medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-2-70-75medsovet-6737Research ArticleНЕРВНО-ПСИХИЧЕСКИЕ РАССТРОЙСТВАNEUROPSYCHIATRIC DISORDERSПсихиатрические и неврологические аспекты нарушения сна после перенесенной коронавирусной инфекции (COVID-19)Psychiatric and neurological aspects of sleep disturbance after coronavirus infection (COVID-19)https://orcid.org/0000-0003-0714-9476СпекторЕ. Д.SpektorE. D.

 врач-невролог, аспирант кафедры нервных болезней и нейрохирургии Института клинической медицины 

119435, Россия, Москва, ул. Россолимо, д. 11, стр. 1 

 

 Neurologist, Postgraduate Student of the Chair of Neurology and Neurosergary

11, Bldg. 1, Rossolimo St., Moscow, 119435, Russia 

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

 .м.н., доцент, заведующий отделением медицины сна, Университетская клиническая больница №3 

 119435, Россия, Москва, ул. Россолимо, д. 11, стр. 1 

 Cand. Sci. (Med.), Associate Professor, Head of the Department of Sleep Medicine

11, Bldg. 1, Rossolimo St., Moscow, 119435, Russia 

polouekt@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202211032022027075Copyright © Спектор Е.Д., Полуэктов М.Г., 20222022Спектор Е.Д., Полуэктов М.Г.Spektor E.D., Poluektov M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6737

Отдаленные последствия новой коронавирусной инфекции (COVID-19) представляют большой научный и практический интерес в связи с исходно высокой заболеваемостью и значительной распространенностью среди переболевших новой коронавирусной инфекцией широкого спектра разнообразных жалоб, объединяемых термином «постковидный синдром». Одним из частых проявлений данного синдрома служат нарушения сна, преимущественно в виде инсомнии (бессонницы). В статье приведены эпидемиологические данные, патогенетические механизмы, социоэкономические факторы и терапевтические возможности в отношении инсомнии, ассоциированной с постковидным синдромом.Увеличение распространенности нарушений сна, наблюдаемое в условиях пандемии новой коронавирусной инфекции, имеет комплексную природу и включает в себя как непосредственно связанные с заболеванием факторы, так и изменение внешних условий. К несвязанным с болезнью факторам относится прежде всего изменение стиля жизни в условиях самоизоляции, которое сопровождается снижением физической активности и нарушением гигиены сна. Кроме того, отдельным негативным фактором выступает повышение уровня стресса в связи с угрозой жизни и здоровью, а также в связи с экономическими последствиями пандемии. Непосредственные эффекты новой коронавирусной инфекции в отношении центральной нервной системы изучены в настоящий момент неполно, однако есть основания полагать, что в увеличении распространенности психической и неврологической патологии вообще и нарушений сна в частности после перенесенного COVID-19 играют роль малоизученные нейротропные свойства вируса.С учетом того, что с последствиями перенесенной новой коронавирусной инфекции чаще сталкиваются врачи первичного звена, основными требованиями к фармакологическим препаратам, назначаемым для коррекции инсомнии, выступают безопасность, простота назначения, быстрое наступление эффекта. При этом следует также оценивать наличие коморбидной психической патологии, проявлениями которой могут служить расстройства сна.

There are both scientific interest and practical value to study the medical consequences of the Coronavirus disease 2019 (COVID-19) due to its pandemic status and high prevalence of different complaints among COVID-19 survivors. These complaints are called “post-COVID” or “long COVID” syndrome. One of the frequent symptoms of post-COVID syndrome is sleep disturbances, predominantly insomnia. The article provides epidemiological data, pathogenesis, socioeconomic factors, and therapeutic approach to insomnia associated with post-COVID syndrome.The increase of sleep disturbances prevalence in pandemic conditions has a comprehensive nature. It includes the disease consequences itself and change of lifestyle due to lockdown. The lifestyle change leads to physical activity decrease and inadequate sleep hygiene. Besides, the high stress level is also the reason for sleep disturbances. The direct effects of COVID-19 on the central nervous system are understudied at the moment. Nevertheless, there are reasons to suggest neurotropic characteristics of SARS-CoV-2 to underlie post-COVID neurological and psychiatric disturbances.Taking into account that general practitioners are mainly addressed post-COVID complaints, the recommended hypnotics should be safe, easily prescribed, and highly effective. The probable presence of the psychiatric pathology should be also assessed because the sleep complaints might be its manifestation.

сонCOVID-19постковидный синдроминсомниягипнотикидоксиламинsleepCOVID-19post-COVID syndromelong COVID syndromeinsomniahypnoticsdoxylamineReferencesNalbandian A., Sehgal K., Gupta A., Madhavan M.V., McGroder C., Stevens J.S. et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601–615. https://doi.org/10.1038/s41591-021-01283-z.Nalbandian A., Sehgal K., Gupta A., Madhavan M.V., McGroder C., Stevens J.S. et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601–615. https://doi.org/10.1038/s41591-021-01283-z.Gupta A., Madhavan M.V., Sehgal K., Nair N., Mahajan S., Sehrawat T.S. et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26:1017–1032. https://doi.org/10.1038/s41591-020-0968-3.Gupta A., Madhavan M.V., Sehgal K., Nair N., Mahajan S., Sehrawat T.S. et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26:1017–1032. https://doi.org/10.1038/s41591-020-0968-3.Najjar S., Najjar A., Chong D.J., Pramanik B.K., Kirsch C., Kuzniecky R.I. et al. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020;17:231. https://doi.org/10.1186/s12974-020-01896-0.Najjar S., Najjar A., Chong D.J., Pramanik B.K., Kirsch C., Kuzniecky R.I. et al. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020;17:231. https://doi.org/10.1186/s12974-020-01896-0.Carfì A., Bernabei R., Landi F., Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603–605. https://doi.org/10.1001/jama.2020.12603.Carfì A., Bernabei R., Landi F., Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603–605. https://doi.org/10.1001/jama.2020.12603.Tenforde M.W., Kim S.S., Lindsell C.J., Billig Rose E., Shapiro N.I., Files D.C. et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network – United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):993–998. https://doi.org/10.15585/mmwr.mm6930e1.Tenforde M.W., Kim S.S., Lindsell C.J., Billig Rose E., Shapiro N.I., Files D.C. et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network – United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):993–998. https://doi.org/10.15585/mmwr.mm6930e1.Huang C., Huang L., Wang Y., Li X., Ren L., Gu X., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–232. https://doi.org/10.1016/S0140-6736(20)32656-8.Huang C., Huang L., Wang Y., Li X., Ren L., Gu X., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–232. https://doi.org/10.1016/S0140-6736(20)32656-8.Augustin M., Schommers P., Stecher M., Dewald F., Gieselmann L., Gruell H. et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur. 2021;6:100122. https://doi.org/10.1016/j.lanepe.2021.100122.Augustin M., Schommers P., Stecher M., Dewald F., Gieselmann L., Gruell H. et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur. 2021;6:100122. https://doi.org/10.1016/j.lanepe.2021.100122.Oronsky B., Larson C., Hammond T.C., Oronsky A., Kesari S., Lybeck M., Reid T. a Review of Persistent Post-COVID Syndrome (PPCS). Clin Rev Allergy Immunol. 2021:1–9. https://doi.org/10.1007/s12016-021-08848-3.Oronsky B., Larson C., Hammond T.C., Oronsky A., Kesari S., Lybeck M., Reid T. a Review of Persistent Post-COVID Syndrome (PPCS). Clin Rev Allergy Immunol. 2021:1–9. https://doi.org/10.1007/s12016-021-08848-3.COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (UK); 2020. Available at: https://pubmed.ncbi.nlm.nih.gov/33555768.COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (UK); 2020. Available at: https://pubmed.ncbi.nlm.nih.gov/33555768.Mostel Z., Perl A., Marck M., Mehdi S.F., Lowell B., Bathija S. et al. Post-sepsis syndrome – an evolving entity that afflicts survivors of sepsis. Mol Med. 2019;26:6. https://doi.org/10.1186/s10020-019-0132-z.Mostel Z., Perl A., Marck M., Mehdi S.F., Lowell B., Bathija S. et al. Post-sepsis syndrome – an evolving entity that afflicts survivors of sepsis. Mol Med. 2019;26:6. https://doi.org/10.1186/s10020-019-0132-z.Stam H.J., Stucki G., Bickenbach J., European Academy of Rehabilitation Medicine. Covid-19 and Post Intensive Care Syndrome: a Call for Action. J Rehabil Med. 2020;52:jrm00044. https://doi.org/10.2340/16501977-2677.Stam H.J., Stucki G., Bickenbach J., European Academy of Rehabilitation Medicine. Covid-19 and Post Intensive Care Syndrome: a Call for Action. J Rehabil Med. 2020;52:jrm00044. https://doi.org/10.2340/16501977-2677.Annane D., Sharshar T. Cognitive decline after sepsis. Lancet Respir Med. 2015;3(1):61–69. https://doi.org/10.1016/S2213-2600(14)70246-2.Annane D., Sharshar T. Cognitive decline after sepsis. Lancet Respir Med. 2015;3(1):61–69. https://doi.org/10.1016/S2213-2600(14)70246-2.Rattray J., Johnston M., Wildsmith J.W. The intensive care experience: development of the ICE questionnaire. J Adv Nurs. 2004;47(1):64–73. https://doi.org/10.1111/j.1365-2648.2004.03066.x.Rattray J., Johnston M., Wildsmith J.W. The intensive care experience: development of the ICE questionnaire. J Adv Nurs. 2004;47(1):64–73. https://doi.org/10.1111/j.1365-2648.2004.03066.x.Hoffer E.P. Long COVID: Does It Exist? What Is It? We Can We Do For Sufferers? Am J Med. 2021;134(11):1310–1311. https://doi.org/10.1016/j.amjmed.2021.05.023.Hoffer E.P. Long COVID: Does It Exist? What Is It? We Can We Do For Sufferers? Am J Med. 2021;134(11):1310–1311. https://doi.org/10.1016/j.amjmed.2021.05.023.Jahrami H., BaHammam A.S., Bragazzi N.L., Saif Z., Faris M., Vitiello M.V. Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. J Clinical Sleep Medicine. 2021;17(2):299–313. https://doi.org/10.5664/jcsm.8930.Jahrami H., BaHammam A.S., Bragazzi N.L., Saif Z., Faris M., Vitiello M.V. Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. J Clinical Sleep Medicine. 2021;17(2):299–313. https://doi.org/10.5664/jcsm.8930.Ohayon M.M. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6:97–111. https://doi.org/10.1053/smrv.2002.0186.Ohayon M.M. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6:97–111. https://doi.org/10.1053/smrv.2002.0186.Smolík P. Significance of sleep and sleep disorders in psychiatry. Cas Lek Cesk. 2019;158(5):193–199. Available at: https://pubmed.ncbi.nlm.nih.gov/31703531.Smolík P. Significance of sleep and sleep disorders in psychiatry. Cas Lek Cesk. 2019;158(5):193–199. Available at: https://pubmed.ncbi.nlm.nih.gov/31703531.Rumble M.E., White K.H., Benca R.M. Sleep Disturbances in Mood Disorders. Psychiatr Clin North Am. 2015;38(4):743–759. https://doi.org/10.1016/j.psc.2015.07.006.Rumble M.E., White K.H., Benca R.M. Sleep Disturbances in Mood Disorders. Psychiatr Clin North Am. 2015;38(4):743–759. https://doi.org/10.1016/j.psc.2015.07.006.Roehrs T.A., Roth T. Sleep Disturbance in Substance Use Disorders. Psychiatr Clin North Am. 2015;38:793–803. https://doi.org/10.1016/j.psc.2015.07.008.Roehrs T.A., Roth T. Sleep Disturbance in Substance Use Disorders. Psychiatr Clin North Am. 2015;38:793–803. https://doi.org/10.1016/j.psc.2015.07.008.Agorastos A., Olff M. Sleep, circadian system and traumatic stress. Eur J Psychotraumatol. 2021;12:1956746. https://doi.org/10.1080/20008198.2021.1956746.Agorastos A., Olff M. Sleep, circadian system and traumatic stress. Eur J Psychotraumatol. 2021;12:1956746. https://doi.org/10.1080/20008198.2021.1956746.O’Sullivan O. Long-term sequelae following previous coronavirus epidemics. Clin Med (Lond). 2021;21:e68–70. https://doi.org/10.7861/clinmed.2020-0204.O’Sullivan O. Long-term sequelae following previous coronavirus epidemics. Clin Med (Lond). 2021;21:e68–70. https://doi.org/10.7861/clinmed.2020-0204.Мосолов С.Н. Длительные психические нарушения после перенесенной острой коронавирусной инфекции SARS8 CoV82. Современная терапия психических расстройств. 2021;(3):2–23. https://doi.org/10.21265/PSYPH.2021.31.25.001.Mosolov S.N. Long-term psychiatric sequelae of SARS-CoV-2 infection. Current Therapy of Mental Disorders. 2021;(3):2–23. (In Russ.) https://doi.org/10.21265/PSYPH.2021.31.25.001.Medvedev V.E., Dogotar O.A. COVID-19 and mental health: challenges and first conclusions. RJTAO. 2020;12:4–10. https://doi.org/10.14412/2074-2711-2020-6-4-10.Medvedev V.E., Dogotar O.A. COVID-19 and mental health: challenges and first conclusions. RJTAO. 2020;12:4–10. https://doi.org/10.14412/2074-2711-2020-6-4-10.Бузунов Р.В., Назаренко И.В. Диагностика и лечение нарушений сна в практике терапевта. М.; 2009. 13 c. Режим доступа: https://buzunov.ru/wp-content/uploads/2011/07/Narusheniya-sna-v-praktike-terapevta_Metodicheskie-rekomendatsii-DZ-g.-Moskvyi-1.pdf.Buzunov R.V., Nazarenko I.V. Diagnostic and treatment of sleep disturbances in general practice. Moscow; 2009. 13 p. (In Russ.) Available at: https://buzunov.ru/wp-content/uploads/2011/07/Narusheniya-sna-v-praktike-terapevta_Metodicheskie-rekomendatsii-DZ-g.-Moskvyi-1.pdf.Garrigues E., Janvier P., Kherabi Y., Le Bot A., Hamon A., Gouze H. et al. Postdischarge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81:e4–6. https://doi.org/10.1016/j.jinf.2020.08.029.Garrigues E., Janvier P., Kherabi Y., Le Bot A., Hamon A., Gouze H. et al. Postdischarge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81:e4–6. https://doi.org/10.1016/j.jinf.2020.08.029.Gupta R., Pandi-Perumal S.R. COVID-Somnia: How the Pandemic Affects Sleep/Wake Regulation and How to Deal with it? Sleep Vigil. 2020:1–3. https://doi.org/10.1007/s41782-020-00118-0.Gupta R., Pandi-Perumal S.R. COVID-Somnia: How the Pandemic Affects Sleep/Wake Regulation and How to Deal with it? Sleep Vigil. 2020:1–3. https://doi.org/10.1007/s41782-020-00118-0.Bhat S., Chokroverty S. Sleep disorders and COVID-19. Sleep Med. 2021:S1389-9457(21)00403-2. https://doi.org/10.1016/j.sleep.2021.07.021.Bhat S., Chokroverty S. Sleep disorders and COVID-19. Sleep Med. 2021:S1389-9457(21)00403-2. https://doi.org/10.1016/j.sleep.2021.07.021.İnönü Köseoğlu H. COVID-19 pandemic and sleep disorders: COVID-somnia. Tuberk Toraks. 2021;69:387–391. https://doi.org/10.5578/tt.20219711.İnönü Köseoğlu H. COVID-19 pandemic and sleep disorders: COVID-somnia. Tuberk Toraks. 2021;69:387–391. https://doi.org/10.5578/tt.20219711.Orrù G., Bertelloni D., Diolaiuti F., Mucci F., Di Giuseppe M., Biella M. et al. Long-COVID Syndrome? a Study on the Persistence of Neurological, Psychological and Physiological Symptoms. Healthcare (Basel). 2021;9:575. https://doi.org/10.3390/healthcare9050575.Orrù G., Bertelloni D., Diolaiuti F., Mucci F., Di Giuseppe M., Biella M. et al. Long-COVID Syndrome? a Study on the Persistence of Neurological, Psychological and Physiological Symptoms. Healthcare (Basel). 2021;9:575. https://doi.org/10.3390/healthcare9050575.Mazza M.G., De Lorenzo R., Conte C., Poletti S., Vai B., Bollettini I. et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.Mazza M.G., De Lorenzo R., Conte C., Poletti S., Vai B., Bollettini I. et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors.Guedj E., Campion J.Y., Dudouet P., Kaphan E., Bregeon F., Tissot-Dupont H. et al. 18F-FDG brain PET hypometabolism in patients with long COVID. Eur J Nucl Med Mol Imaging. 2021;48:2823–2833. https://doi.org/10.1007/s00259-021-05215-4.Guedj E., Campion J.Y., Dudouet P., Kaphan E., Bregeon F., Tissot-Dupont H. et al. 18F-FDG brain PET hypometabolism in patients with long COVID. Eur J Nucl Med Mol Imaging. 2021;48:2823–2833. https://doi.org/10.1007/s00259-021-05215-4.Arbour N., Day R., Newcombe J., Talbot P.J. Neuroinvasion by human respiratory coronaviruses. J Virol. 2000;74:8913–8921. https://doi.org/10.1128/jvi.74.19.8913-8921.2000.Arbour N., Day R., Newcombe J., Talbot P.J. Neuroinvasion by human respiratory coronaviruses. J Virol. 2000;74:8913–8921. https://doi.org/10.1128/jvi.74.19.8913-8921.2000.Desforges M., Le Coupanec A., Dubeau P., Bourgouin A., Lajoie L., Dubé M. et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? Viruses. 2019;12:E14. https://doi.org/10.3390/v12010014.Desforges M., Le Coupanec A., Dubeau P., Bourgouin A., Lajoie L., Dubé M. et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? Viruses. 2019;12:E14. https://doi.org/10.3390/v12010014.Sateia M.J. International Classification of Sleep Disorders-Third Edition. Chest. 2014;146(5):1387–1394. https://doi.org/10.1378/chest.14-0970.Sateia M.J. International Classification of Sleep Disorders-Third Edition. Chest. 2014;146(5):1387–1394. https://doi.org/10.1378/chest.14-0970.Riemann D., Baglioni C., Bassetti C., Bjorvatn B., Dolenc Groselj L., Ellis J.G. et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26:675–700. https://doi.org/10.1111/jsr.12594.Riemann D., Baglioni C., Bassetti C., Bjorvatn B., Dolenc Groselj L., Ellis J.G. et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26:675–700. https://doi.org/10.1111/jsr.12594.Morin C.M., Vallières A., Guay B., Ivers H., Savard J., Mérette C. et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005–2015. https://doi.org/10.1001/jama.2009.682.Morin C.M., Vallières A., Guay B., Ivers H., Savard J., Mérette C. et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005–2015. https://doi.org/10.1001/jama.2009.682.Полуэктов М.Г., Бузунов Р.В., Авербух В.М., Вербицкий Е.В., Захаров А.В., Кельмансон И.А. и др. Проект клинических рекомендаций по диагностике и лечению хронической инсомнии у взрослых. Consilium Medicum. Неврология и ревматология (Прил.). 2016;(2):41–51. Режим доступа: https://www.rnmot.ru/public/uploads/2020/RNMOT/%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5%20%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8%20%D0%BF%D0%BE%20%D0%B8%D0%BD%D1%81%D0%BE%D0%BC%D0%BD%D0%B8%D0%B8.pdf.Poluektov M.G., Buzunov R.V., Averbukh V.M., Verbitskiy E.V., Zakharov A.V., Kel’manson I.A. et al. Project of clinical recommendations on diagnosis and treatment of chronic insomnia in adults. Consilium Medicum. Neurology and Rheumatology (Suppl.). 2016;(2):41–51. (In Russ.) Available at: https://www.rnmot.ru/public/uploads/2020/RNMOT/%D0%9A%D0%BB%D0%B8%D0%BD%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5%20%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8%20%D0%BF%D0%BE%20%D0%B8%D0%BD%D1%81%D0%BE%D0%BC%D0%BD%D0%B8%D0%B8.pdf.Culpepper L., Wingertzahn M.A. Over-the-Counter Agents for the Treatment of Occasional Disturbed Sleep or Transient Insomnia: a Systematic Review of Efficacy and Safety. Prim Care Companion CNS Disord. 2015;17(6):10.4088/PCC.15r01798. ttps://doi.org/10.4088/PCC.15r01798.Culpepper L., Wingertzahn M.A. Over-the-Counter Agents for the Treatment of Occasional Disturbed Sleep or Transient Insomnia: a Systematic Review of Efficacy and Safety. Prim Care Companion CNS Disord. 2015;17(6):10.4088/PCC.15r01798. ttps://doi.org/10.4088/PCC.15r01798.Мельников А.Ю. Острая инсомния: естественное течение и возможности коррекции. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019;119(4):28–35. https://doi.org/10.17116/jnevro201911904228.Melnikov A.Yu. Acute insomnia: natural course and correction modalities. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2019;119(4):28–35. (In Russ.) https://doi.org/10.17116/jnevro201911904228.Vande Griend J.P., Anderson S.L. Histamine-1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc. 2012;52(6):e210-е219. https://doi.org/10.1331/JAPhA.2012.12051.Vande Griend J.P., Anderson S.L. Histamine-1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc. 2012;52(6):e210-е219. https://doi.org/10.1331/JAPhA.2012.12051.

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