Why do I get a headache when I lie down?

If you get a headache as soon as you lie down, you should pay attention to it. It may be caused by sleep disorders, which will cause some physical discomfort. You should go to a regular psychiatric department for corresponding examinations, find the specific cause, and then conduct standardized treatment. In addition, you should also pay attention to rationalization in daily life, eat more foods that help promote sleep, relieve stress, and avoid anxiety and depression.

Clinical manifestations

1. Abnormal amount of sleep

It can include two categories: one is excessive sleep, such as drowsiness or lethargy caused by various brain diseases, endocrine disorders, metabolic abnormalities, and narcolepsy caused by brain lesions. This type of sleeping sickness is manifested by frequent short-term (generally less than 15 minutes) irresistible sleep attacks, often accompanied by symptoms such as falling, sleep paralysis, and hallucinations before falling asleep. Another type of insomnia is insufficient sleep, with less than 5 hours of sleep throughout the night, characterized by difficulty falling asleep, shallow sleep, easy awakening or early awakening. Insomnia can be caused by external environmental factors (too bright indoor light, too much noise around, working the night shift, traveling by car or boat, arriving in an unfamiliar place), physical factors (pain, itching, severe coughing, drinking strong tea or coffee before going to bed, frequent urination at night or diarrhea, etc.) or psychological factors (anxiety, fear, excessive thoughts or excitement). Some diseases are often accompanied by insomnia, such as neurasthenia, anxiety, depression, etc.

2. Paroxysmal abnormalities during sleep

It refers to some abnormal behaviors during sleep, such as sleepwalking, talking in sleep, night terrors (sudden agitation, screaming, rapid heartbeat, rapid breathing, sweating all over the body, disorientation or hallucinations during sleep), nightmares, teeth grinding, involuntary laughter, involuntary muscle or limb twitching, etc. These paroxysmal abnormal behaviors do not occur throughout the night's sleep, but rather occur during certain sleep periods. For example, sleepwalking and night terrors often occur in the late stage of normal sleep; sleep talking is more common in the middle or even early stage of normal sleep; teeth grinding, involuntary laughter, muscle or limb twitching are more common in the early stage of normal sleep; nightmares often occur in the paradoxical sleep stage.

Traditional Chinese medicine has a rich history of diagnosis and treatment of sleep disorders. In recent years, many doctors have explored the mechanism of sleep disorders based on clinical practice and proposed some new ideas for diagnosis and treatment.

1. Treating from the perspective of the five internal organs

Some scholars believe that the etiology and pathogenesis of insomnia are mainly manifested in the liver, spleen and five internal organs, taking into account the physical symptoms of the five internal organs. It advocates the holistic view that "all five internal organs can cause insomnia", and treats the disease based on the liver while taking other organs into consideration, adopting a syndrome differentiation and treatment system that adds or subtracts symptoms. Based on this, a syndrome differentiation and treatment plan for insomnia is developed based on the different organs.

2. Treatment from the perspective of mental state and emotions

Mental emotions are closely related to insomnia, so insomnia is divided into worry type, suspicious type, tension type, and depression type. They are treated with clearing heat and purging fire, soothing the liver and relieving counterflow, nourishing yin and clearing heat, regulating qi and relieving depression, clearing the heart and calming the mind, and harmonizing the liver and spleen, and achieved good results.

3. Treatment based on circadian rhythm

Human sleep is a physiological activity with circadian rhythm, and insomnia is the result of the disorder of this normal sleep-wake rhythm. Following this rule, we propose to treat insomnia by “adapting measures to the circumstances”.

4. Treatment based on the interaction between the heart and kidney

All insomnia is caused by "fire not returning to its roots", and all treatment plans ultimately need to return to the issue of "leading fire back to its roots and connecting the heart and kidneys". Insomnia is divided into five types: liver qi stagnation type, kidney essence deficiency type, heart fire excess type, meridian stasis type, and phlegm and dampness blockage type.

5. Treatment from the perspective of liver and spleen

Many of the causes and pathogenesis of insomnia are related to liver and spleen disorders. The selection of Chinese medicine for treating insomnia should be based on syndrome differentiation and treatment, with emphasis on regulating the liver and spleen.