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“Il sonno profondo, quello ristoratore, per me è un miraggio. Fatico ad addormentarmi ma, ancora peggio, mi sveglio ogni due ore. L'estate poi, con il caldo, la situazione diventa insopportabile”. È la triste dichiarazione fatta da Nancy Brilli in un’intervista al Corriere della Sera. L’attrice è un’insonne cronica e “quando va bene riesco a dormire al massimo quattro ore, sempre a intermittenza. Il mio sogno più grande è dormire otto ore di fila”.
Insonnia cronica per il 10-15% degli italiani
Brilli, che sostiene di avere “provato di tutto: tisane, sciroppi, pillole e medicine di ogni tipo”, è in buona compagnia visto che il 10-15% degli italiani è affetto da una forma cronica di insonnia e le più colpite sono le donne durante la menopausa.Il dato è emerso al 62/mo Congresso nazionale della Sno - Scienze neurologiche Ospedaliere, a Firenze nel 2023.
Non guarisce da sola
"L'epidemiologia dell'insonnia evidenzia come sia un problema comune in tutto il mondo: circa 1/3 della popolazione adulta riferisce di averla sperimentata per un breve periodo e il 10-15% è affetto da una forma cronica - sottolinea Enrica Bonanni, responsabile del Centro di medicina del sonno della Uo di Neurologia dell'azienda ospedaliero-universitaria Pisana - L'insonnia cronica è un disturbo che raramente va incontro ad una remissione spontanea; a questo riguardo alcuni studi indicano che nell'85% dei pazienti è ancora presente dopo due anni e che può persistere per 10 anni o più nel 15-50% dei casi".
Cosa rischia chi soffre d’insonnia
I principali fattori di rischio per l'insonnia cronica sono stati individuati nel sesso femminile, specialmente nel periodo della menopausa, con una stima del disturbo in circa il 14% degli adulti di 18-34 anni e nel 40-60% nei soggetti over 65. Tra le principali complicanze dell'insonnia c'è "un aumentato rischio di depressione, ipertensione, disabilità lavorativa e prolungato uso di farmaci o prodotti da banco". Insomma, se il problema è persistente e non si tratta di un’insonnia episodica, magari peggiorata dal grande caldo di quest’ultimo periodo, il consiglio è quello di rivolgersi agli specialisti.
Melatonina contro l'insonnia: ecco quando prenderla
Tra i rimedi consigliati per chi non riesce a dormire c’è la melatonina ma in tanti ci hanno provato senza esito. Oggi però sappiamo perché non ha funzionato: bisogna sapere quanto e quanta prenderne. Quattro milligrammi al giorno tre ore prima di coricarsi: con questi tempi e con questa dose la melatonina è davvero efficace contro l'insonnia. Lo afferma un nuovo studio condotto all'Università di Pisa e pubblicato sul Journal of Pineal Research. "Per la prima volta - spiega Ugo Faraguna, coordinatore del lavoro dell'Ateneo pisano - la nostra ricerca dà indicazioni precise su come usare efficacemente la melatonina per favorire il sonno". Finora, aggiunge, "gli studi condotti hanno dato risultati incoerenti: la nostra ipotesi è che dipendesse dallo schema di somministrazione, da una combinazione non fisiologica di orario e dosaggio".
Dose e orario meglio se personalizzato
L'analisi è stata condotta su 26 studi randomizzati pubblicati tra il 1987 e il 2020, per un totale di 1689 osservazioni su pazienti con insonnia e volontari sani, che hanno valutato l'effetto della somministrazione di melatonina sul sonno. "Rispetto alle indicazioni più utilizzate nella pratica clinica, ovvero 2 mg 30 minuti prima di coricarsi - spiega Faraguna - i nostri risultati suggeriscono che per ottimizzare l'effetto della melatonina sia importante anticipare i tempi di somministrazione a 3 ore prima di coricarsi e aumentare la dose a 4 mg al giorno. Oltre ad esser anticipato, l'orario di somministrazione dovrebbe dunque essere personalizzato sulla base del ritmo sonno/veglia di ogni paziente, in modo da riprodurre la naturale produzione di melatonina nell'essere umano. Infatti, quando la melatonina viene somministrata secondo lo schema di trattamento da noi proposto, ottiene la sua massima efficacia esattamente quando la melatonina normalmente prodotta dal corpo umano viene rilasciata nel sangue".
I consigli per prendere sonno
In aggiunta ecco delle pratiche “manutenzione ordinaria” del proprio sonno che in realtà sono semplici buone abitudini da seguire:
- praticare esercizio fisico (ma non intenso nelle ore serali).
- Trascorrere tempo all’aria aperta durante la giornata (possibilmente a contatto con la natura facendo una passeggiata in un parco).
- Evitare cibi e bevande (come quelli che contengono caffeina o alcol) che possono interferire con il sonno.
- Assicurarsi per quanto possibile che le condizioni ambientali (letto, materasso, temperatura) favoriscano la qualità del sonno.
- Coricarsi e, ancora più importante, svegliarsi a orari regolari.
- Limitare l’utilizzo di tablet, computer e smartphone un paio di ore prima di coricarsi.
- Mangiare almeno due o tre ore prima di andare a dormire.
- Evitare il carico di informazioni e notizie nelle ore serali (in particolare in questo momento e selezionando sempre fonti autorevoli).
In aggiunta ai “buoni consigli”, si può utilizzare uno smartwatch con la funziona di monitoraggio del sonno: non ci aiuterà a dormire ma ci farà capire come lo facciamo: quante volte ci svegliamo, quante ore di sonno profondo, di sonno leggero e quante di sonno rem, quello in cui si sogna. Se ci si rivolgerà a un medico può essere importante dargli delle informazioni precise sulla qualità del proprio sono.
