Suffering from insomnia during quarantine



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“I am momentarily disengaged from my job and suffering from sleep difficulties, tiredness, restlessness. Despite the self-help measures that I impose myself, they continue. What do you advise me to do? “

Angel War

Insomnia is a very frequent pathology, which has shown a prevalence of up to 10% in the population. It increases with age, with the majority of cases being concentrated in those over 65 years of age and more frequently affecting women.

“In the last classification of sleep disorders, from 2014, it is defined as a difficulty to initiate sleep, maintain it and consolidate it. In other words, it can be difficult to fall asleep, to stay asleep, you can wake up many times at night or you can also get to the end of the night, wake up and not sleep anymore ”, describes the Director of the UC Christus Health Network Sleep Center, Carolina Aguirre.

According to the specialist of the Psychiatric Clinic of the University of Chile, Luis RiscoIn a context like the current one, where people face very different living conditions than they usually had, stress tables begin to appear, because “the organism is subjected to excessive demands,” says the psychiatrist.

Risco describes four degrees of stress. In the first, there is an “over alert, an increase in self-demand.” In second grade, there are “sleep difficulties and decreased energy.” In three, “concentration and performance capacity are affected” and in grade four, “collapse occurs.”

“With a degree two stress picture, there can be a decrease in the reparative quality of sleep, and difficulty falling asleep or staying asleep, a clear message that the body is being overwhelmed,” says the expert.

The doctor Aguirre, explains that the chronic insomnia It is the one that motivates more queries. “It occurs for more than three weeks, more than three times a week, approximately.” It is different from adjustment insomnia, which occurs in the context of some external stressor, “some specific concern or something in the environment that generally resolves after a maximum of three weeks.” So he explains, the evolution time of insomnia is key.

The neurologist complements that the symptomatology of patients with insomnia is that “during the day they feel tired, fatigued and more irritated, they find it difficult to concentrate, they perform worse”. This drowsiness during the day is an important symptom to know if the insomnia is chronic, of adjustment or is related to other pathologies.

That is why it is recommended to rule out those pathologies that can affect sleep and be confused with insomnia. “There are patients who have movement disorders, like restless legs syndrome, and that is what prevents them from falling asleep, not so much that they do not stop thinking and anxiety, but rather physical discomfort. There are also the respiratory pathologies, Like the snoring associated with apnea, which wake them up systematically throughout the night. On the other hand there are the circadian rhythm disorders, where the patient sleeps, but in a schedule that does not correspond to him, something common in young people “, adds the specialist.

For Dr. Aguirre one of the most important steps is lower sleep expectationsKnowing that in the context we are facing, it is not unusual for sleep problems to develop. “Insomniacs start the day awake and when darkness comes they begin to question what their sleep will be like. That already generates anxiety. They go to bed with a negative predisposition to not sleep and that generates a disorder in itself, “describes the neurologist.

“Several say they are very sleepy during the day, but there is a trick there, because the paradox of insomnia is that it generates a hyper alert state: one walks fast, with the body cut off. So patients who try to sleep during the day, to regain sleep at night, usually do not find it, especially the most chronic, “adds the doctor.

First of all, you have to make sure you have a silent place to sleep (that also considers not having someone who snores around) and low light.

With that under control, Carolina Aguirre advises wearing a most physiologically friendly schedule possible. In other words, getting up early every day, regardless of the responsibilities of that particular day, I hope to be physically active during the first hours, maintain a healthy eating routine and respect its schedules ”.

Luis Risco adds that the measures of sleep hygiene. “It consists of preserving the conditions so that the dream is carried out optimally. Among those measures are not drinking coffee or stimulating drinks after after six in the afternoon, having rituals to carry out before falling asleep, etc ”.

In addition, sports, reading, social interactions (be they face-to-face, virtual or by phone) and “the simple fact of opening up in a conversation with another person triggers an emotional catharsis that is very healthy.” All of this lowers stress, helps you relax, and eventually better sleep, adds the psychiatrist.

If none of this works, Aguirre assures that the best approved alternative for the management of insomnia is the Cognitive Behavioral Therapy, supported by the use of drugs, associated with this treatment. “It is a therapy made by psychologists that seeks to manage anxiety and expectation about sleeping, including all these negative associations that are beginning to take shape around the dream space. For insomniac patients, their beds cease to be their resting places and become their place of torture, ”he explains.

The drug alone helps, acknowledges the specialist, but it is “bread for today and hunger for tomorrow. “The remedy puts out the fire, but it should always be indicated by a specialist. The self medication it is a problem that we have to deal with frequently. What people do not take into account is that drugs work for a while, but then the body becomes tolerant and resistant to them. So it is important to associate them with psychotherapy, ”he says.



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