Insomnia

Insomnia is a highly prevalent disorder with consequences for the patient's physical and mental health, daily function, and job performance. This paper gives an overview on current and new pharmacological treatments of insomnia. Additionally, some evidence based treatment options with regard to cognitive behavioral therapy are presented.     

失眠症的药物治疗

临床上习惯使用的镇静催眠药苯二氮艹卓类(BZD)属抗焦虑药,长期服用容易产生依赖,失眠者须遵循小剂量、短疗程的用药原则。对伴有抑郁情绪的失眠病人BZD无效。镇静性抗抑郁药在帮助病人恢复正常睡眠结构的同时发挥抗抑郁、抗焦虑的作用,更有效纠正失眠。     

Management of Insomnia

ObjectiveTo review current issues in the pharmacologic and nonpharmacologic management of insomnia.Data SourcesControlled trials and case studies identified via MEDLINE for 1990 through April 1999 under the search terms insomnia, hypnotics, flurazepam, quazepam, estazolam, temazepam, triazolam, zolpidem, zaleplon, L-846, CL-284,846, melatonin, and valerian.Data SynthesisInsomnia is a common, undertreated disorder. Nonpharmacologic management strategies (e.g., stimulus control, relaxation therapy, sleep hygiene) are therapeutic options that, compared with medication use, provide more sustained effects. The benzo· diazepines and zolpidem are the most commonly prescribed hypnotic agents, but their use is associated with tolerance and central nervous system adverse effects. A new nonbenzodiazepine hypnotic agent, zaleplon, was very recently approved in the United States. Because of its short half-life, zaleplon will be useful in patients experiencing difficulty in falling asleep and in those who wake up at night and have trouble falling back to sleep. Antidepressants, antihistamines, and alternative medications are other treatment options. To avoid complications of therapy, hypnotic agents should be used at their lowest possible doses and for limited treatment durations.ConclusionPharmacotherapy is currently the most common treatment modality for insomnia, but long-term use of hypnotic agents can become complicated by drug tolerance, dependence, or rebound insomnia. Nonpharmacologic options–including combinations of behavioral interventions, sleep-restriction therapy, and patient education-provide longer-lasting benefits.     

失眠的诊断与治疗

问：失眠的病因是什么？ 答：导致失眠的原因归纳起来可分为三类：1．应急状态或环境改变（环境、工作、学习、饮食、家庭变化），破坏了正常生活和生物钟规律.     

失眠的你,请对号入座

随着人们生活习惯的改变、工作压力不断增大,现代社会中人们普遍感到,想睡个好觉越来越不容易了。据统计,美国成人中30%～35%患有失眠症;全国50%的严重车祸都是因睡眠不足造成的。法国成人中30%患有失眠症。我国仅上海一地,失眠者就占全市总人口的15%以上,而其中56%为女性。     

帮老爸老妈斗失眠

一般人都知道,老人睡觉轻,睡不实。有人轻微的说话,或一些声音不大的响动,都会让老人惊醒。甚至有的老人睡梦中都会自己醒来。这是由老年人生理特点决定的。     

阿托伐他汀钙加重失眠

1例75岁男性患者冠状动脉内支架植入术后规律服用氟伐他汀钠80mg,1次／d,因血脂水平未达标改服阿托伐他汀钙10mg,每晚1次。第4天,患者原有失眠加重,彻夜不眠。停用阿托伐他汀钙,改服瑞舒伐他汀钙10mg,每晚1次。3d后,患者失眠缓解。     

中药治疗失眠浅谈

中医将失眠症的病因病机概括为化源不足,心神失养;阴虚火旺,阴不敛阳;心虚胆怯,心神不宁;痰热、实火扰动心神四个方面,在此基础之上某些学者对其辨证论治提出了更进一步的见解,医家报道以中药单方、复方治疗失眠取得较好疗效。中医治疗失眠症方法多、效果好、不良反应少,但是还存在一些尚未解决的问题,在今后的研究中应予以重视。     

失眠患者的治疗体会

目的对失眠患者的治疗方法和临床治疗效果进行观察和分析。方法随机选择45例于2012年1月至2013年9月间在我院进行失眠治疗的患者资料进行研究和分析,将患者分为对照组和治疗组两组,对照组20例,治疗组25例,对照组患者进行地西泮治疗,对治疗组患者进行黛力新联合地西泮治疗,对两组患者的临床治疗效果进行对比和分析。结果治疗组17例患者痊愈,4例患者治疗显效,4例患者治疗有效,治疗总有效率为100%,对照组7例患者痊愈,3例患者治疗显效,5例患者治疗有效,5例患者治疗无效,治疗总有效率为75%,两组患者临床治疗效果差异具有统计学意义(P<0.05)。结论对失眠患者采用黛力新联合地西泮治疗能够取得显著疗效。     

A Neurobiological Model of Insomnia

Insomnia is a common clinical condition resulting in significant costs and morbidity. Previous models of insomnia focusing on psychological and behavioral processes are useful clinically, but lack neurobiological specificity. We propose an insomnia model based on basic and clinical neuroscience findings, and hypothesize that insomnia results from persistent activity in wake-promoting neural structures during NREM sleep. The simultaneous occurrence of sleeping and waking neural activity helps to explain clinical phenomenology and treatment effects in insomnia.     

失眠的药物治疗策略与评价

目的：睡眠是人体重要的生理活动,人类生存时间的1/3要在睡眠中度过,为此,失眠的药物治疗策略显得尤为重要,本文归纳其治疗用药与评价。方法：综述近期的国内外文献报道。结果及结论：失眠的药物治疗已完成数次过渡,寻求作用于新靶位、选择性强、作用专一的新型催眠药已成为临床关注的课题。伴随着科研的发展,对失眠的根治有望于更多安全有效的催眠药物问世。     

睡眠障碍治疗药物的应用状况与评价

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。     

扎来普隆治疗失眠症的临床评价

目的评价扎来普隆治疗失眠症的疗效及安全性。方法以“zaleplon”、“insomnia”、“polysomnography”为关键词,在“OVID”数据库中检索最新文献。结果扎来普隆能快速诱导睡眠,不良反应小。结论扎来普隆是治疗失眠症安全、有效的药物。     

Herbal Medicine for Anxiety,Depression and Insomnia

The prevalence and comorbidity of psychiatric disorders such as depression, anxiety and insomnia are very common. These well-known forms of psychiatric disorders have been affecting many people from all around the world. Herb alone, as well as herbal formula, is commonly prescribed for the therapies of mental illnesses. Since various adverse events of western medication exist, the number of people who use herbs to benefit their health is increasing. Over the past decades, the exploration in the area of herbal psychopharmacology has received much attention. Literatures showed a variety of herbal mechanisms of action used for the therapy of depression, anxiety and insomnia, involving re-uptake of monoamines, affecting neuroreceptor binding and channel transporter activity, modulating neuronal communication or hypothalamic-pituitary adrenal axis (HPA) etc. Nonetheless, a systematic review on herbal pharmacology in depression, anxiety and insomnia is still lacking. This review has been performed to further identify modes of action of different herbal medicine, and thus provides useful information for the application of herbal medicine.