2023-08-21 09:14:35
Milagros Merino Andreu is the coordinator of the Neurological Sleep Disorders Unit at La Paz University Hospital and head of the Sleep Medicine Program at Hospital Ruber Internacional.
He develops a research activity that includes clinical, pharmacological and genetic aspects of sleep disorders in the pediatric and adult population.
He has presented more than 130 papers at congresses and scientific meetings and published in national and international journals.
The importance of a good rest: ten recommendations
Dr. Milagros Merino, president of the Spanish Sleep Society
Sleep is a physiological state that has existed in hominids for millions of years and if it has persisted, it means that it has a real utility: it allows a physical and mental restoration in our body to restore biochemical and psychological processes such as tissue repair. , protein synthesis, muscle growth or the consolidation of memory and learning.
It is estimated that normal and healthy sleep in adults is around 7-9 hours per night, but in any case the duration must be long enough so that there is no sleepiness or fatigue during the day.
However, sometimes there is a lack of sleep or unrefreshing sleep, prolonged sleep or events during rest (apneas, sleepwalking, etc.) that have daytime repercussions.
They are sleep disorders, which are classified as insomnia, parasomnia, hypersomnia, sleep-disordered breathing, circadian rhythm disorders, and sleep movement disorders.
Sleep disorders
The incidence of sleep disorders is estimated to be 40% globally and 20-48% nationally in the adult population.
Children are not free of them either: a third have sleep problems. In adults, the most common disorders are insomnia (15-20%), which are even more common in women, and obstructive sleep apnea, which is more common in subjects with obesity and affects 20% to a medium-severe degree. of men and up to 10% of postmenopausal women.
Due to its severity, obstructive sleep apnea stands out above all, which cause apnea pauses during sleep and intermittent hypoxemia, and can cause cardiac, vascular, metabolic involvement and traffic accidents (according to the DGT, it is estimated that up to 15- 30% of traffic accidents are attributed to drowsiness at the wheel).
Y narcolepsy, which causes excessive daytime sleepiness, episodes of weakness in the face of emotions and disturbed nighttime sleep, and which seriously influences the quality of life of those affected, without, fortunately, presenting a higher mortality rate.
Any disorder that is not resolved effectively tends to become chronic, even if it arose after a stressful event and it has disappeared.
The consequences of this chronification are numerous: from increased sleepiness, fatigue, irritability and apathy, to anxiety problems, depression, memory and concentration loss, attention deficit and hyperactivity in children; going through weight gain, headaches, arterial hypertension and a greater immunological vulnerability.
If there are apneas, in addition, these consequences can be added to a greater risk of cardiac arrhythmias and a greater predisposition to suffer a heart attack or stroke, thrombosis, heart failure, etc.
Dr. Milagros Merino, president of the Spanish Sleep Society (SES)/Courtesy photo
Get a restful sleep
More and better treatments are being developed to deal with the main sleep disorders, but in any case, the fundamental thing from a therapeutic point of view is to apply sleep hygiene rules and, once the type of disorder has been identified, start the specific treatment.
In no case, yes, you should take a drug without medical supervision. In this sense, it is important to remember two things: on the one hand, that what is effective in one person may not be indicated for another, even if the sleep problem is similar; on the other, that not everything that “produces drowsiness” serves as a treatment for insomnia.
Ten recommendations for a good rest
As we said, to prevent it is essential to apply some basic sleep hygiene tips. Among them, these ten absolutely necessary recommendations to have a good rest, but not always enough to deal with sleep disorders that require treatment:
1. Keep a fixed time to go to bed and get upincluding weekends and holidays.
2. The siesta It has two advantages: it “recharges the battery”, that is, it is restorative, and it helps to synchronize the circadian rhythm. In any case, yes, it is necessary to avoid that the nap lasts more than 30 minutes.
3. Keep the bedroom to a temperature pleasant and with minimum levels of light and noise.
4. Avoid taking in the afternoon chocolate and beverages containing caffeine and theophylline.
5. The alcohol and tobacco they impair sleep and their consumption should be avoided several hours before bedtime.
6. Avoid lying down until two hours have passed after dinnerwhich should be light.
7. Avoid doing strenuous exercise in the hours before night sleep.
8. Avoid using the computer or other device with an illuminated screen in the two hours prior to night sleep.
9. Stay in the cama long enough, adapting it to the real needs of sleep.
10. Avoid activities in bed such as: watching television, reading or listening to the radio. You have to associate the bed with sleep.
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