medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-034medsovet-7416Research ArticleНЕРВНО-ПСИХИЧЕСКИЕ РАССТРОЙСТВАNEUROPSYCHIATRIC DISORDERSБессонница: определение, распространенность, риски для здоровья и подходы к терапииInsomnia: definition, prevalence, health risks and therapy approacheshttps://orcid.org/0000-0002-7465-0677ПизоваН. В.PizovaN. V.

Пизова Наталия Вячеславовна - доктор медицинских наук, профессор, профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией.

150000, Ярославль, ул. Революционная, д. 5

Nataliia V. Pizova - Dr. Sci. (Med.), Professor, Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery.

5, Revolutsionnaya St., Yaroslavl, 150000

pizova@yandex.ruЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation202311042023038591Copyright © Пизова Н.В., 20232023Пизова Н.В.Pizova N.V.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/7416

Бессонница является широко распространенным расстройством среди населения в целом с хроническим течением и тяжелым бременем для пациентов и системы здравоохранения. Эпидемиологические работы, посвященные нарушениям сна, показывают, что большое количество людей предъявляют жалобы на нарушения сна. В настоящее время используются несколько классификаций и определений нарушений сна, и в первую очередь бессонницы. Недостаточный сон может способствовать появлению быстрого утомления в дневное время, снижению активности, внимания и работоспособности. Проведенные исследования показали, что длительные и выраженные расстройства сна могут приводить к различным соматическим, неврологическим и психическим заболеваниям или усугублять их. Бессонница может способствовать снижению познавательных способностей. Хотя доступны как нефармакологические, так и фармакологические вмешательства, лекарства часто назначаются из-за большей доступности. Когнитивно-поведенческая терапия бессонницы рекомендуется в качестве первой линии лечения у взрослых любого возраста. Фармакологическое вмешательство может быть предложено, если когнитивно-поведенческая терапия бессонницы недостаточно эффективна или недоступна. В то же время фармакотерапия нарушений сна, несмотря на огромное количество снотворных препаратов, остается сложной проблемой. Широко применяемые в медицинской практике снотворные средства как по механизмам своего действия, так и по конечному результату – влиянию на сон, не всегда способствуют развитию естественного (или, по крайней мере, близкого к физиологическому) сна. Бензодиазепины, агонисты бензодиазепиновых рецепторов, антидепрессанты, антигистаминные препараты, антипсихотики, мелатонин и фитотерапевтические средства могут быть использованы для лечения бессонницы.

Insomnia is a common disorder among the general population, which has a chronic course and a heavy burden on patients and the health care system. Epidemiological papers on sleep disorders show that a large number of people complain of sleep disorders. Today, there are several classifications and definitions for sleep disorders, and first of all for insomnia. Insufficient sleep can contribute to the occurrence of rapid fatigue during the daytime, reduced activity, attention and efficiency. Studies have shown that long-term and severe sleep disorders can lead to and/or exacerbate various somatic, neurological and mental diseases. Insomnia can contribute to cognitive impairment. Although both non-pharmacological and pharmacological interventions are available, drugs are more often prescribed due to greater availability. Cognitive behavioural therapy for insomnia is recommended as the first line treatment for adults of any age. Pharmacological intervention may be offered, if cognitive behavioural therapy for insomnia is not enough effective or not available. At the same time, the pharmacotherapy for sleep disorders remains problematic despite a large number of sleeping pills. Sleeping agents that are widely used in medical practice both in terms of their mechanisms of action and final results such as their effect on sleep do not always contribute to the development of natural (or at least close to physiological) sleep. Benzodiazepines, benzodiazepine receptor agonists, antidepressants, antihistamines, antipsychotics, melatonin, and phytotherapeutic medicines can be used to treat insomnia.

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