![]() ![]() May be intermittent or continuous and can be experienced as a ringing, hissing, whistling, buzzing, or clicking sound and can vary in pitch from a low roar to a high squeal. Tinnitus: Abnormal noise perceived in one or both ears or in the head.Brain fog: When the brain is dedicating a great deal of energy to maintain equilibrium and stay steady, activities such as recalling details or short-term memory may become more difficult, and thinking might seem “slow”.Vertigo: A rotational, spinning component, and is the perception of movement, either of the self or surrounding objects.Imbalance: Unsteadiness or loss of equilibrium that is often accompanied by spatial disorientation.Dizziness: A sensation of lightheadedness, faintness, or unsteadiness. ![]() If the system is damaged by disease, aging, or injury, vestibular disorders can result, and are often associated with one or more of these symptoms, among others: Sleep restriction also may increase daytime sleepiness and make activities such as driving unsafe.The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. 17, 28 Sleep restriction therapy should be used with caution in patients with epilepsy, bipolar disorder, and parasomnias (e.g., sleepwalking) because it may worsen these disorders. Sleep restriction therapy has been shown to decrease sleep latency from 48 to 19 minutes 5 and is one of the more effective therapies, even when used alone. This calculation is repeated on a weekly basis. When sleep efficiency exceeds 90 percent, the patient’s time in bed is increased by 15 to 20 minutes. Sleep efficiency is calculated by dividing total sleep time by time spent in bed and multiplying by 100. Time in bed must not be less than five hours, and morning wake time should be held constant throughout treatment. Patients are asked to estimate their total time asleep by using sleep diaries, and to restrict their time in bed to the average estimated sleep time. Sleep restriction consists of limiting the time in bed to maximize sleep efficiency. Cognitive behavior therapy involves four to eight weekly sessions of 60 to 90 minutes each, and should be used more frequently as initial therapy for chronic insomnia. Relaxation therapies are techniques taught to patients to reduce high levels of arousal that interfere with sleep. Paradoxical intention seeks to remove the fear of sleep by advising the patient to remain awake. Sleep restriction therapy consists of limiting time in bed to maximize sleep efficiency. Stimulus control therapy helps patients to associate the bedroom with sleep and sex only, and not other wakeful activities. Sleep hygiene education teaches patients about good sleep habits. Cognitive psychotherapy involves identifying a patient’s dysfunctional beliefs about sleep, challenging their validity, and replacing them with more adaptive substitutes. Cognitive behavior therapy for insomnia has multiple components, including cognitive psychotherapy, sleep hygiene, stimulus control, sleep restriction, paradoxical intention, and relaxation therapy. Nonpharmacologic interventions have been studied and shown to produce reliable and sustained improvements in sleep patterns of patients with insomnia. It is a major cost to society in terms of health care expenditure and reduced productivity. Chronic insomnia is highly prevalent in our society, with an incidence of 10 to 30 percent. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |