[The role of central histamine receptor blockers in the treatment of insomnia]. / Rol' tsentral'nykh blokatorov gistaminovykh retseptorov v lechenii insomnii.

The article analyzes the anatomy, morphological and neurochemical connections and functions of the brain histaminergic system, one of the leading systems in the mechanism maintaining wakefulness. The possibilities of histaminergic system modulating for the treatment of various sleep/wake cycle disorders are discussed. The data of clinical trials on the influence of the histamine H1 receptor antagonist doxylamine on sleep in healthy volunteers and patients with insomnia are considered. The evidence-based efficacy of the drug in sleep disorders is discussed.

[Sleep and stress].

Stress is one of the main factors influencing sleep. Sleep could be considered as the adaptive mechanism including the stress defence. In the article, changes of the human night structure under the influence of stress are discussed. Specific and unspecific reaction of sleep parameters reflecting stress influences of different modalities, the pole of personality factors, and the methods of increasing the adaptive forces of the human through sleep normalization are described.

[The use of andante in the therapy of insomnia].

Thirty patients with psychophysiological insomnia (mean age 46,2+/-9,8 years) have been examined. All patients received 10 mg andante (zaleplone) in the evening 15 minutes before going to sleep during 7 days. A comparative assessment was conducted on the 1st and 7th days using a questionnaire for assessment of subjective sleep characteristics, the Obstructive Sleep Apnea Questionnaire, the Epworth Sleepiness scale, the Hospital Anxiety and Depression scale and the Beck Depression Inventory. Polysomnographic recording of night sleep was conducted in 15 patients. A significant decrease of anxiety and depression on the Hospital Anxiety and Depression scale and the Beck Depression Inventory (p<0,05) was found to the 7th day. After the treatment, the mean value on the questionnaire for assessment of subjective sleep characteristics increased by 63,6% from baseline and reached the normal level (p<0,05). Patients with initial pathological changes of the hypnogram had the following improvements: the significant increase of duration and percentage of stage 4 and delta sleep; decrease of falling asleep time, fast sleep latency period and awakenings during sleep; sleep quality index had reached the normal level (p<0,05) in 66% of cases. Forty percents of patients rated the efficacy of therapy as "very good", 34% as "good" and 13% as "moderate". No side-effects of andante were reported.

Interhemispheric EEG asymmetry in patients with insomnia during nocturnal sleep.

Sleep EEG was recorded and analyzed in patients with neurotic insomnia. It was found that interhemispheric asymmetry in the same individual can vary during sleep from right-hemispheric to left-hemispheric. Interhemispheric EEG asymmetry is closely related to the stage of sleep. The development of left-hemisphere or right-hemisphere asymmetry is mainly determined by activity of the right hemisphere. The development of interhemispheric asymmetry during wakefulness, stages 1 and 2 sleep, and delta sleep is mediated by common mechanisms.

[Specific features of the structure of sleep and personality under the conditions of chronic emotional stress and methods of improving the adaptive abilities of man]. / Osobennosti struktury sna i lichnosti v usloviiakh khronicheskogo émotsional'nogo stressa i metody povysheniia adaptivnykh vozmozhnostei cheloveka.

The results of a complex psychophysiological study of human sleep in the chronic stress condition are described. 20 patients with complaints of night sleep disturbances in the chronic stress condition and 10 healthy controls were examined by polysomnography. Profound changes of the quantitative and qualitative sleep parameters, mainly, related with the slow sleep phase, sleep delta characteristics and adaptive wakefulness mechanisms. The study demonstrated the effectiveness of improving the human adaptive parameters in the chronic stress conditions by using the drug and drugless therapy methods.

Stages of sleep after psychoemotional tension: the individual character of changes.

This report describes complex psychophysiological studies of nocturnal sleep in healthy humans in normal concentrations and after emotional tension. A series of contemporary methods was used: questionnaires, psychological tests, motor tests, and polysomnography with heart rate recording. These experiments showed that psychoemotional tension induced changes mainly in the structure of the first sleep cycle, decreasing the proportion of the second stage of slow sleep in total nocturnal sleep, led to a redistribution of delta sleep, increasing delta sleep in the second half of nocturnal sleep, and suppressed the mechanisms underlying the organization of the phases of rapid sleep. Psychoemotional tension affected human cerebrovisceral functions, for example inducing increases in the frequency and variability of the heart rhythm during nocturnal sleep. The nature of these changes in sleep structure and autonomic responses depended on the personality characteristics of the individual person. Thus, the individual approach to the question of psychoemotional stress in sleep disturbances is, we believe, the most appropriate.

[Sleep stages after psychoemotional exposure: individuality-dependent changes]. / Stadii sna posle psikhoémotsional'nykh vozdeistvii: individual'nost' izmenenii.

Sleep stages were studied in healthy subjects with the aid of a battery of tests involving questionnaires, psycho-tests, motor tests, polysomnography, and cardiomonitoring. An induced psychoemotional tension was shown to change the 1st sleep stage, to decrease percentage of the 2nd stage of the slow-wave sleep, to redistribute the delta-sleep, and to suppress the REM sleep mechanism. The cerebro-visceral function of increasing the heart rate and its variability in night sleep was also affected. Patterns of the sleep structure changes depended on personality characteristics of the subjects. Thereupon, individual programs should be used in studies of psychoemotional stress effects upon the sleep pattern.