The Spanish Society of Neurology (SEN) estimates that between 20% and 48% of the adult population Our country suffers – or has suffered – at some point when it comes to falling asleep or staying asleep. Furthermore, they also indicate that around 10% of cases are due to a chronic and serious sleep disorder, but the truth is that this figure could increase because many patients are not diagnosed. In addition, and although many sleep disorders are treatable or preventable, at least one third of patients seek professional help.
With regard to age ranges, it has been perceived that sleep problems are no longer specific to adults, but are also occurring among the younger population. Furthermore, during the pandemic, multiple studies have been carried out in relation to insomnia. According to Dr. Vitsidis, who has published a study that included 2,427 people in a prestigious journal, 37.6% of these had sleep problems, with women and city dwellers being the most vulnerable.
Between 20% and 48% of the adult population suffers from sleep problems
In this sense, Dr. Juan Carlos Percovich, endocrinologist of Ruber International Havana Medical Center, explains that in the insomnia pathophysiology there is a state of psychophysiological hyperarousal in which brain, vegetative and endocrine system activity is involved, partly secondary to the excessive activation of the stress response system by altering the CRH-ACTH-cortisol and sympathetic axis and the rate of secretion of pro-inflammatory cytokines (IL-6 and TNFalpha).
«Consequently, many authors consider insomnia as a state of hyperalertness or alertness disorder that lasts 24 hours a day, which produces continuous fatigue in those who suffer from it, “he emphasizes.
According to the specialist, something very important in the hormonal system is the ritmo circadiano, which is nothing other than the physical, mental and biological changes that occur rhythmically over 24 hours. In this line, the dream is the clearest example. «The pacemaker that regulates sleep is found in the brainstem and the diencephalon, and the most important stimulus is exposure to sunlightThat is why it is used in the treatment of circadian sleep disorders and seasonal affective disorders, ”explains Percovich.
Insomnia as a state of hyperalertness
And he adds: «The melatonin, is a hormone synthesized in the pineal gland that begins to be secreted in the afternoon and until 5:00 am, when it decreases before the appearance of light. Melatonin as a drug may be helpful for the treatment of work-life insomnia, however, has not been shown to be useful in maintaining sleep», He points out.
There are various alterations in the ritmo circadiano of many other hormones during sleep disturbances. “For instance, growth hormone (GH) decreases its secretion at the beginning of sleep, cortisol is increased in the afternoon during insomnia, and the hormone that stimulates the thyroid gland (TSH) increases from lack of sleep. As for sex hormones, in aging slow waves of sleep are reduced by the little increase in testosterone at the beginning of sleep. Something similar could occur in sleep apnea ”, emphasizes Dr. Percovich.
In the reproductive stage of women, he explains, the circadian rhythm of luteinizing hormone (LH), also known as lutropin, changes according to the stage of the menstrual cycle and in menopause the levels of gonadotropins are elevated and this produces hot flashes and alterations in the quality of sleep. However, with hormone replacement therapy, it can be improved. “Recent studies suggest that sleep disorders are associated with increased menstrual irregularity, subfertility / infertility,” says Percovich.
exist various diseases that can be made worse by sleep disturbances or the other way around. According to Dr. Juan Carlos Percovich, it is shown that Sleep apnea syndrome (SAHS) is one of the possible causes of Type 2 diabetes and obesity is the main reason for this syndrome and vice versa.
Uncontrolled hypothyroidism is associated with a high prevalence of sleep apnea, however, there are other endocrine diseases Also related to insomnia, such as acromegaly (excessive secretion of growth hormone) and Cushing’s syndrome (hormonal disorder).
How can you fight insomnia?
The approach to insomnia must start from an accurate diagnosis, in which various endocrinological diseases that cause insomnia. The treatment will begin by complying with the sleep hygiene measures.
The measures are many, but necessary and effective. You just have to create a habit and do it daily. First, we must adhere to schedules when we go to bed and wake up, go to bed only when we are sleepy and avoid long naps.
In addition, the specialist details, You should reduce alcohol, caffeine and hypnotics and not eat large meals before going to bed. Nor should we forget to keep the room well ventilated, with adequate light and temperature, as well as without noise. Avoiding stress at night is very important, as is doing physical exercises in the afternoon and, of course, relaxation exercises before bedtime.
“If these guidelines are not followed, the treatment is doomed. However, if the situation requires it, pharmacological measures can be used.», Concludes the doctor.