What should I do if I can't sleep after learning I have the disease?

Since learning that she had ovarian cancer, Zhang has never had a good night's sleep. As soon as she lies down, she starts to worry about her health, the failure of the surgery, etc. Later, with the comfort and encouragement of the doctor, Zhang has a deeper understanding of the disease and is more confident in the surgery and postoperative recovery.

However, Zhang still couldn't sleep well. She would think about many things before falling asleep, but her heart couldn't fall asleep. She woke up in the middle of the night and couldn't fall asleep again. After not getting a good night's sleep for a long time, Zhang's two dark circles under her eyes were almost like a giant panda. Two days ago, Zhang couldn't stand it anymore and came to Shanghai Mental Health Center for treatment.

After the doctor's diagnosis, Sister Zhang realized that she was suffering from insomnia.

Insomnia is a common sleep problem that occurs in all kinds of people regardless of age and gender. Physical illness is often accompanied by anxiety, and it is even more difficult to escape the clutches of insomnia. Ms. Zhang is now entangled: Do I have to take sleeping pills to cure insomnia? Will taking sleeping pills have a negative impact on my health?

First of all, do you need to clarify whether you have insomnia?

Insomnia is a sleep disorder characterized by frequent and persistent difficulty falling asleep and/or maintaining sleep, which leads to unsatisfactory sleep. One or more of the following symptoms occur due to difficulty sleeping at night: fatigue or lack of energy; decreased attention or memory; impairment of social, family, occupational or academic functions; irritability or irritability; daytime sleepiness; behavioral problems (hyperactivity, impulsivity or aggression); lack of drive, energy or motivation; prone to making mistakes or accidents; and anxiety about sleep quality. Sleep problems and symptoms during the day the next day occur at least 3 times a week.

Insomnia can exist in isolation or be comorbid with mental disorders, physical illnesses or substance abuse, and can be accompanied by a variety of functional impairments during wakefulness. If you have difficulty falling asleep at night, have a short sleep time or shallow sleep, and it affects your life the next day, you should go to the hospital for treatment with medication.

Secondly, how to choose a suitable sleeping pill?

The treatment of insomnia should first identify the cause, and it is best to treat the cause. Medication is one of the means of treating insomnia. Generally speaking, the commonly used sleeping pills are divided into: barbiturates, benzodiazepines and non-benzodiazepines. Depending on the different manifestations and causes of insomnia, the treatment drugs are also different.

Tips 1 Drug selection:

1. For those who have difficulty falling asleep, you can choose drugs that have a fast onset and a short duration of action: such as zolpidem, zopiclone, and s-zopiclone.

2. For those who have difficulty maintaining sleep, you can choose drugs with longer duration of action: such as diazepam, alprazolam and clonazepam.

3. For patients who have light sleep and wake up easily, medium-acting drugs can be used: such as estazolam and alprazolam.

4. Other options include melatonin receptor agonists, including ramelton and agomelatine, which can stabilize the sleep-wake rhythm and shorten the sleep latency. However, there is a lack of research on the treatment of patients with stroke-related insomnia, and the efficacy is still unclear.

As mentioned above, if you really can’t stand the pain of insomnia and it has a negative impact on your work and study the next day, then with the help of a doctor, choosing the right sleeping pill can greatly improve your quality of life. Here are a few tips for taking the pills:

Tips 2 How to use:

1. Take the medicine 5 minutes before bedtime.

2. If you cannot fall asleep within 30 minutes after going to bed, you can also take medication.

3. If you wake up at night and cannot fall asleep again, and the time since you got up is more than 5 hours, you can take short-acting medication in time.

4. Take the medicine only when necessary. Do not take it if you can sleep better.

Do sleeping pills affect your health?

Standardized use of sleeping pills will not affect physical health, nor will it make existing malignant tumors "worse". On the contrary, long-term lack of good sleep has a greater impact on the nervous system, respiratory system, circulatory system, and endocrine system. Studies have shown that insomnia is a high-risk factor for stroke. However, we need to be alert to other effects of sleeping pills on the body, such as addiction to sleeping pills; excessive use of sleeping pills causing respiratory center depression and respiratory arrest; and decreased wakefulness after taking the medicine, causing falls, fractures, etc. Therefore, you need to understand the precautions.

Tips3 Notes:

1. When taking sleeping pills, be sure to follow the doctor's instructions, take the medicine under the doctor's guidance, and be wary of drug addiction.

2. Take fast-acting drugs, such as zolpidem, before going to bed, and lie down and prepare to fall asleep after taking the medicine.

3. After taking sleeping pills, you may feel slow and dizzy when you get up in the middle of the night. Move slowly to prevent falling.

4. Do not change the dosage of sleeping pills at will.

5. Sleeping aids should be kept out of the reach of children to avoid accidents.

References

1. Chinese Guidelines for the Diagnosis and Treatment of Insomnia. Chinese Medical Journal, 2017, 97(54): 1844-1854

2. Instructions for clinical medication. 2015 edition

3.Ayako Furugen 1, Ayako Nishimura 2, Masaki Kobayashi. Quantification of eight benzodiazepines in human breastmilk and plasma by liquid-liquid extraction and liquid-chromatography tandem mass spectrometry: Application to evaluation of alprazolam transfer into breastmilk. Journal of Pharmaceutical and Biomedical Analysis 168 (2019) 83–93

Note: There is no copyright issue for the pictures in this article

Author: Wang Yun, Jin Jin, Shanghai Jiao Tong University School of Medicine Mental Health Center

About the Author

Wang Yun

Chief Physician of Shanghai Mental Health Center, Master. Has been engaged in clinical diagnosis and treatment of psychiatric diseases and teaching of medical students for a long time.

Expertise: Clinical diagnosis and treatment of depression and anxiety disorders, neurosis, schizophrenia, and consultation on general psychological issues such as study, work, marriage and love.

Excellent teaching teacher of Shanghai Medical College, Fudan University in 2019. Secretary of CSNP Chinese Depression Researchers Alliance, and the first author of more than ten papers published in domestic and foreign journals.

Jin Jin

Attending physician and clinical psychotherapist at the Mental Health Center affiliated to Shanghai Jiao Tong University School of Medicine, engaged in the prevention and treatment of mental disorders.

Research direction: Three-level prevention and treatment of mental health, research related to anxiety disorders.

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)