“Insomnia is a real disease” classified according to international criteria that define the “specific disorder, not linked to other comorbidities (diseases, ed.). It affects women more and tends to increase in prevalence with advancing age. The problem affects approximately 10% of the general population”, approximately 6 million Italians, “if we consider insomnia as a chronic disorder, but if we also include patients who suffer from it acutely”, that is, not continuously, “we can say that it is a problem that affects 20% of the general population”. This was stated by Luigi Ferini Strambi, director of the Irccs Sleep Medicine Center at the San Raffaele hospital, professor of Neurology at the Faculty of Psychology, Vita Salute San Raffaele University (Milan) and member of the Italian Society of Neurology (Sin), in the twelfth episode of the monthly column ‘Protect your brain, rely on the neurologist’. The project, born from the collaboration between Sin and Adnkronos, aims to increase knowledge on neurological pathologies and on the figure of the neurologist, but also, and above all, to raise awareness among the population to rely on the care of this specialist when the symptoms of a nervous system problem appear.
“Despite the high number of people with insomnia – continues Ferini Strambi – only a portion requires more specific clinical evaluations and, once the diagnosis has been made, the disorder is certainly treatable. The insomnias to be analyzed in depth – he clarifies – are those characterized by difficulty maintaining sleep, frequent awakenings during the night”, or “when we are faced with drug-resistant insomnia”, in which “no response is obtained despite continuing to change drugs. In these cases – suggests the neurologist – it is certainly appropriate to carry out an investigation”.
Typical symptoms of insomnia include difficulty sleeping in the evening, waking up at night and never going back to sleep or waking up very tired in the morning with, in addition, negative reflexes in carrying out daily activities. “The diagnosis can also be made by a general practitioner – recalls Ferini Strambi – the important thing is to know the criteria. Only in some cases, however, is it necessary to resort to particular tests. Those, for example, who suffer from a problem such as of obstructive sleep apnea, which we often clinically link to daytime sleepiness, in reality, in 40% of cases, can have a problem of insomnia”.
Regarding the treatment, “we must consider that there are different phenotypes of the insomniac patient – underlines the neurologist -. Until recently we had the only possibility of using drugs that work on the Gaba system, which press the accelerator on a sedative action. Today we have another therapeutic opportunity – explains Ferini Strambi – which is exactly the opposite and which turns off the centers of wakefulness, counteracting the receptors to which orexin, a typical neurotransmitter of wakefulness, binds. receptor, the drug prevents the orexin from functioning, with a completely different therapeutic approach” which works “especially in people who struggle to turn off the centers of wakefulness, who have an excessive state of excitement (arousal) before sleeping. Orexinergic drugs which counteract the effects of orexin – concludes the expert – are certainly a very suitable option”.
2023-09-12 08:41:00
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