Insomnia
Most people are familiar with the negative effects of both insomnia and daytime sleepiness: irritability, difficulty concentrating, headaches, fatigue, etc. However, chronic insomnia can produce physiological changes that contribute to cognitive impairment, attention deficits, an increased risk of domestic, traffic, and work accidents, as well as neuropsychiatric disorders that compromise quality of life and life expectancy.
Insomnia also contributes to changes characterized by insulin resistance, with its negative cardiometabolic effects; elevated cortisol levels, which worsen insulin resistance; and hyperglycemia, diabetes, and dyslipidemia. Increased ghrelin and decreased leptin, which stimulate appetite, alter fat tissue distribution and lead to weight gain, exacerbated by the reduced energy expenditure in these patients. Similarly, we observe a decrease in growth hormone, which increases fat and decreases muscle mass (sarcopenia).
Insulin resistance observed in insomnia stimulates endothelial damage, the production of free radicals, oxidative stress, an increased prothrombotic state, and activates the sympathetic system, which favors the development of ischemic cardiovascular diseases, high blood pressure, cerebrovascular disease, and sudden death.
Insomnia, a chronic inflammatory state can be observed with an elevation of pro-inflammatory cytokines and growth factors that produces alterations in the intestinal microbiota and changes in the cellular genome, favoring mutations and the appearance of neoplasms.
Insomnia has significant medical, economic, and social repercussions. Physicians should investigate sleep patterns, and family members should be vigilant about the sleep patterns of those in their care. Organic causes that generate or worsen insomnia should be considered and addressed whenever possible. Improving sleep patterns will enhance quality of life and contribute to overall health improvement.
Dr. Lucia M. Gonçalves Jardim
Internal Medicine Physician.
Specialist in Endocrinology and Metabolism
Email: luciamgoncalvesj@gmail.com
Telephone: +351 939 056 458