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insomnia, abnormal wakefulness or inability to sleep. The condition may result from illness or physical discomfort, or it may be caused by stimulants such as coffee or drugs. However, frequently some psychological factor, such as worry or tension, is the cause. Mild insomnia may often be relieved by a soothing activity like reading or listening to soft music. Chronic or severe insomnia requires treatment of the underlying physical or psychological disorder. In a few, very rare cases, individuals in certain families are subject to an incurable inherited insomia caused by prions that form plaques in the thalamus; the disease appears suddenly in adulthood and ultimately is fatal.
Many patients respond to the assurance that their sleeplessness is a result of normal anxieties or a treatable physical disorder. Opportunities to ventilate anxieties often ease distress and helps resume normal sleeping patterns. Elderly persons are encourage to exercise more during the day; instructed relaxation, administration of tryptophan, and intake of warm milk helps some patients sleep. Sedatives and hypnotics drugs may be employed if the sleeplessness is impairing the subject's sense of well being. Those who wake because of pain receive an analgesic at bedtime; for those who experience insomnia accompanied with depression, an antidepressant often suffices.
(also agrypnia), disturbed sleep. Insomnia manifests itself as a shortening of the period of nocturnal sleep, delay in onset of sleep, early awakening, and repeated interruption of sleep during the night. Sleep is also impaired qualitatively; it becomes more superficial, the length of deep sleep is diminished, and the balance between dream-sleep and dreamless sleep is upset. Insomnia occurs in cases of neurosis, certain cardiovascular and psychological illnesses, neuro infections, and injury to those parts of the brain that regulate the correct alternation of sleep and wakefulness. In healthy people, it may occur after great physical or mental stress, fatigue, strong emotional experiences, and similar instances. The total absence of nocturnal or daytime sleep for long durations almost never occurs.
Treatment involves adherence to the correct regimen of work and rest, the elimination of irritating factors, bathing, and exercise. The patient may be prescribed tranquilizers and, in cases of persistent insomnia, soporifics. In cases of insomnia caused by illness, treatment consists in eliminating the original illness responsible for the insomnia.
REFERENCESPervov, L. G. Son i ego narushenie, Moscow, 1965.
Fedotov, D. D. Son i ego rasstroistvo. Moscow, 1966.
V. S. ROTENBERG