Insomnia is an factor aggravaging the course of cardiovascular diseases: modern understanding of the problem and ways of solution

Abstract

Insomnia is a common and serious health problem associated with a significant and growing health burden. About 10% of the adult population suffers from chronic insomnia, and 20% suffer from it periodically. Insomnia is associated with an increased risk of mental (depression, cognitive impairment), somatic (arterial hypertension, coronary heart disease, arrhythmias, metabolic disorders) and occupational problems. The review examines current data on the effect of insomnia on the course of diseases of the cardiovascular system, showing the negative impact of insomnia on coronary heart disease, arterial hypertension and cardiac arrhythmias. A high prevalence (40-80%) of sleep apnea is observed in patients with cardiovascular disease, including coronary artery disease, atrial fibrillation, heart failure and hypertension, leading to adverse cardiac outcomes. A negative fact is the steady (epidemic) increase in cardiovascular diseases among young people aged 18 to 50 years, due to lifestyle changes and an increase in the level of stress factors. Individuals with insomnia have a significantly increased risk of myocardial infarction, cardiovascular mortality, cardiovascular disease morbidity, and all-cause mortality compared with healthy individuals. The optimal drug for the treatment of insomnia may be doxylamine, especially its most easily titrated form - a solution in drops. The drug has a high level of safety and is highly effective in the treatment of insomnia. A concomitant positive effect of the drug may be a decrease in the intensity of vestibular symptoms.