Read the heart doctor’s words | Insomnia really needs to be checked

Insomnia patients know that insomnia can bring a lot of harm and pain, and also know that regular diagnosis and treatment is required. But many insomniacs understand that the treatment of insomnia is taking sleeping pills. In fact, for the diagnosis and treatment of sleep, we really have to do clinical examinations to clarify the severity of insomnia and find out the cause of insomnia.

What are the common clinical examinations for the symptom of “insomnia”?

The clinical examination of insomnia symptoms mainly includes the following three aspects:

The first is to assess the condition: qualitative and quantitative The severity of insomnia;

The second is to find the cause: clarify the cause of insomnia, make a differential diagnosis, and prescribe the right medicine;

Third Re-examination and evaluation: For patients who are re-examined, part of the examination results need to be re-examined to evaluate the curative effect and adjust the treatment plan if necessary.

1. Assessment of the condition

1. Assessment of sleep quality

< p>Pittsburgh Sleep Quality Index (PSQI): Evaluate sleep quality and severity. Different levels of insomnia have different quality plans. For example, patients with mild insomnia can be conditioned with traditional Chinese medicine. For moderate and severe insomnia, Western medicine and psychotherapy may be supplemented. Wait.

2. Assessment of accompanying symptoms

Cornell Medical Index Questionnaire (CMI): Insomnia as a physical and mental disease, It is often accompanied by emotional symptoms and other physical symptoms, such as anger, tension, depression and other emotions, as well as common somatic manifestations such as cardiovascular system, digestive system, eye and ear problems. The evaluation of accompanying symptoms helps clinicians make more accurate diagnosis, more accurate medication (Chinese and Western medicine), and helps patients alleviate disease troubles to a greater extent.

2. Find the cause

1. Mental and psychological Aspects

(1) Psychological examination: For insomnia caused by emotional problems, there are often stressful events, including acute stress and chronic stress, and the occurrence of stressful events Can lead to negative emotions and affect sleep.

(2) Psychological personality-related assessment: further screening and assessment are required according to the preliminary psychiatric examination results. Personality, relationship and environmental tests can better understand the causes of sleep problems in patients, and facilitate adjustment and treatment of the causes.

(3) Evaluation of emotional and mental disorders: quantitatively measure the degree of emotional fluctuations, which is convenient for the diagnosis of primary and secondary causes of insomnia.

2. Other checks

< p>Insomnia can be secondary to other medical diseases, or caused by the side effects of taking drugs (such as hormones), so clinically, it is necessary to clarify the past medical history or basic medical history and medication history. Clinicians will also conduct corresponding medical examinations based on clinical symptoms to rule out/confirm the diagnosis.

(1) Sleep breathing monitoring (PSG): Sleeping snoring, twitching of legs and feet during sleep, etc. can also lead to insomnia, PSG examination can confirm the diagnosis, Guide medication;

(2) Endocrine examination: endocrine diseases such as hyperthyroidism and menopausal syndrome can also cause insomnia symptoms, which need to be excluded or diagnosed;

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(3) Rheumatic immune diseases: commoncommon immune system diseases, due to the disorder of the neuroimmune mechanism In addition, this type of disease has the characteristics of long course, slow treatment and high recurrence, and it is easy to produce and accumulate negative emotions, which further aggravates the symptoms of insomnia; p>

(4) Cardiovascular system: such as blood pressure detection, ECG examination, etc. cardiovascularThere is a bidirectional effect between disease and sleep. Patients with myocardial infarction or coronary heart disease often have symptoms such as chest tightness, dizziness, and nausea that affect sleep at night;

(5) Nervous system: such as head CT , MR, etc. Various neuroses such as neurasthenia, cerebrovascular disease (95% have sleep disorders), brain trauma, brain degeneration, dementia, etc. are all risk factors for insomnia;

< span draggable="true">(6) Other laboratory tests: such as blood routine, biochemistry, etc. Anemia caused by excessive blood loss and iron deficiency can also cause insomnia. Electrolyte disturbances, such as arrhythmia caused by high or low potassium, twitching of hands and feet or joint pain caused by calcium deficiency, can also affect sleep;

(7) Monitoring of drug concentration: Evaluate drug efficacy and side effects to adjust drug regimen, etc.