Struggling with Insomnia and Autonomic Nervous System Disorders - Psychiatry

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Insomnia, autonomic nervous system dysfunction?


Hello Doctor: I have had trouble sleeping since middle school, and it has become increasingly difficult now that I am in college.
At night, my body tends to twitch while I sleep.
In September, I experienced a whole night of insomnia and consulted a family physician who prescribed medication, but the doctor advised me to take it only if I couldn't sleep.
I was able to sleep in September, but by early December, my sleep worsened.
Therefore, I sought help from a nearby psychiatrist, who diagnosed me with anxiety disorder, autonomic nervous system dysregulation, insomnia, and neurasthenia.
The doctor prescribed me JEXIT S.C.
Tablets 0.5 mg and U-chi Aprazo 0.5 mg.
I take them every night, but I still wake up around 3 or 4 AM, and after waking up at around 6 AM, I can't fall back asleep, which is very distressing.
I try to take a nap in the afternoon, but I still can't sleep.
Is the medication not strong enough? I have been exercising, but my sleep issues persist.
Are there any other methods I can try to improve my sleep? Thank you, Doctor.

L, 20~29 year old female. Ask Date: 2018/12/26

Dr. Li Zhengfeng reply Psychiatry


Hello: The causes of insomnia can be categorized into three main types: 1.
Caused by mental disorders, 2.
Caused by physical illnesses, 3.
Due to individual constitution.
For insomnia caused by mental disorders, both pharmacological and non-pharmacological treatments can be utilized.
Non-pharmacological treatments include psychotherapy and activity therapy.
Pharmacological treatment may be adjusted based on the situation, and it is advisable to discuss medication adjustments with your physician to aid in your recovery.

Reply Date: 2018/12/26

More Info


Struggling with insomnia and autonomic nervous system disorders can be a challenging experience, especially when it affects your daily life and mental well-being. It sounds like you've been dealing with significant sleep issues for quite some time, and it's understandable that you're feeling frustrated and exhausted. Let's break down your situation and explore some potential strategies for improvement.

First, it's important to recognize that insomnia can be influenced by various factors, including anxiety, stress, and autonomic nervous system dysregulation. The autonomic nervous system (ANS) controls involuntary bodily functions, such as heart rate, digestion, and respiratory rate. When the ANS is out of balance, it can lead to physical symptoms like restlessness, muscle tension, and sleep disturbances. Anxiety, on the other hand, can exacerbate these symptoms, creating a cycle that makes it even harder to sleep.

You mentioned that you have been prescribed medications such as JEXIT (a benzodiazepine) and U-chi Aprazo (an anxiolytic). While these medications can be effective for managing anxiety and promoting sleep, they may not always provide the desired results for everyone. It's not uncommon for individuals to experience partial relief or to wake up during the night, as you've described. This could be due to several reasons, including the dosage, the specific medication, or even the underlying anxiety and stress that may still be present.

Here are some strategies that may help improve your sleep quality and overall well-being:
1. Sleep Hygiene: Establishing a consistent sleep routine is crucial. Try to go to bed and wake up at the same time every day, even on weekends. Create a relaxing bedtime ritual, such as reading a book or practicing deep breathing exercises, to signal to your body that it's time to wind down.

2. Limit Stimulants: Avoid caffeine and nicotine, especially in the afternoon and evening. These substances can interfere with your ability to fall asleep and stay asleep.

3. Create a Comfortable Sleep Environment: Ensure your bedroom is conducive to sleep. This includes a comfortable mattress and pillows, a cool room temperature, and minimal noise and light. Consider using blackout curtains or a white noise machine if necessary.

4. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation, yoga, or progressive muscle relaxation, can help reduce anxiety and promote relaxation before bedtime. These techniques can help calm your mind and prepare your body for sleep.

5. Physical Activity: Regular exercise can significantly improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week, but try to avoid vigorous workouts close to bedtime, as they may energize you instead.

6. Limit Naps: While it may be tempting to nap during the day, especially if you're feeling fatigued, long or irregular napping can negatively impact your nighttime sleep. If you do nap, try to keep it short (20-30 minutes) and earlier in the day.

7. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a structured program that helps individuals address the thoughts and behaviors that contribute to insomnia. It has been shown to be effective for many people struggling with sleep issues.

8. Consult Your Doctor: If you continue to experience difficulties despite trying these strategies, it may be worthwhile to discuss your medication with your healthcare provider. They may consider adjusting the dosage or exploring alternative medications that may be more effective for your specific situation.

9. Seek Professional Support: Since you've been diagnosed with anxiety and autonomic nervous system dysregulation, working with a mental health professional can provide additional support. Therapy can help you develop coping strategies for managing anxiety and stress, which may, in turn, improve your sleep.

In conclusion, managing insomnia and autonomic nervous system disorders often requires a multifaceted approach. By combining medication, lifestyle changes, and therapeutic interventions, you can work towards achieving better sleep and overall well-being. Remember, it's essential to be patient with yourself as you navigate this journey, and don't hesitate to reach out for support when needed.

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