Dados do Trabalho

Título

Insomnia: an analysis of its pathophysiology, clinical treatments and related comorbidities

Resumo

Introduction: Insomnia is characterized by difficulty in the quality of sleep, whether to initiate or maintain sleep, which leads to substantial suffering and daytime impairment, being more common in elderly people. The pathophysiology of insomnia is associated with sleep-wake regulation through wakefulness promoters such as orexin, norepinephrine, and histamine and sleep-producing chemicals such as GABA, adenosine, melatonin, and prostaglandin. Insomnia, therefore, results from increased orexin-mediated neuronal firing and inhibition of sleep-promoting areas. In this way, the diagnosis and treatment of insomnia depends on a clinical history that analyzes precipitating factors, behavioral issues and environmental factors that can lead to poor sleep quality. Objective: To highlight the pathophysiology, associated comorbidities and therapeutic strategies for treating insomnia. Methodology: This is a systematic literature review based on data extraction in indexes such as PUBMED and MEDLINE. Publications between 2018 and 2022, in English and with the following descriptors: Insomnia, Neurology, Treatment, were considered. Results: Insomnia disorder goes beyond an individual complaint of poor sleep or misperception of sleep status, and there is evidence that insomnia in adolescents can be associated with changes in several biosystems, including functional cortical alterations and systemic inflammation. Insomnia disorder may also be associated with depression, hypertension, type 2 diabetes, gastroesophageal reflux disease, and asthma. The treatment of insomnia symptoms can be done through cognitive behavioral therapies and through this already achieving very positive results, at the same time they can be done through drug therapy that acts on GABA-A receptors exerting sedative, anxiolytic, muscle relaxant and hypnotic effects. Conclusion: In this way, it is important that physicians recognize and administer the treatment of insomnia to enable the reduction of morbidity related to it, which can guarantee the return of the quality of life that is lost, reduce daytime fatigue and the predictive risks for other pathologies.

Palavras Chave

Keywords: Insomnia. Treatment. Pathophysiology.