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  • Subject area(s): Marketing
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  • Published on: 14th September 2019
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The insomnia is difficulty falling or staying asleep, waking up earlier than expected, or just waking up to the impression of not having had a good night's sleep, for at least a month.

Most important to differentiate changes related sleep age and insomnia are the

effects on daytime functioning. If the changes are not accompanied sleep and daytime consequences stress will not talk about insomnia. An older person can sleep 4-5 hours a day and if you have no impact during the day will not be considered insomnia.

Insomino.  Treatment of insomnia.  Dream.The insomnia is very common at any age but increases with age as a normal consequence of aging and it is not diagnosed or treated with the impact it has on the quality of life and functioning of the individual problem.

A insomnia treaty can not cause fatigue, impaired memory and concentration, anxiety, depression and increased risk of falls.

Half of the elderly population may have a sleep disorder.

Features disorders in the elderly

In older people there are a number of features in the dream:

Sleep is more fragmented with repeated and frequent arousals that makes it not refreshing

There is a tendency to nap or multiple naps during the day.

Tendency to sleep at night and early emergence advance

Increased number of nighttime awakenings that can be longer

lighter sleep (easier waking up to environmental stimuli such as light, sound, temperature)

Often they have several diseases and take multiple drugs

Decreased amount of sleep over time in bed

Perception of poor sleep quality

Among the protective factors to have a sleep disorder in the elderly out an active and socially satisfying lives and to present risk having bad sleep habits, taking drugs and some medical conditions.

How is insomnia treated?

The aim of the treatment of insomnia is  to improve the quality and quantity of sleep and daytime functioning, reduce nighttime awakenings, and increase total time asleep.

Cognitive-behavioral therapies

These approaches include sleep hygiene, relaxation, stimulus control, sleep restriction ..

Sleep hygiene

It aims to create better sleep habits:

Insomino.  Treatment of insomnia.  Dream

Maintain a regular bedtime and wake, including weekends and holidays.

Avoid napping. In specific cases you can allow no more 30-minute nap.

Avoid drinks that contain caffeine and protein.

Stay in bed long enough adapting to the real needs of sleep. Reducing time in bed improves sleep and instead spend much time in bed can produce a more fragmented sleep and light

Avoid carrying out activities in bed and watch TV, read or listen to the radio

Limit fluid intake in the afternoon and after dinner

Avoid alcohol and snuff several hours before going to sleep as impair sleep. Alcohol facilitates sleep but fragmented and gives nightmares.

Physical exercise at least one hour a day for at least 3 hours before bedtime and avoid intense physical activity before bedtime.

Keep the bedroom with comfortable temperature and minimum levels of light and sound.

Avoid large dinners and not lie down until they have passed two hours after dinner.

If you wake up at night do not eat anything because it might start waking up at the same time feeling hungry.

Go to bed when you feel sleepy and get up if they spend more than 30-45 minutes without falling asleep and out of bed and the room and make a relaxing and monotonous activity until you feel sleepy again and only then return to the bed, not before. Repeat if necessary.

Avoid worry in bed

Do not take drugs with stimulant effects overnight or with sedation during the day.

Relaxation techniques

The objective of progressive relaxation is that the patient gets deep levels of muscle relaxation quickly and easily when bedtime to facilitate sleep, help control anticipatory anxiety. You can listen to soft music, muscle relaxation exercises, visualize pleasant images, diaphragmatic breathing, meditation ...

Sleep restriction

The aim is to adjust the time in bed to actual sleep time since we have seen a slight sleep deprivation promotes a more effective sleep.

the number of hours of sleep at least four hours and not allowed to sleep outside these hours are reduced.

Stimulus control

The goal is for the patient to associate the bed with sleep and for that the patient should go to bed only to sleep and to sleep.

Phototherapy or bright light therapy

They are based on exposure to light for 1-2 hours in the morning or early afternoon in patients who have difficulty falling asleep.

phytotherapy

Insomino.  Treatment of insomnia.  Dream

They have recommended various medicinal plants for the treatment of insomnia such as lemon balm, cannabis, mullein, poppy seed or rosemary. Its use is usually based on good tolerability and absence of side effects rather than its effectiveness. Valerian may help some patients in the treatment of insomnia.

Pharmacotherapy

For the pharmacological treatment of insomnia of the elderly it is recommended to use the lowest effective dose, using drugs that can be suspended easily use them temporarily (2-4 weeks) treatment administered intermittently (once every three nights).

is not recommended in general the use of hypnotics in older people and if used not to use more than 4 weeks and the lowest possible dose.

Hypnotics used for insomnia include:

Benzodiazepines (lorazepam, lormetazepam, midazolam ...). The most common side effects are sedation, slowed, falls, daytime residual effects, depression and withdrawal. Tolerance (loss of the drug's effects over time forcing up the dose to recover the initial effect) occurs within 5-15 days of continuous shot. If taken continuously withdrawal can produce rebound insomnia and precipitate a withdrawal syndrome.

Non-benzodiazepine hypnotics (zolpidem, zopiclone). Increase total sleep time and reduce the number of awakenings but can also produce dependence and withdrawal difficulties if more than 2-4 weeks are maintained.

Antidepressants such as trazodone or mirtazapine should be used only if depression is associated.

Melatonin. It is a hormone that has its approved in Spain for over 55 years with insomnia but there are problems in their marketing use. It has the ability to regulate biological rhythms of sleep and wakefulness from the perception of light. Melatonin has a daily rhythm that shows greater focus on periods of darkness as it is stimulated by darkness and inhibited by light and melatonin increases when the body goes to sleep. Administration of melatonin may improve sleep quality particularly in patients over 55 years because with age there is a decrease in endogenous production. It takes half an hour before bedtime after food intake.

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