RESULTS OF A CATAMNESTIC STUDY OF THE QUALITY OF SLEEP AND QUALITY OF LIFE OF PATIENTS WITH CHRONIC INSOMNIA AFTER COMPLEX SPA TREATMENT WITH TRANSCRANIAL MAGNETOTHERAPY
Relevance. Dissatisfaction with night sleep occurs in 45 % of the population. One of the most common sleep disorders is chronic insomnia. The frequency of insomnia is estimated at 9-15 %. Since disorders during the daytime waking period in chronic insomnia are quite nonspecific, they often manifest as clinical symptoms of anxiety and depressive, as well as psychovegetative disorders, which determine the negative impact on the quality of life of patients with insomnia. In turn, effective treatment of insomnia and improved sleep quality leads to improved quality of life for patients. However, the study of the persistence of positive effects of Spa and nonmedicinal methods of treatment of chronic insomnia remains an insufficiently studied issue. Aim: To evaluate and compare the results of the study of sleep quality and quality of life in patients with chronic insomnia 6 months after complex Spa treatment with transcranial magnetic therapy (TCMT). Materials and methods. 122 patients with a verified diagnosis of chronic insomnia were Examined, with an average age of 54±7.3 years, of which 68.9 % were women and 31.1 % were men. Patients were randomly selected into 2 randomized groups: 62 in the main group (who received a Spa complex and TCMT) and 60 in the comparison group (identical exposure complex without TCMT). All patients were surveyed before and after treatment to assess the insomnia severity index (ISI) and quality of life using the General Russian questionnaire "SF-36". After 6 months of treatment, patients were sent questionnaires asking them to reevaluate the severity of insomnia and quality of life. Results. As a result of the treatment program, patients in both groups showed a decrease in the index of insomnia severity and improved quality of life. Thus, in the main group, treatment led to an increase in the number of patients with mild disorders by 51.7 %, a decrease in patients with moderate disorders by 16.2 %, severe disorders by 45.2 %, and the formation of a group of 6 people (9.7 %) with no sleep disorders. In the comparison group, after treatment, the number of patients with mild disorders increased by 33.3 %, with moderate disorders by 3.3 %, and the number of patients in the group with severe disorders decreased by 41.6 %, 3 people (5 %) had no symptoms. As a result of the course of treatment, the average index of insomnia severity in the main group decreased by 35.9 % (p<0.001), in the comparison group by 23.1 % (p<0.001). Clinically patients reported improved sleep, fewer night awakenings, increased sleep duration, improved performance in the wakeful state. The analysis of long term results of treatment dynamics showed that after 6 months in the main group, ISI remained more stable compared to the comparison group, in which ISI increased by 12.1 % (p<0,001). After the use of treatment complexes in patients of both groups, there was a favorable reliable dynamics in the change of quality of life indicators, however, the positive result in the main group was more pronounced than in the comparison group (p<0.05). Analysis of the dynamics of quality of life scales in patients with chronic insomnia 6 months after treatment showed the advantage of maintaining treatment results in the main group (p>0.05). Among the quality of life scales of the psychological component of health in the main group, there was a persistent preservation of the positive effect of treatment for 6 months and no statistically significant differences were found in comparison with the results after treatment (p>0.05). Conclusions: The Inclusion of TCMT in complex Spa treatment can significantly improve the effectiveness of treatment of sleep disorders and improve the quality of life of patients with CHI immediately after treatment and in the long term period after 6 months.