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CLINICAL PSYCHOPATHOLOGICAL FEATURES OF SLEEP DISORDERS
1
Tursunboyev Muxammadjon Shuxrat o‘g‘li
2
Yaxyayev Muxammadsobit Saidakbar o‘g‘li
3
Turayev Bobir Temirpulotovich
1-2
Student of group 532 of the medical faculty of Samarkand State Medical University,
Samarkand, Republic of Uzbekistan
3
Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State
Medical University, Samarkand, Republic of Uzbekistan
https://doi.org/10.5281/zenodo.14634321
Abstract. "Insomnia" is the most common sleep disorder and occurs when a person is
difficult to fall asleep or unable to continue sleeping even if they have enough time to fully sleep.
The causes, symptoms and intensity of insomnia in different people are different. Insomnia leads
to sleep disorders and causes some symptoms throughout the day. Insomnia can affect almost all
areas of life.
Key words: Insomnia, sleep disorders, dissomnia, clinical psychopathological features.
КЛИНИКО-ПСИХОПАТОЛОГИЧЕСКИЕ ОСОБЕННОСТИ НАРУШЕНИЙ СНА
Аннотация. "Бессонница" является наиболее распространенным нарушением сна и
возникает, когда человеку трудно заснуть или он не может продолжать спать, даже если
у него достаточно времени, чтобы полностью заснуть. Причины, симптомы и
интенсивность бессонницы у разных людей различны. Бессонница вызывает нарушения сна
и вызывает некоторые симптомы в течение дня. Недостаток сна может повлиять
практически на все сферы жизни.
Ключевые слова: Бессонница, нарушения сна, диссомния, клинические
психопатологические особенности.
Introduction.
Sleep disorders or insomnia (insomnia) are a common concept that includes
difficulty falling asleep, problems with falling asleep, and waking up too early. As a result, during
sleep, a person cannot fully restore strength and performance, which reduces the quality of life. To
one degree or another, sleep disorders are observed in almost half of the adult population, but only
in 9-15% of people this problem becomes clinically significant. In older people, chronic insomnia
is observed more often than in young people-in more than 55% of cases [1-5].
Depending on the cause of sleep disorders, primary and secondary insomnia are
distinguished.
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When diagnosed with primary insomnia, no organic, psychiatric or neurological causes of
sleep disorders are recorded. Secondary insomnia is the result of various diseases, taking
stimulants or any unfavorable external conditions.
Sleep disorders can be acute (transient), short-term (up to 6 months), and chronic (over six
months). Acute sleep disorders can occur in any person under the influence of stress,
overexcitation or changes in the time zone. Chronic insomnia develops in people prone to it.
Usually, this condition affects elderly patients, women, people who, for one reason or
another, sleep no more than 5 hours a day, as well as those who have not been at work for a long
time, who suffer from marital separation, psychological and mental injuries. chronic diseases [6-
9].
Possible causes of sleep disorders: difficulty falling asleep - the most common complaints
of patients. The desire for sleep that a person experiences before going to bed, but it disappears
when a person goes to bed under the influence of various factors. It can be unpleasant thoughts
and memories, discomfort in the legs, pain or itching, or inability to find a comfortable position
due to extraneous sounds. Mild drowsiness is disturbed even with the slightest noise, and
sometimes the sleeping person thinks that he "didn't sleep for a minute [10-14].
Problems with waking up in the early morning are observed in older people, people
suffering from depressive disorders and panic attacks. As a rule, sleep is stopped at 4-5 in the
morning and does not continue. Immediately after waking up, the patient notices a stream of
negative thoughts over them. In the morning and during the day, they complain of a "disturbed"
state, they have a decrease in performance and constant drowsiness [15-17].
Sleep can be defined as the state of the div's relative calm and external influences
characterized by a much greater increase in sensory perception compared to that during the
refreshment period, with a regular recurrence and easy retrograde.
Sleep in the norm is a periodic process, which consists of several successive stages:
Ye-sleep (from English — the rapid movement of autumns) or rapid sleep stage – TUB
this stage is observed with a high activity of the brain, which is close to refreshment, in contrast to
other periods of sleep. At night, 4-5 periods of Ye sleep are observed, with a total time of 1.5-2
hours. The deepest and most peaceful sleep (delta-sleep) falls on the first hours. In the norm, sleep
passes in 4 stages. EEG results are used in the definition of sleep stages [18-21].
Trigger in EEG-the frequency of waves in 1 second fluctuated from 8 to 12 and has a
mixed, low amplitude frequency.
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Phase I is the superficial stage of sleep and has a low amplitude, 3-7 vibrational frequency
at 1 second, regular activity.
Phase II-Eegda K — complex is a three-phase wave complex with a frequency of 12-14
oscillations per second (“sleep urchins”).
Phase III-delta waves, with high amplitude activity, oscillate 0.5-2.5 times per 1 second
(50% of the total length of EEG).
Phase IV-delta waves account for 50% or more of the total length of the curve (phases III
and IV are the "slow sleep" phase).
In the Ye stage, the EEG has the appearance of a sawtooth, in which waves are similar to
those in the sleeping position.
An average of 15-20 minutes is required for a person to fall asleep. In the next 45 minutes,
stage III and IV of sleep (too deep sleep) begins. Then, after 45 minutes, after Phase IV, period I
— the period of rapid movement of the eyeball — the REM phase is observed, lasting an average
of 90 minutes. During the night, each subsequent REM phase is longer than the previous one, with
sleep becoming more and more superficial and accompanied by dreaming. (The fast sleep phase
is qualitatively another type of sleep, characterized by high brain activity that is close to
refreshment) [22-26].
Usually, during human aging, there is an increase in night awakenings, the time of night
sleep changes, a lot of time is spent falling asleep, sleep dissatisfaction occurs, daytime drowsiness
and a lot of sleep are observed.
The function of Normal sleep is to control the div's regenerative functions.
Need for sleep. It is not for nothing that most people assess the ability to sleep peacefully
and wake up peacefully as the highest pleasure of life. A portion of the Daily 6-hour sleep is normal
for humans. These people are usually curious, hardworking, conscious, adapted to life and sociable
to activities. Some people require more than 9 hours of sleep per day. They are relatively
depressive, anxious, and humane. Increased need for sleep is mainly observed in strong tension,
pregnancy, emotional tension. At the age of deafness, the extensibility of the uyku decreases [27-
31].
Dissomnias include:
insomnia, difficulty sleeping, hypersomnia — excessive sleepiness
or daytime drowsiness, sleep – impaired refreshment cycle.
Parasomnias include those in it: sleepwalking, talking during sleep, disorders such as
nightmares.
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Dissomnias:
insomnia (insomnia). it is short-lived or stagnant, as a result of which intense
fatigue, tightness in daylight, a decrease in work activity are characteristic.
The diagnostic criteria for MKB-10GA kura, insomnia (inorganic nature) are:
-difficulty sleeping, difficulty maintaining sleep, or poor quality of sleep;
-systemic Sleep Disorders (at least 3 times a week for 1 month);
-the patient is disturbed not only by insomnia at night, but also by its daytime
consequences;
-this is the anguish of the condition and, as a result, a decrease in work activity and social
ability.
Short-term insomnia is often an alarming condition, loss in life y, a connection with the
reaction to acute changes. But the doctor should remember that acute psychosis or depression can
begin with poor sleep. Often insomnia is considered one of the first signs of mental illness. Severe
unipolar depression is characterized by a normal onset of sleep, but repeated waking up and
insisting very early in the morning. Depressive states are accompanied by “sleep sensation” colic.
Despite the fact that the patient slept objectively, it confirms that “his brain does not sleep,
continues to work” [32-36] .
Bipolar depression, along with insomnia, can cause hypersomnia. Maniacal patients
usually sleep little, wear their sleep and wake up refreshed after 2-4 hours of sleep.
Stagnant insomnia can be observed after undergoing encephalitis or after prolonged
administration of psychostimulants and other drugs (antimetabolites, cytostatics, thyroid drugs,
oral contraceptives, blockers, MAO inhibitors) for a long time. Insomnia caused by taking
morphine series drug substances, heroin, alcohol is especially severe and prolonged. In neuroses,
dress usually sleep and wake up with difficulty in the morning typical. Patients with cranial conic
vascular diseases experience mild evening sleepiness and “night-time trigger performance”. One
of the first signs of psychotic disorders is imsomnia, manifested by the anxiety and fear affect.
Somatic disorders, usually observed with insomnia, are associated with pain, anguish and the
individual's reaction to illness and changes in social status. In some patients, worrying about sleep
disorders can turn into an extremely valuable-hypochondriac appearance. Agripnophobia-that is,
a capricious fear of insomnia occurs. It is usually accompanied by anxiously waiting for sleep,
increasing demand for those around it and creating special conditions for sleep. Sometimes these
phobias take the appearance of fear of death during sleep, and patients meet the night as if waiting
for the arrival of the executioner, force themselves to walk, study, occupy uncomfortable positions,
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by which they try to "stick" to heart attacks (in cardiophobia), bleeding and other phenomena [37-
41].
Hypersomnia.
2 groups consist of signs: long sleep and complaints of excessive
drowsiness (somnolence) during the day. These patients tend to fall asleep suddenly in a state of
trigger. Somnolence may be associated with menstrual cycle, acquired encephalitis, alcohol intake,
stimulant cancellation syndrome. The conditions that most often call somnolence are sleep apnea
and narcolepsy. Excessive drowsiness during the day is observed at the initial stage of most
depressive disorders. It can be associated with physical illness and pronounced asthenia [42-46].
Parasomnias.A disturbance in the form of sleepwalks is somnambulism. Starting in the first
third of the night, the patient gets out of place, walks in an unconscious state, followed by amnesia
relative to this time. The patient has "meaningless seizures" that cannot enter into communication,
has no response to external influences, wakes up with difficulty, is sometimes observed with
periods of spontaneous fainting for several minutes. It is often 6-12 years old, more common in
males than females. 15% occurs in children, as an episodic condition.
Talk in his sleep.
In children, as in adults, it occurs at all stages of sleep and is sometimes
observed against the background of anxious dreaming.
Disorders in the form of night terrors and anxious dreaming. It is usually observed in the
previous third of the sleep period with panic screams and subsequent symptoms of sudden
awakening, intense anxiety and vegetative activation. Characteristic is the absence of reactions to
a few minutes of whining, deorientation, calming after waking up. There is no memory of the
dream, or fragmented [47-50].
When it comes to treating sleep disorders, we must show a clear differential-nosological
approach, taking into account the characteristics of the premorbid of the personality of each
patient.
In sleep disorders with neurotic Genesis, phytotranquilizers are used: pusternik, valeriana,
mint, etc. Calming assemblies can be used. They ”avoid everyday stress". Eliminates tension in
the evening and prepares for sleep, but cannot lose the REM phase of sleep.
Compared to Phytotherapy
in the framework of neuroses and neurosis conditions, it is
advisable to use tranquilizers in disorders of rather turgunous and tolerant sleep: phenazepam,
relaxorm, radedorm, rogipnol and others. But as a result of prolonged, irreplaceable and interval-
free use of these drugs, the patient develops drug dependence, which can turn into a toxicoman.
The new drug substance imovan has a number of advantages.
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Antidepressants of a sedative nature are used in depression – amitriptillin, lerivon, triptizol.
In hypomania observed with sleep disorders, it is recommended to use lithium salts in combination
with aminazine, galoperidol. In patients with schizophrenia, the use of tizersin, leponex is
recommended. In insomnia in MNS organic disorder, it is recommended to use tranquilizers, in
combination with vegetotropic drugs (bellataminal) and normotimics (carbomazepine), in the form
of epileptiform – antilepsin.
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