Disorders of sleep and wakefulness

Disorders of sleep and wakefulness are expressed in two main forms: insomnia (see) and excessive sleepiness (hypersomnia). Hypersomnia are paroxysmal when sleep comes pristupoobrazna, and permanent, when there is a constant sleepiness. An example of paroxysmal hypersomnia, except for narcolepsy (see), is a periodic hibernation, which is followed by sleepiness comes sleep with decreased blood pressure, decreased muscle tone, a relaxation of the sphincter of the bladder. Patients unable to Wake up, they don't eat, urinate. Such an attack can last up to 3 days. In other cases, the attack periodic sleep can last much longer (up to 10 nights), but it is less difficult: patients can be awake for some time, they eat, and their physiological functions are not violated. In patients with periodic hibernation there are signs of injury (trauma, infection, etc.,) the hypothalamic-mesencephalic region.
Constant sleepiness is a result of the defeat of the hypothalamic-mesencephalic region infection (epidemic encephalitis), tumor intoxication. When hypersomnia patients without special work can get from sleep state using external influences, but by themselves they fall back to sleep.
Sometimes the permanent hypersomnia meet in asthenic syndrome or hysteria, in these cases, they do not usually combined with signs of organic lesions of the Central nervous system.
One of the types of disorders of sleep and wakefulness is a perversion of the rhythms of sleep that occurs most frequently in patients with severe cerebral arteriosclerosis, in the clinic of psychosis later age, sometimes after a previous neuroinfections. In patients with no specific time of sleep and waking, sleeping periods fall and at night and in the daytime. For cerebral arteriosclerosis within days short sleep periods interspersed with short periods of wakefulness.
Treatment and prevention of insomnia - see Insomnia.
Sleep disorders - excessive sleepiness, perverted rhythm sleep - you should refer the patient to a neurologist and under his instructions to conduct appropriate medical treatment.
Treatment of excessive sleepiness: treatment of the underlying disease (with tumors - operation and dehydrating, when infection - inflammatory, vitamin therapy). In mild cases give ascorbic and glutamic acid (0.5 g 3-4 times a day), calcium preparations. In more severe cases, using modern psihologicheskie drugs: iprase 0,025 grams in the morning or morning and afternoon, pratidin in the same doses (contraindicated in hypertension and epilepsy), melipramine 1 tablet in the morning, centerin 0.01 g in the morning. In the treatment of perverted rhythm sleep at people of elderly and senile age should be combined vasodilator drugs (papaverine, Dibazol, nicotinic acid 0.02 g 2-3 times a day) with weak stimulants (glutamine and ascorbic acid) and mild tranquilizers (motherwort, Valerian tea). Avoid barbiturates.
Prevention of excessive sleepiness is to prevent injuries and neuroinfections, leading sometimes to hypersomnia. Cm. also Lethargy.