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Management of Insomnia01:19

Management of Insomnia

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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
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Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
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Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
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Insomnia, Medicalization, and Expert Knowledge.

Kenton Kroker

    Canadian Bulletin of Medical History = Bulletin Canadien D'Histoire De La Medecine
    |November 8, 2021
    PubMed
    Summary
    This summary is machine-generated.

    Insomnia became a medical pathology in the 1870s. Its history is better understood as a boundary object, where patients and medical professionals shape its definition and treatment.

    Keywords:
    auto-expérimentationbiomedicinebiomédecinecognitive behavioural therapyinsomniainsomnieliterature and medicinelittérature et médecinemedicalizationmédecine du sommeilmédicalisationpsychologiepsychologyself-experimentationsleep medicinethérapie cognitivo-comportementale

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    Area of Science:

    • History of Medicine
    • Medical Sociology
    • Psychology

    Background:

    • Sleeplessness is a long-standing human experience.
    • Insomnia emerged as a distinct medical pathology around the 1870s.
    • Classical medicalization theories do not fully explain insomnia's history.

    Purpose of the Study:

    • To analyze the historical development of insomnia as a medical condition.
    • To explore the unique dynamics of insomnia's medicalization.
    • To understand the role of patients and medical experts in defining insomnia.

    Main Methods:

    • Historical analysis of medical and psychological literature.
    • Examination of public health interventions related to sleep.
    • Application of boundary object theory to understand medical concepts.

    Main Results:

    • Insomnia's pathological status arose in the late 19th century.
    • Patient self-diagnosis and authority challenge traditional medicalization models.
    • Insomnia functions as a boundary object, integrating biomedical and psychological perspectives.

    Conclusions:

    • The history of insomnia is characterized by patient agency, not solely medical authority.
    • Insomnia's definition evolves at the intersection of patient experience and medical/psychological frameworks.
    • Contemporary understandings of insomnia involve self-medicalization and self-experimentation.