"It's 4:12 in the morning and here I am, unable to sleep." The phrase sums up the routine of 35-year-old Patrick, one of the millions of Brazilians who face insomnia. As the dawn progresses, he remains awake, watching the clock and trying to overcome a problem that affects his work, his mood and his quality of life. Experts warn that insomnia goes far beyond the discomfort of a bad night's sleep and can increase the risk of cardiovascular disease, stroke and dementia.
In Brazil, almost a third of adults living in capital cities experience some symptom of insomnia. The disorder is characterized by difficulty in initiating or maintaining sleep, accompanied by tiredness, fatigue and impairment in daily activities. When these symptoms occur at least three times a week for three months, the recommendation is to seek specialized treatment.
Sleepless nights and days of exhaustion
Today working with physical rehabilitation, mainly for the elderly, Patrick says he spends most of his nights awake.
"When it gets close to my time to get up, that's when it's worse, because I keep checking the time, every hour, so as not to waste my time", he says.
The impact of sleep deprivation has already reached the workplace.
"I was so tired that my eye closed immediately", he says, remembering a session in which a patient with Alzheimer's almost fell after a moment of exhaustion.
The situation of Vitória, aged 30, is also worrying. A visual artist, jewelry designer and model, she has had trouble sleeping since childhood and feels the effects especially when she wakes up.
According to her, the lack of adequate rest affects mood and reduces energy throughout the day.
"I feel weak. I feel like I've been drained of energy," she says.
When you wake up in the early hours of the morning, going back to sleep is not always easy.
"My head is racing. I remember something I have to do, something I didn't do", he says.
The brain in a state of alert
According to experts, part of the problem is related to the modern lifestyle. The brain has a biological clock that synchronizes the body with the alternation between day and night. But constant exposure to artificial lighting and screens can confuse this natural mechanism.
Cell phones, tablets and computers stimulate the brain just when it should start to slow down. As a result, the body remains in a state of alert and falling asleep becomes more difficult.
After evaluating the two patients, psychiatrist Alexandre Azevedo, from the USP Sleep Laboratory, concluded that they both needed treatment.
“They both need treatment, especially behavioral treatment,” he says.
The specialist highlights that medicines are not the first option.
"Medication does not come before behavioral measures", he explains. "It will only appear as an indication if some of these techniques fail."
What helps fight insomnia
For ten days, Patrick and Vitória followed a series of guidelines from experts. These included avoiding screens for at least two hours before bed, reducing coffee consumption at the end of the day, maintaining regular wake-up times and increasing exposure to natural light.
For Vitória, one of the most important changes was always waking up at the same time.
According to the doctor, exposure to light in the morning helps the body start a kind of countdown to the next night's sleep.
Patrick was referred for cognitive behavioral therapy for insomnia, currently considered the first-line treatment for many patients.
Psychologist Kidsay Souza, a specialist in the field, explains that the work involves changing the patient's relationship with sleep.
"Sleep therapy will work on the patient's relationship with the bed, the thoughts that remain at bedtime, the emotional aspects and that anxiety that the patient has about having to sleep", he states.
The cleaning that happens during sleep
In recent years, science has advanced in understanding the effects of sleep deprivation on the brain. Research shows that, during deep sleep, a system responsible for removing waste and toxins that accumulate throughout the day comes into action.
When a person sleeps poorly on a recurring basis, this cleaning process is compromised. The result may be the accumulation of proteins associated with the development of neurodegenerative diseases, such as Alzheimer's.
Neurologist Diego Carvalho states that the risks go beyond brain health.
"Insomnia is also associated with cardiovascular problems, increasing the risk of having a stroke, a stroke, or having a heart problem", he explains.
According to him, studies also show that people over 60 years of age with chronic insomnia have a significantly higher risk of developing dementia in the following years.
Changes that made a difference
At the end of the ten days of follow-up, both participants reported improvement.
When asked about the main transformation perceived during the period, Vitória responded without hesitation:
"Disposition."
Patrick said he has regained confidence that he can sleep better again without relying exclusively on medication.
"I felt very hopeful that I would be able to sleep without medication," he said.
Experts emphasize that those who suffer from insomnia can seek help through the SUS, which offers monitoring, therapies and referrals to specialists when necessary. The main message, according to doctors, is that sleeping well is not a luxury, but a fundamental necessity for the health of the brain and the entire body.
