Mất ngủ: Bệnh thường gặp - Khó điều trị

 Phần 1. Mất ngủ - Căn bệnh của thời đại

Mất ngủ là tình trạng giảm sút về thời gian độ sâu hoặc hiệu quả phục hồi của giấc ngủ.

Bệnh có thể gặp ở mọi lứa tuổi nữ nhiều hơn nam người cao tuổi nhiều hơn người trẻ. Ở người trẻ thường hay than phiền khó đi vào giấc ngủ trong khi ở người trung cao tuổi thường hay than phiền khó giữ giấc ngủ và hay dậy sớm. Trong thời gian gần đây mất ngủ ở người trẻ tuổi có xu hướng tăng cao.

Mất ngủ có nhiều dạng như khó đi vào giấc ngủ ngủ không yên giấc dậy sớm không ngủ lại được hoặc tỉnh dậy nhiều lần trong khi ngủ.

Chúng ta ngủ khoảng 1/3 cuộc đời. Giấc ngủ chiếm nhiều thời giờ nhất của cuộc sống nhiều hơn tất cả mọi hoạt động khác và là một bí mật vô cùng tận về con người. Trung bình người lớn độ tuổi lao động cần ngủ 7-8 giờ mỗi ngày trẻ em cần khoảng 9-10 giờ hoặc hơn (tuổi càng nhỏ thời gian ngủ càng nhiều) và người già 5-6 giờ.

Tỉ lệ mất ngủ có thể từ 4 cho tới 48%. Khoảng 33% dân số bị một trong nhiều triệu chứng của mất ngủ 15% bị ngầy ngật vào ban ngày 18% không thoả mãn với giấc ngủ 30% bệnh mất ngủ có liện hệ bệnh tâm thần. Cảm giác không có được giấc ngủ thoải mái rất phổ biến gặp ở 20 - 50% dân số tại các quốc gia khác nhau.

Mất ngủ kéo dài sẽ dẫn đến giảm trí nhớ khó tập trung chú ý giảm sút khả năng lao động và hậu quả tất yếu là giảm tính tích cực trong cuộc sống hiệu quả lao động thấp và làm giảm chất lượng sống. Ngoài ra mất ngủ còn có nguy cơ phát sinh một số bệnh hoặc làm nặng thêm bệnh đang mắc.

Bệnh mất ngủ đang ngày càng gia tăng theo chiều hướng phát triển của xã hội. Do áp lực lớn của xã hội công nghiệp làm cho điều kiện sống thay đổi trong đó môi trường sống và do kinh tế buộc con người phải căng thẳng quá mức với những bức xúc về xã hội công việc khủng hoảng tâm lý tình cảm stress mạnh hoặc có những vấn đề rắc rối mà họ không thể vượt qua được.

Tiếc thay bệnh mất ngủ không được nhận diện chẩn đoán xác thực để tránh nguy hại và được giúp đỡ đúng mức có lợi cho thể xác và tinh thần.

Phần 2. Tại sao bạn bị mất ngủ?

Có 3 nguyên nhân chính dẫn đến tình trạng mất ngủ:

Một là do các bệnh về nội ngoại khoa như đau dạ dày sau phẫu thuật cao huyết áp bệnh tiểu đường bệnh đường hô hấp...). Đây là mất ngủ nhất thời chỉ cần uống thuốc an thần tại thời điểm đó khi bệnh được điều trị khỏi thì giấc ngủ sẽ trở lại bình thường.

Ở những người cao tuổi đau là nguyên nhân nổi bật gây ảnh hưởng đến giấc ngủ phổ biến nhất là các bệnh cơ xương khớp như thoái hóa khớp loãng xương... có đặc điểm là đau tăng lên về nửa đêm gần sáng làm cho bệnh nhân bị tỉnh giấc và sau đó rất khó ngủ tiếp. Các bệnh lý khác bao gồm bệnh thiếu máu cơ tim gây đau ngực hiện tượng hay tiểu đêm (như u xơ tiền liệt tuyến) hoặc khó thở (do suy tim viêm phế quản hen phế quản)...

Hai là do rối loạn tâm thần như trầm cảm loạn thần hoang tưởng bệnh nhân phải dùng thuốc an thần kinh chống trầm cảm.

Nguyên nhân thứ 3 phổ biến nhất: Do "stress" - Mất ngủ do tâm sinh lý rối loạn.

Dạng mất ngủ này thường xảy ra do xúc cảm buồn chán thất vọng thất bại trong công việc căng thẳng lo âu xung đột trong gia đình xã hội... Nhiều bệnh nhân mất ngủ do tâm sinh lý dùng thuốc ngủ lúc đầu có hiệu quả nhưng sau đó gặp rắc rối vì nghiện thuốc và tương tác với rượu. Khi bệnh trở thành mạn tính dù dùng thuốc họ cũng ít khi ngủ được và trạng thái bệnh lý sẽ trầm trọng thêm. Ngoài ra một số nguyên nhân khác cũng thường gặp như:

- Mất ngủ do dùng một số thuốc để chữa bệnh như: Lạm dụng thuốc ngủ thuốc an thần nên hệ thần kinh trung ương suy yếu gây hội chứng mất ngủ. Loại thuốc thường gây ra tình trạng này là barbituric benzodiazepin (Seduxen). Ngoài ra một số thuốc khác cũng gây mất ngủ như corticoid nội tiết tố tuyến giáp thuốc điều trị tăng huyết áp bệnh thần kinh và ngay cả một số thuốc dùng để điều trị bệnh trầm cảm.

- Một số chất tuy không hẳn là thuốc nhưng mọi người lại hay dùng và rất dễ gây mất ngủ như rượu caffeine (có trong chè cà phê) nicotine (có trong thuốc lá). Uống rượu nhiều và kéo dài sẽ gây rối loạn giấc ngủ nặng. Thời gian ngủ rút ngắn đêm thường thức giấc. Giai đoạn dỗ giấc ngủ khó và lâu. Khi đã ngủ thường xuất hiện các đợt giật mình cảm giác hoảng sợ tim hồi hộp.

- Vào tuổi mãn kinh phụ nữ bị bệnh mất ngủ tăng gấp 5 lần (triệu chứng là nóng nhiệt khó chịu và khi ngủ thở khó khăn).

- Sinh hoạt thường ngày không chừng mực làm nhiều việc không hoạt động thể dục có thể làm chứng bệnh mất ngủ nặng hơn.

Các chuyên gia về sức khỏe khuyên rằng khi bị mất ngủ bệnh nhân đừng vội uống thuốc ngủ mà hãy đến bác sĩ để tìm nguyên nhân. Với mỗi nguyên nhân gây bệnh thầy thuốc sẽ có cách điều trị khác nhau.

Phần 3. Bạn nên làm gì khi bị mất ngủ:

Mấu chốt để điều trị mất ngủ là phải tìm được nguyên nhân gây bệnh. Liệu pháp tâm lý có vai trò rất quan trọng trong điều trị mất ngủ.

Ðể định bệnh mất ngủ người bệnh cần nói rõ về giấc ngủ các bệnh đang được chữa trị các thuốc đang sử dụng những thói quen liên quan đến giấc ngủ cách sinh sống nghề nghiệp phương cách giải trí (thuốc lá cà phê rượu…)

Để có giấc ngủ ngon bạn có thể tham khảo những lời khuyên sau:

1. Không dùng chất caffein sau 2 giờ chiều như trà café CocaCola Chocolate.

2. Không ăn quá nhiều trước khi ngủ.

3. Không uống rượu vào buổi tối.

4. Không nên chợp giấc trừ khi bạn tạo ra một thói quen như thế (ví dụ ngủ trưa).

5. Không nên hút thuốc lá gần giờ ngủ hoặc trong đêm.

6. Không dùng thuốc ngủ trừ khi có chỉ định của bác sĩ.

7. Không uống nước quá nhiều vào buổi tối.

8. Không nên vận động mạnh trước khi ngủ. Tập thể dục buổi sáng hoặc buổi trưa không nên tập thể dục nhiều vào buổi chiều tối.

9. Phòng ngủ yên tĩnh tối và nhiệt độ vừa phải. Không nên nhập phòng ngủ với phòng đọc sách phòng học làm việc hoặc ti vi.

10. Cố gắng tạo một thời khóa biểu tốt đi ngủ và thức dậy điều độ đúng giờ.

11. Thư giãn. Khi có việc căng thẳng luyện tập những bước thư giãn nhằm thoải mái hơn để dễ dàng đi vào giấc ngủ.

12. Ngâm chân vào nước nóng 5 phút trước khi ngủ massage bàn chân.

13. Loại thức ăn có thể làm giảm chứng mất ngủ như chuối hạt hướng dương hay hạt vừng rất giàu magiê - chất khiến cơ bắp được thư giãn. Tăng magiê trong cơ thể bạn có thể tránh chứng co rút cơ bắp hay những cơn giật mình làm bạn tỉnh giấc.

14. Vitamin tổng hợp và vitamin nhóm B có thể hữu ích.

Và cuối cùng khi vào giường ngủ bạn hãy “Quẳng gánh lo đi và vui sống”. Hãy quên hết mọi chuyện ưu phiền những tính toán lo toan thường ngày để bước vào một giấc ngủ đích thực. Chất lượng sống của bạn bắt đầu bằng giấc ngủ và đem lại hiệu quả vào buổi sáng hôm sau.

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