nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2020-4-119-124nnp-1424Research ArticleREVIEWSОБЗОРЫInsomnia and cognitive behavioral therapy for chronic back painИнсомния и когнитивно-поведенческая терапия при хронической боли в спинеПарфеноваЕ. В.ParfenovaE. V.

Елена Владимировна Парфенова

115419, Москва, ул. Донская, 43

Elena Vladimirovna Parfenova

43, Donskaya St., Moscow 115419

parfenovaelenavlad@gmail.comГБУЗ «Научно-практический психоневрологический центр им. З.П. Соловьева» Департамента здравоохранения г. МосквыРоссияZ.P. Solovyev Research and Practical Psychoneurology Center, Moscow Healthcare DepartmentRussian Federation202027082020124119124Copyright © Parfenova E.V., 20202020Парфенова Е.В.Parfenova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1424

To manage patients with chronic back pain (CBP) is one of the urgent problems of modern medicine, as CBP is associated with high disability, considerable socioeconomic costs, and low quality of life. Concurrent disorders, such as insomnia, depression, and anxiety, which make a significant contribution to the severity of CBP and related disability, are frequently disregarded when managing patients with CBP. Insomnia is observed in the majority of patients with CBP, but it is relatively rarely diagnosed, therefore the bulk of patients do not receive appropriate treatment. Cognitive behavioral therapy (CBT) combined with therapeutic exercises is one of the most effective treatments in patients with CBP; moreover, of great importance is the identification of concomitant insomnia, whose treatment with CBT is able not only to improve sleep, but also to reduce pain and to increase the physical and social activities of patients. A positive combination treatment effect is achieved due to a change in the patients’ ideas about the prognosis and causes of the disease, as well as to the increased intensity of physical activity and to the prevention of strenuous exercise and static stresses.

Ведение пациентов с хронической болью в спине (ХБС) – одна из актуальных проблем современной медицины, так как ХБС связана с высоким уровнем инвалидизации, значительными социально-экономическими затратами, а также низким качеством жизни. При ведении пациентов с ХБС часто не учитываются сопутствующие расстройства, такие как инсомния, депрессия и тревога, которые вносят существенный вклад в тяжесть ХБС и связанную с этим инвалидизацию. Инсомния отмечается у большинства пациентов с ХБС, но относительно редко диагностируется, поэтому значительная часть пациентов не получает соответствующего лечения. Комбинация когнитивно-поведенческой терапии (КПТ) и лечебной гимнастики представляет собой одно из наиболее эффективных направлений терапии пациентов с ХБС, при этом большое значение имеет выявление сопутствующей инсомнии, лечение которой с помощью КПТ способно не только улучшить сон, но и снизить боль и повысить физическую и социальную активность пациентов. Положительный эффект при комплексном лечении достигается благодаря изменению представлений пациентов о прогнозе и причинах заболевания, а также увеличению двигательной активности и профилактике чрезмерных физических и статических нагрузок.

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The authors declare that there are no conflicts of interest present.