Diagnostic criteria of sleep disorders in patients with long-term chronic mercury intoxication

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Abstract

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.

About the authors

Elena V. Katamanova

East-Siberian Institute of Medical and Ecological Research

Author for correspondence.
Email: katamanova_e_v@mail.ru
ORCID iD: 0000-0002-9072-2781

MD, Ph.D., DSci., associate Professor, chief physician of the clinic of the East-Siberian Institute of Medical and Ecological Research, Angarsk, 665827, Russian Federation.

e-mail: aniimt_clinic@mail.ru

Russian Federation

N. V. Slivnitsyna

East-Siberian Institute of Medical and Ecological Research

Email: noemail@neicon.ru
ORCID iD: 0000-0002-8984-2452
Russian Federation

E. N. Korchuganova

East-Siberian Institute of Medical and Ecological Research

Email: noemail@neicon.ru
ORCID iD: 0000-0002-9247-4072
Russian Federation

O. I. Shevchenko

East-Siberian Institute of Medical and Ecological Research

Email: noemail@neicon.ru
ORCID iD: 0000-0003-4842-6791
Russian Federation

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Copyright (c) 2019 Katamanova E.V., Slivnitsyna N.V., Korchuganova E.N., Shevchenko O.I.


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