Results of a pilot study of the structure and evaluation of the therapy for chronic sleep disorders in comorbid patients with chronic cerebral ischemia

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OBJECTIVE

To evaluate the effect of the drug Cortexin on the clinical course and treatment of comorbid insomnia.

MATERIAL AND METHODS

The study included 50 patients, average age 50.4±2.26 years, with CHI stage 1—2. with concomitant diseases arterial hypertension, atherosclerosis, diabetes mellitus (study CHRONAS). All patients were examined on the day of treatment, 11—15 days and 30—31 days after the end of therapy. At all visits, complaints, neurological status, and changes in physiological and laboratory parameters were assessed. The condition was assessed using the following scales: mental status assessment (MMSE), quality of life questionnaire (EQ-5D), assessment of general health, Pittsburgh Sleep Quality Index (PSQI), Epworth daytime sleepiness assessment, hospital anxiety and depression (HADS)).: Patients with additional diabetic polyneuropathy were assessed using the Central Sensitization Inventory (CSI).

RESULTS

A high percentage of the prevalence of comorbid insomnia in patients was revealed. The structure of sleep disturbances in patients with chronic cerebral ischemia consisted of disturbances in sleep duration, difficulty falling asleep, frequent awakenings at night, and daytime sleepiness. After treatment, there was a regression of the main complaints, the severity of symptoms, including anxiety and depression, decreased, and a significant stabilization of cognitive status was observed. The positive dynamics persisted 1 month after the end of therapy. An additional normalizing effect of the drug on a number of biochemical parameters was revealed. Clinical dynamics were recorded already by the 11—15th day of treatment and persisted for up to 1 month. During observation, no patient had adverse drug interactions with other drugs (hypotensives, antiplatelet agents, statins).

CONCLUSIONS

The clinical effectiveness of the drug Cortexin has been proven for all types of sleep disorders. The clinical effectiveness of the drug Cortexin at a dose of 10 mg IM for 10 days has been proven in patients with chronic sleep disorders due to CHI.

Keywords:

sleep disorders

comorbid insomnia

chronic cerebral ischemia

daytime sleepiness

concentration

anxiety and depressive disorders

Cortexi

study CHRONAS

Authors:

Putilina M.V.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-8655-8501

Shabalina N.I.

Central Clinical Hospital «RZD-Medicine»

ORCID: 0000-0002-1814-3531

Received:

16.01.2024

Accepted:

21.02.2024

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