Drowsiness is one of the types of sleep disorders, which is characterized by a constant or periodic desire to fall asleep at inappropriate times, for example, during the day at work or on transport. Such a disorder is similar - a person's retribution for a wrong way of life. A large amount of daily information and important things, which increases every day, not only leads to increased fatigue, but also reduces the time allotted for sleep.

There are a great many reasons for the appearance of constant drowsiness, but mostly it is a banal lack of time, and from a medical point of view, diseases of the nervous and cardiovascular systems... Very often, this condition accompanies women in early pregnancy. The main symptoms in this case are the slowness of the reaction.

Such a violation occurs in many diseases, which is why it plays an important role in the diagnosis of some of them, for example, in traumatic brain injuries. Often, drowsiness can also occur during late pregnancy.

Etiology

As mentioned above, increased sleepiness can occur at any time, even during the day, against the background of a wide range of factors, divided into several groups. The first includes those causes of drowsiness that are not associated with pathologies or diseases of internal organs:

• taking medications and pills, side effect which are drowsiness, fatigue and dizziness. Therefore, before starting treatment with such medicines, you must read the instructions;
• lack of sunlight - oddly enough, it can cause this sleep disorder, because the sun's rays contribute to the release of vitamin D in the body, which is necessary for its well-coordinated work;
• overwork, not only physical, but also mental or emotional;
• the influence of electromagnetic radiation. For example, if a person lives in the vicinity of television towers or cellular stations;
• eating a lot of foods can cause drowsiness during the day, but if you overeat at night, it will cause insomnia;
• prolonged eye strain - during long-term work at the computer or watching TV;
• there is insufficient air in the living or working space, therefore it is recommended to ventilate it regularly;
• vegetarianism;
• excessively high body weight;
• overexertion of auditory receptors, for example, noise at work;
• irrational sleep patterns. Normally, a person should sleep eight hours a day, and pregnant women - up to ten;
• the body's response to stressful situations.

Constant sleepiness can be caused by various disorders and diseases, which make up the second group of factors:

• lack of iron in the body;
• lower blood pressure permissible norm;
• functional disorder thyroid gland, in case of removing one or both of its halves;
• and the body;
• repeated cessation of breathing during sleep - apnea;
• - in which a person falls asleep for a few minutes, and without feeling tired;
• wide range traumatic brain injury;
• violation of the central nervous system;
• Klein-Levin diseases - during which a person falls asleep at any time, even during the day, and can sleep for several hours or several months;
• chronic inflammation or infectious diseases;
• decrease in blood levels and;
• insufficient oxygen supply to the brain;
• hypersomnia - this pathological condition is characterized by a strong decrease in the period of a person's wakefulness, accompanied by constant fatigue. In these cases, a person can sleep up to fourteen hours a day. Quite often occurs with mental illness;
• chronic nature;
• liver and kidney disease;
• the influence of microorganisms, bacteria, fungi and helminths;
• oncological neoplasms;
• nervous exhaustion.

Sleepiness during pregnancy should be considered as a separate cause, because it occurs at a certain period of a woman's life - in the early, less often in later stages of pregnancy (passes after the birth of the baby). Drowsiness and fatigue in this case are absolutely normal conditions, because the fairer sex is experiencing changes in the functioning of some internal organs and systems. If a woman is dizzy and weak, it is best to lie down for a few minutes.

Increased sleepiness in babies under the age of one year is due to the underdevelopment of the nervous system. Therefore, it is quite normal for babies to sleep between eleven and eighteen hours a day. The causes of drowsiness in children of primary and school age are explained by a combination of the above factors. Weakness and drowsiness in elderly people is quite a natural phenomenon, because all processes in the body begin to slow down. Also, this condition is facilitated by the presence chronic diseases.

Varieties

In medical practice, the following classification of drowsiness is used, expressed in the following forms:

• light - a person suppresses sleep and fatigue in order to continue to perform work duties, but he begins to fall asleep when the stimulus for wakefulness disappears;
• moderate - a person falls asleep even when doing work. This entails social problems. Such people are not recommended to drive a car;
• heavy - a person cannot remain active. It is affected by severe fatigue and dizziness. The motivating factors do not matter to him, so they often get work injuries and become the culprits of road accidents.

For people with constant sleepiness, it does not matter when to fall asleep, sleep can occur not only at night, but also during the day.

Symptoms

Increased sleepiness in children and adults is accompanied by various symptoms... Thus, in adults and the elderly, the following are observed:

• constant weakness and fatigue;
• attacks of severe dizziness;
• lethargy and distraction of attention;
• decreased ability to work;
• memory impairment;
• loss of consciousness, but in very rare cases. Dizziness often precedes this state, therefore, at its first manifestations, it is necessary to sit down or take a lying position.

For children and infants, drowsiness or constant sleep is the norm, but when following symptoms you need to seek help from a doctor:

• frequent gagging;
• increased body temperature;
• diarrhea or lack of fecal discharge;
• general weakness and lethargy;
• the child has stopped breastfeeding or refuses to eat;
• the acquisition of a bluish tint by the skin;
• the baby does not respond to the touch or voices of the parents.

Diagnostics

In order to diagnose sleep disorders, which include increased drowsiness, polysomnography is necessary. It is carried out as follows - the patient is left overnight in the hospital, several sensors are attached to him, which record the work of the brain, respiratory system and heart rate... It is especially important to carry out such an examination if the doctor suspects that the patient has apnea, that is, the person stops breathing during sleep - the attacks are not long-lasting, but they recur quite often. This method is not publicly available, therefore it is carried out only if the specialist has not been able to find out the causes of drowsiness and constant fatigue in other ways.

In order to exclude or confirm the occurrence of sleep disorders due to diseases or infectious processes, the patient needs to contact a therapist who will conduct examinations, and if necessary, appoint additional consultations from specialists such as the necessary laboratory or apparatus examinations of the patient.

In addition, the observation of how a person falls asleep is carried out, namely, the determination of the time it takes him to fall asleep. If the previous examination is carried out at night, then this one is carried out during the day. The patient is given the opportunity to fall asleep five times, in each of which the doctors wait until sleep enters the second phase - if this does not occur twenty minutes after the person fell asleep, they wake him up and determine the time it takes to repeat this process. This procedure will help determine the form of drowsiness and give a reason for the doctor to prescribe the most effective treatment.

Treatment

There are several ways to get rid of drowsiness, which differ depending on what were the causes of the occurrence. Therapy for each patient is assigned individually.

If this process has caused a disease or an inflammatory process, it is necessary to eliminate it. For example, at low blood pressure will help medicines vegetable origin- Eleutherococcus or ginseng. Preparations or tablets high in these elements can prevent daytime sleepiness. If the cause becomes, the patient will be helped by a complex of vitamins and minerals (with a high concentration of iron). With insufficient oxygen supply to the brain the best remedy there will be a rejection of nicotine and therapy of vascular pathologies, which may be the cause of such a process. In cases where disorders of the nervous system, traumatic brain injury, heart problems and others have become a factor of expression internal organs, therapy is carried out by a doctor of a narrow specialty.

It is worth paying more attention to the selection of medications if drowsiness manifests itself during pregnancy or in infants, because not all medications can be taken by such groups of patients.

Prophylaxis

Since in most cases drowsiness and typical fatigue and dizziness appear due to completely harmless reasons, you can take preventive measures yourself, with the help of:

• a rational sleep pattern. A healthy adult should sleep at least eight hours a day, and children preschool age and women during pregnancy - up to ten hours. It is best to go to bed and wake up every day at the same time;
• walks in the fresh air;
• daytime sleep, unless, of course, it will harm work or training;
• regular moderate physical activity;
• adherence to a healthy lifestyle. It is worth giving up drinking alcoholic beverages, smoking and narcotic substances;
• studying instructions for medicines;
• healthy eating... Should be consumed more fresh vegetables and fruits, as well as enrich the diet with vitamins and nutrients. Reduce food intake from high content carbohydrates;
• sufficient fluid intake. On average, a person needs two or more liters of water per day;
• restrictions on coffee intake, as the drink can cause drowsiness after a short wakefulness. It is best to replace coffee with weak green tea;
• passing a preventive examination in medical institution several times a year, which will help prevent the development of infectious and inflammatory processes causing this sleep disorder, fatigue and dizziness.

Throughout life, the question of how a person dies of old age is of concern to most people. They are given by the relatives of the old person, the person himself who has crossed the threshold of old age. The answer to this question already exists. Scientists, physicians and enthusiasts have collected a bunch of information about this, based on the experience of numerous observations.
What happens to a person before death

Aging is not believed to lead to death, given that old age itself is a disease. A person dies from a disease that a worn-out body cannot cope with.

Brain reaction before death

During death, irreversible changes take place in the brain. Oxygen starvation, cerebral hypoxia occurs. As a consequence of this, there is a rapid death of neurons. At the same time, even at this moment, its activity is observed, but in the most important areas responsible for survival. During the death of neurons and brain cells, a person can experience hallucinations, both visual, auditory and tactile.

Loss of energy

An elderly dying person experiences a loss of energy potential. This is manifested by longer sleep and shorter wakefulness. He constantly wants to sleep. Simple actions, such as moving around the room, exhaust the person and he will soon go to bed for a break. It seems that he is constantly sleepy or in a state of permanent drowsiness. Some people even experience energy depletion after simple communication or reflection. This is explained by the fact that the brain requires more energy than the body.

Malfunction of all body systems

• The kidneys gradually refuse to work, so the urine secreted by them turns brown or red.
• The intestines also stop working, which is manifested by constipation or absolute intestinal obstruction.
• The respiratory system fails, breathing becomes intermittent. It is also associated with the gradual failure of the heart.
• Function failure circulatory system leads to pallor of the skin. Wandering dark spots... The first such spots are visible first on the feet, then on the whole body.
• Hands and feet become icy.

How does a person feel at death?

Most often, people are concerned not even with how the body manifests itself before death, but with what the old person feels, realizing that he is about to die. Karlis Osis, a 1960s psychologist, conducted a global study on this topic. He was helped by doctors and medical staff in the care units for dying people. There were 35,540 deaths reported. Based on observations of them, conclusions were drawn that have not yet lost their relevance.

It turned out that the dying people had no fear. There was discomfort, indifference and pain. Every 20th person was elated. According to other studies, the older a person is, the less afraid they are of dying. For example, one social survey of older people showed that only 10% of those surveyed admitted to fear of death.

What do people see as they approach death?

Before death, people experience hallucinations that are similar to each other. During visions, they are in a state of clarity of consciousness, the brain worked normally. Moreover, he did not respond to sedatives. Body temperature was also normal. On the verge of death, most of the people have already fainted.

Mostly, the visions of most people are associated with the concepts of their faith. Those who believed in hell or heaven have seen corresponding visions. Non-religious people have seen beautiful visions associated with nature and living fauna. More people saw their dead relatives, calling them to go to another world. Observed in the study, people suffered from various diseases, had different levels of education, belonged to different religions, among them were convinced atheists.

The dying person often hears various sounds, mostly unpleasant. At the same time, he feels himself rushing towards the light, through the tunnel. Then, he sees himself as separate from his body. And then he is met by all those close to him, deceased people who want to help him.

Scientists cannot give an exact answer about the nature of such experiences. They usually find a connection with the process of neuronal death (tunnel vision), brain hypoxia and the release of a hefty dose of endorphin (vision and a feeling of happiness from the light at the end of the tunnel).

How to recognize the arrival of death?

The question of how to understand that a person is dying of old age is of concern to all relatives of a loved one. To understand that the patient will die very soon, you need to pay attention to following signs:

1. The body refuses to work (incontinence of urine or feces, urine color, constipation, loss of strength and appetite, refusal of water).
2. Even if there is an appetite, there may be a loss of the ability to swallow food, water and one's own saliva.
3. Loss of ability to close eyelids due to critical exhaustion and sinking eyeballs.
4. Signs of wheezing when unconscious.
5. Critical jumps in body temperature are either too low or critically high.

Important! These signs do not always indicate the coming of a mortal end. Sometimes they are symptoms of disease. These signs apply only to old people, sick and infirm.

Video: what does a person feel when he dies?

Conclusion

More details on what death is in Wikipedia.

As you can see, old people are rarely afraid of death. This is what statistics say, and this knowledge can help young people who are almost panicky afraid of it. Relatives whose old loved one dies can recognize the first signals of the end and help the patient by providing the necessary care.

The dozing old man evokes a kind smile in the majority. It is normal when, in old age, you want to sleep during the day. The body gets tired faster, it needs more time to recover. But doctors wondered: when an elderly person sleeps a lot, what does it mean. And the answer turned out to be disappointing - most often the duration of a night's sleep more than 10 hours indicates the presence of pathological processes.

How much should old people sleep

Many believe that with age, the need for sleep decreases, and a person in 60-70 years old enough to get enough sleep, only 6-7 hours of night rest. This is a common mistake. The exact amount of time it takes for a particular person to sleep can only be determined individually by experience. But in 90% of adults, it ranges from 7-9 hours.

It is easy to check how much sleep you personally need - the body itself will tell you if you give up the alarm for a few days and go to bed at about the same time.

If you are chronically sleep deprived, you will sleep much longer than usual on the first day, and then you will start to get up on your own at a certain period. This is your individual amount of sleep necessary for a good rest. How much sleep do you need every day to avoid accumulating sleep deprivation?

Unfortunately, sleep problems in older people are not uncommon, but rather common, which has given rise to the myth that they need to sleep less. And more often the elderly suffer from lack of sleep than from excess.

There are many reasons for senile insomnia, but more often than others, chronic diseases (which increase with age) and irreversible hormonal changes interfere with sleep.

When you really want to sleep

Sometimes old people really start sleeping longer than usual. It manifests itself as a late awakening or a long (more than an hour) regular daytime sleep. If this happens from time to time, then the reason is most likely a banal overwork. But when prolonged sleep becomes a constant phenomenon, then it is worth worrying. There can be both physiological and pathological reasons for this:

The cause of recurrent drowsiness can also be a strong meteorological dependence. You have noticed that in rainy, cloudy weather, you often want to sleep and are too lazy to actively move even at a young age. And old people react to such weather changes even more strongly and can sometimes doze off for half a day, sitting in their favorite chair.

Elderly people sleep longer even in winter. The lack of sunlight, which causes a deficiency of vitamin D, as well as cold, which constricts blood vessels and impairs cerebral circulation, affects.

The periodic lengthening of sleep caused by such reasons is not dangerous and, if desired, it can be eliminated by fairly simple preventive methods.

Hypersomnia symptoms

If a person of any age (not only the elderly) sleeps more than 14 hours a day, we can talk about a serious disease - hypersomnia. Depending on the form and reasons that caused the development of the disease, the symptoms of hypersomnia can be different:

Unfortunately, many people do not pay enough attention to hypersomnia, believing that additional hours of sleep can only be beneficial. It is, but not when the symptoms listed above are constantly present.

Usually hypersomnia is a sign of other mental or serious diseases: encephalitis, oncology, microstroke, etc.

Therefore, if an elderly person has at least two of the above symptoms, it is necessary to consult a neurologist as soon as possible. If necessary, he will conduct a diagnostic examination and prescribe a course of treatment.

Why is it dangerous to sleep for a long time

Constant long sleep is not good for you. As we have already found out, this is an abnormal state of the body, which has its own reasons and signals that a failure has occurred in some of the systems. If you do not take any measures to normalize sleep, then over time, the negative consequences of oversleeping appear:

These symptoms significantly reduce the quality of life. And worst of all, they limit physical activity, which in old age is simply necessary to keep the body in good shape. That is why it is so important to recognize sleep disorders in time and be sure to eliminate them.

Death is close?

Often, relatives of old people become very anxious if they see that their loved ones are sleeping too long. They consider this to be a symptom of impending death. This also happens sometimes.

But if an elderly person feels good, is healthy, is active during the day, then even in the presence of several chronic diseases, in most cases, nothing threatens him in the near future.

Sleeping too long can be an alarming sign if it is accompanied by:

• almost complete refusal of food;
• frequent fainting or blackouts;
• incoherent speech, severe articulation disorders;
• constant signs of oxygen starvation;
• Difficulty breathing and / or wheezing
• cooling and severe numbness of the limbs;
• manifestations of cyanotic subcutaneous spots on the body;
• complete lack of interest in the environment.

In this case, we can really talk about the slow extinction of life and the gradual shutdown of various organs and systems. If you understand that you cannot change anything, then you should not bother and wake up the person again.

In dying states, lethargy and drowsiness are natural defensive reaction organism, helping a person to complete the process of transition to another world painlessly and without unnecessary anxiety. Better to just be around, talk, hold your hand. In such states, a deep sleep does not occur, but only a saving slumber, through which a person still perceives what is happening.

Prevention measures

Alas, drugs for old age and death have not yet been invented, and who knows if they will ever come up with it. We are not yet able to fight this natural process, but we can prolong the period of a full-fledged active life and prevent excessive sleepiness even in old age with strong desire and some effort is quite possible.

But to accept such preventive measures it is necessary not when the body has already weakened and it is difficult to lift the body out of bed, but much earlier, ideally, even in young years. The effect will be even if you take care of yourself only in old age, but you will not be able to catch up with those who began to train the body and blood vessels at least after forty.

Delaying old age is easy. And three main whales will help in this: physical activity, balanced diet and positive emotions.

And now a little more about what you need to do in order not to become like a marmot in hibernation in old age:

Old age is not a sentence. This is the period when you can devote yourself to what the time was sorely lacking before.

If you are dying or caring for a dying person, you may have questions about how the process of dying will work out physically and emotionally. The following information will help you answer some questions.

Signs of impending death

The process of dying is as varied (individual) as the process of birth. It is impossible to predict the exact time of death, and how exactly a person will die. But people who are on the verge of death experience many of the same symptoms, regardless of the type of illness.

As death approaches, a person may experience some physical and emotional changes, such as:

Excessive sleepiness and weakness, at the same time, periods of wakefulness decrease, energy is extinguished.

Breathing changes, periods of rapid breathing are replaced by respiratory stops.

Hearing and sight change, for example, a person hears and sees things that others do not notice.

Appetite decreases, a person drinks and eats less than usual.

Changes in the urinary and gastrointestinal systems. Your urine may turn dark brown or dark red, and you may have bad (difficult to pass) stools.

Body temperature changes, ranging from very high to very low.

Emotional changes, a person is not interested in the outside world and certain details of everyday life, such as time and date.

A dying person may experience other symptoms depending on the disease. Talk with your doctor about what to expect. Alternatively, you can contact a program for helping the hopelessly ill, where they will answer all your questions regarding the dying process. The more you and your loved ones know, the more prepared you will be for this moment.

Excessive sleepiness and weakness associated with approaching death

With the approach of death, a person sleeps more, and it becomes more difficult to wake up. The periods of wakefulness are getting shorter and shorter.

As death approaches, the people caring for you will notice that you are lacking a response and that you are in a very deep sleep... This condition is called a coma. If you are in a coma, then you will be tied to bed, and all your physiological needs (bathing, turning, feeding and urinating) will have to be controlled by someone else.

General weakness is very common as death approaches. It is normal for a person to need help walking, bathing, and going to the toilet. Over time, you may need help rolling over in bed. Medical equipment such as wheelchairs, walkers, or a hospital bed can be of great help during this period. This equipment can be rented from a hospital or a terminal for the hopelessly ill.

Respiratory changes as death approaches

As death approaches, periods of rapid breathing may be followed by periods of breathlessness.

Your breath may become moist and congested. This is called death rattle. Changes in breathing usually happen when you are weak and there is normal discharge from your respiratory tract and the lungs cannot go out.

While noisy breathing can be a wake-up call to your loved ones, you probably won't feel pain or stagnation. Since the fluid is deep in the lungs, it is difficult to remove it. Your doctor may prescribe oral pills(atropines) or patches (scopolamine) to relieve congestion.

Your loved ones can turn you to the other side so that the discharge comes out of your mouth. They can also wipe these secretions with a damp cloth or special tampons (you can ask at the center for the hopelessly ill or buy in pharmacies).

Your doctor may prescribe oxygen therapy to help relieve your shortness of breath. Oxygen therapy will improve your well-being, but will not prolong your life.

Changes in vision and hearing as death approaches

Visual impairment is very common in the last weeks of life. You may notice that you have become difficult to see. You may see or hear things that no one else notices (hallucinations). Visual hallucinations are common before death.

If you are caring for a dying person who is hallucinating, they need to be encouraged. Accept what the person sees. Denying hallucinations can upset a dying person. Talk to the person even if he or she is in a coma. It is known that dying people can hear even when they are in a deep coma. People who came out of a coma said they could hear all the time they were in a coma.

Hallucinations

Hallucinations are the perception of something that is not really there. Hallucinations can affect all senses: hearing, sight, smell, taste, or touch.

The most common hallucinations are visual and auditory. For example, a person may hear voices or see objects that the other person cannot see.

Other types of hallucinations include gustatory, olfactory, and tactile.

Treatment for hallucinations depends on the cause.

Changesappetitewithapproachingof death

As death approaches, you will likely eat and drink less. It's connected with general feeling weakness and a slowdown in metabolism.

Since nutrition is important social significance, your family and friends will find it difficult to watch you eat nothing. However, metabolic changes mean you don't need the same amount of food and fluids as before.

You can consume small portions of food and liquids while you are active and able to swallow. If swallowing is a problem for you, thirst can be prevented by moistening your mouth with a damp cloth or a special tampon (available at the pharmacy) dipped in water.

Changes in the urinary and gastrointestinal systems with the approach of death

Often, the kidneys gradually stop producing urine as death approaches. As a result, your urine turns dark brown or dark red. This is due to the inability of the kidneys to properly filter urine. As a result, the urine becomes very concentrated. Also, its number is decreasing.

As the appetite decreases, some changes also occur in the intestines. Stools become harder and more difficult to pass (constipation) as the person takes in less fluids and becomes weaker.

You should tell your doctor if you have a bowel movement less than every three days or if you are uncomfortable with a bowel movement. Stool softening medications may be recommended to prevent constipation. You can also use an enema to cleanse your bowels.

As you become more and more weak, it is natural that it is difficult for you to control. bladder and intestines. A urinary catheter may be placed in your bladder as a means of continuous drainage of urine. Also, a program for the hopelessly ill can provide toilet paper or underwear (also available at the pharmacy).

Changes in body temperature as death approaches

As death approaches, the part of the brain responsible for regulating body temperature begins to function poorly. You may have a high fever and feel cold in a minute. Your hands and feet may feel very cold to the touch and may even turn pale and stained. Changes in skin color are called patchy skin lesions and are very common in the last days or hours of life.

The caregiver can control your temperature by wiping your skin with a wet, lukewarm cloth, or by giving you the following medications:

Acetaminophen (Tylenol)

Ibuprofen (Advil)

Naproxen (Alev).

Many of these medicines are available in the form of rectal suppositories if you find it difficult to swallow.

Emotional changes as death approaches

Just as your body prepares itself physically for death, you must prepare for it emotionally and mentally.

As death approaches, you may lose interest in the world around you and in particular details of daily life, such as the date or time. You can close in yourself and communicate less with people. You might only want to chat with a few people. This introspection can be a way of saying goodbye to everything you knew.

In the days before death, you may enter a state of unique conscious awareness and communication that may be misinterpreted by your loved ones. You can say that you need to go somewhere - "go home" or "go somewhere." The meaning of such conversations is unknown, but some people think that such conversations help prepare for death.

Events from your recent past may be intermingled with events far away. You can remember very old events in the slightest detail, but not remember what happened an hour ago.

You can think of people who have already died. You may say that you have heard or seen someone who has already died. Your loved ones can hear you talking to the deceased person.

If you are caring for a dying person, you may be upset or intimidated by this strange behavior. You may want to bring your loved one back to reality. If this communication interferes with you, talk to your doctor to better understand what's going on. Your loved one may go into a state of psychosis, and you may be scared to watch it. Psychosis occurs in many people before death. It can have a single cause or be the result of several factors. Reasons may include:

Medications such as morphine, sedatives and pain relievers, or too much medication that does not work together.

Metabolic changes associated with high fever or dehydration.

Metastasis.

Deep depression.

Symptoms may include:

Revitalization.

Hallucinations.

Unconsciousness, which is replaced by revival.

Sometimes delirium tremens can be prevented with alternative medicine, such as relaxation and breathing techniques, and other methods that reduce the need for sedatives.

Pain

Palliative care can help you relieve the physical symptoms associated with your medical condition, such as nausea or shortness of breath. Controlling pain and other symptoms is an important part of your treatment and improving your quality of life.

How often a person feels pain depends on their illness. Certain fatal diseases, such as bone cancer or pancreatic cancer, can be accompanied by severe physical pain.

The person may be so afraid of pain and other physical symptoms that they may contemplate suicide with the assistance of a doctor. But the pain of death can be effectively dealt with. You should tell your doctor and loved ones about any pain. There are many medications and alternative methods (such as massage) that can help you manage your near-death pain. Be sure to ask for help. Ask a loved one to tell the doctor about your pain if you are not able to do it yourself.

You may want your family not to see your suffering. But it is very important to tell them about your pain, if you cannot tolerate it, so that they immediately see a doctor.

Spirituality

Spirituality means a person's awareness of the purpose and meaning of his life. It also denotes a person's relationship with higher forces or energy that gives meaning to life.

Some people don't think about spirituality often. For others, it is part of everyday life. As you approach the end of your life, you may face your own spiritual questions and concerns. Religious ties often help some people achieve comfort before dying. Other people find solace in nature, in social work, strengthening relationships with loved ones, or creating new relationships. Think about things that can give you peace and support. What questions do you care about? Seek support from friends, family, programs, and spirit guides.

Caring for a dying relative

Controlling pain and symptoms at the end of life

At the end of life, pain and other symptoms can be effectively managed. Talk to your doctor and loved ones about the symptoms you are experiencing. Family is an important link between you and your doctor. If you yourself cannot communicate with a doctor, your loved one can do it for you. There is always some way to relieve your pain and symptoms so that you feel comfortable.

Physical pain

There are many pain relievers available. Your doctor will choose the lightest, most non-invasive pain relief medication. Oral medications are usually given first because they are easier to take and less expensive. If your pain is not severe, pain relievers can be purchased without a doctor's prescription. These are drugs such as acetaminophen and non-steroidal anti-inflammatory therapies (NSAIDs) such as aspirin or ibuprofen. It is important to stay ahead of your pain and take your medications on schedule. Irregular use of medication is often the cause of ineffective treatment.

Sometimes pain cannot be controlled with over-the-counter medications. In this case, more effective forms treatment. Your doctor may prescribe pain relievers such as codeine, morphine, or fentanyl. These drugs can be combined with others, such as antidepressants, to help relieve pain.

If you are unable to take the pills, there are other forms of treatment. If you have trouble swallowing, you can use liquid medication. Also, medications can be in the form of:

Rectal suppository. Suppositories can be taken if you have swallowing problems or nausea.

Drops under the tongue. Just like nitroglycerin tablets or heart pain sprays, liquid forms of some substances, such as morphine or fentanyl, can be absorbed blood vessels under the tongue. These drugs are given in very small amounts - usually just a few drops - and are effective way pain management for people with swallowing problems.

Patches applied to the skin (transdermal patches). These patches allow pain relievers such as fentanyl to pass through the skin. The advantage of patches is that you get the dose of the medicine you need instantly. These patches are better at controlling pain than pills. In addition, a new patch must be applied every 48-72 hours, and the tablets must be taken several times a day.

Intravenous injection (droppers). Your doctor may prescribe treatment with a needle inserted into a vein in your arm or chest if you have very severe pain that cannot be controlled by oral, rectal, or transdermal methods. The medication can be given as a single injection several times a day, or continuously in small amounts. If you are connected to a drip, this does not mean that your activity will be limited. Some people walk around with small, portable pumps that provide small doses of medicine throughout the day.

Injections into the area of ​​the spinal nerves (epidural) or under the tissue of the spine (intrathecal). For acute pain, strong pain relievers, such as morphine or fentanyl, are injected into the spine.

Many people who suffer from severe pain fear that they will become addicted to pain relievers. However, addiction rarely occurs in hopelessly ill people. If your condition improves, you can slowly stop taking the medication to avoid becoming addicted.

Pain relievers can be used to relieve pain and help keep it at a bearable level. But sometimes pain relievers can make you sleepy. You can only take a small amount of the medication and therefore tolerate a little pain in order to remain active. On the other hand, perhaps weakness does not matter to you. of great importance and you are not bothered by the drowsiness caused by certain medications.

The main thing is to take medications on a specific schedule, and not only when "the need arises." But even taking medication regularly, you can sometimes feel a lot of pain. This is called "pain breakthroughs." Talk to your doctor about what medications you should have on hand to deal with pain breakouts. And always tell your doctor if you stop taking your medicine. Sudden termination can cause serious side effects and severe pain. Talk to your doctor about pain management methods without medication. Alternative medical therapy can help some people relax and relieve pain. You can combine traditional treatment with alternative methods like:

Acupuncture

Aromatherapy

Biological feedback

Chiropractic

Guiding images

Healing touch

Homeopathy

Hydrotherapy

• Magnetotherapy

• Meditation

For more information, see the Chronic Pain section.

Emotional stress

During the period when you are learning to cope with your illness, short-term emotional stress is normal. Depression that lasts more than 2 weeks is no longer normal and should be reported to your doctor. Depression can be cured even if you have a terminal illness. Antidepressants, combined with counseling, can help you cope with emotional distress.

Talk to your doctor and family about your emotional stress. While grief is a natural part of the dying process, it doesn't mean you have to endure severe emotional pain. Emotional distress can exacerbate physical pain. They can also reflect badly on your relationships with loved ones and prevent you from properly saying goodbye to them.

Other symptoms

As death approaches, you may experience other symptoms. Talk to your doctor about any symptoms you may have. Symptoms such as nausea, fatigue, constipation, or shortness of breath can be managed with medication, special diets, and oxygen therapy. Have a friend or family member describe all of your symptoms to a doctor or terminally ill worker. It is helpful to keep a journal and write down all your symptoms.

Most people assume that as they get older, it takes more and more time to sleep, which is why the older person sleeps a lot. It is logical that in this case, growing up is identified with aging. In parallel, there is an opinion that old people need less time to recuperate than adults who lead an active life. In view of this, there is a theory that 6-7 hours of sleep is enough for pensioners.

Causes contributing to an increased need for sleep

If you depict a graph of sleep duration at different ages, then it will appear as a parabola with the highest values ​​in the first and last days of life. No wonder it was noted that when an old person sleeps all the time, it means that internal resources have been worked out and the released life period is coming to an end. But to believe that all people in old age have a great need for sleep is wrong.

Each person is individual and with general physiological laws, there are also individual characteristics. This applies to the duration of sleep in the elderly. This is determined by two factors:

• well-established daily routine;
• the presence of diseases.

The pensioner maintains a sleep schedule established during his work activity. Although most people note that after retirement, on the contrary, they began to sleep better, because problems related to professional duties disappeared. However, people wake up without an alarm at the same time as before. It takes a year or two for the body to get used to the new routine. But for some, until the end of their lives, a clear daily routine and activity, developed throughout their life, remain. By the way, such people feel better and get sick less.

It is not entirely true that old people sleep a lot. Old people sleep as long as their body needs. Sleep is the time that is let go the human body nature to restore and recharge with vitality. A sleeping person is like a rechargeable battery. The longer the battery lasts, the longer it takes to charge, and still less energy. Therefore, on average, it takes about nine hours of total daily sleep for the aging organism to continue its vital functions.

Diseases that arise with age also do not contribute to the normal recovery of the body during sleep, since they affect both the duration and quality of night rest. Age-related ailments are characterized by night pains, so older people sleep a lot during the day, when they feel better.

Normal sleep duration in the elderly

Physiologists have found that an elderly person should normally sleep 7-9 hours. It is believed that old people sleep a lot if their sleep lasts 10 hours or more. This indicates the development of pathological processes in the body. Old age in itself is not a pathology, it is physiology, i.e. norm. Changes in hormonal levels are also physiological, which also affect the quality of sleep.

A good night's sleep in old age allows you to:

• sleeping mode;
• sleep hygiene;
• if necessary, the use of medications.

For old people, the same rules for healthy sleep apply as for workers:

• ventilated room;
• clean bed linen;
• humidity and temperature.

Doctors note that old people are constantly freezing, so they need warmer bed and pajamas, soft warm socks. A warm bath before bedtime, or at least a hot foot bath, is helpful.

When talking about sleep hygiene, one should not overlook personal hygiene products - urological pads for women. With a change in hormonal levels, urine leakage at night can be observed, which significantly reduces sleep comfort and is the cause of psychological discomfort.

In men, the age-related hormonal scourge is changes in the prostate gland. In the early stages of the disease, an enlarged prostate makes a person get up to urinate several times a night, and in advanced cases it leads to urinary incontinence. In these cases, special diapers for the elderly can improve the quality of sleep.

Compliance with the doctor's prescriptions for taking medications, if any disease (and more often several) is diagnosed, affects the duration and quality of sleep. Timely medication intake ensures restful sleep... When night pains appear, it is imperative to consult a doctor to correct drug treatment.

Daytime sleep is required. It is best to take a nap in the afternoon for 30-40 minutes. Long daytime sleep can cause biorhythms to fail, which will affect health: a headache, a feeling of lethargy. If an elderly person is constantly sleeping, this is already a sign of serious pathologies.

The main symptoms of hypersomnia

When an elderly person is constantly asleep, the reasons must be discovered as soon as possible: often this is a symptom of serious diseases, the timely detection of which will help, if not cure, then at least alleviate the condition of the elderly patient.

Hypersomnia is excessive (more than 14 hours) sleep duration. In older people, attacks of insomnia (insomnia) and hypersomnia may alternate, when, due to feeling unwell or for psychological reasons, first the grandmother or grandfather sleep in fits and starts, and then, when the pain goes away or the cause of negative emotions disappears, they just sleep off. This is a situational hypersomnia, which does not cause cause for concern (except for the root cause, of course, which must be dealt with). If the old person just sleeps a lot, this is not normal.

Signs of hypersomnia are:

• constant sleepiness;
• feeling tired after a long sleep;
• lack of a sleep schedule per se.

These symptoms may indicate the onset serious illness(microstroke, encephalitis, etc.), so it is dangerous to miss such moments.

If an elderly person sleeps for too long, it is necessary to establish why this is happening. Violation of the schedule can be caused by both pathological and physiological factors, among which it should be noted:

• overwork (fatigue has a cumulative effect, it can accumulate);
• alcoholism and drug addiction;
• depression, stress, unfavorable, from the point of view of psychology, the atmosphere in the house;
• suffered a stroke;
• high or low blood pressure;
• disruption of the endocrine system;
• brain tumors.

It should be borne in mind that in winter people sleep longer due to shorter daylight hours. Bedridden patients spend much more time sleeping than healthy patients. Some medications also affect the duration of rest.

The peculiarity of the elderly is the dependence of their well-being on the weather: a decrease in atmospheric pressure causes an irresistible desire to sleep at any time of the day.

Abnormally long sleep leads to:

• the development of migraine attacks;
• hyperglycemia against the background of hormonal disorders;
• persistent muscle weakness;
• decrease in intellectual abilities, memory impairment, absent-mindedness;
• the formation of excess weight due to metabolic disorders;
• constant fatigue and feeling of weakness.

Even the working capacity that is possible for a given age decreases. The bad news is that all these symptoms significantly impair physical activity, which is useful for maintaining tone at any age.

Long sleep as a harbinger of death

Popular belief says that people sleep a lot before death. The reasons for long sleep can be very different, but there are warning signs by which you can determine that a person will die soon.

1. Loss of appetite. At first, a person loses interest in food, even in the most favorite dishes, while eating much less than usual. The complete extinction of appetite and refusal of food may indicate the approach of death.
2. Increased sleepiness. Sleep lasts at least 12 hours, it is very difficult to wake a person up. The duration of sleep increases every day, dizziness appears after waking up.
3. Confusion and confusion. Old man in the intervals between sleep, he cannot understand where he is, how old he is. He ceases to recognize relatives, cannot remember their names, can rave in a dream and in reality.
4. Respiratory problems. Breathing becomes difficult, irregular, accompanied by wheezing. Cheyne-Stokes syndrome may occur.
5. Violation of urination. Involuntary urination occurs, often accompanied by uncontrolled defecation.
6. Puffiness lower limbs... Due to impaired blood circulation and lymph flow, the legs and feet swell, sometimes very significantly (it is impossible not only to put on indoor shoes, but also to put on stockings and socks).
7. Hypothermia. With impaired blood circulation, the body temperature decreases, this is especially noticeable on the fingers and toes: they become icy to the touch.
8. Venous spots. Vascular fragility leads to the appearance of characteristic bluish spots under the skin, similar to hematomas. They appear especially often when diabetes mellitus, since any, even a slight mechanical effect, leads to damage to the vessel and subcutaneous hemorrhage.
9. Uncontrollable emotions. Old people become capricious, sometimes their behavior is simply unbearable. At the same time, bouts of anger alternate with violent apologies. Unreasonable tears, resentment, suspicion can infuriate others, so you need to be patient. The worst should be expected when old people become completely indifferent, do not react to any stimuli.

Medical evaluation of patients with prolonged sleep

Medicine is powerless to restore youth, so old age must be taken for granted. At the same time, it depends on the person himself how he will age. The correct daily routine, a healthy lifestyle make it possible to maintain a clear mind and be active in old age.

If hypersomnia is a symptom of the disease, you need to direct all efforts to treatment. If this is the approach of the end, you need to make it light.

It is possible to determine the cause of excessive sleepiness based on the results of examination, clinical tests and on the basis of the stories of the patients themselves and their loved ones.

The main help is to provide the elderly with a dignified old age. When it comes to near death, you need to overcome the feeling of powerlessness and not disturb the old people once again when they sleep. So that even in a dream they feel the care and love of their relatives, it is better to hold their hand in your hands, quietly say kind, affectionate words, even quietly hum a lullaby. A person should leave with the knowledge that he has lived a decent life and that he is surrounded by loving and caring people.

In old age, as in any other, you need a sleep regimen. He must take into account age features... If you experience excessive sleepiness, you should see your doctor.