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SONNO,ORMONI,INVECCHIAMENTO DI SUCCESSO


SONNO,ORMONI, IMMUNITA',INVECCHIAMENTO DI SUCCESSO  E LONGEVITA'.


RELAZIONE PRESENTATA AL CONGRESSO FEDERAZIONE GERONTOLOGICA GIUGNO 010-SANIT ROMA GIU 010-CONGR. INTERNAZIONALE DI MED ANTIAGING DI VARSAVIA E DI PARIGI OTTOBRE 010.


Il Sonno è un processo attivo caratterizzato dal ripetersi ciclico di alcuni fenomeni fisiologici, organizzati in diversi stadi, secondo una determinata sequenza temporale; ciascuno di questi è caratterizzato da un particolare pattern di onde rilevabile mediante l’elettroencefalogramma che caratterizzano le fasi del sonno REM e NREM.
Queste fasi si alternano nel corso della notte ogni novanta-cento minuti con la prevalenza di fasi NREM nella prima parte della notte e di fasi REM nella seconda parte. Il sonno svolge uno ruolo vitale per il nostro benessere psicofisico al pari di quello svolto dal cibo che ingeriamo e dall’aria che respiriamo e la sua qualità è strettamente correlata alla qualità e all’aspettativa di vita. 
Molteplici sono le funzioni del sonno, tra queste vanno menzionate la conservazione dell’energia, la consolidazione della memoria e il recupero psicofisico.  Anche il sistema immunitario beneficia degli effetti del sonno che ne regola la circadiana alternanza tra l’immunità cellulo-mediata, che si sviluppa prevalentemente di notte animata dagli ormoni notturni come il GH e la melatonina e quella umorale che, viceversa, si espleta prevalentemente durante le ore diurne e  viene stimolata dal cortisolo e dalla vit.D.
D’altra parte il sonno risente degli effetti fisiologici e patologici del sistema immunitario in quanto le citochine pro infiammatorie svolgono effetti ipnoinducenti, mentre quelle antinfiammatorie esercitano effetti opposti. 
Nel sonno vengono altresì liberati molti ormoni a circadianità prevalentemente notturna e tra questi vanno ricordati la melatonina, il GH, la leptina, la grelina, la prolattina ed il testosterone, mentre di giorno e nella seconda parte della notte vengono rilasciati gli ormoni della veglia come l’asse CRH-ACTH-CORTISOLO e gli ormoni tiroidei. In particolare il sistema GHRH-GH, in cooperazione con PRL e melatonina, prevale nella prima parte della notte e sollecita la fase non rem ed in particolare la fase del sonno a onde lente  o  3 e 4, mentre il sistema CRH-ACTH-CORTISOLO prevale nella seconda parte della notte che viene maggiormente occupata dalla fase REM.
I due sistemi GHRH-GH da una parte e CRH-ACTH-CORTISOLO coadiuvato dalla SOMATOSTATINA dall’altra,svolgono azioni antagoniste e si inibiscono a vicenda.
Naturalmente molti sono gli ormoni che influenzano le varie fasi del sonno e lo stato di veglia in modo diverso come gli ormoni sessuali, la prolattina, la galanina,l’NPY,l’ossitocina,la vasopressina,gli ormoni tiroidei oltre ai citati melatonina, gh e cortisolo.
D’altra parte anche i disturbi del sonno influenzano notevolmente la produzione ed i ritmi ormonali favorendone squilibri che possono essere cofattori di diverse patologie in particolare di quelle correlate al processo di invecchiamento. 
Con l’età si osservano alterazioni progressive delle qualità e quantità del sonno, caratterizzate da una riduzione della fase NREM e successivamente anche della REM che si estrinsecano con superficializzazione e frammentazione del sonno, micro risvegli notturni, risveglio mattutino precoce, riduzione delle performances psicomotorie  e sonnellini diurni.
E’ ormai dimostrato che  i disturbi del sonno come l’insonnia cronica, la sindrome della gambe senza riposo e l’apnea ostruttiva, molto diffusi nella popolazione che invecchia,  possono  favorire un invecchiamento non favorevole ed  essere concausa di molteplici patologie correlate all’età nonché aumentare il rischio di mortalità per diverse cause.
Tra le patologie legate all’insonnia e ad altri disturbi del sonno, vanno segnalate l’obesità, il diabete, le patologie cardiovascolari e la sindrome metabolica. I disturbi del sonno che caratterizzano il processo di invecchiamento sarebbero altresì un importante concausa dei disturbi cognitivi di varia gravità, dell’immunosenescenza e dell’inflammaging.
Diversi studi hanno messo in evidenza come l’insonnia cronica possa favorire l’aumento del rischio di mortalità per malattie cardiovascolari. D’altra parte nei centenari si osserva  un sonno più continuativo e ristoratore associato ad un maggior  equilibrio dei ritmi circadiani. Disturbi del sonno, disarmonia dei ritmi circadiani, in particolare di quelli ormonali come espressione di un alterato funzionamento dell’orologio biologico, andrebbero considerati come un importante marker biologico di invecchiamento sfavorevole.

 
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26 Ottobre 2010