[The clinical significance of insomnia in chronic headache]. / Klinicheskaya znachimost' insomnii pri khronicheskoi golovnoi boli.

OBJECTIVE: To study the features of the manifestation of insomnia and its impact on the condition and quality of life in patients with chronic tension-type headache. MATERIAL AND METHODS: The study included 65 patients with chronic tension-type headache and insomnia. Patients filled out questionnaires on headache severity, sleep quality, emotional status and quality of life. Seventeen patients underwent polysomnography. RESULTS: Patients with more severe insomnia had significantly more severe anxiety (p<0.001) and depression (p=0.025). Such patients assessed their quality of life worse according to the SF-12 questionnaire (p<0.002) and the Subjective Well-Being Scale (p<0.001), a higher level of central sensitization was observed in patients with more severe insomnia (p<0.001). CONCLUSION: The negative impact of insomnia on the condition of patients is not so much an increase in pain as such, but rather its influence on the quality of the emotional state and life in general, as well as an increase in the interdependence and mutual influence of other clinical and psychophysiological manifestations of the disease. Therefore, the clinical significance of insomnia is the deterioration of a person's ability to tolerate pain, which is the main prerequisite for a decrease in quality of life.

[Insomnia in neurological patients with disabilities]. / Insomniya u nevrologicheskikh bol'nykh s ogranichennymi vozmozhnostyami.

Sleep is the most important factor reflecting the level of psychophysical well-being of a person and influencing him/her to the same extent. The greater susceptibility to sleep disturbances in patients with disabilities is associated with numerous factors. In the existing literature, there are few studies of insomnia in people with neurological disabilities. This article presents a current view on sleep disorders in disabled people and methods for their treatment.

[New opportunities for non-drug treatment of insomnia using sleep normalization medical device SONYA]. / Novye vozmozhnosti nelekarstvennoi korrektsii insomnii s pomoshch'yu apparata dlya normalizatsii sna SONYa.

OBJECTIVE: To study the effectiveness and safety of the sleep normalization medical device SONYA in the treatment of insomnia. MATERIAL AND METHODS: The effectiveness and safety of the SONYA device was studied in 32 subjects randomized into two groups - those who received stimulation using this device and those who received false stimulation (placebo). The indicators of subjective sleep characteristics, polysomnography, and emotional state were evaluated. RESULTS: The SONYA device exerts the positive effect on the main characteristics of night sleep and the emotional state of patients. The overall sleep efficiency, the total duration of delta sleep in its 1st and 2nd cycles, the delta sleep index significantly increased, while the time of falling asleep and the time of onset of delta sleep as well as the number and duration of night awakenings decreased. The severity of emotional and motivational disorders significantly decreased in the form of a decrease in the level of state anxiety, an increase in the background mood, the level of cheerfulness and well-being. No adverse events and side-effects from the use of the SONYA device have been recorded. CONCLUSION: According to the results of clinical studies, the SONYA device was registered as a medical device of the 2nd safety class for the treatment of insomnia of inorganic nature (F51.0) and sleep-wake disorders of inorganic nature (F51.2).

[Nightmares in patients with insomnia]. / Nochnye koshmary u bol'nykh insomniei.

Studies show a high frequency of comorbidity of insomnia and nightmares, which aggravate and chronicle each other. The mechanisms of their mutual influence are different. Insomnia changes the nature of dreams, both indirectly through emotional hyperactivation characteristic of insomnia, and as a result of frequent awakenings. However, frequent recurring unpleasant and frightening dreams can themselves increase the frequency of nocturnal awakenings and worsen the quality of sleep. The comorbidity of insomnia and nightmares should be taken into account when choosing a therapeutic approach in this category of patients. Priority are drugs that do not cause nightmares as a side effect, as well as psychotherapy.

[Comorbidity of tension headache and insomnia]. / Komorbidnost' golovnoi boli napryazheniya i insomnii.

The review shows the relationship between tension-type headache (THT) and insomnia. The pathophysiological and psychological mechanisms of their mutual influence on each other are considered. Evidence is provided that the combination of these pathologies often leads to the development of maladaptive coping strategies that aggravate the patient's condition. The features and difficulties of therapy of patients suffering from TTH and insomnia are considered in detail. It has been shown that the treatment of such patients should include approaches aimed at stopping TTH, sleep disorders and associated emotional disorders using drug and non-drug methods of treatment.

[Depressive disorders and diabetes mellitus in children and adolescents]. / Depressivnye rasstroistva i sakharnyi diabet u detei i podrostkov.

AIM: To clarify the role of depressive disorders and personality traits in the pathogenesis of diabetes mellitus type I in children and adolescents. MATERIAL AND METHODS: One hundred and three patients with diabetes, aged from one year nine months to 17 years, mean 9.7±0.7), with diabetes mellitus and depressive disorders were studied using clinical-psychopathological, psychometric, paraclinical and statistical methods. RESULTS: Biological and psychosocial risk factors of a somatic disorder have been identified. Mental disorders are represented by affective disorders and personality features of the patients. Affective disorders include mild psychogenic anxiety and asthenic-anxiety depression, personality features are represented by hysterical signs and emotional lability. Clinical variants of these mental disorders and their diagnostic assessment according to ICD-10 are presented. CONCLUSION: The dynamics of diabetes mellitus correlate with characteristics of depressive disorders. This result can be used to optimize the therapy of diabetes mellitus.

[Peculiarities of affective disorders in residual cerebral insufficiency]. / Osobennosti affektivnykh rasstroistv pri tserebral'noi rezidual'no-organicheskoi nedostatochnosti.

AIM: To determine clinical and psychopathological features of anxiety-depressive disorders in patients with cerebral residual organic insufficiency. MATERIAL AND METHODS: One hundred and fourteen patients with anxiety-depressive disorders and cerebral residual-organic insufficiency were studied. Psychopathological, psychometric, statistical methods were used. RESULTS AND CONCLUSION: Asthenia was identified as a core syndrome in anxiety-depressive disorders developed in patients with cerebral residual-organic insufficiency. Severe anxiety and depression with somatization of symptoms were characteristic of the structure of affective pathology. The somatization of affect, interpersonal sensitivity, marked asthenic and autonomic disorders as well as negative attitudes about their own condition, abilities and activity were main features of affective disorders in patients with cerebral residual-organic insufficiency. Clinical characteristics of cerebral residual-organic insufficiency and the diversity of its manifestations, including the combination with mental disorders, determine the relevance of further research.

[Sleep disturbances in panic disorders]. / Narusheniia sna pri panicheskom rasstroistve.

The most frequent among the symptoms and syndromes, which are comorbid to panic disorder, are sleep disorders, primarily, insomnia, persisting in 60-80% of patients in this category. Panic disorder and insomnia have bilateral relationships. On one hand, there is a clear correlation between disease severity and accompanying sleep disorders. On the other, the conditionality of sleep disturbances with pathological anxiety has been demonstrated. Treatment of insomnia in panic disorder includes a set of measures aimed at harmonizing the emotional state and stopping insomnia as a syndrome. A comprehensive approach, which includes, along with adequate pharmacotherapy, a wide range of methods of psychotherapeutic treatment, is the key for the success of therapy for sleep disturbances in panic disorder.

[A case of narcolepsy in adolescent].

A description of the clinical observation of the teenager with narcolepsy is presented. This case demonstrates specific clinical and polysomnographic characteristics of narcolepsy with cataplexy as well as a unique combination of paroxysmal forms of diseases affecting the state of sleep and wakefulness (narcolepsy, epilepsy and other phenomena related to sleep medicine). These forms include sleep-associated eating disorder and restless legs syndrome. The current approaches to treatment of narcolepsy are presented.