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Background. Adequate sleep ensures a person’s physical and psycho-emotional well-being. Adolescence is one of the critical stages of life. The exclusive attention of specialists and leveling the impact of adverse factors on the body during this period is the key to the proper development and preservation of the health of adolescents. Meanwhile, sleep problems in teenage girls remain poorly understood.The aim. To study the features of the sleep regime and quality of sleep of teenage girls in the city of Irkutsk.Materials and methods. A survey of 422 teenage girls in the city of Irkutsk was conducted using a translated version of a questionnaire about adolescent sleep habits to subjectively assess their sleep and wakefulness. Two groups were formed: group I – girls with sleep problems (n = 171); group II – girls without sleep problems (n = 251).Results. Sleep disorders among teenage girls in the city of Irkutsk occurred with a frequency of 40.52 %. In most cases, a complex effect of various unfavorable factors on the sleep process has been identified. The adolescents with sleep disorders we examined were characterized by higher rates of sleep latency, later bedtime, earlier awakening, decreased time of night sleep, as well as changes in the sleep shift indicator towards its increase. These violations were noted both on weekdays and on weekends.Conclusions. Sleep problems were reported in 40.52% of respondents. The complex impact of various unfavorable factors on sleep quality has been revealed. The features of sleep hygiene of teenage girls are reflected. The group of girls with sleep problems was characterized by increased sleep latency, later bedtime, earlier awakening, reduced sleep time, and an increase in sleep shift.

Insomnia, defined as difficulty falling or staying asleep, significantly impacts the quality of life and mental health of people worldwide. In recent years, there has been growing interest in using medical marijuana as an alternative treatment method for various conditions, including sleep disorders. The purpose of this review is to examine the available scientific evidence regarding the efficacy and safety of using medical marijuana in the treatment of insomnia. Analyzing data from clinical, observational, and experimental studies, this work aims to present a comprehensive picture of the potential benefits and risks associated with such treatment. This review seeks to provide doctors, patients, and policymakers with up-to-date information that can support the decision-making process regarding the use of medical marijuana as an adjunct therapy in the treatment of insomnia, highlighting both the therapeutic potential and the need for further research in this field.

The aim: To study the problem of insomnia in Ukrainians during the first 11 months of the martial law in the country. To determine the predominant type of insomnia in the population. To calculate and assess the risk indicator for the development of cardiovascular complaints in the context of deteriorating sleep quality during the martial law and the risk ratio. Materials and methods: Anamnestic, statistical and calculative methods were used. 321 participants from Ukrainian population took part in an anonymous online survey. 210 respondents were female (65.4 %) and 111 were male (34.6 %). The age distribution was as follows: 18-19 years old (23.1 %), 20-21 years old (14 %), 22-23 years old (28.7 %), 24-25 years old (8.1 %), 26-27 years old (6.2 %), 28-29 years old (6.2 %), 30 years and older (13.7 %). The questionnaire included several sections: general questions regarding the respondents’ characteristics and presence of sleep disorders; questions of the Pittsburgh Sleep Quality Index (PSQI) [2]; subjective assessment of the sleep quality of the respondents during the first 11 months of the martial law and the presence of cardiovascular complaints that appeared or intensified during this period; details of mentioned complaints. Results: 245 respondents (76.3 % of 321) of the entire sample reported about sleep disturbances that developed after February 24, 2022. According to the PSQІ, only 17 respondents (7 %) scored 0-7 points, indicating the absence of insomnia, 180 respondents (73 %) scored 8-14 points, suggesting subclinical insomnia, 48 respondents (20 %) scored 15-21 points, indicating clinically significant insomnia. 209 (85.3 %) attributed these changes to the wartime events in the country. The most significant deterioration in sleep quality during the first 11 months of martial law in the country was observed in March 2022 and the best level of sleep quality was indicated in July. The odds ratio in risk calculation was 3.01; the significance level of the obtained data is 0.006. Conclusions: Subclinical insomnia dominates among Ukrainians during the martial law in the country. There is an increased risk of cardiovascular complaints in the population of Ukraine in the presence of clinically significant sleep disorders related to the martial law. Prolonged exposure to stress for Ukrainians can result in deteriorating sleep quality and increasing in cardiovascular complaints.

Introduction and purpose: Each phase of a woman's life, from childhood to menopause, may be associated with a variety of sleep disturbances. The pregnancy is particularly predisposed to develop sleep disorders such as insomnia, restless legs syndrome and sleep-disordered breathing, which require special management. This article reviews the most common sleep disturbances in pregnancy and discusses epidemiology, pathophysiology, maternal and fetal possible implications and therapeutic options in the pregnant population. Material and methods of research: The search was conducted using PubMed and Google Scholarship databases available to January 2024. Results: Although the exact cause of previously mentioned diseases remains uncertain, the impact of hormonal changes, the body mass before pregnancy and weight gaining during gestation on their development is highlighted by researchers. Poor sleep in pregnancy may have negative outcomes for women as well as fetuses and influence the pregnancy course. These sleeping disorders may also contribute to development of other systemic diseases. The management of sleep disturbance in pregnant patients is challenging due to the risk of teratogenicity, pharmacokinetic changes and the dynamic nature of pregnancy, thus nonpharmacologic interventions should be preferred as safer than medications. Conclusions: Sleep disturbances result in poorer quality of pregnant women’s life and have negative impact on the condition of pregnancy. Thus, this theme should create the need for additional research on the possibilities of prevention and treatment strategies of sleep disorders in pregnant women.

This publication discusses the mechanisms underlying the development of arterial hypertension on the background of stress, discusses the current problems of blood pressure control in patients with stress-induced sleep disorders, the clinical features of patients with hypersympathicotonia as the main mechanism for the development of arterial hypertension and blood pressure variability in patients with comorbid pathology, a diagnostic algorithm, as well as presenting current recommendations in the strategy for choosing the optimal antihypertensive therapy with the possibility of personalized choice in various clinical situations.

Objective: to study the connection between smoking and sleep disorders in the open population of 45–64 year old in Novosibirsk.Patients and methods. IV screening of the population was carried out in 2003–2005, 1650 persons were examined (576 men, mean age – 54.23±0.2 years, response – 61%; 1074 women, mean age – 54.27±0.2 years, response – 72%). Attitudes towards smoking were studied using the scale “Knowledge and attitude to one's health” of the WHO “MONICA-psychosocial” program. To study sleep disorders and sleep duration, a standard Jenkins questionnaire was used.Results and discussion. In an open population of 45–64 years of age, 65.8% of men experienced sleep problems (satisfactory sleep – 53.6%, poor sleep – 12.2%) and 78.6% of women (satisfactory sleep – 58.9%, poor sleep – 19.7%; χ2 =38.553; df=2; p0.05). Women who smoke were more likely to report 5–6 hours of sleep (30%) than 9–10 hours (18.2%).Conclusion. It has been established that smoking men and women aged 45–64 are more likely to experience both sleep disorders and lack of sleep.

Introduction. The COVID-19 pandemic has become a global health problem worldwide. The consequences of the new coronavirus infection continue to be studied. Cardiovascular symptoms and sleep disorders are among the dominant complaints in postCOVID-19 syndrome in women.Aim. To assess sleep disorders, cardiovascular symptoms, body weight dynamics and their statistical relationships in women with post-COVID-19 syndrome.Materials and methods. Using a voluntary anonymous questionnaire, we assessed cardiovascular symptoms, body weight dynamics and sleep disorders in 253 women of different age groups who had COVID-19 at least 12 weeks ago. The severity of dyspnea was assessed using the mMRC (Modified Medical Research Council) scale. Resting heart rate was measured. Statistical processing of the obtained data was carried out using the StatPlus 2009 Professional program.Results and discussion. Among the manifestations of the cardiovascular system in post-COVID-19 syndrome in women of different age groups, palpitations, shortness of breath, and increased blood pressure predominate. There is a statistical pattern in the increased prevalence of rises in blood pressure in post-COVID-19 syndrome among women, depending on age. A variety of sleep disorders occur in all age groups of women, most often in the group of older women. Statistical relationships between sleep disorders and increased blood pressure, severity of dyspnea, palpitations in post-COVID-19 syndrome in women of different age groups were revealed. Severe dyspnea in post-COVID-19 syndrome was frequent noticed in older women. Weight loss in women with post-COVID-19 syndrome is associated with sleep disorders.Conclusions. Cardiovascular symptoms and sleep disorders in post-COVID-19 syndrome in women of different age groups are closely interrelated. The management of patients in post-COVID-19 syndrome should be carried out taking into account the diversity and interaction of various clinical manifestations. Correction of the identified violations should be comprehensive, based on an interdisciplinary approach of various specialists.

Anxiety disorders are widespread among patients of primary care physicians and are the cause of increased morbidity and access to healthcare. Anxiety is a reaction of the body to the effects of stress and is manifested by the development of psychovegetative syndrome. In the general population, 5 to 7% of people have clinically significant anxiety, and in the practice of primary care physicians, these disorders are detected in every fourth patient. Anxiety disorder contributes to the development of psychogenic somatic pathology and/or negatively affects the course of background disease. Most patients with anxiety disorders suffer from various sleep disorders. In general practice, the frequency of sleep disorders reaches 73%. Chronic sleep disorder can act as a stressor that contributes to the development of pathophysiological changes in the body and increases anxiety. The above determines the need for early detection of sleep disorders and its timely treatment. The current treatment strategy for patients with sleep disorders involves an individualized approach to insomnia therapy. The existing arsenal of drugs used to treat sleep disorders allows this principle to be applied taking into account concomitant diseases (including anxiety disorders). The choice of product is also determined by good tolerability, efficacy and high safety profile. The optimal drug that answers the above requirements is doxylamine succinate, which allows you to effectively stop both anxiety symptoms and sleep disorders. Due to its high safety profile, doxylamine succinate can be used in the treatment of insomnia in pregnant women. The release form determines the convenience of use and the possibility of selecting an individual dose of the drug.

The pineal gland is an endocrine gland, which is responsible for the human circadian rhythm, through the regulation of its hormone – melatonin. The most common pathology of a pineal gland is pineal cyst – its population incidence is estimated as 1-23%, depending on the publication. The most common symptoms of a pineal cyst include headache (87%), visual field defects (54%), nausea/vomiting (34%), and dizziness/vertigo (31%). Among the majority of patients with the asymptomatic pineal cyst, the wait-and-see strategy is proper. According to the newest meta-analyze, the prevalence of sleep disturbances among patients with pineal cyst estimates to be 17%. The results of direct melatonin level measurements in pineal cysts remain unclear. The study focused on sleep disturbances in pediatric patients with pineal cysts and showed a significantly higher score on Sleep Disturbance Scale for Children (SDSC) in the domains of disorders of excessive sleepiness and disorders of initiating and maintaining sleep than the control groups. The impact of lesion on sleep quality correlated with its size. The pineal cyst may be considered a rare, and potentially reversible, cause of sleep disorders. Nevertheless, according to the present reports (often opposite to each other), this thesis and the mechanism of its occurrence need to be further researched.

Shift work refers to work that takes place at different hours, including at night. It is estimated that 15% to 20% of the working population works in shift work, particularly in the healthcare, energy, communication systems, public safety, and hospitality industries. Research indicates that shift work, particularly night work, can lead to health problems such as fatigue, exposure to harmful work environments, increased risk of workplace accidents, and sleep disorders. Night work is also associated with increased risk of hypertension, nervous system dysfunction, cardiovascular dysfunction. Those working at night are also more prone to hormonal disorders, digestive disorders, lowered immunity, and cancer. Sleep-wake cycle disorders, such as excessive sleepiness during waking hours and insomnia at night, are symptoms of shift work intolerance syndrome, which can occur after several months or years of shift work. It is estimated that over 20% of shift workers suffer from sleep-wake cycle disorders, and various factors such as chronotype, age, gender, family and social obligations, medications, medical and psychiatric conditions, and shift work experience can impact tolerance of shift work. The treatment of sleep and wake disorders related to shift work includes planning for main sleep and supplementary naps, appropriate exposure to light, treatment with melatonin, taking sleeping and psychostimulant medications.

Jet lag is a circadian rhythm disorder, affecting plane passengers travelling across multiple time zones. The severity of symptoms is strictly connected with the number of zones crossed. Common symptoms include: insomnia, difficulty concentrating attention, memory loss, anxiety, diarrhea, confusion, dizziness, headache, as well as malaise. Melatonin is a neurohormone, produced by the pineal gland. The hormone is released into the bloodstream and acts on MT1 and MT2 receptors, having the ability to induce sleep. Melatonin is therefore responsible for regulating the human biological clock and, consequently, the rhythm of sleep and wakefulness. Synthetic forms of melatonin have become a potential medication for various circadian rhythm disorders, including jet lag syndrome. Ten scientific reports were analyzed. The characteristics of the subjects, directions of the trips taken, the doses of melatonin, as well as the patterns of its administration, differed among studies. According to most of the reviewed trials, melatonin may have a beneficial effect on alleviating jet lag symptoms. The timing of intake plays a significant role – it has proven most effective when taken days before travel. However, several studies have not confirmed its effectiveness, compared to placebo. Further research seems to be inevitable to objectively reassess the effectiveness of melatonin preparations. Unambiguous determination of the melatonin dosage, the timing of its administration, the time of initiation, and the duration of the treatment would also be advisable. Nevertheless, all of the mentioned trials confirmed that the use of oral melatonin preparations, especially at low doses, turned out to be free of serious side effects.

Introduction and purpose: Sleep disorders are a diverse and widespread group of diseases affecting the cardiovascular system. The aim of this paper is to review the available literature and to summarize how selected sleep disorders affect the development of hypertension, ischemic heart disease and stroke. Methods and materials: Materials available in the PubMed and Google Scholar database were analyzed using the keywords “sleep disorders”; “sleep apnea”; “insomnia”; “restless legs syndrome”; “cardiovascular disease”; “hypertension”; “coronary artery disease”; “stroke " in various configurations. State of knowledge: Sleep disorders are a wide group of diseases with a diverse phenotype and pathomechanism, having a diverse impact on the condition of the cardiovascular system, leading to the development of diseases in the above system. Summary: The risk of developing hypertension, ischemic heart disease and stroke depends on the accompanying sleep disorders. Occurs with obstructive sleep apnea and sleep shortening. The correlation of restless legs syndrome to stroke is unclear. The relationship between insomnia and hypertension and stroke is not clarified. Keywords: sleep disorders, cardiovascular diseases, sleep apnea, insomnia, restless legs syndrome.

Background. Approximately every third patient who passed new coronavirus infection doesn’t feel absolutely healthy even few months ago after disease. Most constantly have noted fatigue (asthenia), sleep disorders, cognitive dysfunction and cardiovascular symptoms. In spite of coexistence different terms which describe persistent post-COVID-19 clinical manifestations, all of them serve the only goal – to demonstrate that the patients need in continuing medical care and rehabilitation after acute period of disease. Aim. Assessment of clinical manifestations of bridge syndrome in men and women. Materials and methods. Clinical manifestations of post-COVID-19 syndrome were assessed in 80 patients (49 women and 31 men) using a clinical interview and voluntary anonymous questionnaire. The mMRC (Modified Medical Research Council) scale was used to assess the severity of dyspnea, the McNair and Kahn questionnaire – for cognitive dysfunction, the FSS (Fatigue Severity Scale) – for the severity of fatigue (asthenia), and the visual analogue scale (VAS) was used for subjective assessment of fatigue. Statistical data processing was performed using the StatPlus 2009 Professional program. Results. Among the most frequently reported complaints of patients in the post-COVID period were fatigue, sleep disturbances, cardiovascular symptoms, pain in muscles and joints. Among women in the post-COVID syndrome, headache was more often recorded, among men – fatigue. The severity of fatigue (asthenia) was also most pronounced among men. A variety of sleep disorders were identified in the vast majority of patients. Daytime sleepiness was recorded more often in men (almost every third man); for women, a characteristic sleep disorder was nightmares, which were not observed in men. Approximately with the same frequency among both sexes, problems with falling asleep and nocturnal awakenings were revealed. Cognitive impairment was observed in approximately one in four patients who had COVID-19, regardless of gender. Statistical relationships between asthenia and cognitive dysfunction were revealed, which are more significant among men. Conclusion. The multiplicity of post-COVID clinical manifestations among men and women raises questions about the heterogeneity and potential summation of the pathogenic mechanisms underlying each symptom. Differences in the clinical symptoms of the post-COVID-19 period among men and women may can be explained by gender-specific immune response and require further study.

Proper and healthy sleep is an element of everyday life necessary for the proper functioning of the body. Unfortunately, a large part of humanity cannot experience proper rest, due to sleep disorders such as insomnia, restless leg syndrome, obturative sleep apnea and other diseases that complicate sleep. There are not many ways to treat sleep disorders and their use is often associated with difficulties in everyday life and side effects of the used methods. Work on this subject is still ongoing, with time there are more and more new possibilities and different, unconventional applications of substances discovered long ago. Plants containing cannabinoids have been known to mankind since ancient times. And this cannabinoids can have huge importance and contribute to the treatment and prevention of sleep disorders. Studies on the impact of these substances on sleep and sleep disorders are limited, which leads to the fact that in many countries their use is still prohibited. And therefore undertaking research on this topic requires a lot of effort. However, the data that has been collected so far on the subject of the influence of cannabinoids on sleep disorders carry optimistic information. Cannabinoids in the correct doses and ratio as to the content of individual subgroups can bring relief to people suffering from lack of proper sleep. However, the negative effects of these substances should not be forgotten. Chronic use, too high doses or improper application can have a negative impact on the quality of sleep.

Introduction: Sleep disorders are a common problem in society in the modern world. Patients are increasingly seeking alternative treatments for insomnia in order to reduce the side effects of prescription drugs. A new trend is the use of cannabinoids contained in cannabis plants to treat sleep disorders, making patients looking for a solution to their problem more and more eager. Aim of the study: The purpose of this paper is to present contemporary knowledge of the therapeutic benefits of cannabis compounds in treating sleep disorders and improving sleep parameters. Materials and methods: The National Center for Biotechnology Information/PubMed and Google Scholar medical databases were comprehensively analyzed by entering the keywords: cannabis, sleep disorders, insomnia, cannabinoids, THC, CBD in their respective configurations. Analyzing the searched literature, data from 18 scientific articles from the last five years (2017-2022) were evaluated. Results: Cannabinoids may have benefits in sleep-related disorders. The literature does not agree on the effectiveness of their use in treating sleep disorders. The highly variable availability of cannabinoid formulations on the market makes it difficult to develop appropriate dosages for the treatment of insomnia. Conclusions: Research on cannabis and sleep is in its early stages and needs to be continued in order to improve knowledge. There is a need for further long-term studies that are rigorously controlled and use larger study groups.

Introduction. Asthenia, vegetative manifestations, sleep disturbances and psycho-emotional background are companions of the coronavirus infection, the issue of drug correction of which is especially relevant. These symptoms disrupt the habitual way of life of patients for a long time, and in special cases lead to disability.Aim. To study the mental, somatoform and cognitive aspects of anxiety disorders after coronavirus infection during treatment with tofisopam (Grandaxin®) 150 mg/day.Materials and methods. The study included patients who had experienced a new coronavirus infection, who, after the end of treatment for the underlying disease, had complaints suggesting the presence of an anxiety disorder. The Hamilton scale was used to assess the level of anxiety. Examination of patients was carried out before the start of treatment, after 2, 4 and 6 weeks of therapy.Results and discussion. Prior to the start of therapy, all patients had an overall high level of anxiety: the average HAM-A score was 31.4 ± 2.92 points. At the end of Grandaxin® therapy, all patients showed a decrease in the level of anxiety: the average HAM-A score was 12.08 ± 2.27 points (p < 0.001). The maximum decrease in the severity of vegetative disorders was noted by the end of the 6th week of therapy with Grandaxin®. Thus, the indicator of this subscale decreased by more than 2 times – from 2.46 ± 0.54 to 1.05 ± 0.28 points (p < 0.001). The severity of insomnia during six weeks of therapy with Grandaxin® decreased from 2.56 ± 0.54 to 0.96 ± 0.45 points (p < 0.001).Conclusion. Psycho-emotional disorders (more often in the form of increased personal anxiety), sleep disorders, vegetative disorders, asthenic syndrome significantly affect the quality of life of patients who have had a new coronavirus infection. Involvement of the structures of the autonomic nervous system and central structures that regulate GABAergic transmission leads to significant vegetative failures, which requires pathogenetically substantiated drug correction of these disorders.

Sleep disturbances are common in patients with mental disorders. Sleep disturbances, in particular insomnia, are widespread in depression. Depressed patients have a lot of sleep complaints that are often confirmed by polysomnography. Most antidepressants impair sleep, so drugs that help to restore sleep are of particular value in clinical practice. Agomelatine (valdoxan) rapidly improves sleep in depressed patients by making it easier to fall asleep, increasing total sleep time, duration of rapid eye movement (REM), and slow-wave sleep (SWS), and improving functioning during the day.

Trigeminal autonomic cephalalgias (TACs) are rare but are the most intense primary headaches that severely limit patients’ ability to work and be socially active. This article reviews the modern classification of TACs, based on the International Classification of Headache Disorders-3, and the key differences between TAC types, as well as the pathophysiological mechanisms – the role of the trigeminovascular system, autonomic nervous system, hypothalamus and vagus nerve – and their relation to circadian rhythms. The sleep disturbances that can occur in patients with TACs, exacerbating the course of the disease, and the role of melatonin, hypothalamus and suprachiasmatic nucleus in these conditions are also discussed. In addition, current therapies for cluster headache are described, which include acute therapy and prophylactic therapy, with recommendations regarding the timing of prophylactic therapy discontinuation. The review also includes the available data on melatonin as well as new therapies such as CGRP monoclonal antibodies and neuromodulation, which includes the two most promising techniques: non-invasive vagus nerve stimulation and sphenopalatine ganglion microstimulation. Furthermore, the authors present the clinical case of a patient with chronic cluster headache, which was significantly reduced in frequency and intensity when melatonin was added to the therapy.

Sleep disorders often accompany COVID-19 and are a part of post-COVID syndrome. Some of the sleep disorders that occur in patients hospitalized for COVID-19 can be attributed to acute forms of insomnia. This type of sleep disorders is due to special conditions associated with hospitalization, and is short-term. Other sleep disorders appear as a part of anxiety-depressive symptoms diagnosed in patients with COVID-19. These symptoms can be classified as nosogenies psychogenic disorders that are associated with diagnosis of coronavirus infection; somatogenies psychopathological conditions resulting from pathological effects on the central nervous system of somatic and neurological complications of COVID-19; iatrogenies mental disorders that occur due to the intake of medication. Currently, information on the impact of sleep quality on the severity of COVID-19 and the effectiveness of treatment for post-COVID syndrome is accumulating. This review provides up-to-date information on sleep disorders in patients with COVID-19 and the principles of their therapy.

Objective: to establish associations of awareness and attitude towards cardiovascular diseases (CVDs) prevention in people with sleep disorders in an open population of Novosibirsk aged 25–64 years.Patients and methods. We carried out screening surveys of representative samples of the 25–64 years old population: in 2013–2016 – V screening (427 men, mean age– 34±0.4 years, response rate – 71%; 548 women, mean age– 35±0.4 years, response rate – 72%); in 2015–2018 – VI screening (275 men, mean age – 49±0.4 years, response rate – 72%; 390 women, mean age – 45±0.4 years, response rate – 75%) using the protocol of the WHO international program «MONICA-psychosocial». Jenkins sleep evaluation questionnaire was used to evaluate sleep disorders in the study population.Results and discussion. Participants with sleep disorders believed that they were «not entirely healthy» (men – 65.5%, χ2 =57.825, df=8, p

Introduction. In addition to acute manifestations, coronavirus infection is characterized by long-lasting symptoms: asthenia, somatic vegetative manifestations, sleep disorders and psychoemotional background, the question of therapeutic correction of which is especially relevant.The aim of the study was to study the mental, somatoform and cognitive aspects of anxiety disorders after coronavirus infection during treatment with tofizopam (Grandaxin®) at 150 mg / day.Materials and methods. The study involved patients who had a new coronavirus infection, who 4 weeks after the end of treatment for the underlying disease had complaints that suggest the presence of an anxiety disorder. The Hamilton scale was used to assess the level of anxiety. The patients were examined before the start of treatment, after 2, 4 and 6 weeks of therapy.Results. Prior to the start of therapy, all patients had an overall high level of anxiety: the average HAM-A score was 31.72 ± 2.24 points. At the end of Grandaxin® therapy, all patients showed a decrease in the level of anxiety: the average score for HAM-A was 12.68 ± 2.04 points (p distinct – the average score on the “cognitive disorders” subscale decreased three times – from 1.6 ± 0.12 to 0.5 ± 0.09 (p˂0.001).Conclusions. Disorders of the psychoemotional background (more often in the form of increased personal anxiety), sleep disorders, autonomic disorders, asthenic syndrome significantly affect the quality of life of patients who have suffered a new coronavirus infection. A comprehensive approach is needed in the clinical diagnosis of the long-term consequences of a new coronavirus infection and their subsequent correction with drug therapy.

Objective: to study sleep disorders prevalence and trends among the population of Novosibirsk (age group 25–64 years) in 1988–2018.Patients and methods. We screened a representative sample of a 25–64-year-old population: in 1988–1989 (II screening: 725 men, mean age – 43.4±0.4 years, response – 71.3%; 710 women, mean age – 44.8±0.4 years, response – 72%); in 1994–1995 (III screening: 647 men, mean age – 44.3±0.4 years, response – 82.1%; 391 women, mean age – 45.4±0.4 years, response – 72.5%); in 2003–2005 (IV screening: 576 men, mean age – 54.23±0.2 years, response – 61%; 1074 women, mean age – 54.27±0.2 years, response – 72%); in 2013–2016 (V screening: 427 men, mean age – 34±0.4 years, response – 71%; 548 women, mean age – 35±0.4 years, response – 72%); in 2016–2018 (VI screening: 275 men, mean age – 49±0.4 years, response – 72%; 390 women, mean age – 45±0.4 years, response – 75%) according to the standard MONICA Psychosocial study (MOPSY) protocol. Sleep disorders in the studied population were assessed with Jenkins Sleep Questionnaire.Results and discussion. We found a high prevalence of sleep disorders among the 25–64 years old population with the following trends: decrease from 1988–1989 to 1994–1995 (men – 11 and 8.6%, women – 21.8 and 16.6% respectively); increase in 2003–2018 (men – 13.1%, women – 20.5%). An increase in sleep disorders prevalence in 2003–2018 occurred mainly due to older age groups – 45–64 years (χ2 =122.061; υ=16; p

Quality of life indicators (QL) of patients are widely used in dermatological practice, but the influence of depressive and dissomnic symptoms on QL of patients with gender differences is not sufficiently studied.Objective: to identify depressive and dissominal symptoms in patients with psoriasis and evaluate its impact on the quality of life of these patients taking into account gender differences.Materials and methods: 34 patients with psoriasis were examined. Clinical examination included: analysis of complaints, medical history, assessment of dermatological status. Diagnosis of the presence and severity of depression was performed using a PHQ-9 patient health rating scale. Dissominal symptoms in patients with psoriasis were determined using the index of severity of insomnia ISI. To assess the quality of life, a dermatological index of quality of life (DLQI) was used.Results and discussion. Sleep disorders were detected in 15 patients (44.1%), depressive symptoms were determined in all patients, a negative effect of the disease on the quality of life of patients was found in 32 people (94.1%).Correlation analysis of data from the entire population of patients revealed statistically significant correlations of DLQI with the severity of depressive symptoms (r = 0.45, p = 0.008) and sleep disorders (r = 0.35, p = 0.04). In women, DLQI significantly correlates with the severity of depression (r = 0.48, p = 0.04) and tends to be associated with sleep disturbances (r = 0.43, p = 0.07). In men, the relationship between DLQI and indicators of depression and sleep disturbances is significantly weaker and is not statistically significant ((r = 0.34, p = 0.22) and (r = 0.17, p = 0.55), respectively).Conclusion.depressive symptoms and sleep disorders are interrelated with the quality of life of patients with psoriasis, and this relationship is more pronounced in women. Consequently, it is advisable to include effects aimed at normalizing mood and sleep in the program of complex therapy of psoriasis, taking into account gender differences.

Migraine and sleep disorders are common in the general population, may be associated with each other and often significantly reduce patients’ quality of life. Clinicians and epidemiological studies have long acknowledged a link between these conditions. However, the exact nature of this relationship, its underlying mechanisms and patterns are complex and not fully understood. This publication brings together the latest data on the relationship between migraine and sleep disorders: the biochemical and functional-anatomical background, the mutual influence of these conditions on each other and the typical sleep disturbances in migraine patients (such as insomnia, obstructive sleep apnea, parasomnia, snoring, excessive daytime sleepiness). The paper discusses the hypotheses of pathogenetic relationships based on the studies of the central nervous system’s anatomical and physiological features in people with migraine and sleep disorders. The available data should encourage physicians to evaluate sleep quality in migraineurs and use combination therapy systematically. The therapy of insomnia is reviewed: both nonpharmacological and pharmacological therapies are discussed; the advantages of an integrated approach are discussed, and a brief overview of each group of medications is offered.Lastly, a case study of a patient with chronic migraine and insomnia treated with Doxylamine in combination therapy is presented. Treatment with Doxylamine significantly reduced the incidence of insomnia, probably thereby positively influencing the course of migraine as well.

Abstract. Chronic pain syndrome can be widely extended in medical practice. Chronic pain syndrome can lead to a short-term insomnia, which is usually 2–3 days and causes the patient’s asthenia, goneness. Chronic pain forms of painful behavior: avoiding of physical exertion, sufferer outside, overdoing sensation of pain to have a same using, unique unpleasant things, loss of family functions, depletion of function. It is possible to become self-consciously closed because of the next depression, sleep disturbance and anxiety and pain, which is the potential for one another. It is dangerous through the formation of addiction from painkillers preparations (formulation of specific behavior) and the loss of psycho-somatic disorder. Purpose: to find out correlation of the disruption of the patient’s psychological camp and the pain senses. Materials and methods: analysis of 40 medical cards of patients of neurological department of the VCCC CR for the period – June 2020. Patients were comprehensively monitored by a psychologist, psychiatrist, and neurologist. The main complaint all this 40 patients is a chronic pain different localization at the time of the hospitalization. Nosological diagnosis of patients were: radiculities – 8; lumbalgia, sciatica and cervіkalgіa –26; posttraumatic neuropathy – 2; traumatic brain injury – 4. Conclusions: Between 40 patients with chronic pain revealed disorders of psychological health in 23 patients, which redacted 57.5%, any disorders were found in 17 patients – 42.5 %; main psychological disorders in patients with pain are: anxiety in 17 patients – 73.9%, decreased mood in 12 patients – 52.17 %, sleep disturbance in 8 patients – 34.8 %, irritability in 6 patients – 26.1 %, the most often combination was anxiety and low mood alliance in 6 patients – 26.1 %, and combination of the anxiety with sleep disorders in 5 patients – 21.7 %.

ethnic groups. Materials and methods.The objects of the study were menopausal women of Russian and Buryat ethnic groups (n=466), who were divided into a control group (without sleep disturbances) and main subgroups (with insomnia and comorbidity of insomnia with obstructive sleep apnea syndrome). All women underwent clinical and anamnestic examination, genotyping for3111T/C Clock gene polymorphism, determination of the circadian profile of melatonin secretion, parameters of lipid metabolism and the system lipid peroxidation antioxidant protection. Results.In Caucasians with sleep disorders, a higher prevalence of the3111T/T genotype and theClockgene3111Tallele was revealed as compared to the control (p0.05). Perimenopausal Caucasians showed a shift in the peak of melatonin secretion to the morning hours; in Mongoloids, both peri- and postmenopausal women, a decrease in melatonin total levels was revealed. Dyslipoproteinemia is characteristic of both races patients who have comorbidity of insomnia and obstructive sleep apnea syndrome, and it is more pronounced in postmenopausal Caucasians. Oxidative stress in sleep disorders is more pronounced in Mongoloids. The medical technologies directions for correction of sleep disorders are proposed: the use of melatonin drugs in the evening and light therapy in the early morning hours in Caucasians who are carriers of the3111T Clockgene allele; melatonin drugs to increase its total level in Mongoloids; personalized prescription of antioxidant therapy in all patients; specific therapy to eliminate breathing disorders during sleep in those who have obstructive sleep apnea syndrome. Conclusions.Presence of insomnia, chronobiological rhythms of melatonin secretion, lipid peroxidation processes in sleep disorders are ethnospecific.

In recent years, there have been reports of the effect of vitamin D on the intensity of early manifestations of menopausal syndrome (hot flushes, mood instability and symptoms of depression, sleep disorders) in perimenopausal women. This review of Russian and foreign literature presents the latest data on the role of vitamin D in maintaining the physical and emotional health of women during this period of life. According to the results of the study, it was found that vitamin D significantly reduces the intensity of early manifestations of climacteric syndrome in perimenopausal women. Prevention of vitamin D deficiency has a positive effect on the health of women in perimenopause, reducing the severity of manifestations of menopausal syndrome.On the basis of the studied literature data it is shown that the effect of calciferol on serotonin metabolism is similar to the effect of serotonin reuptake inhibitors, which are used in therapy of fever episodes.Inclusion of vitamin D (if there is a deficiency of it) in the complex therapy helps to cope with depression and insomnia. A normal supply of vitamin D provides maintenance of an optimal concentration of intracellular calcium in nerve cells, which reduces the likelihood of depression. During the perimenopause, in addition to the normalization of physical health, it is necessary to maintain its mental component. It has been proven that taking vitamin D in addition to menopausal hormonal therapy can quickly improve the emotional background, sexual function and quality of life. But still, there are cases when taking vitamin D does not cause positive changes. Most often, this is due to polymorphism of vitamin D receptors. The problem needs further study, as there is no clearly formulated treatment tactics in such situations.

Aim. To conduct a comparative analysis of serum orexin A levels in women of different age periods with and without sleep disorder and vasomotor symptoms. To evaluate the dynamics of orexin A levels under menopausal hormone therapy. Materials and methods. The study included 50 postmenopausal women and 30 women of reproductive age with a regular menstrual cycle. Using block randomization, patients are divided into 3 groups: group 1 (main group), n=25, -STRAW+ 10 (+1b and +1c), patients with sleep disorder and vasomotor symptoms; group 2 (comparison group), n=25, STRAW+ 10 (+1b and +1c), patients with vasomotor symptoms without sleep disorder; group 3 (control group), n=30, STRAW+ 10 (-4), women of reproductive age without sleep disorder. Group 1 patients were given menopausal hormone therapy. A comparative analysis was carried out using the questionnaire for assessing menopausal symptoms severity by the Greene Scale (the Greene Climacteric Scale) and Rating Scale for subjective sleep characteristics. After 12 weeks of treatment, a control examination was performed. Results. In group 1 women, the serum orexin A levels were significantly higher compared to the women without the symptoms. The link between the orexin A levels and menopause syndrome severity was established. A significant decrease in the menopausal symptoms severity after 12 weeks of menopausal hormone therapy was shown. It was accompanied by a 1,3-fold decrease in orexin A levels. Conclusions. The obtained data indicate the possible role of orexin A and the orexin neuropeptide system in the pathogenesis of sleep disorder and vasomotor symptoms in postmenopausal women.

The aim of the article is to describe and analyze Children’s Sleep Habits Questionnaire (CSHQ), to consider the problem of sleep disturbances of typical children and children with autism spectrum disorders and to present the results of adaptation and approbation of the Children’s Sleep Habits Questionnaire (CSHQ) in a sample of Ukrainian children using parent reports. Methods. To achieve the aims of the article, we used methods of theoretical analysis of modern research on the topic of the article, methods for assessing psychometric data using statistical criteria. To calculate the points, the Excel 2016 was used, and to check the psychometric characteristics of the questionnaire, the statistical program IBM SPSS Statistics 23 was used. The results of the research. The results of adaptation and approbation of the Children’s Sleep Habits Questionnaire (CSHQ) in a sample of Ukrainian children are presented. The scale was translated into Ukrainian from the original language (English) by a professional translator. In the adaptation of the questionnaire the parents of 506 children took part (293 typical children and 213 children with autism spectrum disorders), who filled in a questionnaire about their children’s sleep patterns. To check the psychometric characteristics of the questionnaire the determination of indicators of reliability (reliability as internal consistency and reliability of repeated testing) and validity (apparent validity, criterion validity and constructive validity) were carried out. Psychometric characteristics showed a high and sufficient level. The procedure and interpretation of the study results were standardized. The frequency distribution was calculated by the general indicator and additionally by age groups to determine the severity of sleep disturbances in children and adolescents. According to the results of frequency distribution, it was determined the overall distribution of scores, which gave the possibility to determine the presence and severity of the sleep disorders among children. Conclusions. According to the objectives of the article, the problem of sleep disturbances of typical children and children with autism spectrum disorders was consided, the original questionnaire of Childhood Habits Questionnaire (CSHQ) was analyzed, translated into Ukrainian, and successfully adapted, tested and standardized on a sample of Ukrainian children and adolescents with and without autism.

This review presents data on changes in the physiology of sleep during reproductive aging. It is noted that insomnia and obstructive sleep apnea syndrome (OSAS) are the main sleep disorders. The results of foreign and domestic studies in the field of free radical oxidation during sleep deprivation in animal models are presented, indicating the dependence of processes on the duration of sleep deprivation. The largest number of studies of free radical processes in a person with somnological pathology was carried out in the study of OSAS. Blood, urine, saliva, condensate of exhaled air can be biomaterial for determining the parameters of free radical oxidation. It was shown that the intensity of oxidative stress depends on the severity of OSAS, as evidenced by the positive correlation of the level of active products of thiobarbituric acid, the products of oxidation of proteins and carbonyl groups with the apnea/hypopnea index, determining the development of not only oxidative, but also carbonyl stress in patients with a severe degree OSAS. Biomarkers such as thioredoxin, malondialdehyde, superoxide dismutase, and reduced iron have shown a more stable relationship between increased oxidative stress and OSA. Despite the results obtained, the question of the association of oxidative stress and hypoxia in OSA remains debatable, which is associated with the opposite results of some studies. Insomnia, which occurs mainly in females, is accompanied by a high level of end products of lipid peroxidation with a decrease in the activity of antioxidants such as paraoxonase, an enzymatic component of the glutathione system. Along with this, menopausal women present low levels of uric acid, which correlates with high scores of the Pittsburgh sleep quality index questionnaire. Recent studies have identified an association between the activity of the «lipoperoxidation – antioxidants» system and the Clock 3111T/C gene polymorphism in menopausal Caucasian women, indicating the protective role of the minor allele.

Relevance. Today LUTS cause a lot of complexity and misunderstanding among doctors and patients. Among the symptoms, nocturia is the most difficult to interpret. Nocturia affects a significant part of the population, especially in older age groups. Currently, there are no data on the ratio of nocturia in various diseases of neurological etiology which are manifested by nocturia. Nocturia can be classified only according to urination diaries: diurnal polyuria, nocturnal polyuria, decreased bladder capacity, sleep disorders, and circadian rhythm disorders. Nocturia is also classified by degree of severity: mild severity from 1 to 3 episodes of nocturnal urination and severe when the number of nocturnal awakenings for urination is more than 3.Objective. To prove the effectiveness of the analysis of additional data on the daily diary of urination, together with the determination of the specific gravity of urine in the daytime and at night in patients with nocturia.Material and Methods. Two hundred eleven male patients were examined, with nocturia from 1 to 6 times and with a diagnosis of benign prostatic hyperplasia (BPH). The average age of the patients was 71 ± 4.7 years, the age interval of patients ranged from 50 to 84 years. the presence of symptoms of the lower urinary tract (LUTS), the total score on the I-PSS scale >21, an indicator of the quality of life index QOL >3, the maximum flow rate of urine (Qmax) >10 ml/s, residual urine volume (OOM)

The aim of the study is to improve the efficacy of the treatment of sleep disorders in patients with arterial hypertension (AH) and obesity. Materials and methods. In total, 62 patients were examined (mean age 58.3 ± 2.3 years) with AH and obesity. All of the surveyed persons underwent general clinical examination, daily BP monitoring, life quality assessment (General Well-Being Questionnaire). The ICSD-2 (2005) criteria were used to identify sleep disorders (dyssomnia) and subjective sleep characteristics questionnaires – for circadian “sleep –wake” rhythm disturbances assessment. Sleep disorders were found in all the examined patients at baseline. After the baseline data registration, the patients were prescribed basic therapy, 32 (group 1) of whom additionally received melatonin at a dose of 3 mg for 4 weeks; 30 patients were included in group 2. Results. After treatment, in group 1, the levels of office SBP and DBP were 6.9 % and 6.7 % (P < 0.05), and the average daily SBP and DBP (according to DMBP data) were 7.9 % and 6.7 % (P < 0.05) lower, respectively, than in group2. In patients of group 1, positive changes in lipid and carbohydrate metabolism, a significant improvement in subjective sleep characteristics and circadian “sleep – wake” rhythm were registered along with an improvement in the quality of life. Conclusions. Thus, melatonin add-on treatment in patients with AH and obesity with sleep disorders increases the efficacy of antihypertensive therapy, has a beneficial effect on glucometabolic parameters, subjective assessment of sleep quality and the quality of life.

Obesity and type II diabetes are 21st century pandemia. These metаbolic disorders are in the focus of attention of various specialties: cardiologists, endocrinologists, nutritionists, therapists, and others. The high incidence of obesity and type II diabetes cardiovascular complications, such as myocardial infarction, stroke, chronic heart failure, dementia, determine the call of risk factors search. Modifiable factors may include sleep disturbances. Recent studies have revealed a connection between changes in sleep duration and metabolic disorders. However, to date, the mechanisms underlying this association have not been established. The aim of the review is to summarize existing epidemiological and experimental observations, as well as an analysis of possible pathophysiological mechanisms linking sleep duration with obesity and type II diabetes. The article considers current data suggesting a bi-directional association of sleep disorders with obesity and diabetes. Sleep disturbances are significant determinant of developing metabolic disorders. Sleep duration correction as one of therapeutic targets for cardiovascular complications of obesity and type II diabetes prevention.

Aim. To assess the relationship between different types of sleep disorders, sleep-related symptoms and hypertension (HTN).Material and methods. This cross-sectional study based on the online survey of persons aged 18-39 years with a body mass index of 18-25 kg/m2.Results. According to the results, the HTN risk in persons aged 18-39 years with normal body mass index increases 2 or more times in the presence of various types of sleep disorders and related symptoms. The prevalence of HTGN depends on the patient's phenotype, i.e. from a combination of different types of sleep disorders and sleep-related symptoms.Conclusion. Given the widespread prevalence of various sleep disorders, as well as the relationship between sleep disorders and hypertension in young people, it is necessary to develop preventive measures aimed at reducing the HTN risk by restoring healthy sleep. We also suggest that various sleep disorders may be the primary link in the development of essential HTN.

Every second patient has sleep disorder. Outcomes of decreased quality of sleep lead to serious medical and socioeconomic value. Population studies identify the main causes of sleep problems: stress, poor sleep hygiene, somatic disorders. The effect of stress on sleep is noted by 75% of responders. The most frequently sleep disorders are insomnia, obstructive sleep apnea and restless legs. Treatment of insomnia based on current standards for the management of patients with insomnia. The main methods for the treatment of chronic insomnia are cognitive behavioral therapy, short-term hypnotic pharmacotherapy or a combination of both. Z-hypnotics, benzodiazepine receptors agonists, melatonine and melatonine receptors agonists, antihistamines, antidepressants, neuroleptics, herbal and antiepileptic drugs are recommended for the treatment of chronic insomnia. Most of them are in tablet form. Cases of gradual cancellation of hypnotics, an increase in half-life of the drug and refusal of hypnotic drug for fear of lack of hypnotic side effects control, require individual selection of the dosage. Liquid form (in drops) of doxilamine from antihistamines group -Valocardine®-Doxilamine (Krewel Meuselbach GmbH, Germany) enables convenient dosing with addition potentiation of the effect due to combination with ethanol and mint oil.

Aim. To analyze heart remodeling features in with obstructive sleep apnea syndrome and its association with obesity in the context of early cardiac aging.Material and methods. The study included 101 men, 41 patients with obstructive sleep apnea (OSA), 30 comorbid patients with OSA and obesity, the control group consisted of 30 healthy people. The average passport age of the patients was 40,4±6,7 years. Evaluation of OSA was carried out by cardiorespiratory monitoring, structural and functional features of the heart condition were studied using the echocardiography method, the average biological age was calculated.Results. Patients of both studied groups were characterized by structural and geometric rearrangement of the left heart chambers, transformation of physiological ellipsoid model into a spherical (left ventricle (LV) sphericity index 0,64±0,07 in the control group, 1,09±0,03 in the OSA group, 1,01±0,03 in the OSA + obesity group, p

Background. It is known that menopausal women suffer from sleep disorders. As additional diagnostic methods, it is possible to use the equations of linear classification functions.Aim: to determine the most informative parameters among the lipid profile, the “lipid peroxidation – antioxidant protection” system parameters and the melatonin secretion chronobiological rhythms in menopausal women with sleep disorders.Materials and methods. 56 perimenopausal women and 70 postmenopausal ones in accordance with the inclusion criteria participated in this study. Diagnoses of insomnia and obstructive sleep apnea syndrome were made according to the results of specialized somnological questionnaires and polysomnographic monitoring. Spectrophotometric methods for studying of lipid metabolism and the “lipid peroxidation – antioxidant protection” system parameters, an enzyme immunoassay method for determining melatonin were also used. A multidimensional discriminant analysis to reveal the most informative parameters among the parameters studied was used.Results. The most informative indicators of the metabolic system for sleep disorders in perimenopausal women with insomnia are melatonin 06.00–07.00 h, melatonin 18.00–19.00 h, melatonin 23.00–00.00 h, ketodienes and conjugated trienes, oxidized glutathione; with insomnia and OSAS – melatonin 06.00–07.00 h, melatonin 12.00–13.00 h, melatonin 23.00–00.00 h, substrates with conjugated double bonds, total cholesterol; in postmenopausal women with insomnia – diene conjugates, α-tocopherol, total antioxidant capacity, active products of thiobarbituric acid, reduced glutathione; with insomnia and OSAS – total antioxidant capacity, α-tocopherol, substrates with conjugated double bonds.Conclusions. The results obtained indicate a great strain in the antioxidant protection system in menopausal women with sleep disorders in response to changes in free radical homeostasis.

Sleep disorders are a significant problem in the dialysis patient population. They range from 30 to 80% of patients with kidney disease. Sleep submergers carry a wide range of consequences, both psychological and somatic. Obstructive sleep apnea, restless legs syndrome, excessive daytime sleepiness and insomnia are the most common sleep disturbances among dialysis patients. The aim of the study was to analyze the conditions and the most frequently occurring sleep disorders in patients with chronic kidney disease, dialyzed based on the subject literature review. Sleep disorders are both quantitative and qualitative. They carry numerous negative effects in the sphere of mental and somatic health of the patient, they decrease the overall quality of life. They heighten the already increased cardiovascular risk in the dialysis population. Therefore, early recognition and treatment of sleep disorders in dialysis patients is important. Periodic assessment of the sleep quality of a dialysis patient should be included in the therapy standard.

The study of neurological symptoms and signs connected with neoplasms and antitumor therapy is relevant in the context of an increasing prevalence of cancer. The COVID-19 pandemic and social factors have increased the number of patients suffering from insomnia. Sleep disorders is an unfavorable prognostic factor for neoplasms. The review presents risk factors and mechanisms of sleep disturbance, their relationship with inflammation and dysfunction of the immune system in cancer. In particular, dysfunction of the melatonergic system is discussed as a risk factor for the development of insomnia and cancer. The relevance of developing measures aimed at the rehabilitation of patients in order to restore normal sleep, which plays a fundamental role in maintaining a person's mental and physical health, is emphasized.

Objective: To analyze complaints about sleep disorders and assess the incidence of various sleep disorders, using relevant scales, in patients with medication-overuse headache (MOH) in comparison with patients without MOH., Material and Methods: The prospective case-control study included 171 patients, aged 18 years and older, with MOH (main group), and173 patients with primary headaches without MOH (control group). A neurologist conducted an initial examination and professional interview before the start of treatment. To diagnose sleep disorders, the International Classification of Sleep Disorders (3rd edition, 2014) was used. Additionally, an assessment was made using the Insomnia Severity Index Scale, the Epworth Sleepiness Scale (ESS) and the Lausanne Obstructive Sleep Apnea Syndrome Scale (NoSAS)., Results: Statistically significant differences were revealed in the prevalence of the following complaints about sleep disorders in patients with MOH: lack of sleep (51.5%), frequent awakenings during sleep (43.3%), discomfort in legs before falling asleep or at rest in the evening (37.4%). Difficulties falling asleep occurred equally often in both patients with MOH (43.9%) and without MOH (37.0%), as well as daytime sleepiness (40.4% vs 36.4%) and the presence of snoring (13% of patients in each group). Patients with MOH were significantly more likely to suffer from chronic insomnia (60.2% and 47.4%, respectively, p =0.02; OR 1.7; 95% CI 1.1-2.6) and restless legs syndrome (37.4% and 22.0%, respectively, p =0.002; OR 2.1; 95% CI 1.3-3.4). The incidence of hypersomnia and obstructive sleep apnea syndrome did not have statistically significant differences., Conclusion: Patients with MOH compared to patients without MOH have a significantly higher incidence of main complaints of sleep disorders, chronic insomnia and restless legs syndrome, which indicates the importance of sleep disorders in the pathogenesis of medication-overuse headaches and requires timely diagnosis and treatment to prevent the progression of both headaches and sleep disorders.

Pregnancy is associated with a number of physiological changes in a woman's body, which in turn affect the quality and duration of sleep. According to research, insomnia and other sleep disorders are associated with a high risk of adverse pregnancy outcomes, as well as postpartum complications. Understanding the mechanisms of sleep disorders during pregnancy is necessary to form an integrated approach in the management of this group of patients. The appointment of medicinal and non-medicinal therapies, as well as general recommendations for lifestyle correction in order to treat sleep disorders, is focused on the safe and prolific effect of a particular drug on the mother and fetus. This review also examined the safety profile of commonly used groups of drugs for sleep disorders during pregnancy.

Objective: To evaluate the effect of the drug Cortexin on the clinical course and treatment of comorbid insomnia., Material and Methods: The study included 50 patients, average age 50.4±2.26 years, with CHI stage 1-2. with concomitant diseases arterial hypertension, atherosclerosis, diabetes mellitus (study CHRONAS). All patients were examined on the day of treatment, 11-15 days and 30-31 days after the end of therapy. At all visits, complaints, neurological status, and changes in physiological and laboratory parameters were assessed. The condition was assessed using the following scales: mental status assessment (MMSE), quality of life questionnaire (EQ-5D), assessment of general health, Pittsburgh Sleep Quality Index (PSQI), Epworth daytime sleepiness assessment, hospital anxiety and depression (HADS)).: Patients with additional diabetic polyneuropathy were assessed using the Central Sensitization Inventory (CSI)., Results: A high percentage of the prevalence of comorbid insomnia in patients was revealed. The structure of sleep disturbances in patients with chronic cerebral ischemia consisted of disturbances in sleep duration, difficulty falling asleep, frequent awakenings at night, and daytime sleepiness. After treatment, there was a regression of the main complaints, the severity of symptoms, including anxiety and depression, decreased, and a significant stabilization of cognitive status was observed. The positive dynamics persisted 1 month after the end of therapy. An additional normalizing effect of the drug on a number of biochemical parameters was revealed. Clinical dynamics were recorded already by the 11-15th day of treatment and persisted for up to 1 month. During observation, no patient had adverse drug interactions with other drugs (hypotensives, antiplatelet agents, statins)., Conclusions: The clinical effectiveness of the drug Cortexin has been proven for all types of sleep disorders. The clinical effectiveness of the drug Cortexin at a dose of 10 mg IM for 10 days has been proven in patients with chronic sleep disorders due to CHI.

Objective: To determine the prevalence of insomnia and the effectiveness of its treatment in patients with a painful form of diabetic polyneuropathy (DPN)., Material and Methods: Fifty patients with the painful form of DPN were randomly divided into 2 groups: the standard therapy group (ST) and the extended therapy group (ET). In the ST group, a single lesson on sleep hygiene was conducted, in the ET group there were 3-4 face-to-face individual sessions for the treatment of insomnia for two weeks. Both groups were interviewed at the time of hospitalization, after 3 and 6 months. The severity of polyneuropathy and the nature of neuropathic pain were assessed using the Neuropathic Neuropathy Impairment Score in the Lower Limbs (NIS-LL) and the Neuropathy Total Symptom Score - 9 (NTSS-9); the intensity of pain was assessed using a Visual Analog Scale (VAS). Sleep disorders were analyzed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI)., Results: Sleep disorders of varying severity were observed in 82% of patients in the initial survey. In both groups, improvement in sleep quality was noted during treatment, but significantly better results were in the ET group, the ISI score after 6 months was 7.15±2.08 for the ST group and 3.07±2.49 for the ET group ( p <0.0001). In the ST group, there was no significant decrease in the intensity of pain and the severity of polyneuropathy in dynamics. In the ET group, a significant decrease in NTSS-9 and VAS scores was found during the initial survey and after 6 months ( p <0.0001). The intensity of pain also significantly decreased in the ET group compared with the ST group ( p <0.0001) at the end of follow-up, which indicates the importance of sleep normalization in the treatment of neuropathic pain., Conclusion: Most patients with the painful form of DPN have insomnia. Treatment of insomnia has shown its effectiveness as part of a multimodal approach to the managing of neuropathic pain in DPN and improving the quality of life of patients.

Insomnia is a serious and widespread public health problem, but is often undetected and patients do not receive needed treatment. Insomnia is often comorbid with other diseases and conditions, such as arterial hypertension, type 2 diabetes mellitus, pain syndromes, anxiety and depressive disorders, etc. A separate problem is drug-induced insomnia, when patients develop symptoms due to other diseases treatments. Insomnia has a negative effect on the prognosis of comorbid diseases, including an increased risk of death, more severe disease, and decreased quality of life. The presence of sleep disorders makes it difficult to effectively treat the underlying disease, so clinical guidelines draft for the evaluation and treatment of insomnia in multimorbid patients is proposed. Diagnostic methods are reviewed and recommendations are given for the treatment of acute and chronic insomnia and features of the treatment of insomnia in multimorbid patients. A clinical algorithm has been proposed to determine treatment tactics in multimorbid patients.

Cerebral strokes in 25-90 % of cases are accompanied by the emergence of various mental disorders. Thus, in 80% of cases of mental disorders manifest mental disorders nonpsychotic level (affective, cognitive, behavioral, personality), which are dominated by depressive disorders. The maximum frequency of depressive episodes recorded in the periods 3-6 months after stroke (70%). The risk of death when combined stroke depression increases 2.6 times, and the treatment of depression can prevent 11% of stroke. National center of psychiatry and neurology im. V.M. Bekhterev has 25 years of experience of use in patients with consequences of sharp violations of cerebral circulation of the drug gliatilin, which not only improves the neuroplasticity of the brain tissue but improves cognitive function and normalization of the emotional sphere of patients. One of the most important symptoms of depression are sleep disturbances. Changes in the structure of sleep in the acute period of stroke prognostic importance. Antidepressant trazodone used in the treatment of depressive disorders accompanied by insomnia. Doctors evaluated the effectiveness of the therapy, trittico in 34% of cases as excellent, 45% as good and 21% of cases as satisfactory. Patients evaluated the effectiveness of the drug in 24% of cases as excellent, 55% as good and 22% as satisfactory. To continue the drug treatment were in agreement 87% of patients.

Obesity and overweight are among the most common diseases in the world. Last data from 2016 showed that 650 million people were obese and since 1960 the number of obese people has increased three times, which is associated with "fast" lifestyle of the majority of the world's population. This is the clue why so many scientists are looking for modified obesity factors. Overweight is a major risk factor for inter alia diabetes, cardiovascular diseases and cancers. Most studies have shown obesity as a cause of sleep disorders such as excessive daytime sleepiness EDS or sleep apnoea, but recent studies have suggested that sleep disorders cause obesity. Otyłość i nadwaga należą do najczęstszych chorób na świecie, ostatnie dane opublikowane w 2016r. wykazały, że 650 milionów osób było otyłych, a od 1960 r. liczba osób zmagających się z otyłością wzrosła trzykrotnie, co wiąże się z "szybkim" stylem życia większości populacji na świecie. W związku z tym, wielu naukowców szuka modyfikowanych czynników otyłości. Nadwaga jest głównym czynnikiem ryzyka między innymi cukrzycy, chorób sercowo-naczyniowych i nowotworów. Większość badań ukazuje otyłość, jako przyczynę zaburzeń snu, takich jak nadmierna senność EDS w ciągu dnia lub bezdech senny, ale ostatnie badania sugerują, że zaburzenia snu mogą powodować otyłość.

Отсутствие объективных методов диагностики депрессивных состояний, а также надежных показателей эффективности антидепрессивной терапии и качества ремиссии диктует необходимость поиска нейробиологических маркеров. Для решения этой задачи может оказаться полезным изучение роли расстройств сна при аффективной патологии. В статье представлено описание основных нарушений сна при депрессии, даны их полисомнографические характеристики, проанализированы вероятные общие патофизиологические механизмы возникновения расстройств сна и депрессивной симптоматики. Также описаны вероятные биотипы депрессии, выделенные на основании различных нейробиологических характеристик, в том числе профилей сна. Кроме того, выполнен обзор исследований влияния транскраниальной магнитной стимуляции (ТМС) на сон у здоровых добровольцев, у лиц, страдающих бессонницей, и у пациентов с депрессией. Дальнейшее изучение воздействия ТМС на картину сна при депрессии представляется перспективным в поиске биологических маркеров эффективности метода, которые позволили бы персонифицировать его применение и тем самым повысить его эффективность.

Alzheimer’s disease (AD), one of the leading causes of dementia worldwide, is commonly accompanied by behavioral and psychopathological disorders. The earliest observed symptoms of AD include sleep disorders, the incidence of which varies from 25 to 60%. Sleep problems and sleep disorders can develop as one of the symptoms accompanying cognitive impairment, but can also be associated with an increased risk of cognitive decline and with a higher risk of dementia. Anti-dementia therapy is of great importance in preventing and treating sleep disorders in patients with AD. Akatinol memantine is one of the drugs with proven efficacy in such patients.

Nocturnal sleep disorders are one of the most important non-motor manifestations of Parkinson’s disease (PD). The clinical significance of sleep disorders in PD is determined by their frequency (up to 88%) and negative impact on quality of life in patients. The paper presents the clinical spectrum of sleep disorders in PD, current approaches to their diagnosis. It discusses the multifactorial nature of the pathophysiology of these disorders. Current views on the relationship of sleep disorders to the neurodegeneration of brain structures involved in the regulation of sleep and wakefulness, to circadian disorders and therapy are depicted. On the basis of the heterogeneity of sleep disorders in PD, a differentiated approach to their treatment is substantiated having regard to the nature of dyssomnic disorders and leading pathophysiological factors. Emphasis is focused on the basic principles of differentiated therapy for sleep disorders in PD in relation to the degree of nocturnal motor symptoms of the disease. There are clinical findings indicating an improvement in the characteristics of nocturnal sleep and a reduction in nocturnal sleep disorders during therapy with long- acting ropinirole, a D2-receptor agonist. Approaches to the pharmacotherapy of non-motor disorders of PD, which worsen nocturnal sleep, are depicted. Non-drug therapies for sleep disorders and their efficiency in patients with PD are discussed.

Objective: to study the prevalence of depression and anxiety and the pattern of sleep disorders in 45-69-year-old population with different levels of depression and anxiety in Russia (Siberia).Patients and methods. A total of 4171 Novosibirsk dwellers were surveyed. Men and women were 42.4 and 57.6%, respectively. Depression and anxiety were assessed using the modified scales, such as Welsh's Depression (WD) and Bending's Anxiety (BA) Scales, the Minnesota Multiphasic Personality Inventory, and the Jenkins Sleep Questionnaire (JSQ).Results. Depression, anxiety, and sleep disorders are significantly common in the Russian/Siberian population aged 45–69 years. The frequency of high depression and anxiety levels were 20.4% (51.3% of the respondents had medium and high depression) and that of anxiety was 15.6% (61.8% of the respondents were found to have medium and high anxiety). The women were noted to have higher levels of depression (21.4%) and anxiety (17.8%) than the men (19 and 12.5%, respectively). No clear relationship was found between high depression levels and age. Apparently, the value of age after 45 years is reduced and the level of depression remains approximately the same in 45–69-year-olds. The study of the relationship between the level of anxiety and age established that it was absent in the older men aged 45–69 years and the women showed a U-distribution characterized by the maximum proportion of individuals with high and low anxiety levels in the 65–69-year age group. Impaired sleep quality and sleep duration were more common in women (24 and 62%) than in men (18 and 59%). There was a relationship between the high level of depression and the duration and quality of sleep: more than 40% of the respondents with high levels of depression had impaired sleep quality and 65% had impaired sleep duration. Conclusion. The high incidence of cardiovascular diseases in Siberia (Russia) is associated with the widespread of psychosocial risk factors, such as high anxiety and depression levels and sleep disorders. The survey has demonstrated that the population shows a high demand for preventing these conditions.