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Understanding Sleep Disorders: A Closer Look at Insomnia and Sleep Quality
Many elders often complain about "insomnia" or poor sleep quality, collectively referred to as "sleep disorders" in clinical terms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by the American Psychiatric Association, sleep disorders are defined by two key criteria: persisting for a continuous period of one month or more and causing subjective fatigue, anxiety, or objective impairment in work efficiency and role functioning. If diagnosed by a specialist and after evaluating one's lifestyle needs, taking sedative-hypnotic medications prescribed by a physician may be appropriate.
"Why do I remember all the dreams I have at night? Does that mean my mind isn't getting enough rest?"
The body's sleep follows a cyclical pattern, with each cycle lasting approximately 70-110 minutes and divided into non-rapid eye movement (NREM) and rapid eye movement (REM) stages. NREM includes the stages of falling asleep, light sleep, and deep sleep, constituting about 80% of the sleep cycle. During this time, relaxation is at its peak, and if awakened, one may feel fatigued and unpleasant.
REM, constituting about 20% of the sleep cycle, is characterized by increased heart rate, breathing, and brain activity similar to wakefulness. Dreams often occur during this stage, and being awakened during a vivid dream can lead to experiences resembling "sleep paralysis" due to the body's temporary inability to move.
"In my younger days, I could sleep through the night, but now I wake up at 3 a.m. and can't fall back asleep..."
Each night, our sleep cycle may go through cycles of light sleep, deep sleep, NREM, and REM sleep, repeating 4-6 times. Contrary to common belief, the ideal sleep duration varies from person to person, decreasing with age. Older adults naturally sleep shorter periods and may wake more easily.
"I don't want to rely on sedative-hypnotic drugs; I'm afraid of becoming dependent and not being able to sleep without them..."
Complaints of "insomnia" include difficulty falling asleep, sleep interruptions, early awakening, and insufficient sleep. Adjusting sleep habits, reducing stress, minimizing stimulants affecting the brain (e.g., caffeine, nicotine, and alcohol), and addressing specific disease symptoms (e.g., arthritis pain, frequent urination) are beneficial. If these methods fail to improve sleep and persist for more than a month, affecting daily routines, professional medical intervention is necessary.
Physicians may prescribe sedative-hypnotic medications to help relax and induce sleep. Sleep aids generally fall into three categories:
1. Ramelteon (8mg): A melatonin receptor agonist that rapidly induces sleep, suitable for adjusting to time zone differences during travel or work.
2. Benzodiazepines (BZDs): Controlled substances, including Alprazolam (0.5mg), Estazolam (2mg), Clonazepam (0.5mg), Fludiazepam (0.25mg), with sedative-hypnotic, anxiolytic, muscle relaxant, and anticonvulsant effects. Some users may experience side effects like drowsiness, headache, and fatigue the following day.
3. Non-Benzodiazepines (Z-drugs): Also controlled substances, including Zolpidem (10mg), Zopiclone (7.5mg), Zaleplon (10mg), Eszopiclone (3mg), primarily used as sleep inducers for difficulty falling asleep. Users may experience sleepwalking behavior without subsequent recall, prompting immediate medical evaluation for medication continuation.
Remember, it's crucial to consult with a healthcare professional for proper diagnosis and guidance on sleep-related issues.
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