空军总医院航空航天睡眠医学中心简介

<正>空军总医院睡眠医学临床研究始于上世纪80年代,2010年在原有基础上扩建为临床睡眠医学中心,2013年正式成立临床"航空航天睡眠医学中心"(以下简称中心)。中心不仅面向军队,而且向全社会开放,开展全睡眠疾病临床诊断与治疗工作,是目前国内系统规范诊断与治疗各种睡眠及其相关性疾病标准化较高的临床睡眠医学中心之一。中心拥有4个符合国际标准的睡眠监测室,每个监测室都配有固定电话、电视和独立洗漱     

中国睡眠研究会睡眠医学教育专业委员会睡眠医学专家讲座答疑(五)失眠认知行为的概念框架

张斌,医学博士,教授、博士研究生导师、主任医师.主编《中国失眠障碍诊断和治疗指南》及主译《失眠的认知行为治疗-逐次访谈指南》.南方医科大学南方医院精神心理科主任,中国精神科医师协会委员,中国睡眠研究会理事及副秘书长,睡眠医学教育委员会常务副主任委员,睡眠与心理卫生工作委员会副主任委员,前任青年精神科医师联盟副主席,青年工作委员会副主任委员,中国医师协会睡眠医学专业委员会委员及副秘书长,睡眠医学技术学组组长、青年医师工作委员会常务副主任委员,中国医疗保健国际交流促进会睡眠分会副主任委员.     

肌筋膜疼痛综合征的研究进展

肌筋膜疼痛综合征(myofascial pain syndrome,MPS)是一种局部疼痛综合征,以激痛点为主要临床特征。临床医师越来越关注此病,因其发病形式多样、发病部位不定、症状轻重程度不一,故易出现误诊,为让更多医师掌握此病,本文对流行病学、激痛点、临床特点、临床检查、诊断标准及临床治疗等方面的国内外相关文献进行综述,为MPS的诊断及临床治疗提供依据。     

睡眠远程诊断模式在睡眠疾病诊治中的应用

远程诊断是"互联网+医疗健康"大范畴中的一个重要组成部分,采用网络技术,邀请其他医疗机构为本医疗机构患者提供诊疗服务。宁夏地区前期在远程医疗方面积累了较为丰富的经验,根据本地区的具体情况,开展睡眠远程诊断。通过基础单位与睡眠远程诊断中心互联互通,实现患者在基层单位就诊及实施睡眠监测,远程中心诊断并指导治疗的模式。目前该睡眠远程网络已投入正常运行,方便患者就近享受优质医疗服务。     

临床药师参与1例青霉素致动眼神经麻痹的诊断

目的：探讨临床药师参与临床实践时在疾病诊断中发挥的作用。方法：通过对1例动眼神经麻痹的患者进行药学专业的病因探寻和分析,为治疗团队提供合理的药学依据,帮助医师做出正确的诊断。结果：临床药师提供的诊断依据合理,帮助医师及时明确诊断、合理用药,促进了患者的早日康复,并预防疾病再次发生。结论：通过临床药师为治疗团队提供药学专业的病因分析,帮助医师及时诊断疾病,为患者的治疗提供用药依据,并对疾病的预防提出合理化建议。     

慢性应激致睡眠障碍的研究进展

睡眠障碍是一种严重影响生活和工作的疾病,其常见原因之一为应激。急性应激障碍或创伤后应激障碍致睡眠异常的研究颇多,关于慢性应激致睡眠障碍的研究相对较少,并且,慢性应激致睡眠障碍一直深受临床医师关注。本研究主要通过对慢性应激致睡眠障碍的机制、危险因素、治疗等方面进行综述,旨在为临床慢性应激致睡眠障碍的诊治提供理论依据。     

165例发作性睡病患者的临床特征分析

目的研究分析山东省立医院睡眠医学中心确诊的165例发作性睡病患者的临床特征,提高临床医师对发作性睡病的认识。方法选取2015年1月至2018年8月我院睡眠医学中心诊治的165例发作性睡病患者的临床资料,进行回顾性分析。结果 165例发作性睡病患者中男性为女性的2.3倍,伴猝倒的患者占84.24%,高于既往研究;患者大部分来自于山东省,以八月、二月、三月就诊者最多;发病年龄、五联征发生概率及其他临床表现与既往研究基本相同。结论发作性睡病是一种相对罕见的神经系统疾病,发病早,临床表现多种多样,病因不明。应尽早诊断、治疗,并加强对患者的管理教育,以提高其生活质量。     

乳腺新的交界性病变——平坦型上皮不典型性的研究进展

通过对平坦型上皮不典型性这一病变的全面回顾，系统介绍该病的由来、临床和组织病理学特点、病情进展风险、遗传学和免疫表型特点及治疗策略，为病理医师对该病的诊断提供参考，为临床医师对该病的处理提供依据。     

照片质量对影像诊断的重要性

X线普通摄影以及CR和DR技术,无论哪种成像系统所获得的影像信息,最终为影像诊断及临床治疗提供依据。正确的影像诊断,是由医师通过优质照片提供的病灶信息做出的,若提供的照片质量差,照片上的正常组织与病灶无法辨认,那么不管医师的医学知识及诊断经验多丰富,都很难做出正确的诊断。与此同时,影像诊断和临床治疗方面对照片技师要求亦越来越高。因此对X线照片质量的客观评价是放射界一个重要的理论和技术问题。     

便携式睡眠呼吸检测仪加诊断性治疗在OSAHS中的诊断价值

【目的】探讨便携式睡眠呼吸监测仪加诊断性治疗在确诊阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome, OSAHS）中的价值,旨为基层医院提供一种简易,准确、低成本、可行性强的诊断方法。【方法】首先分别采用便携式睡眠呼吸监测仪及多导睡眠监测仪,对97例临床上怀疑有OSAHS的对象进行监测,并对其中便携式睡眠呼吸监测考虑为0sAHs的73例患者进行免费持续气道正压通气（CPAP）治疗,一周后进行评估,有效者视确诊为0sAHs,比较便携式睡眠呼吸检测仪加诊断性治疗在诊断OSAHS敏感性和特异性。【结果】便携式睡眠呼吸检测仪的敏感性为100％,特异性为70．6％;便携式睡眠检测仪加诊断性治疗的敏感性为100％,特异性为91．7％。便携式睡眠检测仪加诊断性治疗的诊断特异性高于单纯便携式睡眠呼吸检测仪（P〈0．05）。【结论】便携式睡眠呼吸检测仪加诊断性治疗对诊断0S—AHS有高度的特异性。     

以中为体,以西为用,发展具有中国特色的现代中医睡眠医学

中医学对睡眠疾病的认识和诊疗有着悠久的历史,中医睡眠医学得到了广泛认可。随着现代睡眠医学的崛起,中医睡眠医学亦迎来新的发展良机。笔者认为中医睡眠医学发展当"中体西用",不仅继承和发扬中医学关于睡眠及睡眠障碍的科学精华,又借鉴现代睡眠医学理论与方法为我们所有,使中医学能够在世界睡眠医学界不断创新和发展,彰显中医药特色与优势。     

Sleep-wake patterns of school-age children and adolescents before diagnosis and during induction chemotherapy for acute lymphocytic leukemia

Sleep disturbances are commonly reported by children receiving chemotherapy for leukemia. Sleep patterns before diagnosis and during induction chemotherapy were evaluated in 38 children (7 to 18 years?old). Child Sleep Assessment (CSA) was used to evaluate sleep patterns prior to diagnosis. Sleep diaries and actigraphy were used during chemotherapy. Adolescents went to bed later and awakened later than school-age children before diagnosis and during chemotherapy. During chemotherapy, children averaged 60 minutes of nighttime wake time. The early recognition of sleep problems associated with disease, treatment, and age is important for school-age children and adolescents with leukemia.     

Sleep apnea syndrome

Sleep apnea syndrome is estimated to affect as many as 2 to 3 percent of the adult male population. Excessive snoring and daytime sleepiness are but a few of the many clues to diagnosis. The hypoxemia occurring as a result of apnea may lead to pulmonary hypertension. Depressed respiratory center neural output or upper airway occlusion during sleep may cause the apnea. There are a number of treatment options available.     

老年群体常见睡眠障碍及养老服务中心睡眠健康管理探析

我国已经进入老龄化时代,老年群体的健康问题需要引起足够的重视,老年群体睡眠障碍疾病的发生率较高,失眠、睡眠呼吸暂停低通气综合征等是常见的老年睡眠障碍。严重影响老年人的身心健康。睡眠障碍疾病容易合并心脑血管疾病、神经系统和内分泌系统疾病、心理疾病等,睡眠障碍与这些疾病之间相互影响,互为因果。国家对于养老事业给予积极的支持,随着养老服务机构的兴起,养老机构老年群体的睡眠健康问题日益突出,需要增加和完善养老服务中心的睡眠健康管理体系,促进国家养老健康服务体系的建设和养老事业的发展。     

Sleep disorders associated with traumatic brain injury

OBJECTIVES: To investigate the frequency of sleep disorders in traumatic brain injury (TBI) patients with hypersomnia and to discern the relationship between posttraumatic sleep disorders and pretraumatic sleep symptoms. DESIGN: Prospective cohort study using the criterion standard to diagnose sleep disorders in a consecutive sample of TBI patients. SETTING: Academic medical center with level I trauma center, rehabilitative medicine services, and accredited sleep disorders center. PATIENTS: Ten TBI patients with subjective excessive sleepiness. INTERVENTION: Nocturnal polysomnography followed by Multiple Sleep Latency Test. Subjects who had overt sleep apnea on the first nocturnal polysomnography had a second nocturnal polysomnography with titration of nasal continuous positive airway pressure. MAIN OUTCOME MEASURES: Diagnosis of sleep-disordered breathing, narcolepsy, and posttraumatic hypersomnia. RESULTS: A diagnosis of treatable sleep disorder was made in all 10 subjects. Sleep-disordered breathing was found in 7 subjects: overt obstructive sleep apnea (OSA) was diagnosed in 5 subjects, rapid eye movement-related OSA in 1, and upper airway resistance syndrome (UARS) in 1. Narcolepsy was diagnosed in 2 subjects, and the diagnosis of posttraumatic hypersomnia was made in 1 subject. Three subjects had symptoms of hypersomnia before their injury (1 each with narcolepsy, OSA, UARS), and 2 of these were driving a car at the time of injury. CONCLUSION: Treatable sleep disorders appear to be common in the sleepy TBI population, but may be largely undiagnosed and untreated.     

Assessing ambulatory geriatric sleep complaints

Sleep disturbances afflict more than 50% of adults age 65 and older. Sleep apnea and periodic limb movements of sleep are the primary sleep disorders in the elderly. Patient assessment tools, a thorough physical examination, and appropriate tests can simplify the diagnostic process; sleep center referral is not always warranted. Ultimately, accurate sleep disorder diagnoses can result in decreased geriatric morbidity and mortality, and increased patient quality of life.     

Insomnia in Adults: Etiology and Management

Insomnia is a significant problem in adults that frequently goes undiagnosed and untreated. Untreated insomnia is often associated with undiagnosed medical or psychiatric disorders that increase morbidity and mortality. Sleep patterns change with aging, and the presence of comorbid conditions leads to a higher prevalence of sleep disorders in older adults. Practitioners should inquire about sleep disorders with every patient encounter to increase diagnosis and treatment. Effective treatment of insomnia is available with nonpharmacologic and pharmacologic treatment modes.     

Effects of common medications used for sleep disorders

Sleep disorders are common and their diagnosis is becoming more widespread with improved awareness among clinicians and patients. The armamentarium for the pharmacologic treatment of sleep disorders is rapidly growing, demanding that clinicians be aware of their indications, adverse effects, and interactions. As disorders, such as narcolepsy, shift-work sleep disorder, and RLS are more readily identified, pharmacologic treatments for these conditions will also become more common.     

Sleep disorders in the elderly

Many elderly complain of serious difficulty getting to sleep or staying asleep. Sleep physiology changes with age. Furthermore, medical conditions that may affect sleep and serious pathologic sleep disorders are more prevalent among the elderly. Treatment should be directed toward any identified underlying condition after thorough evaluation by history, examination, and in certain instances, referral to a sleep disorders center.