Treatment of insomnia (II)

    Symptomatic treatment Symptomatic treatment mainly includes two aspects of medication and behavioral treatment.  1.Medication. The main drugs for treating insomnia are tranquilizers (such as eszopiclone, clonazepam, etc.) and non-tranquilizers (such as zopiclone, zolpidem, etc.). In addition to these, there are some antidepressants and antipsychotics with sedative-hypnotic effects, such as mirtazapine and quetiapine. Because each of these drugs has its own characteristics, patients should use them under the guidance of a doctor and should not take them on their own. Regarding the use of sleeping pills, we need to know the principle of using them, which is: “take them as needed and intermittently”. “On-demand” has two meanings: first, if you really need to take it, then take it, do not worry about the side effects of drugs and insomnia pain; second, if the sleep has improved, no longer need sleeping pills, then reduce or even stop the use of sleeping pills. “Intermittent” medication means not to use the same sleeping pill continuously for a long time, because sleeping pills if taken continuously for a long time, it is easy to develop tolerance, dependence, etc.  2. Behavioral treatment. Mainly including stimulation control therapy, relaxation training and the development of good sleep habits three parts.  (1) Stimulus control therapy: Under normal circumstances, the bedroom, bed environment will induce sleepiness and make people fall asleep faster. After insomnia patients enter the bedroom and bed, the brain instead becomes excited and has difficulty falling asleep. Stimulus control therapy aims to correct this poorly conditioned reflex and re-establish the conditioned reflex between the bedroom and bed and falling asleep quickly. The specific requirements are: not to do things other than sleep and sex in the bedroom and bed. If you cannot fall asleep, get up, leave the bedroom and go to another room; return to the bedroom and bed only if you feel sleepy; if you still cannot fall asleep, repeat the above steps. Also do, regardless of how much sleep you feel throughout the night, get up regularly every day, and insist on the same on holidays; avoid lying in bed during the day, and if you need to nap, then only once at noon time, whether you fall asleep or not, the lying time is controlled within 20 minutes to 30 minutes.  (2) Relaxation training: The purpose of relaxation training is to reduce the somatic tension before bedtime and the excitement of thinking that interferes with sleep during sleep time.  (3) Develop good sleep habits: regular exercise, adhere to five times a week, each exercise for more than half an hour, avoid strenuous exercise within two hours before bedtime; control the intake of coffee and tea, and avoid drinking at least 8 hours before bedtime; do not resort to drinking alcohol to induce sleep; eat easily digestible food for dinner, avoid being too full or too hungry; avoid overexciting activities before bedtime, such as watching action movies, listening to Avoid over-exciting activities before bedtime, such as watching action movies, listening to rock music, participating in debates, etc.