INSOMNIA

Disease information

INSOMNIA

Insomnia.

Definition.

The insomnia is the involuntary absence of rest compensatorio. It is pronounced by the disturbance of the quality or the amount of dream with repercussions on the diurnal activity.

Physiological Aspect.

1. Structure of the dream.

The dream has a very specific structure. As much it is so it is even spoken, of the architecture of the dream. One consists of a succession of 4 to 5 cycles of 90 minutes each. A cycle is made up, based on the rythmical waves emitted by the brain, of five stages of unequal duration.

The stages between the 1 and the 4 correspond to the slow dream. Stage 5 corresponds to the denominated paradoxical dream.

ervigilia or to an anxiety related to exogenous causes.

2. To wake up precocious (terminal insomnia)

waves of waking up) and theta appearance of waves.

Stage 2.

It is the slight dream. In him, the person is slept completely. The waves alpha are absentees and appears the fundamental element of the state of the dream: the tips accompanied by complexes K.

Stage 3 and 4.

It is the deep dream. In him an appearance of slow waves is registered delta that are replacing progressively to the tips. The sleepy subject is insensible to the noises, its vital functions are assured to the minimum.

Stage 5.

It represents 20 % of the total dream approximately. Also it receives the name of paradoxical dream, because in encefalograma the appearance of waves next to those of the watch state is registered.

During this stage, expresses take place ocular movements (REM: Rapid Eyes Movements) the muscular tone is reduced to the minimum, the heart rates and respiratory become irregular and the onírica activity is developed.

At the end of stage 5 the sleepy subject has closed a cycle. From it can here appear another stage 1, beginning to the following cycle. This new stage 1, that only lasts some seconds, is often, imperceptible, safe in some particular circumstances: pain, noise, cold.

Each cycle is closed by a stage 5 of paradoxical dream.

It is necessary to consider that the different stages from the dream last variable, based on the cycle during which they are developed.

Both first cycles include the five stages of the dream with a phase of paradoxical dream of relatively short duration. The following cycles do not entail the stages of deep dream, nevertheless, have a long phase of enough paradoxical dream.

One takes place then, a imbalance between the first third at night, in where they take place mainly, the stages of the deep dream, stage 3 and 4) and the rest at night.

According to the people, the duration of each stage of the dream is variable. Nevertheless it has been verified which the amount of deep dream slow (stages 3 and 4) remains relatively constant, even in the cases in which the dream necessity is different between individuals.

However, in which it concerns to the paradoxical dream, great differences exist, in those people greater than they need to sleep more. The people who sleep more than what they need, they cause an increase of the duration of the paradoxical dream (dreams and nightmares) and often rise exhausted.

2. Functions of the different structures.

Each stage of the dream has its importance. Numerous carried out experiments with voluntary people, have allowed to evaluate the respective functions of the different stages.

After the deprivation of the dream, the studied subjects see modified the distribution of the different stages after enjoying one first night of dream complete.

They present / display an important increase of the deep dream (3 and 4) being able to represent until 70 % of the average duration of the cycles. The organism looks for then, the recovery of the lost dream, privileging the stages 3 and 4, that are revealed as the dream recuperator of the physical fatigue.

The paradoxical dream is the one that allows the brain to rememorizar the previous events, the conducts and the learnings. This period serves to eliminate the psychic and nervous fatigue. The experiments made with sleepy people to whom it awoke of systematic form, frequently of conciliation of the paradoxical dream, have allowed to state that the absence of the onírica phase leads progressively to madness. To dream is a biological necessity. In case of insomnia, it is necessary to use a therapy that it respects, in the greater possible measurement, the architecture of the dream.

3. Mechanisms of the dream.

At level of the reticular zone, one is the center of the dream and the center of watch.

The center of the dream is under the dependency of other cerebral structures: the cortico - talámico system and the rinencefalo - hipotalámico system. The dream appears when a disconnection of the reticular system with the rest of the brain takes place. This disconnection is favored by comfortable positions (knocked down position or sitting) and the absence of sensorial information (closed eyes. The set produces a "avalanche decontamination".

The biochemical starting of the dream would be from the braking of the noradrenérgicos nuclei that take part in the watch. A diminution of cerebral noradrenaline is observed and therefore, a reduction of the activity of the catecolaminérgicas neurons. The slow dream appears in a second time. Its appearance is in favor conditional by the stimulation of the serotoninérgicos nuclei and of the serotonin liberation. In the paradoxical dream a reactivation of the noradrenérgicos nuclei with an elevated serotonin level takes place. Noradrenaline takes part then, as much in the state of watch as in the paradoxical dream. The noradrenérgicos and serotoninérgicos nuclei are under the permanent control of different neurons, mainly of the colinérgicas neurons and GABA - érgicas.

4. Biological rates.

With respect to the alternancia sueño / vigilia, numerous biological phenomena follow one another of rythmical form. All variation of quality or amount of nocturnal dream can be the origin of biological disorders.

Problems of the dream.

The manifestations of the insomnia can be multiple. Although one regroups them in three great categories: the difficulties of conciliation of the dream, to wake up precocious and you will wake up nocturnal frequent (sleeplessness)

1. Difficulties of conciliation of sueño (insomnio initial)

Stage 1 is extended (as average does not have to exceed 5 % of the total dream) Often, this type of insomnia must to a state of hyperwatch or to an anxiety related to exogenous causes.

2. To wake up precocious (terminal insomnia)

This type of insomnia is less frequent than the rest. It can be originated by disorders of physiological type. Usually he is bound often to the excessive ingestion of somníferos.

3. Frequent you will wake up nocturnal (sleeplessness)

One is an almost complete absence of dream. It can have relation with an acute anxiety or a camouflaged depressive state.

Treatment.

1. Hygiene of life.

One will be due to resort in the first place, to simple methods that they can be useful, but that nevertheless, fall frequently in the forgetfulness. It is necessary to respect a correct hygiene of life.

Hour to sleep.

It is necessary to lie down when they begin to feel the first symptoms of the dream (bostezos, heavy diminution of the attention capacity, eyelids, adormecimiento. These symptoms are announcing of the initiation of the first cycle of the dream. If the decision is not taken then to go to the bed, half an hour later it will be difficult to conciliate the dream, since the organism will be again in the heat of activity.

The upheavals of conciliation of the dream are very frequent in case of trips or irregular or nocturnal schedules of work.

By all previously exposed, it is necessary to acquire a commitment between the exigencies of the life partner - professional and those of our biorritmos.

Feeding.

The supper must be light, completes and balanced. He is recommendable to ingest glúcidos and poor rich foods in in fats. The greasy bodies persist during but time in the stomach, producing slowness sensation. The fast sugars are due to avoid that cause one hipoglucemia that can at night be reason for insomnia to half.

Drinks.

The exciting drinks (coffee, tea, soda waters with caffein) and the alcohol completely are advised against in people who suffer insomnia.

Physical activity.

The violent sports must be avoided during the afternoon - night. Nevertheless, the physical exercise has positive effects in the dream whenever it is practiced during the day.

2. The hipnóticos medicines.

The Benzodiazepinas.

The benzodiazepinas induce the precocious appearance of the paradoxical dream, increasing also, the density of this one with respect to the one of the slow dream. On the other hand, a quantitative diminution of deep the slow dream takes place (3 and 4)

The diminution of the dream REM has correlation with the increase of comfort of the dream and the diminution of restlessness and insomnia, in contrast to the natural dream, in which the sensation of deep dream has generally correlation with the amount of SWS (time of dream of slow waves) The degree of increase of activity fast beta can have correlation with the fatigue when waking up and the sensation of to have slept without resting truely (Goodman and Gilman)

The dependency to benzodiazepinas as well as the rules to diminish it, well are known by the professionals of the health reason why we will not enter it.

New Molecules.

One is nonbenzodiazepínicos hipnóticos of new generation. These new molecules are ansiolíticas than hipnóticas. It seems that they develop less farmacodependencia than the previous ones.

The Neurolépticos.

The prescribed neurolépticos more in insomnia with nightmares, belong to the chemical group of the fenotiazinas. They can produce sensation of vertigo and ortostática hypotension during the day due to his long plasmática half - life.

3. Fitoterapia.

The medicinal plants exert less intense a therapeutic effect and less fast than the rest of the synthesis therapies and for that reason it is recommended to begin with them before arriving at powerful medicines but.

Nevertheless, they do not seem to cause in any case phenomena of farmacodependencia nor of modification of the architecture of the dream.

Also a progressive relief with good results can be used to begin a deshabituación offering. In this case, both therapies are due to associate (medicines of synthesis with medicinal plants) diminishing after some weeks and of progressive form, the use of the chemotherapy.

The medicinal plants that can be used in the treatment of the problems of the dream are the following ones: Albar hawthorn, Poppy of California, Pasiflora, Valeriana and Amapola.

Plants adapted for this disease.

Hawthorn to albar.

Poppy of California.

Pasiflora.

Valeriana.

Poppy.

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