Abstract. Insomnia is a widespread pathological condition in the general population, which has numerous social and medical consequences. Sleep disorders in patients with chronic mercury intoxications are much more common than in the general population. This study aimed to determine the most significant differential diagnostic criteria for sleep disorders in patients with chronic mercury intoxications for their further effective treatment. In this regard, we examined 30 patients with chronic mercury intoxications, whose age averaged 56 0.71 years, and 30 patients of the control group, whose age averaged 54 0.66. All patients underwent clinical, neurological, polysomnographic, and psychological examinations, and neurotransmitters were determined in the blood. Discriminant analysis based on polysomnography, psychological testing and neurotransmitter metabolism revealed significant differences in the examined groups of patients for the following indicators: total sleep time (decreased in the chronic mercury intoxication group) and wake within sleep (increased in the chronic mercury intoxication group) based on polysomnography, blood dopamine level (increased in the chronic mercury intoxication group) as well as reactive anxiety level according to the Spielberger-Khanin scale (increased in the chronic mercury intoxication group). Taking into account the data obtained, it is possible to improve approaches to the diagnosis and treatment of insomnia in the presence of chronic mercury intoxication.

Introduction. The issues of studying the central nervous system (CNS) damage under the influence of mercury remain relevant at the present time.The aim of the study was to identify the relationship of dissomnic and psychological disorders in patients in the remote post-exposure period of chronic mercury intoxication (ChMI) and to substantiate the effectiveness of the proposed scheme of their therapy.Materials and methods. The study involved 30 patients in the long-term period with occupational chronic mercury intoxication (CHMI) and 30 patients in the control group (CG), with complaints of sleep disorders without chronic expressed diseases, not in contact with toxic production factors in professional activity, 84 men — residents of the Irkutsk region from the comparison group to assess the health-related quality of life comparable with patients in social and living conditions and not in contact with harmful production factors. A set of clinical, neurophysiological, psychological and statistical methods was used in study.Results. Based on the data of polysomnographic examination revealed differences in the nature and severity of insomnia in patients of these groups. Confirmed the mixed nature of insomniatic disorders in patients with chronic mercury intoxication. Patients CG revealed changes in the structure of night sleep has focused on intracomesa violations. It was found that patients with CHMI suffer from a more severe form of insomnia compared to patients with CG, which is confirmed by the data of medical and psychological testing. High rates of reactive and personal anxiety, moderate levels of depression and asthenic state, as well as low values of estimates on all scales of health-related quality of life (HRQL), including the total physical and mental components, were revealed in patients with CRMI. Research’s scales HRQL in patients CG with sleep disorders did not reveal any significant differences compared with those in the comparison group, indicating medium and high levels of overall quality of life.Conclusions. The adequacy of the use of a complex of therapeutic and preventive measures, including two main methods of treatment of insomnia disorders, is proved by improving the quality and quantity of sleep structure and emotional and personal sphere.

Introduction. In the Irkutsk region, chronic mercury intoxication (CRI) occupies a leading place among occupational neurointoxications. An organic personality disorder with insomnia is one of the manifestations of brain damage in CRI. The aim of the study was to establish diagnostic criteria for secondary insomnia in patients with professional CRI for the selection of effective treatment. Material and methods. The study involved 30 people in the long-term CRI and 30 people in the comparison group with sleep disorders that are not in contact with harmful factors. Electroencephalographic, polysomnographic research and questioning were carried out with the assessment of the subjective characteristics of sleep. Information was processed using the Statistika 6.0 application package. Results. It was shown that CRI patients were shown to complain statistically significantly more frequent sleep disturbances than in the comparison group (p = 0.0003), difficulty in maintaining sleep (p = 0.004). As a result of EEG in the group of patients in the long-term CRI, the integral index and the ratio α/β were statistically significantly different from those in the comparison group, and according to the results of polysomnography, more pronounced qualitative and quantitative violations of the night sleep pattern were found in CRI patients; as a decrease in total sleep time (p = 0.0001), increase in sleep time (p = 0.008), number of activations and total wakefulness inside sleep (p = 0.03), decrease in sleep efficiency index (p = 0.006) and increase in an integrative sleep quality index (p = 0.03). According to the discriminant analysis, 4 criteria for diagnosing insomnia in CRI were established: total sleep time (min.), duration of the first stage of slow sleep (%), rhythm ratio α/β, EEG (%) and integral EEG index (%). Conclusion. Considering the data obtained, it is possible to improve approaches to treating insomnia in CRI by prescribing a complex of treatment, including cognitive-behavioral therapy, antidepressants with a sedative effect, as well as alpha training using biofeedback.

Introduction. Despite the apparent connection of the existing neurological disorders and changes in the psycho-emotional sphere with sleep disorders in patients with chronic mercury intoxication (CRI), these relationships remain the least studied in the clinic neurointoxications. The study aimed to establish a connection between neurophysiological, biochemical, and psychopathological indicators in patients with occupational chronic mercury intoxication and insomnia. Materials and methods. Thirty-six patients took part in the examination in the remote period of CRI. The average age of patients in this group was 50.7±1.05 years, with an average work experience of 14.7±1.05. The authors carried out a psychological examination to determine the levels of depression, anxiety, asthenic state, computed electroencephalography (EEG), cognitive evoked potentials (CEP), polysomnography, the level of neurotransmitters. Results. The study showed that asthenization, when exposed to mercury, occurs due to a decrease in the limbic-hypothalamo-reticular complex activity (the presence of equivalent dipole sources of pathological activity in the area of diencephalic formations (thalamus, hypothalamus) in 56.2±5.6% of cases. The study showed a decrease in activity cerebral cortex, confirmed by weakening the coherent connections of the α-range in the occipital, central and frontal leads according to the data of coherent EEG analysis and changes on the part of the CEP. There was a direct correlation between the level of total sleep time and the serotonin level (rs=0.45), an inverse relationship between the level of depression and histamine level (rs=-0.56). Conclusion. The studies carried out to make it possible to establish the mechanisms of insomnia disorders in chronic mercury intoxication, which cause a weakening of the tone of the cerebral cortex and changes in neurotransmitter metabolism, as well as disorders of the reticular system with limbic structures. The study showed a close direct relationship between neurophysiological, psychological, and biochemical parameters in implementing insomnia in patients with chronic mercury intoxication.

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