Insomnia is defined as difficulty falling asleep, persistent sleep disturbance or lack of recovery after sleep, 3 times a week for at least 1 month, causing significant discomfort or interfering with daily life, not caused by neurological disorders, use of psychotropic drugs or other medications, etc.
What is insomnia
Insomnia usually refers to a subjective experience of unsatisfactory sleep duration and/or quality that affects social functioning during the day. Common clinical forms of insomnia include.
- Prolonged sleep latency: sleep onset lasting longer than 30 minutes.
- Sleep maintenance disorders: ≥ 2 nighttime awakenings, or early awakenings in the early morning hours.
- Decreased sleep quality: light sleep and excessive dreaming.
- shortened total sleep duration: usually less than 6 hours.
- Residual daytime effects: feeling dizzy, mental fatigue, drowsiness and weakness the next morning.
Causes of insomnia
Older people are a large group of insomnia. In addition to the push of various old age diseases, some habits that seem to be beneficial to health but can actually lead to adverse consequences are also factors that cannot be ignored. In addition, compared with young people, the elderly have less time to sleep and their sleep is easily interrupted.
If you always look forward to sleep to supplement sleep, it may disrupt the rest pattern, so that the brain biological clock disorder, resulting in the elderly “daytime sleep is not good, can not sleep at night”. For example, many elderly people like to get up early to exercise, and then go home after the morning exercise to make up for a back to sleep.
This does not seem to be a problem, but in fact, sleeping after the morning exercise is extremely detrimental to the health of the elderly and sleep. After the morning exercise, the elderly’s breathing, heartbeat accelerated, the spirit is in a state of hyperactivity, muscle also due to exercise secretion lactic acid and other metabolites.
If the morning exercise immediately after lying down on the sleep back, it is not conducive to the elimination of lactic acid and other metabolites. If this metabolite is not eliminated, it is easy to make the elderly feel tired, muscle pain, and even headaches during the day.
Especially those who are not accustomed to get up early, occasionally after the morning exercise often like to sleep back to sleep. Therefore, it is recommended that such elderly people get up a little later, wait until the sun rises for a period of time, dispel the morning fog, plants release oxygen, the temperature rises and then exercise is not too late, and do not sleep after exercise.
There are many reasons for insomnia, but about 70% are emotional insomnia, including anxiety, depression, etc., and bad moods in turn affect sleep, resulting in a “mental interaction”, which is often referred to as a vicious circle.
Treatment of insomnia
The current treatment consensus is that the treatment of insomnia includes etiological treatment, correction of cognitive and behavioral problems, and medication. Meanwhile, the WHO guidelines for the treatment of sleep problems state that correction of poor sleep hygiene habits and poor cognition is the basis of all treatment.
Among them, sleeping pills can be considered for those with significant insomnia, but non-benzodiazepine selective GABA-A receptor agonists (non-valium sleeping pills) are recommended as first-line drugs of choice, such as zopiclone, zolpidem, and zaleplon. If withdrawal would affect the patient’s quality of life or if other treatments are ineffective, long-term use of Ambien is advocated, following the principle of selection of benefits over harms.
How to overcome insomnia in the elderly
Regular sleep schedule
Follow a regular sleep schedule, going to bed at the same time and getting up at the same time every day, and also on weekends.
Appropriate sleep environment
Maintain an appropriate sleep environment, which should be quiet, clean and comfortable. Keep the bedroom dark and quiet, and the room temperature should not be too cold or too hot, and the humidity should not be too high or too low. Before going to bed, open the windows to ventilate the room, so that the air is fresh and oxygenated, but should prevent colds.
Selection of bedding: the elderly are prone to bone and joint disorders, should avoid sleeping on brown rope bed, to board bed is appropriate, on the mattress, should be soft, flat, moderate thickness, too thick easy to cause false heat inside, too thin is easy to be attacked by the cold outside, are sleepless at night. Quilt, bed sheets, pillows must be neat and tidy, so that people feel comfortable. The pillow should have moderate elasticity.
The correct sleeping posture
Pay attention to the sleeping position, especially good to the right side, can help muscle tissue relaxation, eliminate fatigue, help the stomach food towards the duodenum direction, but also to avoid heart pressure. If you have been lying on your right side for too long, you can switch to lying on your back. Stretch the upper and lower limbs, straighten the torso, relax the muscles of the whole body as much as possible, keep the blood flowing, and breathe naturally and calmly.
Avoid bedtime excitement
Excitement before bed can lead to insomnia and excessive dreaming. Therefore, do not do intense activities before bedtime, do not watch stressful TV programs and movies, and do not read esoteric books.
Adjust the sleep time
Sleeping time is generally good for waking up with a comfortable body, recovering energy and relaxing body and mind. You can adjust it by yourself according to your physical condition and living habits.
Soak your feet in hot water before going to bed
Soak your feet in hot water before going to bed to promote vasodilation and guide the downward flow of qi and blood, making sleep hazy and shortening the time to fall asleep, so that you can sleep more soundly.
Do not eat before going to bed
Eating before bed, especially greasy products, will increase the burden on the stomach and intestines, diaphragm upward, chest pressure, abdominal distension, easy to cause more dreams, dreaming, nightmares, so you should strongly avoid eating before bed, and do not drink drinks containing caffeine and ethanol.
Drink less water before going to bed
Drink less water and urinate first before going to bed. The elderly have a deficiency of kidney energy, and if there are no cardiovascular or cerebrovascular disorders, they should drink less water before going to bed and urinate before going to bed. Avoid bladder fullness and increase the number of bowel movements.
Exercise can help to fall asleep naturally, but not at dusk when it is too late, because it can stimulate the cardiovascular and nervous system and make people excited and awake.