The causes of chronic insomnia among Russians have been identified

Pharmaceutical market analysts note an increasing increase in sales of drugs for insomnia – primarily over-the-counter drugs based on the sleep hormone melatonin. The growth began with the start of the pandemic – and continues to this day. According to the SRO Association of Independent Pharmacies, over the past five years, sales of drugs with a hypnotic effect in packages have increased by about one and a half times.

According to the analytical company DSM Group, sales of products from the category “hypnotics and sedatives” in 2022 grew by 14% year-on-year, and in 2023 by another 9% in rubles, and products containing melatonin grew the most (24 and 11% respectively). In addition, sales of melatonin products in packages also increased (by 25% in 2022 and by 10% in 2023).

There are several explanations for this. The number of sleep disorders and depressive disorders began to rise sharply amid the pandemic, and after February 2022, this trend only intensified. Unfortunately, not everyone goes to the doctor with such problems – so they run to the pharmacy for something sedative or sleeping pills. “Patients cannot always get an appointment with a doctor and get a prescription, so they come to the pharmacy and ask for an over-the-counter drug or dietary supplement to improve the quality of sleep,” says Victoria Presnyakova, director of the SRO Association of Independent Pharmacies, head of the Alliance of Pharmaceutical Associations. “However, in recent years The distribution of sleeping pills has been tightened. Some of them have been transferred to the group of potent drugs; some are dispensed according to a regular prescription, but it must remain in the pharmacy and be stored for 3 months. There are also drugs for which prescriptions are not withdrawn, but, nevertheless, they are prescriptions. “But melatonin, produced under different trade names, is not a prescription drug. Therefore, first of all, various products based on it are bought up, some of them are not registered as medicines.”

Recently, analysts have pointed to a record increase in melatonin sales in 2023 compared to the previous 5 years, both in rubles and in packages. Let’s figure out what this might be connected with.

Melatonin is a hormone that regulates the sleep-wake cycle in humans and animals. Its normal content in the body is necessary to maintain health and normal functioning of the nervous system. It is produced by the pineal gland. Research shows melatonin has more to do with more than just sleep. The sleep hormone reduces the production of cytokines that cause inflammation, is an antioxidant that neutralizes free radicals in cells, and limits oxidative stress and damage that contribute to inflammation. Melatonin is produced in the brain when light stops falling on the retina of the eye. Therefore, using gadgets at night disrupts the production of natural melatonin in the body. This causes problems in falling asleep. Also, increased anxiety also contributes to a decrease in the production of the sleep hormone. “Unfortunately, recently, due to the increase in the use of gadgets, as well as an increase in the level of anxiety in society, the number of visits to the pharmacy for melatonin-containing drugs has sharply increased,” says Victoria Lesnikova, director of the Association of New Independent Pharmacies. “Neurologists and psychiatrists note an increase in the number of patients , especially among young people. However, in society there are many myths and stereotypes that cause resistance to seeking help from a doctor. Recently, various melatonin-based drugs have been actively advertised in the media. And due to the fact that many drugs familiar to our patients contain sleeping pills “The effect of becoming prescription drugs has increased the demand for more affordable analogues, including often dubious dietary supplements, which are widely represented on marketplaces where there is no strict quality and safety control, as in pharmacies.”

The director of a pharmacy chain from the Tver region, Tatyana Semenova, notes that surges in demand are observed after advertising campaigns on television, but in general the demand for this type of product is steadily growing. “For example, compared to the previous year in 2023, sales through our network increased by 26.5%. The reasons for the increase in insomnia and anxiety are also clear to everyone. These are gadgets and the difficult economic situation. Today, most people work to earn money, and often instead eight hours, their shifts last 12 hours, which leads to disruptions in the body’s circadian rhythms. We think that we will get enough sleep “in the next world”… You know, I noticed that young people have been on antidepressants and sleeping pills lately. And many are already taking prescriptions from psychotherapists.”

In the meantime, psychiatrists and somnologists do not recommend self-medication and “throwing in” drugs that people prescribe for themselves, including after seeing advertisements on TV.

The most common cause of insomnia is chronic stress. As psychiatrist and somnologist Oksana Sadykova says, “sleep is a genetically determined state of all warm-blooded animals; against the background of insomnia, disturbances in the functioning of all organs and systems begin. For example, experiments with two groups of dogs showed that in the group where the animals were not allowed to sleep, already after two weeks ago, dogs began to lose hair and fangs. Even a slight lack of sleep leads to an increase in C-reactive protein – a marker of inflammatory processes, cytokines and tau proteins (which, according to various theories, provoke the development of Alzheimer’s and Parkinson’s diseases). consolidation of memory, processing of emotions. And in the slow-wave sleep phase, a deep scanning of the entire body occurs. There is a visceral terrarium of sleep – in a dream, the brain completely scans the body and cleanses it of tau protein and beta-amyloids. Sleep is like a washing machine, and if a person does not sleeps, nothing is washed away. Well, the immune system is also restored in sleep. If we talk about melatonin, it turns on the sleep centers and helps you fall asleep. Its production begins in the evening, at 19-20 o’clock, and the peak occurs at 1-2 o’clock in the morning. And if its first catalyst is light, then the second is the intestinal microbiota, which helps convert tryptophan into melatonin. Recently, melatonin was discovered, which is synthesized in the intestines (mostly in the appendix, so those who have it cut out lose such richness). The intestinal microbiota contains more than a thousand bacteria that synthesize tryptophan, dopamine and melatonin and interact with the central nervous system. However, I do not recommend taking additional melatonin to treat insomnia in the form of various medications. The gold standard treatment for insomnia is cognitive behavioral therapy. You need to make sure that melatonin is synthesized by the intestines – that is, eat fiber, and in the evening. The light regime is also very important (it should be dark at night, warm yellow light in the evening, and cold white light in the morning. The regime is also important: if you are used to going to bed at two in the morning, and have been living like this for ten years, you don’t need to change anything. The amount of melatonin depends depending on your lifestyle and age, its production adapts to you”