The dynamics of sleep quality in patients with chronic insomnia during the complex spa treatment with the inclusion of transcranial magnetic therapy

Dissatisfaction with night sleep occurs in 45% of the population. Chronic insomnia is one of the most common sleep disorders. The incidence of insomnia is estimated at 9-15%. The clinical importance of insomnia is determined by the negative impact it has on social aspects, economic performance and human health. Taking into account the prevalence of insomnia in the population and its social importance the correct diagnosis and effective treatment of insomnia is clear. OBJECTIVE To assess the sleep quality dynamics in patients with chronic insomnia getting the complex spa treatment with the inclusion of transcranial magnetic therapy (TCMT). MATERIAL AND METHODS It was examined 122 patients (mean age 54.0±0.92 years) with a verified diagnosis of chronic insomnia; 68.9% were women and 31.1% were men. The patients were randomized into 2 groups: the main group included 62 patients who received a spa complex and TCMT; the comparison group included 60 patients who received an identical treatment complex without TCMT. All patients were evaluated by polysomnography (PSG) data, insomnia severity index (ISI) and subjective symptoms of daytime functioning. RESULTS As a result of treatment program implementation the patients of both groups showed a decrease in ISI and a subjective improvement in daytime well-being. In the main group the 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%) without sleep disorders. In the comparison group after treatment the proportion of patients with mild disorders increased by 33.3%, with moderate disorders by 3.3%, the number of patients with severe disorders decreased by 41.6%, and 3 (5%) patients had no symptoms. The mean value of ISI in the main group decreased by 35.9% (p<0.001), in the comparison group - by 23.1% (p<0.001), the difference was 12.8% (p<0.001). From clinical perspective, patients noted an improvement in the process of falling asleep, a decrease in the number of nighttime awakenings, an increase in the duration of sleep, and an improvement in functioning while awake. After the use of therapeutic complexes in patients of both groups there was a favorable reliable dynamics in the change in PSG indicators that was more pronounced in the main group. The difference between the groups in terms of PSG was: for the wakefulness time during sleep 16.3% (p<0.005), for the number of awakenings during sleep 12.8% (p<0.001), for the latency of falling asleep 13.9% (p<0.05), for micro-activation index 14.6% (p<0.05), for sleep efficiency 4.9% (p<0.05). CONCLUSION The inclusion of TCMT in complex spa treatment can significantly reduce ISI, the symptoms' severity of impaired daytime functioning and improve sleep quality indicators according to PSG data in patients with chronic insomnia.