Depression – acute neurosis, diagnosis, treatment

Depression (lat. Depressio – “depression”) is a psychological syndrome characterized by oppression of the main psychological processes, the formation of an anxiety dominant, a chronic feeling of melancholy, apathy, headaches    

For a quarter of a century, our clinic has provided comprehensive diagnostics and introduced the principles of drug-free therapy for depression and neuroses in their various forms and manifestations. In the USA and Canada, similar to our technologies for combating depression using transcranial magnetic stimulation of the brain entered clinical practice only after 2010.

A common feature of depression is the loss of a sense of life satisfaction. A person with such an attitude constantly feels a sense of guilt, no matter what, avoids other people. Against the background of such a neurosis, emotions and feelings are dulled, the processes of higher nervous activity are inhibited, the social component suffers.

Sad statistics

The prevalence of depression is so great that neurologists have been claiming the beginning of a pandemic of this neurosis since the end of the 20th century. According to statistics, in the United States alone, about 7-9% of working-age people experience bouts of depression every year, and by 2020 it is expected to become the leader among all mental disorders in the world. This means that neurosis also has a negative economic impact.

Manifestations

The main symptoms of depression have been known since antiquity, when it was called melancholy or spleen. As an independent pathology, this neurosis was identified by Z. Freud, who clearly separated it from the typical feeling of grief, pointing out that during such an illness a person directs his own negative experiences against himself.

Most often, this neurosis develops after prolonged or intense experiences. Grief begins to be perceived as irreparable, it seems to the patient that nothing is already capable of improving the situation for the better. In addition to psychological changes, depression leads to other disorders of the body: it reduces the content of the neurotransmitters serotonin, norepinephrine. In this case, memory, thinking, and other functions of the brain are impaired. At a certain stage, the process can become irreversible, significantly complicating the treatment.

Diagnostics

To diagnose depression, the doctor must identify at least two main, two additional signs in the patient:

The main

Additional

Depression of the emotional background in any conditions.

Anhedonia – loss of interest in previously enjoyable activities.

Pessimistic attitude.

Low self-esteem.

Constant tiredness, fatigue.

Suicidal tendencies, neuroses.

Difficulty concentrating, making decisions.

Increased or decreased appetite, fluctuations in body weight.

Inability to fall asleep or vice versa – excessive sleepiness.

Depression in children, which is less common, is characterized by a different symptomatology:

  • lack of appetite;
  • nightmares;
  • decreased learning ability;
  • character violations: seclusion, resentment, unmotivated aggression;
  • in adolescence – alcoholism or drug addiction as a consequence of depression.

Treatment

Antidepressants considered a panacea. As statistics show, such drugs do not work on 40% of patients. At the same time, they smooth out the symptoms, causing addiction, but not eliminating the disease by 100%. Modern drugs, of which fluoxetine (Prozac) is considered to be a representative, work only for severe symptoms. But their effect is often indistinguishable from placebo.

In addition, these drugs are not without side effects, for example, increase the risk of suicide among adolescents.

Treatment is carried out after diagnosis – taking anamnesis, examining a neurologist, registering electroencephalography, evoked potentials, EEG video monitoring, ECG, biochemical analyzes. 

Psychotherapeutic approach

It has a varying degree of effectiveness, which depends on the training of the doctor and the severity of the disease.

Transcranial magnetic stimulation (TMS)

This technique is becoming more popular today in the treatment of patients with depression, neuroses. Especially in relation to patients who are not helped by drugs. Or if there are contraindications to medicines. The principle of the technique is that induction coils are attached to the patient’s head, which create a magnetic field that stimulates the nerve cells of the brain.

This method is able to act directly on the source of depressive tendencies, it has a fairly well-pronounced effect in most patients.

Physiotherapy instead of medication

The Clinic for Restorative Neurology has widely and successfully used transcranial magnetic stimulation for such patients since 1993 on the basis of scientific data obtained at the Department of Neurology and Clinical Neurophysiology, where this process is led by professor-neurologist, neurophysiologist, Ph.D. Gimranov R.F.

Thanks to the use of this technique, our clinic for restorative neurology shows some of the best results in the treatment of depression both in Russia and among the CIS countries.

Insomnia in men

Sleep is a natural process during which our body rests and regenerates. Deficiency and sleep disturbances lead to serious consequences, including serious illnesses. The development of insomnia is a serious danger to the physical and psychological health of a person, an indicator of the presence of serious problems.  

Males are less likely to experience problem sleep than women [1]. However, they may have difficulty getting a good night’s rest. At the same time, the causes of sleep disorders in men 30 – 40 years old are extremely diverse. 

Causes

There can be many reasons why a man does not sleep at night.

Most often, this is the manifestation of problems of the nervous system, excessive fatigue and psychological stress, but sometimes there are completely physiological explanations for this.

Sometimes, in order to get rid of an unpleasant condition, it is enough to correct the daily routine. But in some cases, full treatment is necessary.

The reasons for sleep deprivation in men:

  1. Acute, chronic stress. It is caused by intra-family and personal problems, external pressure from society. It is provoked by problems at work, in communication, arises when you change your place of residence.
  2. Hormonal imbalance. Sleep problems occur against the background of disorders of the gonads, thyroid.
  3. Taking substances that stimulate the nervous system. It can be both medications and stimulants, caffeine-containing foods, alcohol.
  4. Exercise right before bedtime.
  5. Overeating, excessive consumption of calories. To normalize the regime, first of all, you will have to give up late evening snacks.
  6. Somatic diseases, manifested by regular pain.
  7. Sleep apnea syndrome, snoring. Breathing problems lead to numerous waking up during the night, which makes it impossible to get a good night’s sleep.
  1. Using gadgets before bed. Sleep quality is equally affected by watching TV, playing a game console or reading the news, and communicating on social networks.
  2. Neurological diseases. Early stages of development of Alzheimer’s disease, Parkinson’s disease, multiple sclerosis. 

Insomnia that develops in men for these reasons is often more serious and complex than in women in similar situations. This is partly due to the socio-cultural characteristics of the upbringing of boys in our society. An adult man prefers to hide the psychological stress and experiences in himself, not to share them and not to receive emotional relief.

Sometimes sleep disorders associated with frequent urge to urinate and pain accompanying inflammation of the genitourinary system are perceived as shameful. The male sex prefers to endure such problems, and not go to the doctor at the first symptoms. And thus aggravates the state of his health.

Types and symptoms of insomnia in men

Depending on what causes insomnia in men after 40, 4 groups of diseases are distinguished:

  1. Adaptive, when abrupt changes in the usual routine of life become the cause. Change of type of activity, mode of operation or relocation.
  2. Psychophysiological type. Sleep is disturbed due to a person’s refusal to perceive signals from the body. Overcoming drowsiness during the day, by nightfall, a person loses the ability to sleep peacefully. 
  1. Sleep hygiene disorders. Arise due to improper alignment of the evening pastime. Something: abuse of food and drink, physical work, exercise in the evenings.
  2. Secondary form, which is the consequences of somatic, bodily diseases.

It is not always easy to recognize sleep problems at the initial stage, they are often perceived as other disorders: depression, anxiety. Let’s list the symptoms of developed insomnia: 

  1. falling asleep for a long time, which can last more than 1 hour;
  2. regular conscious awakenings at night;
  3. increased sensitivity, sleep destroys even a random sound;
  4. early awakening without the ability to fall asleep again;
  5. headaches on waking;
  6. fatigue, lack of the usual vigor in the morning;
  7. fatigue, reduced performance;
  8. irritability increases.

Having found at least two of the listed symptoms, you should consult a somnologist. This will help to quickly cope with negative symptoms and restore the quality of life. 

Diagnostics

To find out why there are reasons for insomnia at night in men after 30-40 and how to cure it, a consultation with an experienced doctor will help.

It would be correct to contact a specialized clinic. There, where there is access to consultation by doctors of different profiles: neurologist, psychologist, somnologist. A comprehensive diagnostic approach is needed to understand in which specific area the original problem lies.

Before sending a patient for research to identify the causes of poor sleep in an adult male, the doctor will conduct a detailed survey:

  • will identify the main symptoms;
  • will indicate concomitant changes in the way of life of a person;
  • identify the symptoms associated with sleep disorders;
  • check for established complications;
  • will determine the original cause that triggered sleep problems.

Based on the results of a preliminary survey and examination, diagnostic procedures are assigned:

  • EEG monitoring procedure , which will clearly show how the patient’s sleep process looks like; 
  • polysomnography to determine if sleep apnea is present;
  • functional MRI allows you to accurately establish the features of the brain during sleep and wakefulness. 

After receiving the results, in order to directly eliminate the problem that has arisen, the patient is referred to a specialized doctor. This could be a neurologist, psychotherapist, etc.

Treatment

As a rule, poor sleep is a consequence of negative processes occurring in the body.

In order to prescribe an effective treatment, the doctor must determine the cause of insomnia in men, analyze the symptoms. And have the data of instrumental examinations on hand.

To defeat the problem, depending on the specific situation, the following can be used:

  • A course of psychotherapy, if the condition has arisen due to psychological or mental problems.
  • Prescribing medications to help restore healthy sleep patterns.
  • Herbal remedies that gently affect the body and restore natural biorhythms.
  • The use of vitamin complexes that improve brain function.
  • Treating the root cause of apnea.

How to treat insomnia in a man is always decided on an individual basis and, sometimes, you can achieve a result with folk remedies. However, faced with such a problem, it is required to undergo a full examination in order to identify the cause of the disorder in a particular patient, and not rely on someone else’s experience. 

Prevention

Male insomnia in adulthood is a problem that almost every person faces from time to time. However, discomfort can be avoided by taking preventive measures to help ensure healthy sleep:

  • The bed should not turn into a place of constant pastime. Try to read and watch TV in another part of the apartment, coming to bed just for sleep.
  • Have a healthy sleep and wake schedule, don’t stay up too late, and try to stick to your daily schedule.
  • Avoid eating large amounts of food before bed, foods containing caffeine and sugar.
  • Stop vigorous physical activity 2 hours before bedtime.
  • Do the morning exercises daily.
  • Use the relaxation techniques that work for you before bed.
  • Ventilate the room before going to bed, take a walk down the street in the evening.

If methods to improve sleep quality stop working and your rhythm is out of order, see your doctor as soon as possible. In such a situation, it is highly likely that the appearance of insomnia or dyssomnia is associated with neurological pathology. 

Folk remedies for insomnia

Healthy sleep creates a good mood and normal working capacity for the day.

A sleepless person not only feels optimal after rest, but also contributes to their health in the future. Problems with night rest, provoke the development of physical (somatic) diseases and psychological, intellectual disorders.

The reasons for the development of insomnia

Sleep disturbances are common and can significantly reduce a person’s quality of life. It becomes especially dangerous if it goes into a chronic stage.

However, not everyone finds the time and desire to immediately see a doctor.

Therefore, the question often arises: what to do at home, if insomnia is tormenting, I cannot sleep, how to treat and overcome the disorder that torments every day, how to cope with the problem, determine the reasons, what exactly needs to be taken or drunk in order to cure the disease once and for all …

People have accumulated a lot of advice, the relevance of which is recognized by official medicine.

It is possible to cope with the problem on your own if its appearance was not provoked by a serious physical or mental illness. Below we offer several remedies with reviews that will help get rid of morning insomnia and lack of sleep at night quickly and without pills, both at home and on the road.

Effective treatment of sleep disorders and insomnia with folk remedies in men and women is possible only when the cause of the problem is established. Until the negatively acting factor is eliminated, one should not hope for the return of restful sleep.

External influence

Common reasons are:

  1. constant background noise, sharp sudden sounds in the night;
  2. excessive lighting (light pollution), irritating light sources;
  1. lack of oxygen in the room, unsuitable temperature;
  2. abuse of drinks containing caffeine in the afternoon;
  3. alcohol consumption – sleep after libations is defective, comparable to stunning;
  1. poor nutrition, affects both lack of food and excessive consumption of heavy, fatty foods shortly before going to bed;
  2. disrupted schedule due to work or lack of the habit of going to bed and getting up at the same time;
  3. changed time zone due to flights, rotational working conditions;
  4. stress, depression, constant nervous tension;
  5. side effects of certain medications.

Internal factors

In addition to factors affecting a person from the outside, easily removable, there are also pathological processes in the body itself. To identify and treat them, you will have to consult a doctor.

A number of diseases and pathologies affect the development of insomnia:

  1. digestive disorders;
  2. the development of symptoms of Alzheimer’s disease in young and old people;  
  3. heart failure;
  4. mental illness, schizophrenia;
  5. pregnancy or menopause;
  6. sleep apnea;
  1. allergic reactions;
  2. hyperthyroidism, excessive thyroid function;
  3. hypertrophy of the prostate gland, forcing men to get up at night to use the toilet.

How to cope, overcome and completely defeat insomnia, normalize sleep in an adult without drugs and pills, how to effectively eliminate the effects of lack of sleep, when you cannot fall asleep on your own, what to do with dyssomia, when there is no time and desire to fight sleeping pills with it? Recall the experience of generations of people who have suffered from the same problem. And choose an effective remedy for you! 

Sleep hygiene

When thinking about what can help with insomnia, first of all, remember the rules for eliminating factors that interfere with sleep. Try the following sleep hygiene tips for a while. 

Within a week, the following measures will give results:

  • Turn off gadgets an hour before bedtime. Break the habit of checking social media in bed or watching an episode of a series. Take this time to relax your body and calm your thoughts.
  • Cut out coffee and tea in the afternoon, or limit it after 4 pm.
  • Regulate physical activity. Exercise in the morning or at least 4 hours before bed.
  • Avoid energy drinks and alcohol, especially in the evening.
  • Try to avoid heavy late dinners and late night snacks.

Improving sleep hygiene for children and adolescents is especially effective.

Mental techniques

We often meet requests: “Help, I was tormented by insomnia, what to take from it, what means to use, exercises to do, what needs to be done?”

People are ready for complex procedures and medication in order to find a restful deep sleep. Often this requires nothing more than your own brain.

If the cause of sleep problems was external factors, stress, then mental practices will help to cope with the problem:

  • When you go to bed, turn off unpleasant thoughts. Dream or remember good things, come up with a fantastic story, a fairy tale. Be sure to visualize your thoughts while lying down with your eyes closed.
  • Count in reverse order from 100 to 0. Perhaps sleep will come already in the middle of the count.
  • Relax and imagine in detail that you are lying in a hammock, in a place blown by a light pleasant warm breeze. Concentrate on recreating the feel of a slight rocking motion. After three or five, you will be lulled by a measured roll.
  • When sleeping on a hard surface, use the body-off technique. With your eyes closed, relax, focus on the fingers of your right hand, order them to cease to exist. Then give this command with your wrist, forearm, and gradually “turn off” the whole body. The main thing is not to move. This method will allow you to instantly plunge into sleep, restore strength.
  • The blackboard contains several techniques. With your eyes closed, imagine yourself standing at a regular blackboard with a sponge in one hand and chalk in the other. Mentally draw a circle on it, and then the number 100. Erase it, replace it with 99, 98 and so on. Instead of a number, write the letter X in a circle and erase alternately the rays converging to the center, and then draw it again. Mentally write the word “sleep” in the circle and slowly erase it along the lines of the letters.
  • Choose the type of nature you like. Turn on the appropriate soundtrack: sounds of the surf, rain or forest. Concentrate on visualizing the sensations of being in this place. Imagine yourself relaxing in your favorite place.

With a mild form of insomnia caused by stress, fatigue, thanks to the imagination, each of these techniques will lead to rapid sleep and recovery.

Folk remedies for insomnia

There are many tips on how to treat insomnia at home with folk remedies, how to overcome violations and learn how to fall asleep easily. We have selected recipes, the effectiveness of which is confirmed by the experience of people and the observations of doctors.

Products

Soothing drinks taken just before bed:

  • Warm milk – a recipe known for millennia, you can add a drop of honey. The trick is to keep the liquid warm, not hot.
  • Banana smoothie. The composition is simple: a glass of milk, a medium banana and a spoonful of almond paste. Whisk the ingredients in a blender and drink half an hour before bed. The potassium and magnesium contained in the drink will help to relax the muscles that are tired during the day.
  • Yogurt without additives. It is also worth drinking a drink at room temperature, and not standing in the refrigerator.
  • Freshly squeezed cherry juice. The berry is rich in melatonin, a substance responsible for the work of the biological clock. Its intake into the body contributes to the normalization of biorhythms. But this method only works with a fresh drink. Packaged bags will not work because of the sugar content.

A properly prepared broth, a product eaten on time and tea for sleep will allow you to go to bed on time and have a quality rest. 

Herbs

If insomnia is tormenting, you cannot fall asleep for a long time at night or fall asleep when necessary, you are tormented by fatigue due to the inability to sleep, then a person during dinner can use folk remedies against bad sleep, the main thing is to know what exactly you need to drink:

  • Motherwort relieves nervous tension, gives relaxation, normalizes sleep. The effect is cumulative, so you need to drink the solution during the day.
  • Chamomile is a classic quick-acting remedy. A cup of hot chamomile infusion half an hour before bedtime will give you relaxation and sound sleep.
  • Peppermint is an excellent aid for insomnia or poor sleep, a folk remedy that is advised to get healing from problems with the gastrointestinal tract and inflammatory conditions that lead to lack of sleep
  • Thyme or thyme. The substances included in the herb not only calm the nervous system, but also normalize blood circulation. They stimulate the supply of oxygen to the brain, restore the work of the central nervous system.
  • Honey is good for sleep, if you take it for insomnia or drink it when you suffer from nervousness in other drinks, according to reviews, it saves you when you need to fall asleep quickly.

Folk remedies for good sleep, selected according to reviews, help when insomnia is tortured, but what to do if the cause is a disease and treatment is required, it is better to find out from a doctor.

On our site there is more detailed material about which herbs help with insomnia. 

Sleep disturbance is not always a harmless condition that reduces performance. Often, this is a symptom of an illness. In this case, you will not be able to do without a hospital examination and pills.

Aromatherapy

Often, a problem arises suddenly and needs to be dealt with as quickly as possible. And the question arises: “What should be done with insomnia, if you cannot sleep, and the fight is possible only without drugs, what simple remedy will help?” Especially relevant is a safe solution for pregnant women and the elderly.

In this case, aromatherapy will come to the rescue:

  • Chamomile, Lavender and Neroli Oils are a comprehensive approach for sleep problems.
  • Sage and bergamot will help in case of stress or nervous breakdown.
  • Rose oil can help relieve nightmares.
  • Rosemary, orange, frankincense, laurel, are effective when sleep disturbances become chronic.

Home treatment of insomnia is possible by combining methods of struggle, decide not only the smells, but also what herbs you should drink in case of sleep disturbance.

Yoga for sleep problems

Sometimes a problem arises of what to do if insomnia is already 3-4 days, you cannot fall asleep at night, and medications are either not available or they cannot be used. At the same time, no means help. In this case, it is worth turning to one of the most ancient ways to restore the normal functioning of the body – yoga [7]. 

If insomnia torments you at night, you can’t fall asleep and lie for a long time, and it is impossible to take the medicine, then it is better to do what will definitely help girls and men. Yoga also gives results for neurological problems. 

We suggest trying asanas that help you relax:

  • Balasana – sit on your knees, bending forward and stretching your arms, place your palms and forehead on the floor. Breathe slowly. This pose will help you fall asleep even with pain.
  • Savasana – lie on your back with your arms extended along your body and relax. Breathe slowly and deeply, concentrating on pleasant thoughts.
  • Sukhasana – Sit on the floor or hard bed with your legs crossed, bend forward with your arms outstretched. Try to touch the floor with your elbows and relax.

Among the many popular methods, there is sure to be exactly the one that will save you from sleep problems.

It is best to apply them in combination, acting simultaneously on the body and mind. Choose the optimal set of measures in cooperation with a sleep doctor. 

The crown of the head hurts: what to do and how to treat

Cephalalgia or headache is a fairly common occurrence in a person’s life; almost everyone has encountered this unpleasant sensation. For most, the problem is solved simply by taking pain relievers. However, this is a rather dangerous technique, because such a symptom may not speak of fatigue, but of a serious illness.

If a person often has a pain on the top of the head or responds with an unpleasant sensation when pressed at one point to the right or left, affecting the neck as well, then the doctor will help to understand what this means and why it is happening. After a thorough examination, examination. Self-medication in such a case will cause a worsening of the condition.

Causes

Feelings, such as a headache in the region of the crown on the left or right, a feeling of pressure in the back of the head, are extremely unpleasant. And everyone tries to get rid of them in the usual way: take a pill.

When cephalalgia is caused by temporary exposure to external factors, the use of analgesics is a justified decision. Pain reliever leads to, albeit temporary, but a positive result.

However, if other signs of ill health occur along with the pain in the head, the right decision is to go to the hospital. Since even after taking medications, a person’s condition can deteriorate sharply.

Dangerous symptoms:

  1. Sudden mental abnormalities.
  2. There are drops in blood pressure.
  3. With pressure on the crown, the pain sensations increase.
  4. There is a strong burning sensation.
  5. There is nausea, vomiting.
  6. Dizziness, passing into a light-headed state.
  7. Unsteadiness of gait.
  8. Episodes of falls, convulsions. 
  9. Loss of control or sensitivity in the limb area.
  10.                    Temperature increase.
  11.                    Drying of the mucous membrane in the oral cavity.
  12.                    Problems with orientation in space.
  13.                    Memory losses.

Both the influence of external factors and the development of diseases of the brain, skull, and other parts of the body can lead to the occurrence of cephalalgia in the crown region.

Ophthalmoplegic migraine may occur with similar manifestations [2].  

External factors

Our body is a complex mechanism. The health balance can be disturbed by a phenomenon that seems at first glance not dangerous.

It happens that the head often hurts in the region of the crown on the left or right, the entire left or right side of the skull due to ordinary things:

  1. Hunger. Due to a decrease in blood sugar levels, discomfort occurs in the crown of the head, which disappears immediately after replenishing the lack of carbohydrates.
  1. Lack of caffeine in a person who is used to drinking a lot of coffee every day.
  2. An unhealthy lifestyle that includes regular consumption of alcohol, nicotine, sweets, and fatty foods with supplements such as monosodium glutamate.
  1. Some products with a specific composition cause extremely unpleasant sensations in the crown area.
  2. Excessive alcohol consumption, leading to swelling of the membranes of the brain, hangover.
  3. Poisoning with chemicals.
  4. Inflammation in the area of ​​the jaw bones and teeth.
  5. Diseases of the nasal cavities.
  6. Chronic and acute stress, causing nervous strain.
  7. Depression, being in a depressed mood.

In such cases, getting rid of the problem is not difficult: you need to exclude the negative factor from the usual way of life.

Diseases and pathologies

It is more difficult to cope with secondary pain, which signals the onset of a disease of internal organs and systems.

The right or left side of the crown of the head, seizing the zones on the right or on the left, can be very painful with the following pathologies:

  1. Osteochondrosis of the cervical spine, cervicogenic pain. Including post-traumatic. With the development of such a disease, problems with the vascular system arise in the neck area. The blood supply to the brain is disrupted. Painful sensations gradually spread from the crown of the head throughout the head, to the shoulder area. 
  1. Traumatic brain injury. Pain syndrome can occur a week after the injury. In this case, unpleasant sensations can be both constant and periodically fading.
  2. Neoplasms of the brain or its membranes, benign and malignant. In both cases, cephalalgia is permanent, manifested by pulsation, worsening in the morning, after exercise, or against the background of fluid accumulation.
  3. Arterial hypertension. Chronically high blood pressure leads to problems in the blood circulation in the brain. In addition, against the background of the disease, hypertensive crises, hemorrhages are possible. Therefore, the problem must be solved under the supervision of a cardiologist, therapist.
  4. Allergies or manifestations of dermatitis. If cephalalgia manifests itself only when you touch the scalp, then with a high probability, the basis of the problem is any agent used in this area that causes such an active reaction. In most cases, it is enough to remove the allergen and the problem will be solved.

Diagnostics

To establish the symptoms of which a severe headache becomes in the region of the crown, crown, to the right of the center of the head, what influenced this and what reasons became decisive, and therefore prescribe treatment, the doctor can only after a thorough examination. 

At the first visit, the neurologist will conduct a general analysis of the patient’s condition. Draw up a survey plan. If necessary, he will redirect to a doctor of the appropriate profile.

Diagnosis when such symptoms appear is carried out in several stages:

  • Initial examination, collection of anamnesis. It is important for the doctor to learn not only about the symptoms that have manifested, but also about the external factors accompanying this, the conditions under which the pain intensifies. The possibility of the influence of chronic diseases is also being studied.
  • Consultations with narrow specialists to identify a list of necessary studies.
  • Laboratory blood tests.
  • Hardware studies of the state of the brain, cervical spine, circulatory system: MRI and CT of the brain, X-ray examination of the cervical spine, ECG of the heart.

Based on the results, it will become clear why the crown, forehead and crown of the head or the entire crown of the head hurt. The doctor will then be able to determine the most effective therapy.

Treatment

Therapy is prescribed only after a complete examination.

The doctor will tell you what to do if the top of the head constantly hurts and presses very badly, the skin in this area is on top, periodically nauseous, from which other symptoms appear, treatment is prescribed depending on the cause, age, gender of the patient. 

The method of providing assistance depends on whether the pain is primary or secondary. If discomfort occurs due to lifestyle or the influence of external factors, the following are used:

  • Pain relievers and drugs to relieve spasms. It is imperative to use exactly the medication indicated by the attending physician.
  • Changes in daily routine or habits. Minimizing the impact of external negative factors that lead to the manifestation of symptoms plays a major role in getting rid of pain.
  • Undergoing a course of physiotherapy procedures such as laser therapy, extremely high frequencies. The sessions restore disturbed processes in the body, remove the consequences of negative effects.
  • Compliance with the selected daily routine.
  • Relaxation procedures, as stress and nervous exhaustion often become the reason for a sharp headache at the top of the head.

The result of such an integrated approach will not be long in coming. The patient gets rid of discomfort in 7-14 days. When the case is severe, the time to achieve the result is increased.

Relapse prevention

Throughout subsequent life, in order for the symptoms not to return, the patient will need preventive measures.

If the head hurts on the right or left in the region of the crown every day, showing the presence of internal pathology, then the treatment is primarily carried out to eliminate the disease. In this case, the treatment program is prescribed depending on the identified disease and related factors.

Since the causes of headaches in the crown region or the parts of the head closest to it are different, then various methods are used: 

  • Medication approach. The course includes pain relievers, but only as an anti-symptomatic agent that does not have a particular effect on the treatment of the cause of the condition.
  • Physiotherapy procedures that help to normalize the physiological state of the patient, variously affecting the pathology that has arisen.
  • Surgical intervention is prescribed when conservative treatment will obviously not give the desired result.

Regardless of the cause of the headache in the crown of the head, you need to remember about the inadmissibility of self-medication. Even if some methods give a temporary positive effect. Drowning the pain with folk remedies or self-chosen medicines, you run the risk of not noticing a gradually developing serious illness.

Senile insomnia

Posted on October 5, 2021  in Uncategorized

Insomnia is a problem in human life. It worsens his health throughout the day, contributes to the development of chronic diseases. In relation to children and adults, such a disorder is perceived as a pathology. In older people, it does not seem to be dangerous. And this is wrong.

The percentage of people with sleep disorders after age 65 is steadily increasing. Given the weakened body of the elderly and a predisposition to a number of diseases, disturbed sleep impairs brain function and can become a risk factor for Alzheimer’s disease.

Relatives caring for the older generation often ask themselves the question: “What to do if grandfather or grandmother does not sleep at night?” There is no universal answer and will not be. The way to restore the normal regime depends on the cause and type of insomnia the person has. 

Chronic pathology does not form in a few days. Its development takes place gradually, months and years.

As a rule, sleep problems are caused by a decrease in the production of melatonin, a neurotransmitter responsible for the correct sleep and wakefulness of a person. But for what reason such a disorder arose, it will be necessary to find out.

Sleep disturbances are not accidental, the main causes of insomnia in older people, men and women over 60, are: 

  1. Stressful states. The experiences typical of people in years in the evening, before going to bed, often negatively affect the functions of the nervous system.
  2. Snoring, nocturnal breathing problems, seizures.
  3. Excessive excess weight and a sedentary lifestyle.
  1. Bad habits. Alcohol abuse.
  2. Lack of sleep hygiene. Incorrect, uncomfortable bed, constant background noise (for example, from a working TV), light, lack of evening ventilation.
  3. Chronic diseases affecting the respiratory system or accompanied by pain.
  4. Mental and psychological problems. Depression and mental illness should be treated under medical supervision. And the psychological instability, fears about the future, can be dispelled by loved ones.
  5. Taking medications that provoke insomnia. In this case, it is necessary to inform the attending physician about the side effect so that he changes the dosage regimen or prescribes another remedy.
  6. Little sunlight, vitamin D deficiency. It is recommended to spend more time in the sun or take special medications.

Often, a chronic condition is provoked by several reasons at the same time. For example, high blood pressure with hypertensive encephalopathy and medication that interferes with sleep.  

Types of insomnia in the elderly

To decide what to do if an elderly person does not sleep at night, you need to figure out what form of insomnia developed in old age.

There are three pathology options that are most typical for such patients:

  1. Hypersomnia – a person needs a long period of sleep, sleeps 12-20 hours a day. And even after such a long period of rest, the surge of strength and vivacity does not come. The patient wakes up irritated, tired. Hypersomnia is characteristic of people who are constantly exposed to stress and are depressed.
  2. Insomnia – difficulty falling asleep or its complete impossibility. Even after a person falls asleep, he cannot rest. Sleep is extremely restless, short, fragmentary, often accompanied by nightmares. As a rule, accumulated stress becomes the cause of the condition. The psychotherapist should think over the treatment regimen.
  3. Parasomnia is a sleep phase change disorder. A person wakes up several times during the night, but full awakening does not occur. A similar phenomenon occurs with nocturnal epilepsy, sleepwalking. Requires consultation of a neurologist.

Only by understanding why old elderly people sleep little and poorly can one choose the right treatment. Smart therapy will improve their health and sleep.

Symptoms

In order to determine what to take for insomnia in old age in the elderly and how to get rid of this painful condition, the collection of symptoms plays a significant role at the first visit to the doctor.

The peculiarities of the course of the disease will help to understand what additional examination is required and what treatment will be effective.

Symptoms of insomnia in the elderly:

  1. Intermittent difficulty falling asleep. Even in the dark and relaxed state, sleep does not come for hours.
  2. More frequent nightmares that cause earlier awakening in an agitated state with a feeling of fear, disgust, regret. In this case, the pulse accelerates, blood pressure often rises.
  3. Superficial sleep. Increased sensitivity, frequent awakening at night from the slightest noise, inability to fall asleep after it.
  4. A standard 8 hour nap does not bring any rest. The person is haunted by the desire to either sleep longer, or during the day he experiences fatigue and drowsiness.

Each of these signs, which happened once, is not a cause for concern. However, if the patient regularly experiences these symptoms, it is necessary to see a doctor.

Diagnostics

To understand what to do, what treatment to use, it is required to determine the causes of senile insomnia.

The first method that is used to diagnose a patient’s condition is a survey.

The doctor finds out the symptoms of the process, determines the accompanying problems that arise. The person is asked what diseases he has.

Neurological examination is mandatory.

After that, testing is carried out on the Epworth scale. A person is asked to answer questions related to the characteristics of his sleep. Based on the information received, points are assigned and the level of the problem is determined [3]. 

After undergoing preliminary diagnostics, the patient is redirected to instrumental studies, consultations by doctors of a related profile to determine the specific cause of his condition.

Then, when doctors determine why the elderly person is awake at night, they can develop a plan to restore sleep.

Treatment

How to treat insomnia in old age, what methods of combating and preventing such a condition in older people will be effective, should be decided by a professional doctor after a thorough diagnosis. Depending on the results, a therapy regimen will be selected.

For the treatment of sleep disorders, as a secondary symptom of a third-party disease, the root cause, the disease that led to the dyssomnia, is first treated. Having received the result, they begin to get rid of the symptoms.

When the reduction in sleep time is due to age-related changes in the brain, doctors try not to resort to drastic methods, advising preventive measures and mild corrective procedures.

In some cases, insomnia in old age in people, equally, men and women, has reasons that require drug treatment. When prescribing drugs, the doctor is guided by several rules:

  • Selection of a drug with suitable pharmacological effects.
  • Appointment of small therapeutic doses.
  • Short-term courses of drug use (up to 1 month).
  • Therapy should be intermittent. You can not use the drug more than 2-3 times a week.
  • The gradual withdrawal of hypnotic drugs through dose reduction.
  • Close monitoring of the patient’s condition before taking medications and after discontinuation, during follow-up examinations.

When prescribing therapy, it is extremely important to take into account what other medications a person is taking, what chronic diseases he suffers, so as not to worsen the general well-being.

Due to these features, self-medication with hypnotics is highly discouraged [4]. 

Preventing Poor Sleep in Older People

Sleep disorders in old and senile people do not always require complex treatment. Often, the problem, if not resolved, then becomes less acute.

We suggest following a few rules to help you get healthy sleep:

  • Monitor the diet, make the evening meal lighter and push back from the time of falling asleep by 2-3 hours.
  • Reduce your intake of caffeinated beverages and avoid them in the afternoon.
  • Stop drinking alcohol, nicotine and other stimulants.
  • Use orthopedic pillows and a mattress for a comfortable and safe sleep.
  • Ventilate the bedroom regularly before bed, even during the winter season.
  • Introduce more physical activity into the daily regimen, preferably in the second half of the day.
  • Reduce TV viewing time in the evenings by taking short walks.

And remember: the question: “How to overcome insomnia in old age?” Is solved individually each time.

Hebephrenic schizophrenia

Hebephrenic (hebephrenic) schizophrenia or hebephrenia F20.1 is one of the forms of schizophrenia with a continuous and unfavorable course, characterized by inappropriate emotions, silly behavior and torn thinking.        

In 1863 , K. Kahlbaum first identified hebephrenia as an independent form that develops during puberty and is expressed mainly by the phenomena of mental weakness.     

The first detailed descriptions of hebephrenia belong to E. Hecker (1871). In his opinion, in most cases, already from early childhood, a well-known mental weakness, lethargy and reluctance to mental work can be noted .      

The boundaries of hebephrenia have always remained blurred. Even E. Bleuler (1911) considered hebephrenia as a combined group of mental illnesses. According to W. Mayer-Gross (1932), “heboidophrenia” or “heboid” is difficult to distinguish from psychopathies and neuroses. From his point of view, hebephrenia could stop at any stage and even manifest itself in the form of a single decrease in activity.         

According to E. Kraepelin, the course of hebephrenia can be slow, subacute and acute. Many researchers believed that it is continuous and malignant, although structurally, from the point of view of psychopathology, it looks relatively simple.   

R.A. Nadzharov (1972) attributed hebephrenia to a variant of nuclear schizophrenia, in his opinion, with this mental disorder, various, as it were, “compressed in time” and overlapping affective and catatonic symptoms alternate . The initial states of the hebephrenic form of schizophrenia are described in the literature somewhat contradictory. K. Leonhard (1936) described as one of them “silly, eccentric defect of hebephrenia”. According to V.N. Favorina (1964), in the initial state of hebephrenia, catatonic-apathetic states are noted.             

O.V. Kerbikov (1949) singled out a diagnostic triad of symptoms in hebephrenia: “gymnastic contraction of facial muscles”, grimacing; the phenomenon of “inaction of thoughts” (Levi-Valensi A., 1926), accompanied by unmotivated actions; empty, unproductive euphoria. The hebephrenic form of schizophrenia is characterized by an early onset, beginning in adolescence, usually after 10 years.    

According to E. Hecker, the main features of this disease are as follows: mood is characterized by rapid variability and inconstancy; although at the initial stage a depressed, but superficial mood (initial melancholie) prevails. The patient, after crying, fear and fear of persecution, suddenly becomes cheerful and bursts out with some stupid, senseless trick. These transitions are sharp, quick and unexpected: the patients seem to play and flirt with their feelings and mood.          

Signs of hebephrenic schizophrenia

The main signs and features of the hebephrenic form of schizophrenia: 

  • early and acute onset; 
  • polymorphism of symptoms;
  • pronounced disorganization of thinking, speech (meaningless rhymes, verbigeration, incoherence, neologisms) and behavior (foolishness, disorientation, demeanor, grimacing, importunity); 
  • inadequacy of emotional reactions (“empty euphoria”);
  • infantilism;
  • hypersexuality;
  • increased appetite;
  • malignant and continuous course; 
  • resistance to therapy. 

The clinical picture is characterized by a state of excitement, disunity, foolishness, fragmentary, unsystematic, rudimentary delirium and unstable, episodic, simple hallucinations (Hecker E., 1871). According to many psychiatrists, pure hebephrenic form is rare.      

Hallucinatory-delusional inclusions can be sexual, religious, hypochondriacal, and paranoid. Delusional statements are in the nature of something fictional, composed by the patient for fun and tomfoolery (“confabulation”, K. Kahlbaum). In the presence of delusional and, especially, affective disorders, the course of the disease can be paroxysmal and progressive in nature (Polishchuk Yu.I., 1965).    

In the latest classifications, the hebephrenic form of schizophrenia is defined as a disorganized type of schizophrenia with incoherent speech and disorganized behavior.   

The hebephrenic form often begins acutely, manifested by the syndrome of silly excitement and is often combined with euphoria and a kind of childishness.   

Many psychiatrists emphasized that hebephrenia is characterized by a pronounced regression of mental development: primitive and disinhibited behavior; children’s and archaic speech (invectives) with meaningless rhymes and verbigeration.    

Rapidly changing behavior is one of the significant symptoms of hebephrenia, probably reflecting in general the tendency of such patients to erratic activity, to impulsive, impulsive movements, to ridiculous behavior with the character of a feigned prank (Serbsky V.P., 1912).      

With hebephrenia, the patient is often active, but this activity is unfocused, unconstructive. Persistent orders of the patient can be distracted from meaningless behavior, but this usually succeeds for a short time.    

Usually a patient with hebephrenia exhibits increased sexual activity (casual relationships, sexual perversion). For women, it is quite typical to use diminutive – affectionate words, ridiculous coquetry, flirting, manifestations of exhibitionism. 

Emotional reactions are inadequate, fluctuating in their intensity. The mood is usually heightened (“silly fun”), with a tendency to strange and incomprehensible humor, flat jokes. Unreasonable laughter without sufficient reason can be replaced by crying.    

With hebephrenia, thinking and speech are impaired , which may include neologisms, be incoherent, the nature of the statements does not correspond to the experiences. Other formal speech disorders are also characteristic of hebephrenia : incorrect connection of sentences, violation of logical structures. Patients use the same phrases and phrases, resort to a set of pompous and meaningless words.         

Hebephrenic schizophrenia treatment

The primary diagnosis of hebephrenic schizophrenia occurs during puberty. To make an accurate diagnosis, it is necessary to monitor the patient for 2-3 months, paying attention to the presence of characteristic symptoms, on the basis of which it is possible to draw a conclusion about the presence of the disease.        

Treatment for hebephrenic schizophrenia differs significantly from treatment for other types of schizophrenia because this type is characterized by an unfavorable course, taking into account all its manifestations. Thus, only highly qualified specialists can carry out effective treatment.   

Paranoia and schizophrenia

Paranoid schizophrenia (F20.0) is a type of schizophrenia characterized by hallucinations and delusions, as well as incoherent speech, affective flattening. There may be mild catatonic symptoms that are not predominant. It is one of the most common types of schizophrenia. A distinctive feature of paranoid schizophrenia is the presence of paraphrenic and paranoid delusions. Catatonic symptoms are mild.          

Causes of paranoid schizophrenia

The main cause of paranoid schizophrenia is brain dysfunctions. Also, genetic factors play a role in the appearance and development of schizophrenia. In addition, the causes of paranoid schizophrenia can be:  

  • the presence of viruses in the mother during pregnancy; 
  • malnutrition of a pregnant woman;
  • stress;
  • Alzheimer’s disease;
  • the use of psychotropic drugs in adolescence. 

Paranoid schizophrenia can be diagnosed between the ages of twelve and thirty. However, it can often be detected even in infancy.     

Paranoid schizophrenia symptoms

Along with the universal symptoms of schizophrenia, the symptoms of the disease are: 

  • delirium of persecution, grandeur, jealousy;
  • auditory hallucinations;
  • olfactory, gustatory hallucinations, bodily sensations;
  • visual hallucinations;
  • thinking disorders;
  • irritability;
  • anger;
  • fears;
  • suspicion;
  • violation of volitional functions.

The course of paranoid schizophrenia

The course of the disease can be episodic, or chronic, in which vivid symptoms persist for several years.

Paranoid schizophrenia usually develops after age 25 . At the first stage, the disease is slow, the initial period can last from 5 to 20 years.      

In the debut, anxiety attacks, obsessive states are observed , then suspicion, isolation, rigidity increase.  

The stage of development of the main clinical manifestations of the disease is characterized by the presence of persecution delusions, physical impact, pseudo-hallucinations.

In the future, there is a hallucinatory-paranoid phenomenon, in some cases hallucinosis prevails, in others – delirium and mixed states. The change of stages is characterized by a wave-like flow.     

Treatment of paranoid schizophrenia

Paranoid schizophrenia can have serious consequences: emotional, behavioral disorders. The patient often becomes depressed, abuses alcohol and drugs.     

The main forms of therapy for paranoid schizophrenia are pharmacological treatment, psychotherapy and electroconvulsive therapy.    

In the treatment of paranoid schizophrenia, alcohol and drugs are categorically contraindicated . 

Suicide in schizophrenia

Approximately 40% of patients with schizophrenia make a suicidal attempt during their lifetime, and in 10-20% it is successful.      

Even if it is possible to stop most of the symptoms of depression in patients with schizophrenia, this does not mean that the threat of suicide has passed. Suicidal thoughts in this disease go away relatively late.     

Among patients with schizophrenia, suicidal attempts are more common in young men, especially if they have tried to commit suicide in the past. Severe symptoms of depression, persistent disorders of perception, panic attacks, and frequent hospitalizations in a psychiatric hospital are considered harbingers of suicidal behavior .   

Suicide risk factors for schizophrenia

  • Young age;
  • Male;
  • History of suicidal attempts ; 
  • First psychotic episode;
  • Dominance of positive symptoms over negative;
  • Significant severity of symptoms of depression;
  • Persistent perception disorders (imperative auditory hallucinations);
  • Panic attacks;
  • Frequent relapses of the disease (frequent hospitalizations);
  • The first 3 months after discharge from the hospital;  
  • Resistant variants of the course of the disease;
  • Autoaggression manifestations;
  • Low level of compliance;
  • Severe side effects of therapy (akathisia);
  • Medicines suspected of increasing the risk of suicide (fluoxetine, duloxetine);
  • Inadequate drug therapy (low or high doses of drugs);
  • Substance abuse;
  • Insufficient social support;
  • Stigmatization of the disease;
  • Economic problems;
  • Relatively high level of intelligence in premorbid. 

The degree of suicide risk is influenced by the level of compliance and the adequacy of drug treatment. Neurological complications of therapy, especially akathisia, may be accompanied by suicidal thoughts .    

Poor social support, stigmatization of the disease, and economic hardship also increase suicidality.

The risk of suicide is higher in patients with a dual diagnosis, when, against the background of the course of schizophrenia, there is a dependence on psychoactive substances.    

Many psychiatrists have noted that suicide in schizophrenia is possible in the early stages of mental disorder, in patients with a relatively high premorbid level of intelligence and with deep feelings about the consequences of the mental disorder.      

The tendency to self-harm, auto-aggressive tendencies, imperative auditory pseudo-hallucinations should alert the doctor to possible suicide.  

In almost 20% of cases, suicidal attempts in schizophrenia occur with its resistant variants of the course (“refractory schizophrenia”) (Heila H. et al., 1999).    

According to psychiatrists, hospitalization partly increases the risk of suicide due to the fact that the patient’s forced isolation from society is perceived by him extremely negatively. At the same time, most psychiatrists consider hospitalization in the presence of suicidal thoughts mandatory, since in this case the patient can be monitored constantly, antidepressants can be prescribed, while providing him with the necessary psychological support (increasing the level of self-esteem, the degree of self-confidence , etc.).           

Suicidal thoughts in schizophrenia can be difficult to recognize, suicidal attempts are difficult to prevent, primarily because of their impulsiveness (Gut-Fayand A. et al., 2001). In addition, unlike other patients with mental disorders, patients with schizophrenia resort to methods of suicide, which practically exclude a failed attempt.         

Analysis of suicide cases in schizophrenia shows that in most cases, at least 3 months before suicide, patients or their relatives sought medical help. In particular, they underwent treatment in a psychiatric hospital, of which almost half of the cases were preceded by a visit to a psychiatrist a week before the suicide (Roy A., 1982). Quite often, the cause of suicide can be the wrong prescription of medications, the intake of inadequate doses of drugs that are either too low or too high.               

Medical personnel involved in the treatment of a person with schizophrenia must be constantly aware of the high risk of suicide in this disease. An open conversation with the patient, a sincere attitude to his experiences, attention to his plans often helps prevent a suicidal attempt.     

Clozapine is considered to be a drug that significantly reduces the likelihood of suicide in schizophrenia, which in this respect is superior not only to traditional antipsychotics, but also to modern atypical antipsychotics, such as olanzapine.    

Schizophrenia problem

Schizophrenia is a group of mental disorders characterized by a diverse course, the presence of positive, negative and cognitive symptoms, combined with each other within certain forms.    

The problem of schizophrenia is multifaceted and goes beyond medicine. This mental disorder is not only attracting the attention of doctors, psychologists and social workers, but anthropologists, philosophers, theologians, historians, journalists and people of many other professions are interested in it .        

Writers and artists have repeatedly turned to the topic of schizophrenia, and scientists often looked for traces of genius in the works of those who suffered from this disease.     

Since the moment when the term “schizophrenia” was proposed, the definitions of this concept have often differed among themselves in different countries.  

According to the words of J. Wyrsch (1960), despite the fact that “on the other and the other side of the Rhine authority used as the E. Kraepelin, and E. Bleuler, at one and the same word” schizophrenia “is understood, not one and the same.” It may not have clarified much in twentieth-century psychiatry, but it has often become a stigma that was often mistaken and could cause real harm by violating human rights.                   

It is pertinent to recall that E. Bleuler proposed the term “schizophrenia” just in order to prevent the formation of a negative attitude towards this disease on the part of society. From his point of view, the previous definitions of both “premature dementia” and “intrapsychic ataxia” not only did not correspond to the essence of the disease, but contributed to the mistreatment of people suffering from this disease.          

History knows many examples of the fatal role of many terms in psychiatry. For example, when in 1933 city of in Germany was introduced “Law on prevention of family history of offspring”, the word “schizophrenia” was extremely dangerous.     

In the history of medicine, the importance of schizophrenia can hardly be overestimated. Many terms in psychiatry have developed in parallel with the evolution of the theory of this mental disorder, so the language of modern psychopathology was partly influenced by descriptions of the clinical picture of schizophrenia.    

Some concepts, which were so popular at the time of their appearance, were replaced by others, in the opinion of the researchers, which more accurately corresponded to the essence of the disease. Some terms, such as “premature dementia”, already belong to the pages of history, and the concepts of “procedural”, “psychotic”, “functional psychosis” or “endogenous disease” are recognized as vague, lacking clear criteria.    

And today the meaning of many clinical concepts related to the field of schizophrenia is constantly evolving, gradually adjusting to the requirements of practice and the results obtained in the course of new research.    

Sleep disturbances in schizophrenia

The sleep of a schizophrenic patient is usually disturbed. The structure of sleep especially changes before exacerbation or in the process of relapse of the disease. According to S. Dencker et al. (1986), sleep disorder can be considered the most sensitive indicator of an incipient exacerbation of psychosis. The first signs of sleep disorder are manifested by frequent awakenings during the night, “restless sleep.”      

Sometimes the patient does not sleep for several days, and then there is increased drowsiness, which persists for a fairly long period of time. As they recover from psychosis, the patients’ sleep is gradually normalized, but it is not fully restored either by objective indicators or by subjective data.             

To determine the causes of sleep disturbance and increased sleepiness during the day, it is necessary to study the structure of sleep throughout the night (polysomnography).   

Many sleep doctors believe that sleep disturbances in schizophrenia are likely nonspecific and, unlike depression, do not require expensive sleep research.    

Sleep disturbances are most often recorded in those patients with schizophrenia, whose clinical picture is dominated by anxiety-depressive symptoms.  

Especially persistent sleep disorders are observed in patients with a dual diagnosis: schizophrenia and dependence on psychoactive substances.    

Winkelman J. (2001) noted cases of quite frequent occurrence of obstructive sleep apnea in schizophrenic patients. 

According to some authors, sleep disorder in schizophrenia varies in a wide range, however, most often there are disturbances in falling asleep, changes in the 3rd and 4th phases of sleep, especially the contraction of the 4th phase – deep, slow-wave sleep (“slow wave sleep”), changes in the continuity of sleep, and also the reduction of REM – phases (Monti J., Monti D., 2004). Reduction of the 4 sleep phase is of particular diagnostic value for schizophrenia (Feinberg I. et al., 1969; Poulin J. et al., 2003).                  

Sleep disturbances in schizophrenia

  1. Falling asleep
  2. Sleep disruption
  3. Sleep phase 4 reductions ( NREM sleep duration, percentage of NREM sleep) 
  4. Dysregulation of REM sleep (decreased REM latency, decreased REM sleep during the night) 
  5. Lack of information processing during sleep 

M. Keshavan et al. (1996), proposed to distinguish between variable and invariant sleep parameters in schizophrenia, the former, for example, such as REM sleep parameters (REM – latency and REM density), depended on the mental status of patients, significantly worsening before an exacerbation or during a psychotic episode, on the contrary, the second, in particular, phase 4 , characterizing deep, “slow wave sleep” (duration of slow wave sleep, percentage of slow wave sleep), almost always and regardless of the phase of the disease (prodromal, exacerbation, stabilization, remission) were stably violated in schizophrenia. M. Keshavan et al. (2004) also noted changes in slow-wave sleep in relatives of schizophrenic patients. According to these authors, disturbances in “slow wave sleep” can be an indicator of the danger of developing schizophrenia. It is interesting to note that the proportion of “deep sleep” in young patients shows a negative correlation with the severity of negative symptoms of schizophrenia (Ganguli R., et.al., 1987).                   

For patients with schizophrenia during the period of exacerbation of the disease, it is quite characteristic to disrupt the continuity of sleep, measured by such indicators as: sleep latency, sleep efficiency, awakening time after the onset of sleep, frequency of awakenings per night, total sleep time. From the point of view of B. Hoyt (2005), the continuity of sleep is determined by the state of the dopaminergic system, and the disturbance of the sleep rhythm, in particular, corresponds to its intensification.       

A decrease in REM latency, a decrease in REM sleep density, is especially noticeable during a psychotic episode. Short periods of REM latency are often detected in patients with severe hallucinatory symptoms (Feinberg I. et al., 1965). According to V. Zarcone et.al. (1975), in patients with schizophrenia there is a kind of “selective deprivation of the REM-phase of sleep, i.e. there is a dysregulation of REM sleep, but not a change in its structure.            

Sleep studies in schizophrenic patients show that information processing is impaired during sleep . So, in particular, if light and sound stimuli are used during the night and at the same time the evoked potentials are measured, then in patients with schizophrenia, an enhanced resonance of the response in the theta range can be found (Roschke J. et al., 1998).            

Usually, patients use small doses of clozapine or other antipsychotics to normalize sleep, sometimes they take sleeping pills and tranquilizers. In studies T. Neylan et al. (1992) found that even after the abolition of antipsychotics sleep changes associated with their exposure, may be fixed on for 6 weeks after their cancellation.         

Many researchers associate the directions of further research on somnology in the field of schizophrenia with the use of modern methods of neuroimaging during this period (Gauggel K., 2008).