Medical history (history of illness) represents an important component in the diagnosis of insomnia (sleep disorders). Family history Social history What is your occupation? What are your working hours? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). What time do you … Sleep Disorders (Insomnia): Medical History
Respiratory System (J00-J99) Allergic rhinitis (allergic rhinitis; hay fever). Bronchial asthma Chronic obstructive pulmonary disease (COPD) Chronic rhinosinusitis (CRS; simultaneous inflammation of the nasal mucosa (“rhinitis”) and the mucosa of the paranasal sinuses (“sinusitis“)). Endocrine, nutritional and metabolic diseases (E00-E90). Andropause (male menopause) Hyperthyroidism (hyperthyroidism) Climacteric (menopause in women; eg, hot flashes). Factors affecting health … Sleep Disorders (Insomnia): Or something else? Differential Diagnosis
The following symptoms and complaints may indicate insomnia (sleep disorder): Leading symptoms Difficulty falling asleep – when it takes longer than 30 minutes to fall asleep. Trouble sleeping through – waking up prematurely, respectively, when you sleep through less than four hours If necessary, also sleep-associated motor phenomena (see also under restless legs syndrome, RLS). … Sleep Disorders (Insomnia): Symptoms, Complaints, Signs
Pathogenesis (development of disease) The pathogenesis of the various forms of insomnia is very diverse and cannot be explained by a common pathomechanism. Chronic stress significantly impairs sleep quality. Cortisol levels are markedly elevated in insomnia. Stress and the resulting elevated cortisol levels activate the tryptophan-degrading enzyme tryptophan pyrrolase. Tryptophan is necessary for the production … Sleep Disorders (Insomnia): Causes
General measures Keep a regular daily routine. Exercise regularly during the day. Take a nap during the day (synonyms: siesta; power napping; napping; dozing; napping) – Taking a controlled 30-minute nap by setting an alarm before 3 p.m. – at least three times a week – reduces the risk by 37% of dying from coronary … Sleep Disorders (Insomnia): Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin and mucous membranes. Auscultation (listening) of the heart Auscultation of the lungs Neurological examination [due todifferential diagnoses: Alcohol dependence Huntington’s chorea (synonyms: Huntington’s chorea or Huntington’s … Sleep Disorders (Insomnia): Examination
2nd order laboratory parameters – depending on the results of the history, physical examination, etc. Small blood count Melatonin serum level Melatonin as 6-sulfatoxymelatonin – urine collected in 6-hourly periods over 24 hours. TSH (thyroid-stimulating hormone). Liver – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT).
Therapeutic target Restoration of an adequate sleep-wake rhythm. Therapy recommendations Before drug therapy, cognitive behavioral therapy (CBT) should be the first treatment option for adults of any age. No drug therapy without prior clarification of the cause (see below chronic pain, depression; medication intake)! Sleep-inducing drugs should be prescribed for a maximum of four weeks! … Sleep Disorders (Insomnia): Drug Therapy
The most important diagnostic measure is the collection of medical history, that is, the medical history. Optional medical device diagnostics – depending on the results of the medical history, physical examination, etc. – For differential diagnostic clarification Examination in a sleep laboratory (polysomnography) – if there is a reasonable suspicion to exclude organic sleep disorders; … Sleep Disorders (Insomnia): Diagnostic Tests
An at-risk group indicates the possibility that the condition may be associated with the risk of vital nutrient deficiency. The complaint insomnia indicates a vital nutrient deficiency for: Magnesium Within the framework of micronutrient medicine (vital substances), vital substances (micronutrients) are used for supportive therapy of sleep disorders: Vitamin B12 Magnesium Amino acid tryptophan The … Sleep Disorders (Insomnia): Micronutrient Therapy
To prevent insomnia (sleep disorders), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Physiological causes – eating or drinking at night. Consumption of stimulants Alcohol Coffee, tea (caffeine) Tobacco (smoking) Drug use Amphetamines (indirect sympathomimetic): ecstasy (3,4-methylenedioxy-N-methylamphetamine, MDMA), crystal meth (methamphetamine) or methylphenidate. Cannabis (hashish and marijuana). Cocaine Physical activity … Sleep Disorders (Insomnia): Prevention
The following are the most important diseases or complications that may be contributed to by insomnia (sleep disorders): Eyes and eye appendages (H00-H59). Glaucoma – People who slept less than three or more than ten hours a night were three times more likely to show optic nerve damage from glaucoma than subjects who slept seven … Sleep Disorders (Insomnia): Complications
