Нарушения сна у врачей в условиях пандемии COVID-19

Исследование. Взаимосвязь нарушений сна с тревожностью у практикующих неврологов в условиях пандемии. Цели. Оценить качество сна, уровень тревожности и их взаимовлияние у неврологов.

Дизайн. 330 неврологов были опрошены с использованием сервиса GoogleForms, с использованием опросника «Психологическое воздействие пандемии коронавируса нанаселение измеряется с помощью опросника Psycho-Covid‑19» в партнерстве c международной группой исследователей под руководством VitoTummino и Dr. FrancoVimercati (Италия).

Результаты Нарушения сна от легких до очень выраженных выявлены у 35% респондентов, что указывает на наличие у них высокого риска развития инсомнии. Показана статистически значимая позитивная корреляция нарушений сна как с общим показателем психологического риска, так и возможностью развития психопатологических синдромов. Заключение. Выявление и коррекция нарушений сна важны как мера профилактики и для коррекции тревожных расстройств у медицинских работников.

1. Указ Президента РФ от 25.03.2020 № 206 «Об объявлении в Российской Федерации нерабочих дней» от 25.03.2020 N206.

2. Verma S., Mythily S., Chan Y.H., Deslypere J.P., Teo, E. K., Chong S.A. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Annals of the Academy of Medicine, Singapore. 2004: 33 (6): 743–748. Available at: http://www.ncbi.nlm. nih.gov/pubmed/15608831. Accessed October, 15, 2020.

3. Román G.C., Spencer P.S., Reis J., Buguet A., Faris M.E.A., Katrak S.M., Láinez M., Medina M.T., Meshram C., Mizusawa H., Öztürk S., Wasay M. The neurology of COVID 19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. Journal of the Neurological Sciences. 2020; 414: 116884. https://doi.org/10.1016/j.jns.2020.116884.

4. Varatharaj A., Thomas N., Ellul M. A., Davies N. W.S., Pollak T. A., Tenorio E. L., Sultan M., Easton A. Breen G., Zandi M., Coles J.P., Manji H., Al-Shahi Salman R., Menon D.K., Nicholson T.R., Benjamin L.A., Carson A., Smith C., Turner M.R. Plant G. Neurological and neuropsychiatric complications of COVID 19 in 153 patients: a UK-wide surveillance study. The Lancet Psychiatry. 2020; 7: 875–82. https://doi. org/10.1016/S2215–0366(20)30287-X.

5. Ahmed M. Z., Ahmed O., Aibao Z., Hanbin S., Siyu L., Ahmad A. Epidemic of COVID 19 in China and associated Psychological Problems. Asian Journal of Psychiatry. 2020; 51: 102092. https://doi.org/10.1016/j.ajp.2020.102092.

6. Chen Y., Zhou H., Zhou Y., Zhou F. Prevalence of self-reported depression and anxiety among pediatric medical staff members during the COVID 19 outbreak in Guiyang, China. Psychiatry Research. 2020; 288: 113005. https://doi.org/10.1016/j. psychres.2020.113005

7. Spoorthy M. S., Pratapa S. K., Mahant S. Mental health problems faced by healthcare workers due to the COVID 19 pandemic.– A review. Asian Journal of Psychiatry, 2020; 51: 102–119. https://doi.org/10.1016/j.ajp.2020.102119.

8. Chew N.W.S., Lee G.K.H., Tan B.Y.Q., Jing M., Goh Y., Ngiam N. J.H., L.L.L. Yeo, A. Ahmad, F. A. Khan, G. N. Shanmugam, A. K. Sharma, Komalkumar R. N., Meenakshi P.V., Shah K., Patel B., Chan B.P.L., Sunny S., Chandra B., Ong J. J.Y., Paliwal P.R., Wong L. Y.H., Sagayanathan R., Chen J. T., Ng A. Y.Y., Teoh H. L., Tsivgoulis G., Ho C. S., Ho R.C., V.K. Sharma. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID 19 outbreak. Brain, Behavior, andImmunity. 2020; 88: 559–565. https://doi.org/10.1016/j.bbi.2020.04.049.

9. Tsamakis K., Rizos E., J Manolis A., Chaidou S., Kympouropoulos S., Spartalis E., Spandidos D.A., Tsiptsios D.S., Triantafyllis A. COVID 19 pandemic and its impact on mental health of healthcare professionals. Experimental and Therapeutic Medicine, 2020; 19 (6): 3451–3453. https://doi.org/10.3892/etm.2020.8646.

10. Singh P., Ponniah A., Nikkhah D., Mosahebi A. The Effects of a Novel Global Pandemic (COVID 19) on a Plastic Surgery Department. Aesthetic Surgery Journal. 2020;40(7):423–425. https://doi.org/10.1093/asj/sjaa074.

11. Simione L., Gnagnarella C. Differences between health workers and general population in risk perception, behaviors, and psychological distress related to COVID 19 spread in Italy. 2020; 11: 2166. https://doi.org/10.31234/osf.io/84d2c.

12. Голенков А.В. Нарушения сна при психических расстройствах. Эффективная фармакотерапия. Неврология и психиатрия. Спецвыпуск «Сон и его расстройства». 2014; 22: 22–25.

13. Taylor D.J., Lichstein K. L., Durrence H.H. et al. Epidemiology of insomnia, depression, and anxiety. Sleep. 2005; 28 (11): 1457–1464.

14. Ковров Г.В., Лебедев М.А., Палатов С.Ю., Меркулова Т.Б., Посохов С.И. Нарушения сна при тревожных и тревожно-депрессивных расстройствах. РМЖ. 2015; 10: 530

15. Speed T., Buenaver L. Managing Sleep Problems during COVID 19. Johns Hopkins Psychiatry Guide. 2020. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787390/all/Managing_Sleep_Problems_during_COVID_19.

16. Court A. Rarely has humanity experienced 'collective dreaming' on such a broad scale: Experts say we are all sharing the same vivid coronavirus nightmares. https://www.dailymail.co.uk/news/article 8266207/Experts-say-coronavirus-anxiety-causing-vivid-dreams-ruining-proper-sleep.html Accessed: May, 26, 2020.

17. Проект «Россия-Китай: Главное» Эпидемия COVID 19 спровоцировала повальное нарушение сна в Китае. Принята 04.07.2020. https://ria.ru/20200316/1568662476.html

18. Lai J., Simeng M., Wang Y. Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Network Open. 2020; 3 (3) e203976. Published 2020 Mar 2. https://doi.org/10.1001/ jamanetworkopen.2020.3976.

19. Zhang C., Yang L., Liu S. Survey of insomnia and related social psychological factors among medical staffs involved with the 2019 novel Coronavirus disease outbreak. Front Psychiatry. 2020; 11: 306. https://doi.org/10.3389/fpsyt.2020.00306.

20. Simpson N. Manber R. Treating Insomnia during the COVID 19 Pandemic: Observations and Perspectives from a Behavioral Sleep Medicine Clinic. Volume, 2020; 18 (4): 573–575. https://doi.org/10.1080/15402002.2020.1765781. e-mail: medalfavit@mail.ru

21. Салькова А. Бессоница икошмары: что COVID 19 творит поночам. https://www. gazeta.ru/science/2020/04/17_a_13051945.shtml Принято 23 b.kz 2020.

22. Nguyen Т. Having weird dreams in quarantine? You’re not alone. https://iheartintelligence.com/having-weird-dreams-in-quarantine-youre-not-alone/ Accessed May, 26, 2020.

23. Machemer Т. Insomnia and Vivid Dreams on the Rise with COVID 19. Anxiety by https://www.smithsonianmag.com/smart-news/insomnia-and-vivid-dreams-rise-pandemic-anxiety 180974726 Accessed: May, 26, 2020.

24. Seminog O.O., Goldacre M. J. Risk of pneumonia and pneumococcal disease in people with severe mental illness: English record linkage studies. Thorax. 2013; 68 (2): 171–176. https://doi.org/doi:10.1136/thoraxjnl 2012–202480.

25. Прохоренко И.О., Германова В.Н., Сергеев О.С. Стресс и состояние иммунной системы в норме и патологии. Краткий обзор литературы. Вестник медицинского института «Реавиз». 2017; 1: 82–90.

26. Булгакова О. С. Иммунитет и различные стадии стрессорного воздействия. Успехи современного естествознания. 2011; 4: 31–35.

27. Draugalis J.R., Coons S.J., Plaza C.M. Best practices for survey research reports: a synopsis for authors and reviewers. Am J Pharm Educ. 2008; 72 (1): 11. https://doi. org/doi:10.5688/aj720111.

28. Dillman D.A. Mail and Internet Surveys: The Tailored Design Method. 2nd ed. Hoboken, NJ: John Wiley & Sons; 2007 (2007 Update).

29. Baruch Y., Holtom B. C. Survey response rate levels and trends in organizational research. Human Relations. 2008; 61 (8): 1139–1160. https://doi. org/10.1177/0018726708094863.

30. Yun G.W., Trumbo C.W. Comparative response to a survey executed by post, e-mail, & web form. J Compu-Mediated Com. 2000:6. Available online at: http://jcmc.indiana.edu/vol6/issue1/yun.html Accessed April 1, 2008. (n.d.).

31. ВОЗ Европейский портал информации здравоохранения (2020). https://gateway.euro.who.int/ru/indicators/hlthres_137-of-physicians-by-sexall-ages/visualizations/#id = 31564

32. Bohlken J., Schömig F., Lemke M. R., Pumberger M., Riedel-Heller S. G. COVID 19-Pandemie: Belastungen des medizinischen Personals. Psychiatrische Praxis, 2020; 47 (04): 190–197. https://doi.org/10.1055/a 1159–5551.

33. Huang J.Z., Han M.F., Luo T.D., Ren A.K., Zhou X.P. Mental health survey of medical staff in a tertiary infectious disease hospital for COVID 19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi = Zhonghua Laodong Weisheng Zhiyebing Zazhi = Chinese Journal of Industrial Hygiene and Occupational Diseases. 2020; 38 (3): 192–195. https://doi.org/10.3760/cma.j.cn121094–20200219–00063.

34. Selye H. Stress without Distress. In: Serban G. «eds». Psychopathology of Human Adaptation. New York: Springer Publishing. Shanker S. 2016: 137–146. https://doi. org/10.1007/978–1–4684–2238–2_9.

35. Singh P., Ponniah A., Nikkhah D., Mosahebi A. The Effects of a Novel Global Pandemic (COVID 19) on a Plastic Surgery Department. Aesthetic Surgery Journal. 2020; 40 (7): 423–425. https://doi.org/10.1093/asj/sjaa074.

36. Tan B.Y.Q., Chew N.W.S., Lee G.K.H., Jing M., Goh Y., Yeo L.L.L., … Sharma V.K. Psychological Impact of the COVID 19 Pandemic on Health Care Workers in Singapore. Annals of Internal Medicine, 2020; 20: 1083. https://doi.org/10.7326/M20–1083.

37. Xiao H., Zhang Y., Kong D., Li, S., Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID 19) in January and February 2020 in China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 2020; 26: e923549. https://doi.org/10.12659/MSM.923549.

38. Belleville G., Ouellet M.C., Morin C.M. Post-traumatic stress among evacuees from the 2016 Fort McMurray wildfires: exploration of psychological and sleep symptoms three months after the evacuation. Int J Environ Res Publ Health. 2019; 8; 16 (9): E1604. https://doi.org/10.3390/ijerph16091604.

39. Yang B., Wang Y., Cui F., HuangT., ShengP., ShiT., HuangC., LanY., HuangY.-N. Association between insomnia and job stress: a meta-analysis. Sleep Breath. 2018; 22 (4): 1221–1231. https://doi.org/10.1007/s11325–018–1682-y.

40. Lin L., Wang J., Ou-Yang X., MiaoQ., ChenR., LiangF.-X., ZhangY.-P., TangQ., WangT. The immediate impact of the 2019 novel coronavirus (COVID 19) outbreak on subjective sleep status. Sleep Medicine. 2020 Jun. https://doi. org/10.1016/j.sleep.2020.05.018.

41. Wu K, Wei X. Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the Fight Against COVID 19 in China. Med Sci Monit Basic Res. 2020; 26: 924085. https://doi.org/10.12659/ MSMBR.924085.

42. Lauriola M., Carleton R.N., Tempesta D., Calanna P., Socci V., Mosca O., Salfi F., Gennaro L. De, Ferrara M., A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms. Int J Environ Res Public Health. 2019; 16 (18): 3253. Published 2019 Sep 5. https://doi.org/10.3390/ijerph16183253.

43. Altena E., Baglioni C., Espie C.A., Ellis J., Gavriloff D., Holzinger B., Schlarb A., Fraz L., Jernelov S., Riemana D. Dealing with sleep problems during home confinement due to the COVID 19 outbreak: practical recommendations from a task force of the European CBT-I Academy. J Sleep Res. 2020 Apr 4. https://doi.org/10.1111/jsr.13052.

44. Sher L. COVID 19, anxiety, sleep disturbances and suicide. Sleep Med. 2020; 70: 124. https://doi.org/10.1016/j.sleep.2020.04.019.

45. Buysse D., Ganguli M. Can sleep be bad for you? Can insomnia be good? Archives of General Psychiatry. 2002; 59 (2): 137–138.

46. Muller M.R., Guimaraes S. S. Impacto dos transtornos do sono sobre o funcionamento diário e a qualidade de vida. Estud. psicol. (Campinas). 2007; 24 (4): 519–528, https://doi.org/10.1590/S0103–166X2007000400011.

47. Speed T., Buenaver L. Managing Sleep Problems during COVID 19. Johns Hopkins Psychiatry Guide. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787390/all/Managing_Sleep_Problems_during_COVID_19 Accepted April 21, 2020.

48. Cohen S., Doyle J.V., Alper M. S., Janicki-Deverts D., & Turner R.B. Sleep habits and susceptibility to the common cold. Archives of internal medicine, 2009; 169 (1): 62–67. https://doi.org/10.1001/archinternmed.2008.505.

49. Sartorious N. Comorbidity of mental and physical diseases: a main challenge for medicine of the 21st century. Shanghai Archives of Psychiatry. 2013; 25 (2): 68–69. https://doi.org/10.3969/j.issn.1002–0829.2013.02.002.

50. Ковальзон В.М., Стрыгин К.Н. Нейрохимические механизмы регуляции сна и бодрствования: роль блокаторов гистаминовых рецепторов в лечении инсомнии. Эффективная фармакотерапия. Неврология и психиатрия. Спецвыпуск «Сон и его расстройства». 2013; 12: 8–15.

51. Ковров Г.В., Мачулина А.И., Любшина О. В. Перспективы применения Донормила в лечении инсомнии. РМЖ. 2007; 15 (24): 1788–1794.

52. Griend V. J.P., Anderson S. L. Histamine 1 receptor antagonism for treatment of insomnia. J Am Pharm Assoc. 2012; 52 (6): e210–9.

53. Langer S., Mendelson W. Symptomatic treatment of insomnia. Sleep, 1999; 15 (22): 701–704.

54. Roussin A., Bouyssi A., Pouché L. Pourcel L., Lapeyre-Mestre M. Misuse and dependence on non-prescription codeine analgesics or sedative H1-antihistamines by adults: a cross-sectional investigation in France. PLoS One. 2013; 8(10): e76499.

55. Zhang R., Wang X., Ni L., Di X., Ma B., Niu S., Liu C., Reiter R.J. COVID 19: Melatonin as a potential adjuvant treatment. Life Sci. 2020; 1 (250): 117583. https://doi. org/10.1016/j.lfs.2020.117583. Epub 2020 Mar 23. Review.

56. García I.G., Rodriguez-Rubio M., Mariblanca A.R. Soto L.M., L.D. García, Villatoro J.M., Parada J.Q., Meseguer E.S., Rosales M.J., González J., Arribas J.R., Carcas A.J., Oliva P., Borobia A.M. A randomized multicenter clinical trial to evaluate the efficacy of melatonin in the prophylaxis of SARS-CoV 2 infection in high-risk contacts (MeCOVID Trial): A structured summary of a study protocol for a randomised controlled trial. 2020; 21 (1): 466. https://doi.org/10.1186/s13063–020–04436–6.

57. Teixeira C.M. Terapia cognitivo-comportamental para insônia: revisão sistemática. Dissertação (Mestrado) – Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015. Available in: http://www.repositorio. unifesp.br/handle/11600/48958. Accessed on: 21/05/2020.

58. Сanadian public health campaign on sleep. Сovid 19: special reports on sleep. www.sleeponitcanada.caAccepted September 12, 2020.

59. Stanford sleep and insomnia health program. https://med.stanford.edu/insomnia. htmlAccepted September 18, 2020.

60. Lai J., Ma S., Wang Y. Factors associated with mental health outcomes among health care workers exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020 Mar 2; 3 (3). https://doi.org/10.1001/jamanetworkopen.2020.3976.