nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2021-3-125-130nnp-1578Research ArticleREVIEWSОБЗОРЫSleep disorders in acute and chronic painНарушения сна при острой и хронической болиПолуэктовМ. Г.PoluektovM. G.

Михаил Гурьевич Полуэктов

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11, стр. 1

Mikhail Gur'evich Poluektov

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Build. 1, Moscow 119021

polouekt@mail.ruГоловатюкА. О.GolovatyukA. O.

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Build. 1, Moscow 119021

Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияN.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation202123062021133125130Copyright © Poluektov M.G., Golovatyuk A.O., 20212021Полуэктов М.Г., Головатюк А.О.Poluektov M.G., Golovatyuk A.O.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/1578

Pain is one of the leading causes of decline in quality of life. When pain syndromes occur, a person may experience unpleasant sensory sensations and concomitant disorders, which can lead to pain aggravation and sleep disturbances. According to experimental studies, increased pain sensation with reduced sleep duration occurs due to opioid, serotonergic, noradrenergic, and dopaminergic antinociceptive systems dysfunction. In clinical practice, a reduction in sleep duration is usually associated with insomnia, which is the most common sleep disorder. In pain syndromes, insomnia occurs in 53–90% of patients (for comparison: in the general population – in 7.4%). Non-pharmacological (cognitive-behavioral therapy) and pharmacological approaches are used in insomnia treatment. Some medications (amitriptyline, mirtazapine, trazodone, gabapentin, pregabalin) have both hypnotic and analgesic effects, which allows to use them for pain syndromes with sleep disturbances. It has been shown that the correction of sleep disorders can reduce the severity and frequency of pain.

Боль рассматривается в качестве одной из ведущих причин снижения качества жизни. При появлении болевых синдромов у человека могут возникать не только неприятные сенсорные ощущения, но и сопутствующие расстройства, которые сами по себе могут приводить к усугублению боли, в том числе нарушения сна. На экспериментальных моделях показано, что усиление болевых ощущений при сокращении времени сна обусловлено дисфункцией опиоидергической, серотонинергической, норадренергической и дофаминергической антиноцицептивных систем. В клинической практике к сокращению времени сна приводит инсомния – наиболее частое из расстройств сна. При болевых синдромах инсомния встречается у 53–90% пациентов (для сравнения: в общей популяции – у 7,4%). В лечении инсомнии используют нефармакологический (когнитивно-поведенческая терапия) и фармакологический подходы. Некоторые лекарственные препараты (амитриптилин, миртазапин, тразодон, габапентин, прегабалин) обладают как снотворным, так и противоболевым действием, что позволяет использовать их при болевых синдромах с нарушением сна. Показано, что коррекция нарушений сна позволяет уменьшить выраженность и частоту боли.

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