ИНСОМНИЯ И ГАСТРОЭЗОФАГЕАЛЬНАЯ РЕФЛЮКСНАЯ БОЛЕЗНЬ: ОСОБЕННОСТИ ТЕЧЕНИЯ, МЕХАНИЗМЫ ВОЗНИКНОВЕНИЯ И ПУТИ КОРРЕКЦИИ

Probl bezperervnoï med osv nauki. 2019; 35(3): 62-67.
https://doi.org/10.31071/promedosvity2019.03.062

В работе показано, что инсомния является одной из актуальных коморбидных патологий при гастроэзофагеальной рефлюксной болезни (ГЭРБ). При ГЭРБ отмечаются основные особенности инсомнии: нарушение сна увеличивается с возрастом и поражает чаще женщин, пациенты имеют легкую и умеренную инсомнию, по опроснику PSQI достоверные различия обнаружены в выраженной дневной сонливости, существенно снижен физический компонент качества жизни, симптоматика ГЭРБ, включая инсомнию, более выражена у пациентов с неэрозивной рефлюксной болезнью. Основные причины нарушения сна при ГЭРБ: рефлюкс, ночная изжога, тревога и депрессия. Среди этих факторов одно из ведущих мест принадлежит психосоматическим нарушениям. Среди направлений коррекции инсомнии при ГЭРБ выделяют: дополнительный прием ингибиторов протонной помпы в вечернее время, прием рамелтеона и препаратов мелатонина. Связь между нарушением сна и симптоматикой ГЭРБ является двунаправленной, как и между депрессией и бессонницей.

СПИСОК ИСПОЛЬЗОВАННЫХ ИСТОЧНИКОВ

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Ключевые слова: гастроэзофагеальная рефлюксная болезнь, ингибиторы протон- ной помпы, инсомния, мелатонин, рамелтеон