Бессонница у женщин в пери- и менопаузальном периодах и при некоторых соматических заболеваниях

Бессонница становится все более распространенным состоянием в современном обществе и приводит к серьезным проблемам для здоровья и благополучия людей. Различия во сне между мужчинами и женщинами проявляются в раннем возрасте и далее наблюдаются на протяжении всей жизни, при этом женщины сообщают о более низком качестве сна и подвергаются большему риску развития бессонницы по сравнению с мужчинами. Некоторые исследования показывают, что мужчины и женщины различаются по нейрогормональной секреции, биологическим процессам и морфологии мозга. Значительное число женщин испытывают трудности со сном в преддверии менопаузы и после нее, при этом трудность с наступлением сна, короткая продолжительность сна и плохое качество сна являются наиболее распространенными симптомами. Этиология нарушений сна у женщин в период менопаузы до сих пор не ясна и, по-видимому, отличается в зависимости от конкретных симптомов расстройства сна. Тем не менее потенциальные факторы включают в себя саму менопаузу, старение, вазомоторные симптомы, депрессию, тревогу и многие другие заболевания, такие как сердечно-сосудистые, эндокринные заболевания и психосоциальные факторы. Бессонница может проявляться отдельно или в сочетании с другими заболеваниями или расстройствами психического здоровья, и, если ее не лечить, она может увеличить вероятность развития и обострения любого из этих состояний. Менопауза часто сопровождается повышенным риском сердечно-сосудистых заболеваний. Бессонница считается установленным фактором риска развития инфаркта миокарда, в т. ч. и у женщин. В исследованиях проблем со сном были обнаружены гендерные различия со значительными ассоциациями у женщин в отношении артериальной гипертензии, распространенности дислипидемии, ожирения и сахарного диабета. Диагностика бессонницы в значительной степени основана на квалифицированном сборе анамнеза. Лечение бессонницы основано на двух стратегиях, которые могут использоваться по отдельности или в комбинации: когнитивно-поведенческая терапия бессонницы и фармакологическое лечение.

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