Инсомния – значимый фактор когнитивных нарушений: обзор литературы и клиническое наблюдение

Работа представляет собой анализ современной литературы о влиянии инсомнии на когнитивные функции. Поиск осуществлялся в базах данных РИНЦ, «Российская медицина», Embase, Medline, Scopus, Web of Science, Google Scholar по ключевым словам: инсомния, нарушение сна, когнитивные функции, память, функциональная МРТ, лечение инсомнии, доксиламин. Глубина поиска составила 40 лет. Последствия нарушений сна включают воздействие на теломеры хромосом, снижение активации нейронов и нарушение функциональных связей мозга. Недостаточный сон изменяет активность нейронов коры головного мозга в областях, ответственных за когнитивные функции, нарушает функциональную связь между областями мозга, опосредующими исполнительные функции, память и регуляцию эмоций. Глимфатический клиренс играет важную роль в патогенезе болезни Альцгеймера, т. к. подавляющее большинство токсичных метаболитов удаляется во время сна. Деменция связана с нарушением сна наряду с возрастным снижением функции аквапорина-4. Процесс накопления токсичных метаболитов (в том числе амилоида-β) начинается в молодом возрасте и ассоциирован с укорочением длительности сна. Немедикаментозные меры улучшения сна включают поведенческую коррекцию: обучение привычкам сна, оптимизацию условий сна и улучшение режима сна, умеренную физическую активность в течение дня, коррекцию факторов окружающей среды. При инсомнии возможно назначение блокаторов центральных гистаминовых H1-рецепторов. Доксиламин – лекарственное средство, используемое для лечения тошноты и рвоты у беременных, аллергического ринита и бессонницы. Валокордин®-Доксиламин – это безопасное и эффективное безрецептурное лекарственное средство, которое может принести пользу пациенту с минимальными побочными эффектами при правильном применении.

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