Репозиторий Университета

© 2020 The Author(s) The aim of this European initiative is to facilitate a structured discussion to improve the next edition of the International Classification of Sleep Disorders (ICSD), particularly the chapter on central disorders of hypersomnolence. The ultimate goal for a sleep disorders classification is to be based on the underlying neurobiological causes of the disorders with clear implication for treatment or, ideally, prevention and or healing. The current ICSD classification, published in 2014, inevitably has important shortcomings, largely reflecting the lack of knowledge about the precise neurobiological mechanisms underlying the majority of sleep disorders we currently delineate. Despite a clear rationale for the present structure, there remain important limitations that make it difficult to apply in routine clinical practice. Moreover, there are indications that the current structure may even prevent us from gaining relevant new knowledge to better understand certain sleep disorders and their neurobiological causes. We suggest the creation of a new consistent, complaint driven, hierarchical classification for central disorders of hypersomnolence; containing levels of certainty, and giving diagnostic tests, particularly the MSLT, a weighting based on its specificity and sensitivity in the diagnostic context. We propose and define three diagnostic categories (with levels of certainty): 1/“Narcolepsy” 2/“Idiopathic hypersomnia”, 3/“Idiopathic excessive sleepiness” (with subtypes).

© 2020 The Author(s) The aim of this European initiative is to facilitate a structured discussion to improve the next edition of the International Classification of Sleep Disorders (ICSD), particularly the chapter on central disorders of hypersomnolence. The ultimate goal for a sleep disorders classification is to be based on the underlying neurobiological causes of the disorders with clear implication for treatment or, ideally, prevention and or healing. The current ICSD classification, published in 2014, inevitably has important shortcomings, largely reflecting the lack of knowledge about the precise neurobiological mechanisms underlying the majority of sleep disorders we currently delineate. Despite a clear rationale for the present structure, there remain important limitations that make it difficult to apply in routine clinical practice. Moreover, there are indications that the current structure may even prevent us from gaining relevant new knowledge to better understand certain sleep disorders and their neurobiological causes. We suggest the creation of a new consistent, complaint driven, hierarchical classification for central disorders of hypersomnolence; containing levels of certainty, and giving diagnostic tests, particularly the MSLT, a weighting based on its specificity and sensitivity in the diagnostic context. We propose and define three diagnostic categories (with levels of certainty): 1/“Narcolepsy” 2/“Idiopathic hypersomnia”, 3/“Idiopathic excessive sleepiness” (with subtypes).

© Bukhtiyarov I.V., Yushkova O.I., Fesenko M.A., Merkulova A.G., 2018. The papers dwells on the results obtained during fatigue risk assessment as per subjective and objective parameters in civil aviation crew members. Our research goal was to assess fatigue and overfatigue risks as per subjective and objective cardiovascular system parameters and central nervous system parameters in workers with morning and evening biorhythms under neuro-emotional workloads and shift work performed by planes crew members, air traffic controllers, and operators. Our examined workers were mostly people aged 35-45 with working period equal to 5-15 years. Fatigue which occurred during flights was assessed subjectively by crew members questioning as per Epworth Sleep Scale, Karolinska Sleepiness Scale, and crew state control as per Samn-Perelli. Working efficiency was studied via PVT test (psychomotor vigilance test), sleep monitoring, and actigraphy. Circadian rhythms dynamics was examined as per changes in minimal body temperature which aircrew members had. We applied Ostberg's questionnaires to assess biorhythmologic activity type. Workers' functional reserves were assessed via stress testing. We calculated functional changes index to assess functional abilities of the circulatory system and adaptation state during a working shift in workers with various biorhythmologic types. The paper outlines the examination results for physiological reactions appearing in the cardiovascular system and central nervous system of workers with morning and evening biorhythms. We revealed that functional state peculiarities in operators when they performed their work tasks in a shift regime were closely connected with their biorhythmologic activity type. "Early risers" had more adverse physiological reactions during their work activities. We developed ways to lower risks related to fatigue and overfatigue caused by shift work. It was shown that regulatory mechanisms stress occurring in the circulatory system, lower labor motivation, and poorer health in people with the morning biorhythmologic type made it necessary to correct the body functional state during shift work, especially when labor was very intense.

© Russian Journal of Cardiology. In the article, an analysis provided of recent views on the overtraining syndrome by the data from local and foreign publications. The witness of the problem actuality is also an existence of controversial opinions and absence of clear definitions on properties of the condition. It has been revealed that the main role in pathogenesis of the overtraining syndrome do play the changes of cardiovascular, endocrine and central nervous systems. These changes are complicated and ambiguous, depend upon multiple factors, as the type of sport, specifics of exertion and loads, stage of pathophysiological process. Entraining effect of exertion, if incorrectly utilized, underestimation of current condition of a sportsman, might not lead to expected results. Moreover, non-rational application of exertion might lead to opposite effect, that is, to decrease adaptation potential and reserves, towards the edge of the condition as an overtraining syndrome, which shows phasic, progressing character, starting from fatigue and mild disorders, to persistent, rigidly reversible processes. Due to controversy, multiple stages and multifactorial of the overtraining syndrome, by now there is no unified approach to its definition, as no unified standards to its diagnostics, treatment and prevention.