop. Such data were presented at the round table "What does chronic lack of sleep lead to, and how to overcome insomnia?", Where the somnologist, pharmacologist and psychotherapist discussed this problem

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Russians were tortured by insomnia. According to the Ministry of Health, from 25 to 35 million people suffer from various sleep disorders - every fifth inhabitant of our country. As a result, the quality of life and labor productivity decrease, chronic fatigue develops, as well as serious diseases. Such data were presented at the round table "What does chronic lack of sleep lead to, and how to overcome insomnia?", Where a somnologist, pharmacologist and psychotherapist shared their views on this problem.

Sleep problems at a round table in the Komsomolskaya Pravda press center, held in November 2016, were discussed by a certified sleep doctor of the European Society for Sleep Research, executive secretary of the Russian Society of Somnologists Alexander Melnikov, assistant of the Department of Clinical Pharmacology, VSMU named after Burdenko, Ph. D. Olga Mubarakshina, psychiatrist, psychotherapist, narcologist, Ph. D. Valery Lykov.

What is it fraught with

Insomnia is a broad term that refers to the problem of falling asleep, early awakening, disruption of the continuity of sleep and its quality. And all this necessarily leads to daytime sleepiness and impaired performance. Lack of sleep has a detrimental effect on health, because of this, all organs and systems of the body suffer, says Melnikov. Moreover, according to him, recent studies by Berlin scientists have shown that every third car accident is caused by a sleepy driver who simply loses control of the situation.

“And this is not a single opinion, - said the expert. "Today in Europe it has been decided that people who are suspected of having apnea syndrome (holding the breath while sleeping) will not be able to renew or renew their driver's license." The Russian society of somnologists also proposed to conduct a corresponding examination when issuing a driver's license.

Why can't we sleep

Insomnia does not always have organic causes, often a person himself provokes it, disrupting what is called sleep hygiene. “Sometimes the reasons are very simple - we just don't eat and drink,” Mubarakshina said. - A lot of people abuse coffee and caffeinated drinks, you should at least reduce their consumption. It is foolish to drink 2 liters of Coca-Cola and seize it with sleeping pills."

Or maybe it's a disease

According to Lykov, sleep disorders are found in all mental disorders and non-psychotic disorders, borderline states. “Previously, it was called neuroses, now - anxiety-depressive states, and it is with them that up to 90% of cases of sleep disturbances are associated,” explained the psychiatrist. - Difficulty falling asleep occurs when anxiety prevails, depression is characterized by early awakening. And if quantitative sleep disorders are initially not expressed in everyone, then qualitative ones (including nightmares) are always encountered. It's another matter that not everyone remembers them."

Sleep disturbances, on the other hand, can be called the gateway to anxiety-depressive disorders. If a person does not sleep well, he develops overwork, which leads to a violation of the borderline level. Therefore, the treatment of non-psychotic conditions begins with sleep correction. “As soon as a person starts to sleep, he begins to recover - a vicious circle is broken,” Lykov said.

Rules for healthy sleep

However, not always sleep deprivation occurs due to insomnia; many people deliberately reduce the time of night rest. According to Melnikov, in order for a person's psychomotor reactions to remain normal, he must sleep at least 6 hours a day. Moreover, it is night sleep that helps to recover as much as possible. “There are circadian rhythms of sleep that are tied to human physiology,” explains the somnologist. - A person should sleep when the hormone melatonin is produced in his body, and this happens in the dark. If you constantly sleep at a different time, over time you will inevitably face serious physiological disorders."

Experts do not welcome excessive sleep either, calling it the same deviation from the norm. According to them, on the one hand, this can be a manifestation of pathological conditions, and on the other, it can provoke them (for example, cause a migraine), since excessive sleep disrupts its structure.

The most important thing, according to Melnikov, is the stability of the time of getting up and going to bed. According to him, "social jetlag" (jet lag syndrome) is now very common. When people change their sleep time dramatically on weekends versus weekdays, conditions occur, similar to jet lag. This is also a very harmful stressful situation for the whole organism, and we must try to avoid it, the expert believes. You can, of course, sleep longer on weekends, but not more than two hours than usual.

Who needs a siesta

Afternoon sleepiness, according to Melnikov, is a physiologically conditioned state. And a short daytime sleep can to some extent compensate for the lack of nighttime sleep, but so that it does not go into the third stage of deep sleep. A daytime sleep of 40-45 minutes is useful, but sometimes 15-20 minutes is enough for a person to recover. “We do our best to promote the possibility of daytime sleep, and we welcome companies that create such conditions for employees to rest during the day,” said the somnologist.

How to trick insomnia

Is it possible to do without sleeping pills

Everyone has heard the concept of "auto-training", but today there are already a lot of improved methods of self-regulation, which are more targeted, says Lykov. “I use methods of psychosomatic self-regulation, which, in addition to relaxation, includes figurative adjustment and removal of internal tension (and not just muscle tension),” the expert said. - Primary sleep disturbances are not so common, mainly the cause of insomnia is anxiety and internal tension. It is necessary to remove this tension, and sleep comes automatically."

In this case, the main thing is not to allow a person to have a fear that he will not fall asleep. This fear, in turn, perpetuates insomnia itself. “Old doctors said that a dream is like a dove that sits on your shoulder, but if you try to catch it, it flies away,” Lykov said. - The first steps should be aimed at removing the fixation. Sleep should not be an end in itself - the higher the level of stress, the further a person is from sleep. No need to scroll through the past day before going to bed or plan the next. It is necessary to free the head from thoughts.

There is also such a method of getting rid of anxiety-depressive states as sleep deprivation. “If you can't sleep - well, don't sleep, go do your business, in the end you will want to sleep and fall asleep,” the psychotherapist explained the essence of this technique. - According to this theory, you should get up and start doing some quiet activities already when you cannot sleep for 15 minutes. It is better if it will be some boring, but necessary business that is always put off until later. You can read a book, but it shouldn't be particularly interesting."

As with anything about a healthy lifestyle, healthy sleep requires physical activity. True, no later than 3 hours before the person goes to bed. But at least half an hour of aerobic activity daily, according to Melnikov, is required for everyone.

But experts have a negative attitude towards alcohol as a relaxing and sleeping pill. If at first, due to the anti-anxiety effect of alcohol, a person falls asleep, his sleep will not be productive - it will be limited to the surface stages, without going through the deep ones. “To fall asleep does not mean to get enough sleep,” Mubarakshina explained. - And this applies to alcohol in the first place. The goal of rest and recovery will not be achieved. " In addition, in such a situation, the risks of alcohol dependence significantly increase, experts say. According to them, there are many “quiet alcoholics” in our society, whose addiction was formed in this way.

Good old pills

Most of our fellow citizens do not seek help from doctors with insomnia, trying to regulate sleep on their own. “People go to the pharmacy and buy something that has been well known for a long time,” Mubarakshina says. - One of the groups of such drugs that would not be worth contacting are drugs containing phenobarbital (corvalol, valocordin). It is a serious sleeping pill that disrupts sleep patterns and is addictive. Another danger lies in its ability to reduce intellectual activity. In addition, phenobarbital is a narcotic drug with a long half-life. And if a person driving, who had an accident, is found to have this drug in his blood, he will not be able to prove anything and will lose his rights."

The phytopreparations that our population adores do not cause much harm, but they do not solve problems either, the expert said. They have a slight sedative effect, which, however, can affect performance. A fairly harmless group of drugs is first generation antihistamines (modern antiallergic drugs do not have a hypnotic effect).

In addition, Mubarakshina recalls, many drugs themselves cause sleep disturbances. In particular, beta blockers that enter the brain can cause nightmares. Usually, all side effects are described in the instructions for the drug, but many people have individual reactions. And one and the same drug can cause drowsiness in one, and insomnia in another.

Modern drugs

The modern standard for sleeping pills is drugs that make up for the lack of melatonin, says Mubarakshina. Its role especially increases when the synthesis of this natural sleep hormone is disrupted in the body, in particular, in the elderly. In addition, they are also used as adaptagens that help the body adapt to changing time zones, or when a person employed in shift work needs to fall asleep during the day.

“The professions of pilots and stewardesses are considered one of the most harmful,” Mubarakshina says. - Working in shifts, they constantly not only disrupt sleep patterns, but also change time zones. Due to the fact that the time of activity and sleep changes from day to day, the daily program fails - a violation of the circadian rhythm of sleep. This is a very serious problem: young people 25-40 years old have high blood pressure and gastrointestinal disorders. And melatonin preparations, which allow you to adapt to the change of time zones in 1-3 days, are the number one remedy for them."

Where to find a sleep doctor

“Somnology is not included in the nomenclature of specialties of the Ministry of Health, therefore we have practically no doctors who would specifically deal with sleep disorders. At the same time, the pathological conditions associated with sleep are very specific,”Melnikov complains. In his opinion, such common problems as insomnia and breathing problems during sleep deserve much more attention from the health care system. According to the somnologist, 20-25% of people have sleep disorders up to the level of apnea syndrome. Neurologists, to whom patients first turn, cannot make a diagnosis, even if they are familiar with the problem - this requires instrumental studies.

“We need diagnostic systems to record what happens to a person in a dream, how he breathes,” explains Melnikov. “And our society of somnologists strives to have specialized centers in all major cities.” But the psychotherapist, according to Melnikov, is "the sleep doctor's best friend." And not only with neurotic disorders. “All over the world, psychotherapy is the method of choice for insomnia, its effectiveness has been proven many times over,” said the somnologist. “Therefore, first of all, we refer such patients to sessions of cognitive-behavioral psychotherapy”.

Sleep Does Not Mean Sleep

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