medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-2-56-61medsovet-6013Research ArticleНЕРВНО-ПСИХИЧЕСКИЕ РАССТРОЙСТВАNEUROPSYCHIATRIC DISORDERSСон как биологический ритм: клинические аспектыSleep as a biological rhythm: clinical aspectshttps://orcid.org/0000-0002-2292-6475ПучковаА. Н.PuchkovaA. N.

Пучкова Александра Николаевна, к.б.н., старший научный сотрудник лаборатории нейробиологии сна и бодрствования

117485, Москва, ул. Бутлерова, д. 5а

Alexandra N. Puchkova, Cand. of Sci. (Biol.), Senior Researcher of the Laboratory of Neurobiology of Sleep and Wakefulness

5а, Butlerov St., Moscow, 117485

puchkovaan@gmail.comhttps://orcid.org/0000-0001-6215-0918ПолуэктовМ. Г.PoluektovM. G.

Полуэктов Михаил Гурьевич, к.м.н., доцент, доцент кафедры нервных болезней и нейрохирургии Института клинической медицины

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Mikhail G. Poluektov, Cand. of Sci. (Med.), Associate Professor, Associate Professor of the Department of Nervous Diseases and Neurosurgery of the Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991

Институт высшей нервной деятельности и нейрофизиологии Российской академии наукРоссияInstitute of Higher Nervous Activity and Neurophysiology of RASRussian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202111032021025661Copyright © Пучкова А.Н., Полуэктов М.Г., 20212021Пучкова А.Н., Полуэктов М.Г.Puchkova A.N., Poluektov M.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6013

Бессонница, или инсомния, – широко распространенное нарушение сна, влияющее не только на его количество и качество, но и на дневное самочувствие и работоспособность человека, а также имеющее негативное влияние на физическое и психическое здоровье. У многих людей бывают проблемы с засыпанием и поддержанием сна, которые не достигают клинических критериев бессонницы. При всей распространенности подобных нарушений сна вне внимания специалистов часто оказывается принципиально важный фактор, влияющий на режим сна и бодрствования, легкость засыпания и дневную работоспособность. Это циркадианные, или околосуточные, ритмы организма под управлением биологических часов. Данный обзор освещает специфику работы биологических часов человека и их связь с бессонницей и жалобами на плохой сон. Рассмотрен феномен хронотипа человека как совокупности индивидуальных предпочтений в ритме сна – бодрствования. Поздний хронотип, просыпающийся поздно и активный вечером, оказывается наиболее уязвим для появления жалоб на плохой сон и развития инсомнии. Этот результат характерен для разных возрастных групп. Причиной проблем с засыпанием и сном для позднего хронотипа является необходимость подстраиваться под социальные требования и засыпать и просыпаться в слишком ранней фазе собственного циркадианного ритма.Циркадианные ритмы могут оказывать влияние на формирование и поддержание инсомнии. И у хронической, и у острой бессонницы может быть хронобиологический компонент, который не всегда учитывается. Поздний хронотип может быть фактором, дополнительно усугубляющим течение инсомнии. Также при бессоннице может нарушаться и регулярность циркадианных ритмов.Важность биологических часов в регуляции сна и бодрствования объясняет и успешный подход к лечению бессонницы с помощью мелатонина, играющего важную сигнальную роль в регуляции циркадианных ритмов организма.

Insomnia is a widespread disorder affecting not only sleep quantity and quality, but also daytime well-being and performance, as well as having a negative impact on physical and mental health. Many people have problems falling asleep and maintaining sleep that do not reach the clinical criteria of insomnia. For all the prevalence of such sleep disorders, specialists often overlook a fundamentally important factor that affects sleep and wakefulness cycle, ease of falling asleep and daytime performance. These are circadian rhythms of the body under the control of the biological clock.This review highlights the specifics of the human biological clock and its relationship to insomnia and complaints of poor sleep. The phenomenon of the human chronotype as a set of individual preferences in sleep-wake rhythm is considered. Late chronotype, tat tends to wake up late and be active in the evening turns out to be the most vulnerable to the appearance of complaints of poor sleep and development of insomnia. This result is typical for different age groups. The reason for problems sleep for the late chronotype is the need to adjust to social demands and to fall asleep and wake up too early relative to the phase of one’s own circadian rhythm.Circadian rhythms may contribute to the formation and maintenance of insomnia. Both chronic and acute insomnia may have a chronobiological component that is not always considered. Late chronotype may be a factor further exacerbating the course of insomnia. The regularity of circadian rhythms may also be impaired in insomnia.The importance of the biological clock in the regulation of sleep and wakefulness also explains the successful approach to insomnia treatment with melatonin, which plays an important signaling role in the circadian regulation of the body.

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The authors declare that there are no conflicts of interest present.