Poor sleep is bad for the heart, mind and memory

Clarifying what distinguishes a simple period of stress from a real sleep disorder is Paola Proserpio, a neurologist and expert in sleep disorders. "One speaks of insomnia when difficulties falling asleep, frequent or early awakenings occur at least three times a week and last for more than three months, affecting daily life".

What to do, then, if insomnia becomes chronic? The advice is to consult a sleep specialist, who can frame the problem with appropriate diagnostic tools and propose targeted therapies. It is not always necessary to resort to drugs: 'Non-pharmacological therapies, such as cognitive-behavioural therapy for insomnia (Cbt-I), have demonstrated great effectiveness and are now recommended as the treatment of first choice,' Proserpio explains. The use of drugs may be indicated in some cases, but always under medical supervision, favouring molecules with a good safety profile and a reduced risk of addiction.

Obstructive sleep apnoea is one of the most insidious and serious disorders. "Many patients are unaware that they have them," Strambi explains, "but there are telltale signs: nocturia (getting up several times to urinate), daytime sleepiness, irritability, and physical traits such as obesity, a short, stubby neck, or a small jaw. Alessandro Oldani, head of the Functional Unit at the Centre for Sleep Medicine, describes other symptoms that are often overlooked: snoring, breathing pauses at night (which are only noticed when reported by others), sudden awakenings, headache in the morning, persistent tiredness during the day.

The diagnosis is made through polysomnography, a non-invasive examination that monitors vital parameters during sleep. It can also be performed at home, depending on the case. The most common treatment is Cpap, a mask that keeps the airways open during the night, but there are also alternatives: from maxillofacial surgery to oral devices to weight loss in obese individuals.

The risk of ignoring apneas is high: 'They can significantly increase cardiovascular and cerebrovascular risk, causing hypertension, arrhythmias, and strokes,' Oldani points out. But the good news is that, once diagnosed, apneas can be effectively managed and treated.

Sleeping well is also an investment in memory. 'During sleep, acquired information is consolidated,' explains Strambi, 'but in a differentiated way: non-rem sleep is for declarative memory, that of events and notions; rem sleep is important for procedural memory (the "know how") and emotional memory'.

With age, sleep changes: especially the Rem phase and deep sleep are reduced. 'Older men lose more deep sleep than women, which makes them more vulnerable to the negative effects of sleep deprivation,' the professor points out. Moreover, we now know that poor quality sleep can be a risk factor for dementia, precisely because it prevents the activation of the glymphatic system, the brain 'cleaning' system that eliminates toxic proteins such as beta-amyloid.

And the use of smartphones and tablets before bedtime? 'It is harmful,' Strambi states firmly, 'not only for falling asleep, but also for maintaining sleep: notifications and blue lights alter brain rhythms, even if we don't realise it'.

In conclusion, sleep is a valuable ally of health, but still too undervalued. From memory to blood pressure, from emotional stability to the prevention of cognitive decline, sleeping well - with regularity and attention to quality - is one of the best strategies for living long and healthy lives. And, as the experts remind us, when sleep becomes problematic, it should not be ignored: seeking medical advice is the first step to really getting back to rest. And the message that emerged from this session is simple and powerful: good sleep is prevention, it is memory, it is long-term health. Underestimating sleep means exposing yourself to avoidable risks - physical, cognitive, emotional - while taking care of it, even with small daily gestures, can make a big difference.