Understand the 7 major causes of insomnia and need to prescribe the right medicine

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Article Li Ying “Ming Pao”

I believe that many people have experienced insomnia, lying in bed with “sightedness”, tossing and turning.

What exactly is insomnia? Learn about the top 7 causes of insomnia and sleep hygiene to improve your insomnia!

(Hong Kong News) A study last year by the Department of Psychiatry at the University of Hong Kong found that nearly a quarter of young people suffer from insomnia. Occasional insomnia can lead to poor energy and fatigue the next day. You only need to catch up on sleep at night. However, if the insomnia problem persists, it will not only affect concentration and work efficiency, but will increase the chances of developing high blood pressure, coronary heart disease, and diabetes over time. Induces mental problems such as depression and anxiety, and some people even use alcohol or drugs to help them sleep, which may lead to dependence on alcohol or drug abuse in the long run.

common causes of stress

There are many causes of insomnia, most often due to stress, but also due to bad habits and some physical problems that affect the quality of sleep. If the insomnia problem persists and causes trouble, you must seek medical advice and prescribe the right medicine.

According to Dr. Wang Zetang, a specialist in family medicine at Sanatorium and Hospital, according to the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), patients with insomnia must be dissatisfied with the “quality” and “quantity” of their sleep time, including a Difficulty falling asleep, maintaining sleep, waking up too early, and falling asleep after waking up at least 3 nights a week, and the problem persists for at least 3 months. People who suffer from insomnia have difficulty falling asleep even when given the chance.

He pointed out that there are many causes of insomnia, most commonly caused by stress, but also by bad habits and some physiological problems that affect the quality of sleep. Here are the top 7 causes of insomnia:

1. Pressure:The human body’s autonomic nerves will be over-excited due to school, work and family pressures, causing heart palpitations and muscle tension. Especially those who need to go to work at night or work in shifts, or airline crew members who often travel through multiple time zones, their biological clocks are easily disturbed, which increases the risk of insomnia.

2. Bad habits:Some bad habits, such as eating too much in the evening, may cause acid reflux; drinking too much water can lead to nocturia; smoking in the evening or at night, drinking coffee, strong tea and alcohol, etc. can also stimulate the brain. Other bad habits, such as lying in bed watching TV, mobile phones and tablet computers, or uncomfortable temperature and light in the bedroom, will affect our physical and psychological state, making it difficult to fall asleep.

3. Physical illness:In addition to external factors, some physiological problems can also cause insomnia. He explained that benign prostatic hyperplasia, overactive bladder and diabetes can cause frequent urination and make patients go to the toilet frequently at night; hyperthyroidism can make it difficult for patients to calm down psychologically and physically; patients with chronic obstructive pulmonary disease and heart failure are also prone to breathing difficulties And insomnia.

4. Mental illness:Insomnia can be a symptom of mental illnesses such as depression, anxiety and post-traumatic stress disorder.

5. Drugs:Certain types of drugs can cause insomnia, such as antidepressants SSRIs, bronchodilators for asthma, and certain high blood pressure drugs. Other over-the-counter medicines containing pseudoephedrine (such as decongestants) can also cause insomnia.

6. Sleep-related diseases:Sleep apnea, periodic leg tics and restless legs syndrome can all affect sleep quality.

7. Primary insomnia:If the clinical evaluation completely excludes all the above causes of insomnia, the patient belongs to primary insomnia.

Sleep testing to assess why

He pointed out that if a patient seeks medical attention because of insomnia, the doctor will first ask questions about his sleep pattern, arrange appropriate physical examinations and tests, and even conduct a sleep test, during which the patient’s brain waves, breathing, heartbeat, and eye movements will be monitored. And body movements and other data to find out whether there are other underlying diseases that cause insomnia.

first line treatment Help patients adjust their life and sleep

If the source of the insomnia can be identified, it is necessary to “prescribe the right medicine”. The doctor will also explain good sleep habits to the patient, and assist in the adjustment of life and sleep. This is the first-line treatment plan. Other treatment methods include psychological and drug treatment.

1. Psychotherapy:Cognitive Behavioral Therapy (CBT) is one of the psychological treatments for insomnia, which is as effective as sleeping pills and much safer. Treatment will teach patients to identify the causes of insomnia and correct incorrect sleep concepts, such as not being able to fall asleep without drugs and alcohol.

2. Over-the-counter drugs:Such drugs can be purchased directly in pharmacies or supermarkets without a doctor’s prescription. For example, the first-generation antihistamines used as cold and cold medicines will cause drowsiness after taking them, but patients with glaucoma and benign prostatic hyperplasia should not use them; Hormones may be helpful for those who work shifts or frequently travel through different time zones, but they may not be as effective in treating insomnia.

3. Prescription drugs:If the above methods are not effective, or before cognitive-behavioral therapy takes effect, the doctor may prescribe sleeping pills for short-term treatment to speed up falling asleep and increase sleep time. Commonly used sleeping pills include benzodiazepines, such as Lorazepam and Diazepam, which can shorten the time to fall asleep, prolong sleep time and reduce the feeling of drowsiness after waking up.

“This type of drug is more suitable for short-term treatment,

If it is used continuously for several weeks, there is a chance of dependence,

As well as affect memory, produce hallucinations, suppress breathing and increase the risk of falls in the elderly.

Another class of non-benzodiazepines (Non-Benzodiazepine)

Also known as ‘Z drug’,

Commonly used ones include Zopiclone

and zolpidem (Zolpidem),

Its chemical structure is completely different from that of benzodiazepines,

But the efficacy, side effects and risks are similar. “

Do not self-administer over-the-counter medicines

Proper treatment of insomnia is very important for promoting physical and mental health and improving the quality of life. He reminded that if you continue to suffer from insomnia, you must consult your doctor, and you should not take health care products or over-the-counter medicines of unknown origin, let alone increase the dosage of prescribed drugs by yourself.

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