Insomnia: when it is a pathology and not just a crooked night
To clarify what distinguishes a simple period of stress from a real sleep disorder is Paola Proserpio, an expert neurologist in sleep disorders. “There is talk of insomnia when the difficulties in falling asleep, frequent or early awakenings come to at least three times a week and last for more than three months, influencing daily life”.
What to do, then, if insomnia becomes chronic? The advice is to contact a sleep specialist, who can frame the problem with adequate diagnostic tools and propose targeted therapies. It is not always necessary to resort to drugs: “non-pharmacological therapies, such as cognitive-behavioral therapy for insomnia (CBT-I), have shown great effectiveness and are now recommended as a first choice treatment”, explains Proserpio. The use of drugs can be indicated in some cases, but always under medical supervision, favoring molecules with a good safety profile and a reduced risk of addiction.
Night apneas: sleep that fragments health
Obstructive sleep apneas are among the most subtle and serious disorders. “Many patients do not know they have them – explains Strambi – but there are spy signals: Niccuria (getting up several times to urinate), daytime sleepiness, irritability, and physical traits such as obesity, short neck and tazzo or small jaw”. Alessandro Oldani, responsible for functional unit at the Center of Sleep Medicine, describes other often neglected symptoms: snoring, night respiratory breaks (of which we notice only if reported by others), sudden awakenings, headache in the morning, persistent tiredness during the day.
Diagnosis passes through polysomnography, a non -invasive examination that monitors vital parameters during sleep. It can also be carried out in home mode, depending on the case. The most common treatment is the CPAP, a mask that maintains the airways open during the night, but there are also alternatives: from maxillofacial surgery to oral devices, to weight loss in obese subjects.
The risk of ignoring apneas is high: “They can significantly increase cardiovascular and cerebrovascular risk, causing hypertension, arrhythmias, strokes”, underlines Oldani. But the good news is that, once diagnosed, apneas can be managed and cure effectively.
