[The clinical significance of insomnia in chronic headache]. / Klinicheskaya znachimost' insomnii pri khronicheskoi golovnoi boli.

OBJECTIVE: To study the features of the manifestation of insomnia and its impact on the condition and quality of life in patients with chronic tension-type headache. MATERIAL AND METHODS: The study included 65 patients with chronic tension-type headache and insomnia. Patients filled out questionnaires on headache severity, sleep quality, emotional status and quality of life. Seventeen patients underwent polysomnography. RESULTS: Patients with more severe insomnia had significantly more severe anxiety (p<0.001) and depression (p=0.025). Such patients assessed their quality of life worse according to the SF-12 questionnaire (p<0.002) and the Subjective Well-Being Scale (p<0.001), a higher level of central sensitization was observed in patients with more severe insomnia (p<0.001). CONCLUSION: The negative impact of insomnia on the condition of patients is not so much an increase in pain as such, but rather its influence on the quality of the emotional state and life in general, as well as an increase in the interdependence and mutual influence of other clinical and psychophysiological manifestations of the disease. Therefore, the clinical significance of insomnia is the deterioration of a person's ability to tolerate pain, which is the main prerequisite for a decrease in quality of life.

[Nightmares in patients with insomnia]. / Nochnye koshmary u bol'nykh insomniei.

Studies show a high frequency of comorbidity of insomnia and nightmares, which aggravate and chronicle each other. The mechanisms of their mutual influence are different. Insomnia changes the nature of dreams, both indirectly through emotional hyperactivation characteristic of insomnia, and as a result of frequent awakenings. However, frequent recurring unpleasant and frightening dreams can themselves increase the frequency of nocturnal awakenings and worsen the quality of sleep. The comorbidity of insomnia and nightmares should be taken into account when choosing a therapeutic approach in this category of patients. Priority are drugs that do not cause nightmares as a side effect, as well as psychotherapy.

[Comorbidity of tension headache and insomnia]. / Komorbidnost' golovnoi boli napryazheniya i insomnii.

The review shows the relationship between tension-type headache (THT) and insomnia. The pathophysiological and psychological mechanisms of their mutual influence on each other are considered. Evidence is provided that the combination of these pathologies often leads to the development of maladaptive coping strategies that aggravate the patient's condition. The features and difficulties of therapy of patients suffering from TTH and insomnia are considered in detail. It has been shown that the treatment of such patients should include approaches aimed at stopping TTH, sleep disorders and associated emotional disorders using drug and non-drug methods of treatment.