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1.
目的探讨认知疗法及放松训练对失眠者的睡眠疗效。方法对35例门诊主诉失眠者采用认知疗法及放松训练对其进行治疗,疗程6周。以阿森斯失眠量表(AIS)于治疗前,治疗后第1、2、3、4、6周对主诉失眠者进行睡眠评价及疗效评定。结果35例失眠症者28例(80.00%)完成6周的治疗。并停用了安眠药物。AIS评分从治疗前的(8.9±2.5)分降为第6周的(5.6±1.5)分,治疗后第2周AIS评分下降即有显著性差异(氏0.05),第3周AIS评分下降有非常显著性差异(P〈0.01)。以AIS评分〈6分计算睡眠较满意率.睡眠较满意率从治疗开始时的0.0%上升到治疗后6周的46%。结论认知及放松疗法对于改善失眠者睡眠质量有显著的效果。  相似文献   

2.
目的 观察用电刺激小脑核顶治疗失眠对药物的依赖性的影响.方法 选择60例原发性失眠患者随机分成治疗组和对照组,每组30例.治疗组给予电刺激小脑核顶和药物治疗;对照组仅给予药物治疗,采用匹兹堡睡眠质量指数和临床疗效标准进行比较.结果 治疗组在入睡时间、睡眠时间、睡眠效率、日间功能,明显优于对照组,特别是非药物依赖更优于对照组.结论 电刺激小脑核顶治疗失眠能降低对药物的依赖性,改善睡眠质量.  相似文献   

3.
失眠是一种常见的病人主诉,特别是老年人。美国食品与药品管理局(FDA)已批准许多药物治疗失眠,包括五种苯二氮类药物和一种可在脑中与苯二氮受体相结合的非苯二氮类药一唑吡(Zolpidem)。某些药物加抗组胺药、抗抑郁药和抗精神病药,也可用作催眠药。当然,对许多病人,特别对长期失眠者来说,失眠的非药物治疗也许比药物治疗更有效卜」。1非处方药的催眠药1.1二种抗组胺药:盐酸苯海拉明(diphenhvdramine)和多西拉敏(doxylamine)最近已由FDA批准作为辅助睡眠的非处方药,它们有白天镇静作用,可损害操作技能如驾驶机动车以及…  相似文献   

4.
“药”安眠   总被引:12,自引:0,他引:12  
镇静催眠药向来被人们视为专科药物中的一类小品种。实际上,据国外一项大规模抽样调查结果表明:患有程度不同的“睡眠障碍”的人约占成年人总数的50~60%,虽然不是所有失眠者都求助于药物治疗,但安眠药的市场容量实际也并不小。1999年世界安眠药物市场总销售额已达13亿美元。  相似文献   

5.
失眠是非常痛苦的一件事,每当夜深人静时,别人已进入梦乡,而失眠病人像烙饼一样在床上翻来覆去,倍受失眠的煎熬。不少长期失眠者要靠服用药物维持睡眠。一种常用的安眠药“安定”深受失眠者珍视,许多人对安定情有独钟、偏爱有加。更有人认为安定没有什么副作用,几乎天天服用安定,其实长期服用安定并不安定。 安定类药物有多种如利眠宁、硝西泮、氟安定、  相似文献   

6.
豆腐果苷片配合睡眠卫生指导治疗失眠症临床观察   总被引:5,自引:0,他引:5  
目的:验证豆腐果苷片配合睡眠卫生指导治疗失眠症临床疗效。方法:对35例门诊失眠症病人采用豆腐果苷片配合睡眠卫生指导进行治疗,疗程6wk。以阿森斯失眠量表(AIS)判断失眠者的睡眠满意情况。结果:35例失眠症病人中28例(80%)完成6wk的临床观察及量表评定。AIS评分从治疗前的(8.9±s 2.5)分降为wk 6的(5.6±1.5)分,尤其在治疗wk 3后下降显著,治疗3 wk后量表评分经统计有非常显著差异(P<0.01),以AIS评分<6分的人数计算睡眠较满意率,睡眠较满意率从治疗开始时的0%上升到治疗wk 6的46%。结论:豆腐果苷片配合睡眠卫生指导法治疗失眠症有显著疗效。  相似文献   

7.
<正> 失眠是非常痛苦的一件事,每当夜深人静时,别人已进入梦乡,而失眠病人像烙饼一样在床上翻来覆去,备受失眠的煎熬。不少长期失眠者要靠服用药物维持睡眠。一种常用的安眠药"安定"深受失眠者珍视,许多人对安定情有独钟、偏爱有加。更有人认为安定没有什么副作用,几乎天天服用安定,其实长期服用安定并不安定。安定类药物有多种如利眠宁、硝西泮、氟安定、舒乐安定、安定等。不论哪种安定药物都有一定的副作用。长期服用安定类药物,会有类似吗啡成瘾的特点。一旦成瘾,若不继续服药,会出现戒断症状,如情绪激动、易怒、忧郁,甚至出现幻觉以及被害的念头。  相似文献   

8.
<正>睡眠是维持人体生命极其重要的生理功能,与人的健康息息相关。调查显示,很多人都患有睡眠方面的障碍或者和睡眠相关的疾病,成年人出现睡眠障碍的比例高达30%。常见的睡眠障碍有如下8种。1.失眠。失眠是最常见的睡眠障碍,表现为睡眠时间不足和质量差。对于一个失眠者来说,是无法尽情地享受酣甜的睡眠、美妙的梦乡。失眠常  相似文献   

9.
睡眠障碍治疗药物的应用状况与评价   总被引:5,自引:0,他引:5  
王泽民  王建女 《医药导报》2005,24(3):0238-0240
目的了解睡眠障碍治疗药物的应用状况。方法选用1998~2002年长江流域6城市150家医院录入"长江流域医院用药分析系统"中睡眠障碍治疗药物的用药数据及杭州市第七人民医院2002年6~12月门诊用药数据进行统计分析。结果睡眠障碍治疗药物的用药金额、使用频度呈上升趋势;苯二氮类药物(BZD)仍占睡眠障碍药物治疗的主导地位;在使用睡眠障碍治疗药物的门诊处方中有9628%使用BZD类药物,DUI值提示,氯硝西泮、氟西泮有一定滥用倾向。结论新一代睡眠障碍治疗药物前景看好。正确的诊断、合适的药品和个性化给药方案是确保睡眠障碍药物治疗安全、有效、经济、合理的基础。高比例联合用药、较长的服药周期必须引起临床高度重视。  相似文献   

10.
失眠症的阶梯式治疗   总被引:1,自引:0,他引:1  
失眠是最为常见的一种睡眠障碍性疾病,是躯体、精神和行为疾病所具有的常见临床表现。我国卫生部一项统计资料显示,目前我国失眠者已达120~140万人,失眠率高达10%~20%。椐专家估计,到2020年全球大约有7亿多失眠者。失眠发生的范围也很广,不管男性或女性,健康与否,老人或青年,均可发生。一般来说,女性失眠率稍高于男性,老年期失眠多于任何年龄组。可见要让每个人能拥有良好的睡眠,是一个全世界的重大课题。本文就失眠的临床治疗提出自己的见解。  相似文献   

11.
目的 对比耳穴治疗前后失眠症飞行人员的睡眠脑电图记录,评价耳穴治疗的效果.方法 2011年7月-2013年8月就诊于空军总医院患失眠症的飞行人员21例,采用中医辨证分型,进行一疗程的耳穴治疗,治疗前后采用多导睡眠监测系统监测睡眠脑电图,以观察耳穴治疗的疗效.结果 治疗总有效率为90.48%,睡眠脑电图各个指标均有显著性差异(P<0.05),睡眠效率增高.结论耳穴治疗飞行人员失眠症安全有效.  相似文献   

12.
INTRODUCTION: Insomnia is associated with a number of medical and psychiatric disorders, including chronic pain and clinical depression. Until recently, it was assumed that effective treatment of the underlying medical condition would also correct the sleep disturbance. However, some evidence indicates that treatment of secondary or comorbid insomnia should be considered separately from, and perhaps in addition to, optimizing treatment of the primary condition. METHODS: This article reviews the extant literature to examine the impact of secondary and comorbid insomnia on the patient, and on healthcare economics, in the primary care setting, and discusses current diagnostic and treatment approaches. A MEDLINE search was performed for literature published from 1980 to 2005, and retrieved randomized, controlled clinical trials and key review articles for the conditions most often accompanied by secondary insomnia: depression, chronic pain, and menopause/perimenopause. The search terms included those for commonly used pharmacologic treatments and behavioral therapy. RESULTS: Due to the paucity of clinical trial data in secondary insomnia patients, physicians have had to rely on evidence derived from primary insomnia trials. These data indicate that hypnotic medications are effective in treating sleep onset insomnia. However, few of these agents are effective against the most commonly occurring insomnia symptom - poor sleep maintenance - and many are associated with problematic residual sedation. Nevertheless, the cost of not treating these insomnia symptoms is often greater than the treatment inadequacies. Physicians should thus consider treating what they perceive as secondary insomnia with one of the available forms of therapy. CONCLUSION: Patients experiencing sleep problems associated with a potential medical or psychiatric primary condition would likely benefit from increased physician awareness of secondary insomnia and the subsequent increased attention to diagnosing and treating this prevalent condition. Recommendations for managing secondary or comorbid insomnia in the primary care setting are discussed.  相似文献   

13.
The efficacy and safety of three doses of zaleplon, a novel non-benzodiazepine hypnotic, were compared with those of placebo in outpatients with insomnia in this 4-week study, using zolpidem 10 mg as active comparator. Postsleep questionnaires were used to determine treatment effects on the patient's perception of sleep, as well as any development of pharmacological tolerance during therapy or rebound insomnia or withdrawal symptoms upon discontinuation of therapy. During week 1, sleep latency was significantly shorter with zaleplon 5, 10, and 20 mg compared to placebo. The significant decrease in sleep latency persisted through week 4 with zaleplon 20 mg, and was again evident with zaleplon 10 mg at week 3. Zaleplon 20 mg also had significant effects on sleep duration, number of awakenings, and sleep quality compared to placebo. No pharmacological tolerance developed during treatment with zaleplon and there were no indications of rebound insomnia or withdrawal symptoms after treatment discontinuation. Zolpidem 10 mg had significant effects on sleep latency, sleep duration, and sleep quality compared to placebo. However, a significantly greater incidence of withdrawal symptoms and a suggestion of sleep difficulty after treatment discontinuation (rebound insomnia) for all sleep measures was seen with zolpidem compared to placebo. There was no significant difference in the frequency of adverse events with active treatment compared to placebo. These results show that zaleplon provides effective treatment of insomnia with a favourable safety profile.  相似文献   

14.
Hair PI  McCormack PL  Curran MP 《CNS drugs》2008,22(11):975-978
Eszopiclone (Lunesta), the S-enantiomer of racemic zopiclone, is a nonbenzodiazepine hypnotic agent that is approved in the US as an oral, once-nightly therapy for insomnia in adults; eszopiclone is also currently under review by the European Medicines Agency.Eszopiclone is rapidly absorbed after oral administration without any next-day clinical residual effects being detected. Large, well designed trials of up to 6 months' duration have shown that eszopiclone significantly improves both sleep onset and sleep maintenance compared with placebo in adult and elderly patients with primary insomnia. Eszopiclone for 4-8 weeks also significantly improved sleep parameters compared with placebo in patients with insomnia coexisting with other conditions that also disturb sleep (co-morbid insomnia), and improved certain measures of the co-morbid conditions to a greater extent than the standard therapies alone. Short-term eszopiclone produced improvements in daytime functioning in patients with co-morbid insomnia. Six months' therapy in adults with primary insomnia improved daytime functioning and health-related quality of life. Eszopiclone was generally well tolerated. There was no evidence of tolerance during 12 months of treatment with this agent. On discontinuation of eszopiclone, there was no rebound insomnia or serious withdrawal effects. Well designed, comparative trials with other nonbenzodiazepine hypnotics are needed to determine its relative efficacy and tolerability. A cost-utility analysis suggested that eszopiclone is cost effective for the treatment of primary insomnia in the US. Therefore, eszopiclone is a useful therapeutic option in the management of adult and elderly patients with primary or co-morbid insomnia. Unlike most other hypnotics, eszopiclone is not limited to short-term use.  相似文献   

15.
Hair PI  McCormack PL  Curran MP 《Drugs》2008,68(10):1415-1434
Eszopiclone (Lunesta), the S-enantiomer of racemic zopiclone, is a nonbenzodiazepine hypnotic agent that is approved in the US as an oral, once-nightly therapy for insomnia in adults; eszopiclone is also currently under review by the European Medicines Agency.Eszopiclone is rapidly absorbed after oral administration without any next-day clinical residual effects being detected. Large, well designed trials of up to 6 months' duration have shown that eszopiclone significantly improves both sleep onset and sleep maintenance compared with placebo in adult and elderly patients with primary insomnia. Eszopiclone for 4-8 weeks also significantly improved sleep parameters compared with placebo in patients with insomnia coexisting with other conditions that also disturb sleep (co-morbid insomnia), and improved certain measures of the co-morbid conditions to a greater extent than the standard therapies alone. Short-term eszopiclone produced improvements in daytime functioning in patients with co-morbid insomnia. Six months' therapy in adults with primary insomnia improved daytime functioning and health-related quality of life. Eszopiclone was generally well tolerated. There was no evidence of tolerance during 12 months' treatment with this agent. On discontinuation of eszopiclone, there was no rebound insomnia or serious withdrawal effects. Well designed, comparative trials with other nonbenzodiazepine hypnotics are needed to determine its relative efficacy and tolerability. A cost-utility analysis suggested that eszopiclone is cost effective for the treatment of primary insomnia in the US. Therefore, eszopiclone is a useful therapeutic option in the management of adult and elderly patients with primary or co-morbid insomnia. Unlike most other hypnotics, eszopiclone is not limited to short-term use.  相似文献   

16.
ABSTRACT

Introduction: Insomnia is associated with a number of medical and psychiatric disorders, including chronic pain and clinical depression. Until recently, it was assumed that effective treatment of the underlying medical condition would also correct the sleep disturbance. However, some evidence indicates that treatment of secondary or comorbid insomnia should be considered separately from, and perhaps in addition to, optimizing treatment of the primary condition.

Methods: This article reviews the extant literature to examine the impact of secondary and comorbid insomnia on the patient, and on healthcare economics, in the primary care setting, and discusses current diagnostic and treatment approaches. A MEDLINE search was performed for literature published from 1980 to 2005, and retrieved randomized, controlled clinical trials and key review articles for the conditions most often accompanied by secondary insomnia: depression, chronic pain, and menopause/perimenopause. The search terms included those for commonly used pharmacologic treatments and behavioral therapy.

Results: Due to the paucity of clinical trial data in secondary insomnia patients, physicians have had to rely on evidence derived from primary insomnia trials. These data indicate that hypnotic medications are effective in treating sleep onset insomnia. However, few of these agents are effective against the most commonly occurring insomnia symptom – poor sleep maintenance – and many are associated with problematic residual sedation. Nevertheless, the cost of not treating these insomnia symptoms is often greater than the treatment inadequacies. Physicians should thus consider treating what they perceive as secondary insomnia with one of the available forms of therapy.

Conclusion: Patients experiencing sleep problems associated with a potential medical or psychiatric primary condition would likely benefit from increased physician awareness of secondary insomnia and the subsequent increased attention to diagnosing and treating this prevalent condition. Recommendations for managing secondary or comorbid insomnia in the primary care setting are discussed.  相似文献   

17.
Insomnia is the most common sleep disorder in the industrialized world. A variety of precipitating events have been identified, but when it becomes a persistent problem, maladaptive patterns become established, thereby, perpetuating the sleep disturbance. Individuals with insomnia have impaired next-day functioning, which impacts their quality of life and places them at increased risk of motor vehicle accidents. Insomnia is commonly associated with chronic medical conditions, as well as an increased incidence of mental disorders. Despite considerable scientific advances in both the understanding and treatment, insomnia continues to be inadequately identified and treated, with < 15% of those with severe insomnia receiving appropriate treatment. The mainstay of treatment for insomnia is cognitive-behavioral therapy, along with judicious use of hypnotic agents.  相似文献   

18.
郭磊 《中国当代医药》2014,(1):57-58,61
目的探讨健康干预在心血管内科高龄失眠患者中的临床疗效。方法选取本院2009年1月~2012年1月心血管内科高龄失眠患者160例,将其随机分为干预组和对照组各80例,对照组进行常规治疗,干预组在常规治疗的基础上实施健康干预,观察比较两组患者治疗前后的失眠症状,分析影响睡眠质量的因素。结果影响睡眠质量的主要因素有环境因素、心理因素、疾病因素、药物因素等。两组治疗后睡眠症状均改善,与治疗前比较,差异有统计学意义(P〈0.05);干预组治疗后失眠发生率(53.75%)低于对照组(67.50%),差异有统计学意义(P〈0.05)。结论对心血管内科高龄失眠患者进行有针对性的健康干预可以有效提高患者的睡眠质量,减少患者失眠现象的发生。  相似文献   

19.
Thirty-four experts and a literature supervisor got together in order to reach a 'consensus' regarding the definition, diagnosis and pharmacological treatment of insomnia. Insomnia is a subjective perception of dissatisfaction with the amount and/or quality of sleep. It includes difficulty in initiating or maintaining sleep or early awakening with inability to fall asleep again. It is associated with complaints of non-restorative sleep and dysfunction of diurnal alertness, energy, cognitive function, behaviour or emotional state, with a decrease in quality of life. The diagnosis is based on clinical and sleep history, physical examination and additional tests, although polysomnography is not routinely indicated. Therapy should include treatment of the underlying causes, cognitive and behavioural measures and drug treatment. Hypnotic therapy can be prescribed from the onset of insomnia and non-benzodiazepine selective agonists of the GABA-A receptor complex are the drugs of first choice. It is recommended that hypnotic treatment be maintained in cases where withdrawal impairs the patient's quality of life and when all other therapeutic measures have failed. Experience suggests that intermittent treatment is better than continuous therapy. The available data do not confirm safety of hypnotics in pregnancy, lactation and childhood insomnia. Benzodiazepines are not indicated in decompensated chronic pulmonary disease but no significant adverse effects on respiratory function have been reported with zolpidem and zopiclone in stable mild to moderate chronic obstructive pulmonary disease and in treated obstructive sleep apnoea syndrome. Data for zaleplon are inconclusive. If the patient recovers subjective control over the sleep process, gradual discontinuation of hypnotic treatment can be considered.  相似文献   

20.
Insomnia is a prevalent disorder, altering night time sleep, daytime mood and performance. Current treatment strategies, used separately or in combination, include pharmacological, circadian, behavioural and cognitive therapy. An increased diversity of available hypnotics with different potency, pharmacodynamic and pharmacokinetic profiles and improved side effect profiles provides more flexibility in designing individual treatment strategies. Melatonin, a pineal hormone with acute sleep-promoting and chronobiotic properties, allows additional possibilities in treating insomnia and circadian sleep disorders. Current studies of processes involved in normal sleep regulation and pathophysiology of insomnia should result in the development of new medications based on physiological mechanisms of sleep.  相似文献   

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