I can’t sleep. Do you have any medicine? "Some time ago, a news that" taking melatonin for a long time will lead to infertility "went on a hot search, which opened the public’s topic about insomnia. Recently, initiated by the Psychiatric Branch of the Chinese Medical Association and the People’s Daily Health Times, Lingbei Company supported the "Sunshine Mind, Workplace Peer — — The Green Ribbon Action for Caring for the Mental Health of the Workplace Population was held in Guangzhou. Gong Meien, chief physician of the Department of Psychology of the Second Affiliated Hospital of Guangzhou Medical University, and Zhang Lulu, chief physician of the Department of Psychiatry of the First People’s Hospital of Guangzhou, gave a popular science lecture on depression. Experts remind that people who suffer from insomnia for a long time are prone to depression, and melatonin health products derived from food actually have little effect on improving insomnia symptoms.
Insomnia is related to many factors.
Liang Kuan (pseudonym), born in 1990s, has been suffering from insomnia for several months. "I can’t sleep, but I wake up easily when I sleep, feeling very anxious, and my mood is easily agitated during the day, which makes me unable to work."
Zhang Lulu introduced that insomnia is very common in clinic, and the survey from International Sleep Day shows that 45.4% people in China have insomnia.
There are many reasons for insomnia, including external environmental factors, genetic factors, taking certain drugs, bad living habits and so on. Among them, insomnia accompanied by mental illness and physical illness, such as schizophrenia and depression, and physical diseases such as cardiovascular disease, digestive system disease, respiratory system disease and Parkinson’s disease, is also one of the causes of insomnia.
Zhang Lulu pointed out that people with chronic insomnia have three times the risk of depression as normal people. 34.6% of depressed patients are accompanied by insomnia. It can be said that depression and insomnia are mutually causal, forming a vicious circle.
According to statistics, the incidence of insomnia is 20%— 50%, women are higher than men. With the increase of age, the central nervous system will undergo degenerative changes, and the elderly will have symptoms such as sleep rhythm disorder and night sleep. There is evidence that insomnia can reduce the elderly’s evaluation of their own health and increase the risk of depression, which can cause cognitive decline and increase the risk of dementia. It will also affect immunity, and the immunity of patients with long-term insomnia will decrease, and their risks of colds and infections will increase; The risk of cardiovascular disease increases, and some studies suggest that insomnia will also affect the digestive system, which will cause indigestion and even increase the incidence of digestive tract ulcers.
Gong Meien reminded that emotional symptoms of depression are easily concerned, but physical symptoms and cognitive symptoms are often ignored. "The number of 400 numbers in the psychology department of our hospital is in short supply every day, and most of them are referred from gastroenterology and cardiovascular departments." Patients with depression sometimes show insomnia, loss of appetite or palpitation, palpitation and chest tightness, but patients can’t solve the problem by turning to various departments. In addition, depression can also lead to memory loss (always unable to remember), attention loss (always distracted at work), slow mental movement (slow response, unable to keep up with other people’s thinking), and impaired executive function (indecision, difficulty in making decisions, and serious procrastination). These cognitive symptoms may appear before other symptoms of depression. Cognitive impairment will seriously affect the social function of patients and may also bring more serious emotional symptoms.
Melatonin health care products tend to have "comfort effect"
The treatment of insomnia requires the right medicine. For example, insomnia caused by depression and anxiety disorder needs to be treated in psychiatric department in time for anti-depression and anti-anxiety treatment.
The drugs for insomnia mainly include traditional benzodiazepines, such as estazolam, alprazolam, lorazepam and clonazepam, and non-benzodiazepines, such as zolpidem, zobiclone and zaleplon. Severe insomnia can be improved by drugs.
Recently, some media reported that there are 200 million insomnia patients in China, and many insomnia patients turn to melatonin for help in falling asleep. According to the data of an e-commerce platform, from January to August this year, 62% of the total consumers bought imported sleep aid products after 1990s, and 85% consumed melatonin products after 1990s. Some doctors pointed out that taking melatonin products in large quantities for a long time will cause side effects such as hypothermia, infertility, and reducing male physiological desires.
In this regard, Zhang Lulu introduced that melatonin is a hormone secreted by the pineal gland, reaching its peak at two or three in the morning. The level of melatonin at night directly affects the quality of sleep. "Melatonin drugs can play a role because it can act on the central nervous system of the brain through the blood-brain barrier. However, melatonin health care products or foods sold online actually have few active ingredients, and the proportion that can pass through the blood-brain barrier is very low, which has little improvement for insomnia patients. But for people who only have insomnia symptoms, eating such melatonin products will have certain effects, mainly because there is still a small amount of melatonin acting on the brain, and the second is psychological suggestion. "
Experts say that the melatonin sustained-release drug used in clinic to treat insomnia is a prescription drug, which needs to be applied under the guidance of a doctor and will not have a devastating impact on the fertility of patients. "More objectively, some individuals may have reduced physiological needs and male sexual dysfunction after using such drugs, but they will not lose their fertility or have an impact on sperm. Most patients are also reversible after stopping taking the drugs."
■ Expert advice
Non-drug intervention therapy
Effective methods for insomnia
Zhang Lulu pointed out that non-drug intervention in the treatment of insomnia is also very important, including maintaining a comfortable bedroom environment, free from interference from light and sound, maintaining the best sleep temperature (16℃-20℃), and not being too cold or too hot; Exercise regularly, but try not to exercise 3 hours before going to bed; Eat regularly, don’t go to bed on an empty stomach, eat a small amount of snacks before going to bed, but avoid too greasy or indigestible food; Avoid drinking alcohol, strong tea, coffee, smoking, etc. When you can’t sleep, don’t force yourself. You can help yourself to sleep by imagining relaxation, breathing relaxation, muscle relaxation, or listening to sleep-helping music before going to bed. Insomnia patients can eat Ziziphus jujuba seeds, lilies, longan, lotus seeds, propolis, etc. every day, all of which have the effect of relieving depression and calming the nerves. (Nanfang Daily reporter Yan Huifang)
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