What is insomnia?

       Sleep accounts for 1/3 of the total human life span and is an essential physiological process to maintain the health of the organism. Good sleep is a guarantee of a good quality of life and facilitates the completion of various social activities. In today’s particularly competitive society, insomnia is on the rise year by year. According to statistics, about 1/3 of adults in the United States have sleep disorders, while in Japan, Canada, France and Finland, the proportions are 21%, 18%, 12% and 19%, respectively. Insomnia has a great impact on both individuals and society, with a prevalence of 10%-20% in the general population and little difference in prevalence between men and women.  Insomnia is usually a subjective experience of unsatisfactory sleep duration and/or sleep quality that affects daytime social functioning. Among other things, whether or not there is an impact on daytime functioning and quality of life is clinically important for the diagnosis of insomnia. Since there are significant individual differences in sleep requirements, reductions in sleep duration do not always have pathological significance. If there is a persistent reduction in sleep duration without adverse daytime consequences, it may be a shortening of the natural normal sleep duration and cannot be diagnosed as insomnia. Insomnia can only be diagnosed when there is a lack of sleep time or a decrease in sleep quality accompanied by clinical manifestations of decreased brain and somatic function during the day due to lack of sleep. Therefore, the presence of daytime functional impairment associated with sleep deprivation is one of the necessary conditions for the clinical diagnosis of insomnia.  In acute insomnia (insomnia within 1 month), the cause may be obvious. Being in a stressful situation, a change in sleep environment, ingestion of a new medication, or the presence of uncomfortable new symptoms such as cough, nasal congestion, or pain can lead to insomnia.  When acute insomnia occurs and continues, it can progress to chronic insomnia. Contributing to chronic insomnia can be multifactorial, with psychophysiological insomnia such as emotional anxiety, including despair, helplessness and fear of the consequences of sleep deprivation. It may also result from an illusion of sleep state (in some sleep states, the use of polysomnography suggests that the individual is sleeping, but the individual experiences it as an awakened state), or it may be due to an underlying sleep disorder, most commonly obstructive sleep apnea hypopnea, central sleep apnea (CSA), restless legs syndrome, or periodic limb movements of sleep, and circadian rhythm disorders sleep disorders.  Treatment for restless legs syndrome and periodic limb movements of sleep is primarily pharmacologic, and the most standard treatment for obstructive sleep apnea is continuous positive airway pressure ventilation (stable) or biphasic positive airway pressure ventilation. Patients with sleep apnea should avoid alcohol and medications that inhibit breathing before bedtime. For central sleep apnea the underlying cause should be treated, in case of hypoventilation type, with respiratory stimulants, as well as continuous positive airway pressure ventilation, and biphasic positive airway pressure ventilation. In case of insomnia due to circadian dysrhythmic sleep disorder, light therapy as well as melatonin can be applied.  For patients with chronic insomnia for which no specific cause can be found, developing good sleep habits may be more effective than medication: 1. Go to bed and get up on time every day.  2. Make sure you are in a quiet, dark, relaxing sleep environment where the ambient temperature is neither cold nor hot, and make sure your bed is comfortable.  3, make sure your bed is only used for sleep, not as a place for daily activities, such as reading, listening to music, playing computer, etc. (in order to establish normal reflexes). Only lie in bed when you sleep, do not lie in bed for more than 20 minutes when you are awake (depending on the situation), if you can not sleep in bed, go to another room, do some non-stimulating exercise in soft light, if sleepiness comes, return to bed to sleep, repeat if necessary.  4, avoid eating a lot before meals, do not take food or drugs containing caffeine within 4 to 6 hours before going to bed, do not smoke, do not drink. Caffeine, nicotine, alcohol are prone to cause nervous system excitement, which is not conducive to sleep.  5, three hours before going to bed without strenuous exercise.  6, you can take a proper nap, but no more than 30 minutes.  7, the morning after getting up that the sun’s rays, which is conducive to the regulation of their own biorhythms.  8. Learn to relax.