Somnologist: sleeping pills are contraindicated for patients with sleep apnea

Treatment of insomnia requires special attention from a psychotherapist or psychiatrist. This is due to the fact that sleep disturbance is a direct signal of a disturbance in higher nervous activity, the beginning of the formation of some kind of mental disorder. That is why the sooner you start treating insomnia, the easier the recovery will be and prevent the development of a mental spectrum disorder.

Insomnia is a complex painful condition of the brain that prevents it from getting proper rest. If problems with falling asleep occur at least once a week or become natural, caused by some event or state of the body (for example, a woman’s period), then you should think about the need to treat insomnia.

Treatment of insomnia is a necessity!

People often try to get rid of the disease on their own, thereby disturbing their mental state. At the same time, the disease continues to develop.

Psychotherapists at the Preobrazhenie Clinic are widely known in our country as excellent specialists in the effective treatment of this disease. Patients come to us from the most remote regions of Russia, knowing that the Preobrazhenie Clinic will help them forget about insomnia forever.

Reasons for treating insomnia

It is known that sleep is a “mirror” of mental health. Insomnia is a signal that the brain needs help. Every person experiences sleep disorders several times throughout their life. However, one-time cases cannot be considered a sign of pathology. For example, occasional insomnia indicates that the brain was overloaded during the day. With severe overexcitation, a person may not sleep for 1 to 3 days in a row, after which sleep recovery occurs.

Each of the existing symptoms indicates a specific disorder of the brain, and therefore the need for a special method of treatment.

At the initial stage of sleep disturbance, it is sometimes possible to balance the time of work and rest, completely eliminate the use of alcohol, drugs and other psychostimulants, organize evening exercise, daily walks in the fresh air, physical activity (for example, jogging), increase the amount of vegetables, fruits and herbs in the diet nutrition.

Attention! Any treatment should be prescribed only by a doctor after a thorough diagnosis. Any self-medication is dangerous to health!

Indications for the use of neuroleptics

Often, when people without a mental illness take an antipsychotic drug, they have no effect on their sleep. But when people with schizophrenia take them, they experience an increase in sleep time, including an increase in time spent in slow-wave sleep.

Antipsychotic drugs are usually a form of tranquilizers that allow the body to rest and prepare for sleep in addition to the effects they have on the brain. The most commonly used drugs today are second-generation antipsychotic drugs - these, like other prescription drugs, are approved by the WHO and labeled for specific diseases or indications. Doctors have the freedom to prescribe them off-label, and experienced psychiatrists often do so.

Attention! Low doses of antipsychotic drugs, known as antipsychotics, are prescribed to treat sleep disorders such as insomnia, but the doses are much lower than those used to treat a psychotic disorder.

If insomnia is left untreated

The main “target” of the disease is the brain. For normal functioning, he needs time to rest and process information received during the day. The optimal period for this, determined by human physiology, is night (from 21.00–22.00 to 5.00–6.00). Due to sleep disturbances, the brain is deprived of the opportunity to rest, which leads to changes in the metabolic processes of the brain and the development of various mental disorders.

The most common consequences can affect the occurrence of various types of depression, anxious mental disorders, panic attacks, as well as asthenic conditions. These factors, in turn, influence the development of genetically determined mental disorders to which a person is predisposed.

Main causes of insomnia

• consumption of alcohol, psychoactive substances, drugs;
• individual predisposition;
• regular forced wakefulness (night work schedule);
• forced wakefulness (visiting nightclubs, bars, etc.);
• mental overload (stress);
• depression, neurosis, consequences of head injury, intoxication;
• circulatory disorders of the central nervous system, intracranial pressure.

For treatment to be effective, the cause of insomnia must be immediately eliminated. Treatment of neuroses, depression, elimination of mental overload is a priority.

Consequences of insomnia

Insomnia threatens with quite serious consequences that significantly worsen a person’s quality of life:

• labor productivity is significantly reduced;
• reaction time slows down during work and driving, resulting in an increased risk of accidents;
• mental disorders develop, or the patient begins to abuse psychoactive drugs;
• problems arise with blood pressure and heart activity.

Healthy sleep is no less important for the normal state of the body than a balanced diet and regular physical activity. Insomnia has a negative impact on both mental and physical functioning of a person

Treatment of insomnia

At the initial stage of the disease, you should not resort to self-medication by taking medications without a doctor’s prescription. This can worsen the situation, cause drug dependence, which will complicate the course of the disease and transfer it to the chronic phase.

Restoring brain functions falls within the competence of a psychiatrist-psychotherapist. Only a specialist can correctly understand the true causes of insomnia and prescribe adequate treatment.

Do not put off visiting a professional psychotherapist “for later” - this can lead to irreversible mental health problems.

We do not believe in miracles and easy results in treating brain disorders. We fight together for your healthy life. The desire and willpower of a person, as well as the help of people close to him, are very important.

Insomnia is known to many, but very few see it as a serious problem that needs to be addressed by a specialist. Poor sleep not only causes moral discomfort, but can also cause significant harm to the health of the sleep-deprived.

Violations can also be caused by the use of various psychoactive substances. In this case, therapy should be carried out in a drug treatment clinic.

Insomnia is a sleep disorder that is defined by both deterioration in sleep quality and shortness of sleep. Sleep, as a natural process that replenishes our body with the necessary energy, does not tolerate when little attention is paid to it. Your body immediately reacts with drowsiness, irritability, decreased performance, and a weakened immune system.

Manifestations of insomnia

• prolonged falling asleep, difficulty falling asleep;
• frequent awakening;
• getting up early;
• malaise;
• lack of a full night's sleep;
• depression.

Causes of chronic sleep deprivation

• prolonged depression;
• diseases of the nervous system;
• asthma;
• overwork;
• stress;
• heart failure;
• alcohol and drug abuse;
• kidney diseases;
• arthritis;
• encephalitis.

If all of the above symptoms apply to you, then you need to take proper measures to eliminate this problem. The problem of insomnia itself can develop for numerous reasons. The epicenter of the development of insomnia can be a number of mental and somatic diseases.

Insomnia and the social environment

Often, social factors also influence the quality and duration of sleep. Self-doubt, inferiority complexes, lack of confidence in the future - all this provokes a violation of the structure of the sleep process.

Distortion of normal sleep is not only a problem of an internal psychological nature, but also the fault of technological progress. All inventions of mankind - television, computer, Internet, mobile phone - pay due attention to human consciousness. These factors prevent him from relaxing properly.

What is the benefit of the drug

A sleep disorder does not go away without a trace for the body; it necessarily entails problems: the functioning of blood vessels is disrupted, problems with vision and hearing arise, brain function deteriorates, and metabolic processes are disrupted from the normal rhythm. The body needs rest, as it constantly expends energy on physical and mental activity.

Sleep and food are called upon to replenish them. This is why you need to sleep and eat properly. Information processing occurs during sleep. If you deprive your body of sleep, information will be absorbed much worse. Constant insomnia causes an imbalance in the nervous, endocrine, and somatic systems. In the worst case, it can even lead to insanity.

Insomnia can be triggered by any life circumstances that make us nervous. A person who lacks sleep begins to look bad and his mood deteriorates.

Today, various sedatives for insomnia are produced. Some are synthetic, others are natural. The latter have a gentle effect on the body - it is better to give preference to them, because they have minimal side effects.

Relaxis for stress belongs to these drugs. This remedy for depression is created on the basis of native extracts, extracts from plants. It is completely natural, does not contain hormones, synthetics, or psychotropic substances. This is the best remedy for insomnia. It can be used even by small children from the age of two.

Types of insomnia

• difficulty falling asleep
• night awakenings
• early awakenings
• light sleep
• drowsiness during the day
• feeling of not getting enough sleep
• lack of freshness after sleep
• complete lack of sleep
• sleep disorder

The symptoms of the disorder are very varied. Even when falling asleep, a person may not experience the feeling of sleep, often wakes up in the middle of the night, and his rhythm of sleep and wakefulness changes. If insomnia occurs several times a year, you can try to solve this problem yourself. A prolonged period or repeated episodes require specialist consultation and careful treatment.

Adaptive insomnia

Adaptive insomnia manifests itself in situations where some significant changes have occurred for the human body, such as climate change, during flights, moving and stressful situations. Typically, this type of insomnia does not require intervention and goes away on its own.

A false form of insomnia occurs when a person is completely sure that he often does not sleep at night. In fact, a person simply does not remember the very moment of falling asleep, but is not fixated on the process itself, which seemed to him extremely long and painful.

Insomnia during menopause is a subtype of sleep disturbance that quite often accompanies menopause in women and is considered an almost natural process. Every third woman during menopause suffers from worsening sleep and often does not get enough sleep.

Psychotherapist - online consultations

ANSWERED: 05/02/2014 Kravtsov Alexander Vasilievich Khabarovsk

0.0 psychiatrist-narcologist

Dear Alina! There is no point in placing high hopes on medications. There are simple rules of sleep hygiene: 1. Remove all carpets, furs, heavy curtains, if any, from the bedroom, carry out wet cleaning (once every 3 days, floors daily) including the floor, walls, ceiling, replace linoleum, synthetic coverings, etc. .P. to “environmentally friendly” ones, for example, paper wallpaper, wooden floors, cotton or linen curtains and bed linen, remove pets from the bedroom, remove flowers. Change pillow, mattress. 2. Use “earplugs” (simple cotton wool plugs in your ears), 3. Don’t sleep during the day. Always go to bed and get up at the same time. 4. Never drink tea (including green tea, it contains more caffeine than black tea), coffee, energy drinks after 6 pm, avoid chocolate, citrus fruits, and alcohol in the evening. 5. Exclude physical activity, as well as TV and computer 6 hours before bedtime. Before bed, take a warm, relaxing (not hot) shower or bath for 5-10 minutes. 6. Persen or Novopassit, or sedative herbal tea with honey (motherwort, valerian, hop cones, etc.) - 30 minutes before bedtime, 7. If you can’t sleep, don’t force yourself to sleep: do something calm and monotonous , for example, read, knit, light housework, try to fall asleep again after 30 - 60 minutes, if not, get up again, knit, read, etc. 8. Melaxen - is not a sleeping pill (tranquilizer), unlike Donormil, Phenazepam, Corvalol, it helps normalize night sleep: accelerates falling asleep, improves sleep quality, well-being after waking up in the morning, does not cause a feeling of lethargy, weakness and fatigue upon awakening (unlike most sleeping pills), dreams become more vivid and emotionally rich. It also adapts the body to rapid changes in time zones and reduces stress reactions. Does not cause addiction or dependence. A good and safe drug. It should be taken 1 tablet 1 time in the evening, 30-40 minutes before bedtime. The course of treatment is 4-6 weeks, repeated regularly 4-6 times a year. The duration of normal sleep is individual for each person, on average - 6-8 hours. There are cases when a person sleeps 2-3 hours a day, maintaining increased performance (for example, J. Bernard Shaw (lived 94 years), Leo Tolstoy (82 years old), Mahatma Gandhi (78 years old), Charles Chaplin (88 years old)) Until old age, they all maintained clarity of mind, were very active, and slept very little. For normal recovery of the body, it is not the duration, but the quality of sleep that is important. It is important that you wake up in a good mood and feel rested after waking up. You can try to “deprive” yourself of sleep. If you can’t fall asleep for a long time, don’t try to sleep, keep yourself busy with something, and the next day don’t go to bed until the evening. This will give the body healthy fatigue and good sleep. Antidepressants are often prescribed by psychotherapists, but for a positive effect, they must be taken for a long time, at least 3 months regularly every day. On average, the course of use is 8-12 months. The first signs of antidepressant action begin to appear only after 2-3 weeks of regular use. In addition, it is not always possible to immediately select the “right” drug; you often have to change it.. High-quality psychotherapy is also long and painstaking work, designed to last for years; it is not just a consultation, it will not give anything. Best wishes

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Treatment of insomnia during pregnancy

In women carrying a child, sleep is usually disturbed starting from the third trimester. Expectant mothers focus a lot of attention on the upcoming event, that is, childbirth. Numerous experiences associated with the fear of giving birth, with the awareness that there is another life inside and many experiences with a hormonal background. In addition, at the end of pregnancy, the fetus puts pressure on the internal organs. You have to run to the toilet more often to urinate, and your breathing becomes heavier and faster. It is difficult to find a comfortable position for a large belly. But still, according to statistics, 20% of pregnant women do not suffer from this problem.

Treatment of insomnia during pregnancy is complicated by the fact that the use of medications, including herbal ones, is very limited. Therefore, it is recommended to use special neurometabolic treatment regimens for use.

Insomnia in the elderly

Sleep disturbances in various forms in older people are associated with age-related changes in the brain. The duration of different phases of sleep changes. The fourth phase, responsible for deep and sound sleep. The body reaches its maximum point of relaxation and shortens significantly. Thus, shallow sleep lasts longer, and deep sleep becomes shorter, which means it is more difficult to restore strength.

Sleep disturbance in infants

This type of disorder is explained by the instability and immaturity of the central nervous system of the newborn. Children are very impressionable and experience any surprise with particular emotion and anxiety. Since the hormone that affects the growth of the child’s body is produced mostly during sleep. It is very important for children to sleep soundly while maintaining sleep hygiene and other psychological factors.

How to deal with insomnia due to alcoholism

People suffering from alcoholism often complain of mood instability, irritability and lack of restraint. This leads to the problem of sleep disturbance, which is accompanied by other symptoms. A striking example is fatigue and asthenia at the very beginning of alcohol addiction or binge drinking. Also characteristic of the symptom of insomnia is awakening and the inability to fall asleep at 4-5 o’clock in the morning.

Indications for the use of antipsychotics for sleep

In some cases, people who do not have mental illness may take antipsychotic medications to help them sleep. However, they are not always effective for mentally healthy people. At the same time, patients with schizophrenia note that sleep after antipsychotics becomes much longer, including slow-wave deep sleep.

Antipsychotics for sleep are tranquilizers that, in addition to affecting the brain, provide the body with rest and preparation for sleep. Today, the most commonly used are second-generation antipsychotics, approved by WHO and having a wide range of indications. Experienced psychiatrists at the Yusupov Hospital can prescribe them for the treatment of insomnia.

Treatment of insomnia in the early stages

• In order to prevent problems falling asleep, you need to follow a few simple tips.
• Ventilate the room before going to bed. Fresh air will help you relax and fall asleep faster.
• Brew not hot herbal tea with motherwort, peony root or mint with honey. Herbs have a positive effect on the nervous system.
• Don't overeat at night. A full stomach won't thank you. The body spends energy on digesting food, and therefore the body cannot relax because it is focused on another process.
• Listen to soothing music before bed.
• Try to postpone thinking about difficult tasks and making decisions until the morning.
• Eliminate mentally stimulating moments: computer games, watching horror films and news, hard physical and mental work.

Treating insomnia on your own

Strong tea, coffee, spicy foods and drugs that have a stimulating effect on the body negatively affect healthy sleep. The cure for this disease is based on the main cause. That is, in order to get rid of insomnia, it is worth eliminating all the factors that caused it.

Most often, if a person is healthy, insomnia is treated without the use of medications. To do this, you should take time for quiet walks before bed, a warm bath, and reading. Before going to bed, it is better not to drink strong tea and not to abuse coffee or alcohol. If insomnia occurs more aggressively and persistently, folk remedies will help the person.

Attention! Any treatment should be prescribed only by a doctor after a thorough diagnosis. Any self-medication is dangerous to health!

Night Comshar

— Roman Vyacheslavovich, it seems to me that if a person is positive, then he will have normal dreams. Sleep can probably relax and calm an adequate person, but if he has some kind of mental problems, if he is in a depressed state, then sleep, on the contrary, is not only dangerous for him, but will it cause some negative phenomena?

- Yes, absolutely so. Moreover, there are so-called obsessive dreams. It’s one thing when we have some specific nightmares and fears, we worry, make some decision, adapt, and we stop having a bad dream. But it’s another thing (this, by the way, is well shown in films) when a person after a war or accident is terrified all the time, wakes up in a cold sweat, and relives the accident every time. What the brain does normally:

• analyzes information
• forgets
• stores in long-term memory,
• decides how to act.

And sometimes the brain, like a broken record, turns to a catastrophic event every time, but can neither forget, nor analyze, nor make a decision. Every time the brain turns to this in a dream, but cannot find a solution. And this already requires the intervention of psychiatrists and psychologists. There are interesting techniques. Let's say a person falls from a height, and he dreams about it every time. Under hypnosis, he is told that the next time he falls, wings will grow in his sleep. A man dreams that he falls, his wings grow and he flies. After this, the nightmare disappears, that is, its relevance disappears, because the brain has found a solution - even if it is strange and unusual.

— There are many films about such violations. In The Last Samurai, Tom Cruise's character was a military man, he killed, he had nightmares. Then he found himself among the samurai. They are ready to kill themselves, they have completely different values, so they sleep perfectly. As a result, Cruise's character also begins to sleep peacefully and understand that everything he does is right. Is it possible to get rid of such nightmares without hypnosis? Because we have a lot of traumatic things in our lives. Not necessarily war. There are also simple things that keep us awake.

- We do not have absolute good and absolute evil. There is a person’s attitude to a specific event. A person may take this for granted. For example, he is an executioner, executing people is his job. He can sleep completely peacefully. And some soldier was forced to shoot a guilty colleague, and then all his life he would dream about how he shot a man and executed him.

In the treatment of insomnia, cognitive behavioral therapy is used, when we change a person’s attitude towards the problem. There is a pessimist and an optimist: the pessimist's glass is half empty, and the optimist's is half full.

The attitude towards an event has a much greater influence on the psyche than the event itself.

When a person is weaned using certain psychological techniques from a negative attitude towards a specific event, it loses its relevance for him. Such techniques are actively used in medicine in the treatment of insomnia.

- So you can’t take a pill and everything will go away?

- This is a separate block. I have been treating insomnia for 30 years, and for more than 20 years I have not been treating it very correctly with pills. But when prescribing medications, I understood that, most likely, I would never cure a person; he would constantly take pills. It is almost impossible to cure chronic insomnia with pills. But by changing behavior and attitude, it is possible.

Using cognitive behavioral techniques, I cure 60% of patients with chronic insomnia simply by talking to the person, changing his consciousness, thinking and behavior.

By the way, in “The Last Samurai” there is a similar situation. Cruise's character's attitude towards the problem was changed. He did not become a different person, he did not give up his profession. But he changed his attitude towards her. As soon as we change our attitude towards insomnia, it disappears.

Drug therapy

When people suffer from sleep disorders, the first option to combat this disease most often becomes sleeping pills and other pills or medications that relax the nervous system. But this option is only suitable for people who have previously tried to eliminate the problem using traditional methods without pills. But if the patient has decided to fight insomnia with the help of medications, then their choice should be especially responsible.

• A drug that improves sleep should be selected individually by the treating psychiatrist. This could be an antidepressant with a sedative effect, an antipsychotic, a tranquilizer, or another drug. Some drugs should be prescribed for a short time, others can be prescribed for a long time. The necessary medicine is selected individually, according to the existing problem. In case of somatic diseases, it is often enough to remove pain, frequent urination at night or itching to restore sleep.
• The drug should provoke sound sleep and maintain it until awakening;
• After waking up, residual drowsiness should be minimal;
• The drug should not be addictive;
• Side effects should be minimal.

Insomnia should be treated wisely, without going to extremes. The disease will recede if you treat it without excessive fanaticism, without stuffing yourself with drugs indiscriminately. Contact a psychiatrist-psychotherapist and he will definitely select the necessary treatment for you. It is often enough to teach a person relaxation techniques and self-hypnosis in order for the sleep problem to be solved once and for all.

You can contact the clinic’s specialists by phone in Moscow

Types of antipsychotics for sleep

All antipsychotic sleep medications are antipsychotic drugs. They are divided into two main types: they can be typical or atypical. In addition, antipsychotics are representatives of the first or second generation.

Typical antipsychotics for sleep

Typical first-generation antipsychotics have a sedative effect. In addition, they help reduce muscle tension that occurs during mental disorders, anxiety, obsessive-compulsive disorder, and also have a hypnotic effect. Antipsychotic drugs do not affect sleep cycles, but sleep may be longer and deeper after taking antipsychotic drugs.

The most famous typical antipsychotics are Haloperidol and Chlorpromazine.

Atypical antipsychotics for sleep

Atypical second-generation antipsychotics for sleep have little tendency to induce sedation, but some may cause extreme fatigue and drowsiness.

Most often, to treat patients for insomnia in the psychiatry clinic of the Yusupov Hospital, the following atypical antipsychotics are prescribed:

• Quetiapine is a widely used dopamine receptor agonist drug that affects other neurotransmitters;
• Olanzapine is a psychiatric drug that has a sedative effect. Contraindicated for use in persons suffering from dementia due to an increased risk of stroke;
• Risperidon-approved is a medicine that is used for psychiatric conditions and insomnia.

Alternative ways to sleep

Night sleep is a special component of the correct functioning of the body. Before starting treatment for insomnia with antidepressants, experts advise following the following measures:

• always try to go to bed at a certain time;
• go to bed in a dark room without light;
• ventilate the room before going to bed;
• go to bed in complete silence;
• provide a comfortable bed.

It is important to shower with essential oils before going to bed. Afterwards, without drying yourself, go to bed and wrap yourself up. This session will help you relax and fall asleep faster. You won't even need to take sleeping pills. If such methods do not have a beneficial effect within a week, then try herbal preparations. Since sleeping pills provoke addiction very quickly, only a doctor should prescribe them.

Herbal medicines are made using plants such as motherwort, valerian, and lemon balm. Motherwort is characterized by an excellent hypnotic effect. It has a good effect on the functioning of the heart and nervous system.

Insomnia can also be treated with valerian. The root is saturated with essential oils, which are characterized by a soothing effect. The plant helps you fall asleep easier. In any case, preliminary consultation with a doctor is important.

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