Since an adult person sleeps 7-8 hours a day on average, one third of our life is spent asleep. As can be understood from this, sleep is an indispensable need for the organism, like food, water and breathing, and it has very important functions. Having sufficient and quality sleep is an indispensable necessity for us to both protect our health and perform our functions during the day.
Approximately 90% of the society encounters the problem of insomnia at some point in their life. One-third spend several nights a week without sleeping as much as they would like. At least five out of every 100 people wake up unable to sleep due to breathing problems, and many of them cannot prevent them from falling asleep the next day. 40% of the society snores, and more importantly, they consider snoring normal.
However, sleep medicine, which is considered a separate branch of specialization in some countries today, examines 84 different diseases, the number of which is increasing day by day. The causes of neither insomnia nor excessive sleepiness are as simple as suggested. For a good treatment, these reasons must be examined systematically.
What are the functions of sleep?
Studies show that sleep rests the body and prepares it for the next day. In addition to its function, energy saving (energy accumulation), growth (growth hormone is secreted mostly during sleep and ensures growth in children), renewal of cells, repair of the organism, memory, programming of genetic memory that enables the learning of species-specific features, learning new information and making it permanent, and especially some It shows that living things have functions of adaptation to the environment and protection from dangers (e.g. hibernation).
"Adequate sleep" How long does sleep last?
Adequate sleep duration varies from person to person and is essentially a genetic (innate) feature. In adult humans, this period varies between 4-11 hours; The 7-8 hours that everyone knows are average values. However, quality is more important than duration. In short; It is a type of sleep in which a person feels rested and vigorous when he/she wakes up in the morning and can perform his/her functions without any lack of concentration or fatigue throughout the day. The amount (duration) is sufficient for him/her.
What is Insomnia (Insomnia) and in what situations does it occur?
< br /> It is an important disorder that causes fatigue, exhaustion, insufficiency in cognitive functions, difficulty in concentration, extreme irritability and some other psychological symptoms that are reflected during the day due to decreased and/or poor quality night sleep. With these features, insomnia negatively affects a person's social and professional life, and can even cause more serious events such as work and traffic accidents. The most common cause of insomnia is psychiatric diseases. Affective disorders, especially depression, psychoses, anxiety disorders, panic disorders, alcohol and other substance abuse often cause complaints of insomnia.
What other causes of insomnia are there? ?
Habits that prevent quality sleep are responsible for insomnia due to improper sleep hygiene. Failure to comply with appropriate hours and rules for sleep, intertwining of rest and working hours, overeating before sleep or drinking stimulant drinks such as tea and coffee, using the bed for non-sleep purposes (watching TV, reading books, writing, etc.), insomnia It is an example of faulty habits that create By giving up these habits, sleep can be easily regulated in a short time.
Sleep perception disorder, situations in which the patient's subjective complaint of insomnia is incompatible with the objective findings in the sleep examination. It is a term used for. The patient claims that although he slept normally at night, he did not sleep at all or very little; In other words, the patient's estimate of the time he slept does not match the objective sleep time.
Idiopathic (cause unknown)insomnia can sometimes be familial, begins in childhood and usually lasts a lifetime. It is an objective, rare sleeping disorder that lasts for a long time, sleep duration can be reduced to 4-5 hours almost every night, falling asleep takes longer and the number of wakefulness increases.
What is Restless Leg Syndrome?
It is a very common but important condition that can be easily missed if sufficient information is not obtained from the patient. Another cause of insomnia is restless legs syndrome (RLS). Patients complain of sensations in their legs that become more pronounced when they are at rest and especially when they lie down, and which they cannot describe well, but which are extremely disturbing and create an irresistible need to move. They try to express this feeling, which they cannot localize well, with different terms such as deep burning, pulling, tingling, pricking, pain, aching, numbness, and electricity. With its stated characteristics, RLS is a disorder that makes it extremely difficult to fall asleep. There is usually a genetic (familial) feature. However, RLS can also occur due to other conditions: Various conditions or diseases such as pregnancy, iron deficiency anemia, folate deficiency, peripheral neuropathy, diabetes, kidney diseases (uremia and dialysis patients), rheumatoid arthritis, discopathy, spinal cord lesions. It may cause . When their presence is detected and the cause is treated, RLS symptoms can improve. It is thought that a disorder related to a substance (dopamine) in the nervous system is responsible for cases of unknown cause (genetic in nature).
Periodical leg and arm movements during sleep (UPJD) is often caused by RLS. accompanies. It is thought that the pathophysiological mechanisms of both diseases are the same. UPPH is movements that occur at intervals of 5-90 (average 15-40) seconds, mainly during NREM sleep, and may rarely involve the arms and trunk.
What is hypersomnia? It means, in what situations is it seen?
Hypersomnia literally means excessive sleep and the need for sleep being at the forefront in inappropriate environments and times.
Narcolepsy-Cataplexy Syndrome: It is a disease that begins mostly in adolescence and young adulthood, in which unavoidable sleep attacks occur at intervals of approximately 2-3 hours during the day, the person may feel sleepy or tired outside of these attacks, and even periods of seconds of sleep, which we call micro-sleep, may be mixed into wakefulness. . In addition to sleepiness, cataplexy, which can cause the person to collapse and remain motionless for a while due to the sudden relaxation of the muscles, is also one of the important symptoms.
The most important symptoms are snoring and inability to breathe for a certain period of time during sleep (usually stated by the spouses of the patients), excessive sleepiness during the day, falling asleep during daily tasks. (while watching television, reading the newspaper or at the desk while working), constantly waking up tired, attention disorders and depression.
The most important symptom is snoring. It is not necessary for every snorer to have this disease; However, it is possible to say that every patient with sleep apnea syndrome snores almost without exception. Studies conducted in various countries have revealed that 10-30 percent of adults snore. This rate is determined to be around 26 percent in Turkey.
The diseases whose names and brief descriptions are given above constitute only a small part of sleep disorders. After the patient with sleep problems is evaluated by specialist physicians, a definitive diagnosis is made. and is directed to perform a "polysomnographic examination" in a sleep disorders center or laboratory in order to determine the severity of the disease.
Sleep laboratories examine patients' brain waves (electroencephalogram), eyeball movements (electrooculogram), muscle tension (electromyogram), breathing. These are places where many parameters such as movements, amount of inhaled air, and body movements are examined by printing them on paper. In sleep laboratories, we try to provide conditions that are at least partially similar to the patient's own home environment. Here, patients have to sleep while connected to devices with sensors placed in various parts of their bodies. These sensors are attached to the body surface with special materials and care is taken not to disturb the patient's sleep. Patients are not given any medication to help them sleep. In order to be examined, patients are waited for their usual sleeping hours and their natural sleep is tried to be seen as much as possible. As can be expected, it is not possible to observe a completely natural sleep while connected to devices in a foreign environment. However, examinations performed under these conditions are generally sufficient to diagnose some sleep disorders that are thought to be present in the patient. Considering the need to obtain more detailed and accurate information, the examinations are carried out in a second stage. It is repeated at night, thus data closer to natural sleep is obtained.
These recorded data are examined by a specialist physician in a computer environment during the day, if any, and criteria such as the duration of breathing pauses during sleep, their frequency, their relationship with the lying position, and whether there is a decrease in blood oxygen saturation. Appropriate treatment is planned.
Every individual with a sleep problem must be seen by a specialist physician and evaluated in a sleep laboratory when necessary. It is inevitable for individuals with sleep disorders to achieve normal life standards with a quality sleep process as a result of correct diagnosis and treatment.
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