The treatment of insomnia: non drug therapy (slow onset, need to adhere to): to establish good sleep hygiene habits, behavior and rest time
The treatment of insomnia: non drug therapy (slow onset, need to adhere to): to establish good sleep hygiene habits, behavior and rest time rules and correct the effects of sleep time and sleep, get up on time regardless of whether there is still sleepy sound insulation, shading, moderate temperature, sleep sleep environment comfortable and safe but full or hungry before going to sleep is not severe exercise, not to quarrel excited in reading or watching TV daily moderate movement (which can be arranged in the afternoon, 2 hours before going to bed not in) after dinner drink (4 hours before bedtime), coffee or tea (before 6 hours), not smoking to avoid daytime nap psychotherapy: cognitive therapy: establish the correct cognition to 8 hours of sleep as a normal standard, as long as the energetic is normal (cognitive errors: I must sleep 8 hours, otherwise my body would collapse but) Concerned about insomnia and lead to adverse consequences of fear and worry insomnia (cognitive errors: as long as my sleep is not good, I have no energy to do anything during the day) behavioral therapy: muscle relaxation training gradually, biofeedback to help learn to relax. Before going to bed to sleep, don't look at the clock often; if unable to sleep is to leave the bedroom, then go to sleep. So as not to sleep in the bedroom and bed as a conditioned stimulus, but should make it a good condition for sleep stimulus. Wake up early patients can try to get up early, do not lie on the bed. Drug treatment: first of all, we must clear the cause of insomnia, for the cause of treatment. Secondly, to understand the specific situation of insomnia: sleep difficulties; sleep easy to wake up, wake up early; dream; hypnotic choice: difficulty sleeping: short acting drugs, difficulty maintaining sleep wake early: effects of drugs, or long-acting drugs (daytime anxiety severity) hypnotic drugs commonly used: benzene two nitrogen Zhuo class (An Dinglei) non selective GABA receptor agonist sedative hypnotic, anxiolytic effect and strong. Inhibition of respiration, affect cognition, muscle relaxation, affect the. Long term application can produce dependence, sudden withdrawal of withdrawal symptoms, the initial dose is small. The shorter half-life, faster onset, shorter time, more easy to produce dependence; the longer half-life, the onset is slower, the longer the time, the more is not easy to produce dependence, but the impact of cognitive function during the day. Can be used in small doses to avoid dependence, addiction. Long-acting drug: clonazepam and diazepam, nitrazepam; effect of Medicine: alprazolam, estazolam, Laura Si etc.; short acting drugs: three alprazolam, midazolam, etc.. Non benzene two nitrogen Zhuo class of selective GABA receptor agonist: rapid onset of sleep does not affect the normal physiological structure; short half-life, residual effect is small, the next day no residual discomfort: sleepiness, fatigue, cognitive impairment, ataxia; rebound phenomenon; no anti anxiety effect. Commonly used are: zolpidem, zaleplon Sahiki Kotaka, antidepressant drugs: NaSSAs (Mi Danping) trazodone: selective inhibition of 5- serotonin reuptake of dopamine in the brain, it may accelerate the update. Class SSRIs: early often aggravate insomnia symptoms, can be considered in combination with benzene two nitrogen Zhuo class (except fluvoxamine, paroxetine sedation). Small doses of second generation antipsychotics: quetiapine and Austria
The principle of hypnotic drug use: clear cause insomnia drugs; starting from a small dose, the dose should be individualized; drug dependence is effective after gradual reduction and withdrawal; drug dependence should be intermittent administration as required; past medication history is helpful to the correct selection of drugs; vigilance worsenthose depressive symptoms; pay attention to respiratory depression, liver and kidney function.