General Considerations Of The Sleep Transor Called Insomnia

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GENERAL CONSIDERATIONS OF THE SLEEP Transor called Insomnia

The dream is a physiological process that occupies the third part of life, therefore it is not difficult to assume the importance of physical, psychological and psychosocial health; In general in the quality of life. At the same time physical health and psychological and social conditions will influence time and sleep quality.

In the adult, insomnia is characterized by night symptoms such as starting insomnia, the insomnia of continuity and premature awakening; And in the pediatric patient the resistance is presented to go to sleep at an adequate schedule and the difficulty to start sleeping without the presence of the parents or the child’s caregiver. During the day the insomniac patient has fatigue, discomfort, attention problems, in performance in their activities of daily life (tendency to errors), mood, drowsiness, behavioral problems, motivation and concerns mainly related to insomnia.

It has been reported that insomnia is a problem that occurs at least occasionally in 30% of the general population, and that it is a chronic condition for at least 10% of adults; and that in clinical environments the prevalence of insomnia is approximately 50%. Particularly, in Mexico City an insomnia prevalence was identified in 35.0% and sedative use consumption in 5.8% of the sample studied. This is not why it can be mentioned that insomnia symptoms can occur in childhood in relation to parenting factors, lack of imposition of inappropriate limits and habits to sleep; and through the life cycle as a consequence of the interaction of dysfunctional habits and lifestyle, emotional factors and the presence of other diseases that are added during life.

There are many reasons for the lack of sleep in our society, which operates 24 hours / 7 days of the week, among the trigger factors the early hours of school or work, the TV schedules that move more and more the prime can be cited Time at advanced hours of the night, the daily stress, the wide consumption of foods rich in caffeine and others; But the main precipitating factor, often little appreciated has been the technological advance from the development of the artificial lighting of our night (5). Thus, the use of electronic entertainment devices and artificial environmental lighting during the night is related to the initial insomnia symptom and the shortening of total sleep time.

Insomnia has been explained by the model of the 3 p: predisposing, precipitating and perpetuating factors. Particularly the factors that perpetuate insomnia are dysfunctional behaviors; For example, inappropriate habits such as using the bedroom to watch television or using electronic devices, sedentary life, consuming food or caffeine drinks during the afternoon or night, self-medication, excessive time in bed during the day and night; Cognitive activation related to intrusive thoughts such as family or professional concerns regarding what happened during the past day or what will happen the next day of the insomnia; emotional activation; For example, despair, anger, personality traits such as perfectionism, mood and anxiety disorders that play an important role in maintaining insomnia.

It should not be mentioned that one of the main complications is the misuse of hypnotic drugs (agonists of benzodiazepine receptors) for insomnia in older adults, since it is associated with falls, dementia, vehicular accidents and physical addiction; Therefore, it has been necessary. Therefore, with the objective of preventing secondary pharmacological effects and increasing patient safety, it is necessary to implement actions to promote multicomponent (pharmacological – psychological) treatment of insomnia.

Finally, one of the factors that affects the dream in an important way is the loss of environmental stimuli and psychosocial activities that serve as synchronizers of biological rhythms (the need to get up early and meet fixed schedules on specific days, social interaction , physical activation, exposure to natural lighting).

During the COVID-19 pandemic, high prevalence of majority, generalized anxiety disorder and acute enter (24 have been identified (24.4%, 18.4% and 15.8% respectively) putting the population at high risk of mental illness.

The loss of the structure of daily life has caused symptoms of initial insomnia, difficulty getting up, tiredness and drowsiness at least 3 times a week; It should be noted that these symptoms are more serious in young people, the female sex, who were alone during quarantine and those who passed the quarantine in spaces smaller than 50 meters.

Therefore, the Covid-19 pandemic raises the need to implement mental illness prevention measures that could be a consequence of the symptoms of sleep disorders caused by quarantine.

References

  1. American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien Il: American Academy of Sleep Medicine; 2014
  2. National Institute of Health. State of the Science Conference Statement on Management and Management of Chronic Insomnia in Adults, June 13-15, 2005. Sleep, 28; 1049-1059.
  3. Bouscoulet Lt, Vázquez-García JC, Muiño A, Márquez M, López MV, Montes de Oca M, Talamo C, Valdivia G, Pertuze J, Menezes Amb, Pérez-Padilla R. Prevalence of Sleep Related Symptoms in Four Latin American Cities. J Clin Sleep Med 2008; 4 (6): 579-585.
  4. Lopes MC, Cardoso Alves RS. Disorders of sono communes na childhood and adolescence. In: Lopes MC, Lahorgue Nunes M. (Coords). Sono e behavior na childhood and adolescence. 1st ed. Sao Paolo: Farma segment, 2009, pp. 49-70
  5. Cardinali d. What is the dream. 2nd ed. Buenos Aires: Paidos, 2016
  6. Spielman AJ, Caruso LS, Glovinsky PB. A Behavioral Perspective on Insomnia Treatment. Psychiat clin north am. 1987; 10 (4): 541-553.
  7. DELGADO RODRIGUES RN, BACELAR REGO NF, PINTO JUNIOR L, RIZZO G. Insomnia council. In: Ribeiro Pinto L, BACELAR REGO A (EDS). Sono do Diagnostic Ao Treatment. 1st ed. Sao Paulo: Atheneu. 2020, pp.57-63.
  8. Pottie K, Thompson W, Davis S, Grenier J, Sadowski GH, Welch V, Holbrook Anne, Boyd C, Swenson R, Farrel B. DEPRESSFORE BENZOODIACEPINE RECEPTOR AGONISTS. Evidence-Based Clinical Practice Guideline. Canadian Family Physician, 2018; 64: 339-351.
  9. Lin L-y et al., The Immediate Impact of the 2019 novel coronavirus (Covid-19) Outbreak on Subjective Sleep Status. Sleep Med, 2020. https: // doi.OORG/10.1016/J.Sleep.2020.05.018

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