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1.
<正>失眠是一种常见的疾病,是以频繁而持续的入睡困难或睡眠维持困难并导致睡眠满意度降低为特征的睡眠障碍。患者的睡眠时间不足或睡眠质量差,难以开始或维持睡眠,夜间频繁觉醒或过早醒来,醒来后难以再入睡,并伴有醒时烦躁或疲劳等症状。Meta分析显示中国普通人群失眠患病率为15%,疫情期间失眠的患病率高达29.1%[1],《健康中国行动(2019-2030 年)》将降低失眠的患病率作为心理健康促进的行动目标之一[2]。在过去的十年里,  相似文献   

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睡眠的不同阶段具有不同的生理功能,各种原因诱发的睡眠剥夺(SD)或失眠都能损害相关睡眠期的生理功能。已知睡眠剥夺或失眠与神经系统变性疾病、心脑血管疾病、内分泌系统疾病及精神疾病等密切相关,因此引起了各专  相似文献   

3.
睡眠障碍是儿童神经科常见的问题,可单独发生或伴随其他神经疾病发生。睡眠障碍对儿童在认知、情绪、社会发展和行为表现等多方面造成损害。但是,一直以来,神经科医师对儿童睡眠障碍的认识相对较少,也缺乏睡眠评估和诊治的能力。失眠是儿科最常见的睡眠障碍,慢性睡眠障碍导致患儿白天出现精神行为异常及认知功能障碍,睡眠日记是诊断失眠的有力工具,行为咨询是儿童失眠管理的基础,认知行为治疗是治疗失眠的有效方法。异态睡眠和发作性睡病可能被误诊为癫痫发作等其他神经科疾病,导致不能得到及时有效的生活管理,出现不适当的药物暴露。文章着重介绍儿童失眠、异态睡眠和发作性睡病相应的临床表现、病理生理、诊断、治疗及研究现状,以期帮助神经科医生在诊治存在睡眠障碍的儿童过程中,准确诊断、提高对睡眠症状的评估及干预水平,优化疾病管理,改善患儿的睡眠状况,缓解家庭压力及照顾者的负担。  相似文献   

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正失眠是最常见的睡眠障碍,但其治愈困难,尤其是慢性失眠(chronic insomnia,CI)。目前对CI的诊断主要基于主观症状,故不能排除共病性失眠或其他疾病伴随的失眠症状。多导睡眠监测虽是失眠诊断的金标准,但结果多与患者主观睡眠时间不符、费用高且操作复杂。研究表明,失眠可引起机体多种生物学改变,如血液、电生理等。鉴于血液标本采集的简便、易行性,血液生物学标志更易用于临床,尤其是基层医院。研  相似文献   

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睡眠-觉醒障碍是一种常见的临床疾病,可单独发生也可伴随其他精神心理疾病发生。本文重点讨论临床常见的三种睡眠-觉醒障碍(失眠障碍、嗜睡障碍及发作性睡病)的临床表现、药物治疗及心理治疗。其中失眠认知行为治疗(CBTI)对睡眠-觉醒障碍安全有效,逐渐成为临床常用的治疗方法之一。  相似文献   

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失眠障碍(Insomnia Disorders)是临床上常见的一种病症,也是最常见的睡眠障碍之一,其特征是入睡困难、睡眠维持困难、早醒和(或)睡眠质量差.文献报道,约25%的成人对自己睡眠不满意,其中6%~10%符合失眠障碍的诊断标准,长期失眠、睡眠质量低下可增加心血管疾病及慢性病的发生率,睡眠问题越来越受到重视[1-2].2013年出版的《精神疾病诊断与统计手册第5版》(DSM-5)将过去"原发性失眠"和"继发性失眠"的诊断条目删除,依据病程将失眠分为急性失眠、慢性失眠和其他类型失眠 3部分,不再用因果关系解释失眠与其他疾病共病的现象,更强调失眠障碍本身在临床工作中的重要意义、应根据诊断标准进行独立评估[3].失眠的治疗主要包括药物治疗和非药物治疗,临床上较常使用的催眠药是苯二氮 类,但长期使用可导致认知功能障碍、记忆损害、睡眠结构受损等不良反应[4-5].非药物治疗作为更安全的治疗方法日益受到推崇.其中松弛疗法治疗在临床应用有较多突破,本文主要就近年国内外松弛疗法治疗失眠障碍的研究进展做一简单综述.  相似文献   

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双相障碍是一种严重的精神障碍,常有昼夜节律紊乱、失眠、睡眠过多等症状,其发生发展受到遗传因素的影响。睡眠障碍有昼夜节律紊乱、失眠等症状,同样和遗传相关。由于双相障碍与睡眠障碍的遗传机制有重叠之处,本文对双相障碍与睡眠障碍的共同致病基因进行综述,回顾两种疾病的基因关联性研究,总结可能的共同致病基因,为疾病的发生发展以及预防和治疗提供新思路。  相似文献   

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目的 分析河北省中年人不同睡眠特征人群现患慢性病情况以及生活饮食、行为方式, 探究睡眠与躯体慢性疾病的潜在关系。方法 2018 年6—9 月采用分层、整群随机抽样方法对河北 省18 岁及以上人群进行调查,共纳入5 733 名被试。评估工具包括一般情况调查表、既往躯体疾病与 精神科疾病史、阿森斯失眠量表问卷、不宁腿综合征问卷、睡眠呼吸暂停-柏林问卷、发作性睡病量表 等。根据是否为短睡眠、失眠障碍分为4 组[对照组(4 343 名,75.8%)、单纯短睡眠组(526 名,9.2%)、非 短睡眠的失眠障碍组(365 名,6.4%)、短睡眠的失眠障碍组(499 名,8.7%)],分析4 组慢性病患病率及慢 性病的风险因素。结果 各组间高血压、糖尿病、脑血管疾病患病率差异有统计学意义(均P < 0.05), 对照组慢性病患病率最低,单纯短睡眠组、非短睡眠的失眠障碍组、短睡眠的失眠障碍组分别与对照组 比较,慢性病患病率差异均有统计学意义(均P < 0.05)。不同年龄、性别、体质指数、城乡居民、教育程 度、职业、摄盐习惯、是否吸烟、饮酒情况、体育锻炼情况4 组间差异均有统计学意义(均P < 0.05)。在 调整了年龄、性别、体质指数、城乡、居住方式、教育程度、职业、摄盐习惯、吸烟饮酒情况、体育锻炼情 况后,Logistic 回归分析结果显示非短睡眠的失眠障碍和短睡眠的失眠障碍是患高血压[OR(95%CI)值 分别为2.074(1.606~2.679)、1.689(1.346~2.121)]和糖尿病[OR(95%CI)值分别为2.273(1.508~3.426)、 1.805(1.244~2.621)]的危险因素(均P< 0.01);单纯短睡眠、非短睡眠的失眠障碍和短睡眠的失眠障 碍均是脑血管疾病的危险因素[OR(95%CI)值分别为1.826(1.203~2.770),2.149(1.389~3.324),1.613 (1.068~2.434);均P< 0.05]。结论 短睡眠者与失眠障碍对躯体的影响可能不同,失眠障碍是高血压、 糖尿病的危险因素,而短睡眠和失眠障碍均是脑血管疾病的危险因素  相似文献   

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正由中华医学会、中华医学会神经病学分会主办,中华医学会神经病学分会睡眠障碍学组承办的中华医学会神经病学分会第四届全国睡眠障碍学术会议拟定于2016年8月26-28日在山东省济南市召开。届时将邀请国内外睡眠领域著名专家进行专题报告。会议内容包括失眠障碍、嗜睡症、神经系统疾病相关睡眠障碍、精神疾病与睡眠障碍、睡眠相关呼吸障碍、睡眠相关运动障碍、异态睡眠等睡眠相关疾病基础与临床研究新进展,同时就睡眠障碍的规范化诊断与治疗及多导睡眠图监测技术在  相似文献   

10.
<正>睡眠障碍疾病在儿童及青少年中较常见。儿童及青少年处于生长发育关键时期,良好睡眠可促进生长发育、提高机体免疫力,与神经系统发育、记忆存储功能密切相关。各种睡眠障碍疾病导致睡眠时间及质量不足,常与多种精神疾病伴发,会影响儿童及青少年身体健康、智力发育,导致情绪、认知和社会心理问题。儿童及青少年常见睡眠障碍疾病包括:失眠、阻塞性睡眠呼吸暂停、发作性睡病、异态睡眠、周期性肢体运动障碍、不宁腿综合征。尽管睡眠障碍性疾病在  相似文献   

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A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.  相似文献   

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Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.  相似文献   

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Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.  相似文献   

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Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005  相似文献   

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After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.  相似文献   

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