A personalized approach to insomnia treatment in patients with chronic back pain

Abstract

Sleep disorders and back pain are often found in the practice of various doctors specialties. Often these two conditions are comorbid. Sleep disorders can be both acute and chronic. To verify the state of insomnia, diagnostic criteria (MKRS-3) are proposed. Sleep disorder therapy is a complex task and includesnon-drug approaches (sleep hygiene, psychotherapeutic techniques, etc.) with more lasting effect. Drug therapy is considered as additional method of treatment using several groups of drugs. Doxylamine H1-receptor antagonists, is one of the well-known and promising drugs. The article describes two clinical cases of patients with back pain and concomitant sleep disorders. To relieve pain in both cases, standard therapy was prescribed, including NSAIDs, a muscle relaxants, B vitamins, and physiotherapy exercises. In order to normalize night sleep, the Doxylamine was additionally in a standard dosage. However, the second patient developed morning sleepiness while taking the standard dose, which required a dose reduction. Taking Doxylamine at a lower dosage effectively stopped sleep disorders and did not cause the development of drowsiness and lethargy.