Medicine: Ziziphus jujuba branch (even skin) 30g, Salvia miltiorrhiza 12g.

Usage: decoct in water 1~2 hours, take 1 time during lunch break and before going to bed at night, and take 1 dose daily.

Indications: used for insomnia and headache caused by blood stasis.

Efficacy: calming the heart and calming the nerves, promoting blood circulation and nourishing blood.

Folk prescription 2

Medicine: fried jujube kernel 10g, Ophiopogon japonicus 6g, Polygalae 3g.

Usage: decoct in water and take it before going to bed at night.

Indications: used for insomnia and other diseases.

Efficacy: nourishing yin, calming nerves, clearing heart and removing annoyance.

Folk prescription three

Drugs: salvia miltiorrhiza 15g, Schisandra 6g, polygala 3g.

Usage: decoct in water, and take it at noon and before going to bed at night 1 time.

Indications: Insomnia caused by insufficient heart blood.

Efficacy: calming the heart and calming the nerves, nourishing blood and nourishing yin.

Folk prescription 4

Medicine: cinnabar 0.6g, amber 0.9g. ..

Usage: grind the powder and swallow it before going to bed. Be careful not to take it too long.

Indications: Suitable for insomnia caused by anxiety.

Efficacy: soothe the nerves in important towns, calm the heart and soothe the nerves.

Folk prescription five

Medicine: Polygonum multiflorum Thunb. 10g, Radix Rehmanniae 10g and Radix Ophiopogonis 6g.

Usage: decoct in water, take it during lunch break and before going to bed at night 1 time.

Indications: insomnia caused by yin deficiency and excessive fire.

Efficacy: nourishing yin, calming nerves, clearing heart and removing annoyance.

Clinical manifestations of insomnia The clinical manifestations of insomnia patients mainly include the following aspects:

1. Sleep process disorder

It is difficult to fall asleep, the quality of sleep declines, and the sleep time decreases.

2. Daytime cognitive dysfunction

Memory function, attention function, planning function decline, leading to daytime sleepiness, work ability decline, and it is easy to appear daytime sleepiness when you stop working.

3. Dysfunction of limbic system and its peripheral autonomic nerves.

The cardiovascular system is characterized by chest tightness, palpitation, unstable blood pressure and peripheral vasodilation disorder; The digestive system is characterized by constipation or diarrhea and bloating; The motor system is characterized by neck and shoulder muscle tension, headache and low back pain. Emotional control ability declines, and it is easy to get angry or unhappy; Men are prone to impotence, and women often have sexual dysfunction.

4. Other system symptoms

It is prone to short-term weight loss, decreased immune function and endocrine dysfunction.

Drug treatment of special types of insomnia (1) Non-drug treatment is the first choice for elderly insomnia patients, such as sleep hygiene education, with special emphasis on receiving CBT-I (first-class recommendation). When the treatment of the primary disease can not alleviate the symptoms of insomnia or can not comply with non-drug treatment, drug treatment can be considered. It is suggested that elderly patients with insomnia should use non-BZDs (non-benzodiazepines) or melatonin receptor agonists (level II recommendation). Care should be taken when BZDs (benzodiazepines) must be used. If ataxia, confusion, abnormal movement, hallucination and respiratory depression occur, the drug should be stopped immediately and properly handled. At the same time, we should pay attention to accidental injuries such as falls caused by taking BZDs. The dosage of drug therapy for elderly patients should start from the minimum effective dosage, short-term application or intermittent treatment is not recommended, and adverse drug reactions should be closely observed during medication.

(2) Lack of information on the safety of sedative and hypnotic drugs used by pregnant women during pregnancy and lactation. Because zolpidem has no teratogenic effect in animal experiments, it can be taken for a short time if necessary (recommended by grade ⅳ). Care should be taken when using sedative-hypnotic drugs and antidepressants during lactation to avoid drugs affecting babies through breast milk. Non-drug intervention is recommended to treat insomnia (I-level recommendation). The existing experiments show that transcranial magnetic stimulation is a promising method to treat insomnia during pregnancy and lactation, but the exact effect needs further large-scale observation.

(3) Perimenopausal and menopausal patients For perimenopausal and menopausal women with insomnia, we should first identify and treat common diseases that affect sleep in this age group, such as depression, anxiety, sleep apnea syndrome, etc., and give necessary hormone replacement therapy according to symptoms and hormone levels. The insomnia symptoms of these patients are the same as those of ordinary adults.

(4) BZDs in patients with respiratory diseases should be used with caution in patients with chronic obstructive pulmonary disease (COPD) and sleep apnea hypopnea syndrome due to its adverse reactions such as respiratory depression. Non-BZDs receptors are highly selective, and the incidence of residual effects in the next morning is low. No reports of respiratory adverse reactions have been found in patients with stable COPD insomnia treated with zolpidem and zopiclone, but the efficacy of zaleplon in insomnia patients with respiratory diseases has not been determined.

Insomnia is the chief complaint of elderly patients with sleep apnea, and the number of patients complicated with sleep apnea is increasing. Zolpidem and other short-acting drugs can reduce the occurrence of central sleep apnea, and the application of noninvasive ventilator can improve compliance and reduce the possibility of inducing obstructive sleep apnea. BZDs is contraindicated in patients with acute exacerbation of COPD with obvious hypercapnia and decompensated restrictive ventilation dysfunction. If necessary, bzds can be used with mechanical ventilation support (invasive or non-invasive) and closely monitored. Melatonin receptor agonist Rameltone can be used to treat patients with sleep-disordered breathing accompanied by insomnia, but further research is needed.