1.General knowledge Insomnia is a common sleep disorder, and more than 1/3 of the general population may experience different forms of insomnia in their lifetime, with no less than 5% of them having chronic insomnia lasting more than 6 months. Insomnia can occur at any age, with a male to female ratio of 1:1.41 in adults (including the elderly). insomnia can cause significant distress to patients and their families, affecting the quality of life and also increasing the financial burden due to repeated visits to the doctor by patients. The causes of insomnia are complex and varied. Somatic diseases (especially various chronic diseases), dependence on and abuse of psychoactive substances such as alcohol, various psychiatric disorders, and some specific sleep disorders (such as sleep breathing disorder and restless legs syndrome) can cause insomnia. The occurrence and persistence of insomnia is also related to genetics, some personality traits, experiencing stressful life events, as well as excessive concern about sleep, excessive worry about the “consequences” of insomnia, various poor sleep hygiene habits and other psychological and behavioral changes. 2, the performance of insomnia In the case of sufficient sleep opportunities and good sleep environment, there are difficulties in falling asleep, shallow sleep, easy to wake up, dreamy or wake up too early, or after sleep can not restore energy, the quality is not satisfactory, accompanied by obvious distress or affect the daytime social and occupational functions. The clinical diagnosis of insomnia requires a course of illness that generally occurs most nights of the week and lasts for 4 weeks or more. Insomnia that is associated with an apparently stressful event, lasts from a few days to 3-4 weeks, and resolves upon disengagement or adaptation to the specific stressful event is referred to as adaptive or acute insomnia. If sleep is artificially reduced at night due to study, work or recreation, resulting in sleep deprivation, even if symptoms such as sleepiness and lethargy occur during the day, it is not insomnia as such, but sleep deprivation. Long-term sleep deprivation is a common cause of insomnia, which is an important but avoidable “killer” of health. 3, instructions for medical care After insomnia occurs, especially in middle-aged and elderly patients with the first onset of insomnia, or patients who do not feel they have experienced an obvious stressful event, they should go to a hospital with a sleep clinic for consultation as soon as possible. If the cause of insomnia can be clarified, the first treatment should be directed at the cause, such as active treatment of chronic physical diseases; among mental diseases, it is more common that insomnia is a symptom of depressive disorder and anxiety disorder, and systematic antidepressant and anti-anxiety treatment should be carried out at this time. For insomnia with no clear cause, which is customarily called “simple insomnia” or “primary insomnia”, the significance of early consultation is to receive guidance from doctors on general knowledge of sleep and sleep hygiene, so as to avoid the formation of some poor sleep hygiene habits and misconceptions. It is important to avoid chronic insomnia due to poor sleep hygiene habits and misconceptions. Patients with chronic insomnia should keep in touch with their physicians and work with them to develop a treatment plan, especially behavioral measures, under the leadership of the physician, and actively put them into practice. Polysomnography is a basic auxiliary test for the diagnosis of sleep disorders and the assessment of the severity of the condition, and the only means to objectively assess the quality of sleep. PSG should be performed in patients who are still unsatisfied with the quality of sleep after systematic treatment, especially if sleep disorders such as sleep breathing disorder, restless legs syndrome and periodic limb movement disorder are suspected. 4.Self-care Adhering to regular sports and recreational activities has a positive effect on getting good sleep. However, more strenuous activities in the evening, on the contrary, are likely to affect sleep. Adhere to the correct bedroom and bed use habits, in addition to sleep and sex, do not do other things in the bedroom and bed, such as watching TV, reading, work, etc.. Adhere to regular habits of rest, the most important thing is to get up on time, even on weekends and holidays do not stay in bed, sleep. Once there is no sleepiness after lying in bed, you should leave the bed and bedroom, do something more relaxing in the living room and other rooms, and then lie in bed after having sleepiness. For the average person, in life, work, when encountering stressful events, insomnia is a relatively normal reaction, at this time, the focus should be mainly on solving the problem, rather than shifting to “how to sleep well”, or sleep “well” as a prerequisite for The prerequisite for solving the problem. If you are brave enough to face the stress and actively deal with the difficulties you face, your sleep will naturally improve as the stressful events are resolved. 5.Special medical advice Insomnia should be treated as a whole system with the characteristics of each patient. In addition to the treatment of the cause, understanding basic sleep knowledge, rational use of hypnotic drugs and psychological behavior therapy are the basic methods. In general, hypnotic drugs are effective in improving insomnia, but there is no so-called special drug. Refusing medication for fear of adverse reactions and dependence of hypnotic drugs, or relying entirely on medication, are not conducive to the overall treatment of insomnia. The choice and use of hypnotic drugs must follow the guidance of the doctor, do not choose drugs or increase the dose on your own. The principle of using hypnotic drugs is to take them as needed, intermittently and in sufficient quantity. Continuous use should generally not exceed 4 weeks. Do not use alcohol as a treatment for insomnia, especially not at the same time as hypnotic drugs. If alcohol dependence occurs as a result, insomnia may become more severe and difficult to treat. If depression and anxiety disorders are present, systematic antidepressant and anti-anxiety treatment must be administered. Medication cannot change the misconceptions and bad sleep habits about insomnia, so it is important to pay attention to and receive psychological and behavioral treatment from doctors. 6.Caution Sleep is a high-level function of the brain, and the factors affecting the occurrence and regulation of sleep are complex and diverse, and no single factor or substance can play a decisive role alone. The importance of understanding this is not to expect or seek some “special” drug or treatment after insomnia occurs, but to receive comprehensive treatment from a doctor. The quality and duration of each person’s sleep varies greatly from one individual to another, just as does the appearance of a person’s height, beauty, fatness, and other characteristics. Know your own sleep characteristics and do not simply compare them with others’ sleep. Even if your sleep time is short and your sleep is light and easily disturbed by the outside world, as long as this condition is stable for a long time, and you wake up with a sense of relaxation, emotional stability during the day, and a happy work life, it can be considered normal sleep. There are many “methods” circulating in the society about how to improve sleep, and there are also many propaganda exaggerating the consequences of insomnia, so it is important to screen these claims and not to listen to them blindly. If necessary, you can go to a professional sleep disorder clinic for consultation. 7, treatment goals For acute and subacute insomnia of relatively short duration, the goal of treatment is to improve sleep in the etiology and symptomatic treatment, while mastering the general knowledge of sleep, to avoid chronic insomnia due to excessive concern about sleep and the formation of bad sleep habits. For patients with chronic insomnia, the goal of treatment is to break the “vicious” cycle of “insomnia, gradually becoming overly concerned about sleep and anxious about the consequences of insomnia, thus worsening insomnia and becoming more concerned about sleep”, to improve subjective satisfaction with sleep, and to improve the quality of life. If patients can accept and actively practice psycho-behavioral treatment measures and adhere to good sleep hygiene habits, they can eventually achieve this goal.