^{National Sleep Awareness Week draws attention to insomnia, which grew even more during the pandemic period. Photo: Disclosure}.

Insomnia is a sleeping disorder characterized by difficulty sleeping or being able to maintain the sleeping cycle without interruption at night. The psychiatrist Fábio Aurélio Leite, who was invited by Prati-Donaduzzi Pharmaceutical Industry to clarify the matter, explains that insomnia is not necessarily to spend the whole night without sleeping. It can manifest itself as a change in the quality of sleeping, that is, not only sleep little, but sleep poorly, and other factors such as waking up in the middle of the night and feeling tired during the day.

"The main symptom to consider regarding insomnia is how it affects your daily life, that is, if the person perceives a difficulty in performing his/her activities due to sleepless nights", explains the doctor. There are people who sleep, on average, 4 or 5 hours a night and feel rested and willing throughout the day, which is not the case when the person is suffering from insomnia.

In recent years, insomnia has become the enemy of a large part of the population, and as a result, it has ceased to be a taboo subject, in addition to being a disease constantly studied by specialists. According to a survey by the Brazilian Sleep Association (ABS), 73 million Brazilians suffer from insomnia. In large cities, such as São Paulo, where the pace of life is very hectic, the rates are very high. Data from the Instituto do Sono (EPISONO) reveal that 45% of the population in São Paulo complain about insomnia or difficulty sleeping.

Main causes

The cause of insomnia is explained by experts by using Spielman's theoretical model, which consists of three factors, which are known as the 3 Ps:

• Predisposing factors, or predisposition factors;
• Precipitating;
• Perpetuating.

The psychiatrist explains that the predisposing factor is the one that appears in people who have difficulty falling asleep, as a hyperactive alert person, or who have comorbidities such as anxiety and depression, which are diseases that coexist with insomnia, that is, not necessarily, one causes the other, but they have the potential to intensify the situation as a whole.

The precipitating factor is caused by events that generate emotional triggers such as stress and sadness. Examples are illnesses, the loss of a beloved one, pressure in the workplace, or fears and frustrations caused by situations such as the pandemic, and the circumstance of social isolation. "In the last year, the number of people who claim to suffer from insomnia has increased a lot because of the pandemic," says the psychiatrist.

The last factor, the perpetuating one is when the bad habits hinder our sleep, such as eating a lot before going to bed, doing physical activities late at night, drinking a lot of coffee during the day, among others.

Treatment

As already mentioned, it is not just one or two sleepless nights that characterize insomnia. Therefore, it is necessary to monitor the symptoms for two to three weeks, and if they persist, it is recommended to seek medical aid. The sooner a person sees a doctor, the faster it will be possible to treat and improve the condition of insomnia, says Dr. Leite.

Treatment involves Cognitive Behavioral Therapy (CBT), which is an approach to psychotherapy, carried out by a specialized doctor. CBT will mainly help patients with predisposing factors, such as depression. Medication is indicated in clinical cases when prescribed and accompanied by a doctor. Moreover, the sleeping hygiene, which encompasses several measures adopted to help improve sleeping, is used in parallel with other treatments.

Tips for better sleep

Perpetuating causes, that is, bad habits acquired over time, are factors that can be avoided. If the other causes need more attention and medical monitoring to treat, habits can be changed over time and have the possibility of collaborating with well-slept nights.

Here are some recommendations from the psychiatrist on how to do sleeping hygiene:

• Keep the room airy with little or no light;
• Consume small doses of products with caffeine, especially at night;
• Avoid taking naps during the day;
• Do not eat too much before going to bed;
• Avoid physical exercise late at night;
• Decrease the use of cell phones and television before bed;
• Maintain a sleep routine, even on weekends.

* This content is elaborated by Prati-Donaduzzi pharmaceutical industry, which aims to bring more information about health to the population. The company also provides physicians with exclusive access to content on various pathologies, among other materials on the website: https://www.evolucaoparavida.com.br/.

PRATI-DONADUZZI

Prati-Donaduzzi, a Brazilian pharmaceutical industry, is specialized and a benchmark in the development and production of generic drugs. Headquartered in Toledo, Western Paraná, it produces approximately 12 billion therapeutic doses per year and generates more than 4,500 employments. The industry has one of the largest generic drug portfolios in Brazil and it has been working in the area of Medical Prescriptions since 2019.