The figures speak for themselves. More than 12 million people would suffer from a disease that occurs at night, but ruins life for 24 hours. Is called insomnia. In addition to making it difficult for us to fall into the arms of Morpheus, creating long nights with wide open eyes and advancing thoughts, it affects daytime functioning. And heavily impacts quality of life: it becomes difficult to work, study, be with others. Though often not thought about, insomnia is also a major cause of absenteeism e you reduction in productivity on work and accounts for more than 1% of annual GDP in direct and indirect costs. In recent times, the difficulty of resting well in terms of quantity and quality has increased further, thanks to the pandemic and the economic and war events. The lockdowns, limitations, fear of contagion and war together with the constant consumption of news have increased stress, the sense of uncertainty and imminent danger in the population which have had a significant impact on the quantity and quality of sleep. For this reason it is important to face the picture seriously, without relying on do-it-yourself, empirical remedies, considering that true insomnia must be recognized and treated by specialists. Linsomnia affects all ages, but becomes more frequent with age, and is 1.5-2 times more common in women than in men. To find out more, the video offers answers to the most common questions about insomnia from an expert: Laura Palagini, psychiatrist at the Sleep Center of the University of Pisa.
When to talk about insomnia
Insomnia, despite its negative effects on the health of those affected, remains an underestimated pathology, underdiagnosed e undertreated: Patients often interpret it as a symptom and rely on DIY or word of mouth before seeking medical attention. The propensity of many of the media to consider insomnia as a problem related to well-being, lifestyle and bad habits and not a real pathology also contributes to all this. Insomnia is defined as acontinued dissatisfaction at least 3 months (for at least 3 nights a week) in the quality or quantity of sleep without the presence of known factors that hinder it. In Italy, according to data from theItalian Association for Sleep Medicinecirca 1 in 4 adults suffer from insomnia chronic or transient.
How insomnia manifests itself
Sleep is a physiological event and an essential pillar for good physical and mental health and optimal functionality throughout the day. Therefore, without adequate and quality sleep, many problems can arise that affect daily life. An essential symptom of insomnia is the impaired daytime functioningwhich is related to manifestations affecting health, such as fatigue, reduced energy, mood alterations and cognitive difficulties.
However, insomnia can take many forms:
- difficulty falling asleep;
- trouble staying asleep;
- early awakening;
- a combination of these factors.
The different types of insomnia
Insomnia is classified into three types:
- episodicwhen the symptoms of insomnia have been present for at least 1 month, but for less than 3;
- persistentwith symptoms lasting 3 months or more;
- recurringwhen the person has experienced at least 2 episodes of persistent insomnia (3 months or more) over the course of a year.
How insomnia arises
The healthy alternation of waking and sleeping states is regulated by distinct signaling systems in the brain. The main pathophysiological cause of insomnia is thought to be related to overactivation of the wake signaling system in the brain, also known as “fight or flight reaction” which interferes with the natural “shutdown” necessary for sleep. When a person is about to go to sleep, there is a real “competition” between the centers of wakefulness, which tend to keep him awake, and the sleep centers, which stimulate falling asleep. Insomnia occurs when the person fails to “turn off” the centers of wakefulness and to abandon himself to those of sleep. In particular, one has been observed in people suffering from insomnia reduced deactivation of brain regions involved in executive control, attention and self-awareness.
How much does insomnia weigh on life
The impact of insomnia is often underestimated. In reality, it can be a distressing condition capable of significantly affecting the quality of life by compromising work, study, social life and relationships.
People suffering from insomnia highlight:
- three times more likely to feel down or depressedcompared to people with a normal sleep pattern;
- twice as likely to experiment low energy levels and low motivation to exercise or participate in social activities;
- more likely to feel irritable and misunderstoodwith possible repercussions on relationships in private and working life;
- three times the probability of poor concentration during the day compared to those who sleep well.
Several studies have also shown that inappropriate sleep (both in quantity and quality) can be associated with a increased cardiovascular risk. L’American Heart Association it recently listed sleep as one of the eight major components of good cardiovascular health.
How to deal with insomnia
Depending on the cause of insomnia and its degree of severity, different therapeutic approaches are available.
The main options used up to now are:
- sleep hygiene techniques that is, a series of rules and behaviors that should be followed and adopted to promote a quality night’s rest;
- cognitive behavioral therapy;
- short courses of administration of sleeping pills or melatonin.
The hypnotic therapies currently available can increase sleepiness during the day and compromise the person’s functionality. These effects indicate that current therapies have limited ability to optimally treat people with insomnia, especially elderly patients. According to a recent survey, 72% of Italian doctors state that there is an unmet need in the treatment and cure of insomnia and 88% wish they could do more for their patients.
Recently a new line of research is being developed which aims to inhibit the excessive activation of wakefulness with drugs that improve sleep parameters without some of the side effects associated with commonly prescribed therapies for insomnia.
“In collaboration with Idorsia”