失眠

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失眠
Insomnia
同义词 Sleeplessness、(想睡/該睡覺)卻睡不著
影片介紹(中文字幕建設中)
發音
  • ㄕ ㄇ一ㄢˊ[1]
醫學專科 精神病学睡眠醫學英语sleep medicine
症状 難以入睡、白天想睡覺、沒精神、抑郁[1]
併發症 車禍[1]
肇因 未知、心理壓力英语psychological stress慢性疼痛心臟衰竭甲状腺功能亢进症胃灼熱不寧腿綜合徵[2][3]
診斷方法 根據症狀、睡眠檢測英语sleep study[4]
相似疾病或共病 睡眠相位后移症候群不寧腿綜合徵睡眠呼吸暂停精神疾病[5]睡眠障礙
治療 睡眠衛教英语Sleep hygiene认知行为疗法安眠药[6][7][8]
盛行率 0~20%[9][3][10]

失眠(英語:insomnia)是一種不容易自然地進入睡眠状态的睡眠障碍[1]。可能是很難睡著,或是很難維持較長時間的睡眠[11][9]。失眠一般會伴隨著白天精神不佳、想睡覺、易怒、或是抑郁等症狀[1]。失眠可能會增加車禍的風險,也可能會讓人無法專注及學習[1]。失眠可能是短期的,持續幾天到一週,也可能是長期的,持續一個月以上[1]

失眠可能和其他的藥物或症狀無關,也有可能是受到其他藥物、症狀或疾病的影響[2]。會導致失眠的症狀有心理壓力英语psychological stress慢性疼痛心臟衰竭甲状腺功能亢进症胃灼熱不寧腿綜合徵更年期,也有可能是因為咖啡因尼古丁酒精的影響[2][3],其他風險因子有夜班睡眠呼吸暂停[9]。失眠診斷會根據睡眠習慣為基礎,也會進行身體檢查,以確認是否有其他潛藏造成失眠的病症[4],也可能會進行睡眠檢測英语sleep study來找出失失眠的原因[4]

一般而言,會以睡眠衛教英语Sleep hygiene及生活習慣的調整作為第一線的治療方式[6][8]。睡眠衛教包括充足的睡眠時間、白天時曬太陽、安靜及暗的臥室以及規律的運動[8],可以再配合认知行为疗法[7][12]安眠药可能會有幫助,不過有些受傷失智症成瘾的症狀和安眠药使用有關[6][7]。若使用藥物治療,一般不建議使用超過四週到五週[7]。還不清楚替代療法在治療失眠的效果及安全性[6][7]

類型[编辑]

DSM-5 診斷標準[编辑]

精神疾病診斷與統計手冊第五版(DSM-5英语DSM-5)中寫到,失眠的診斷標準如下: [13]

病患主訴中提到對於睡眠時間長度和睡眠品質的不滿與下列至少一項敘述有關:

  • 难以入睡。(小孩的失眠表現則為:如果照顧者沒有哄小孩睡覺,小孩就會難以入睡)

參見[编辑]

參考資料[编辑]

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 What Is Insomnia?. NHLBI. December 13, 2011 [9 August 2016]. 
  2. ^ 2.0 2.1 2.2 What Causes Insomnia?. NHLBI. December 13, 2011 [9 August 2016]. 
  3. ^ 3.0 3.1 3.2 Dyssomnias (PDF). WHO: 7–11. [2009-01-25]. 
  4. ^ 4.0 4.1 4.2 How Is Insomnia Diagnosed?. NHLBI. December 13, 2011 [9 August 2016]. 
  5. ^ Watson, Nathaniel F.; Vaughn, Bradley V. Clinician's Guide to Sleep Disorders. CRC Press. 2006: 10. ISBN 9780849374494 (英语). 
  6. ^ 6.0 6.1 6.2 6.3 How Is Insomnia Treated?. NHLBI. December 13, 2011 [9 August 2016]. 
  7. ^ 7.0 7.1 7.2 7.3 7.4 Qaseem, A; Kansagara, D; Forciea, MA; Cooke, M; Denberg, TD; Clinical Guidelines Committee of the American College of, Physicians. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians.. Annals of Internal Medicine. 3 May 2016, 165: 125–33. PMID 27136449. doi:10.7326/M15-2175. 
  8. ^ 8.0 8.1 8.2 Wilson, JF. In the clinic: Insomnia. Annals of Internal Medicine. 1 January 2008, 148 (1): ITC13–1–ITC13–16. PMID 18166757. doi:10.7326/0003-4819-148-1-200801010-01001. 
  9. ^ 9.0 9.1 9.2 Roth, T. Insomnia: Definition, prevalence, etiology, and consequences. Journal of Clinical Sleep Medicine. 2007, 3 (5 Suppl): S7–10. PMC 1978319. PMID 17824495. 
  10. ^ Tasman, Allan; Kay, Jerald; Lieberman, Jeffrey A.; First, Michael B.; Riba, Michelle. Psychiatry, 2 Volume Set 4. John Wiley & Sons. 2015: 4253. ISBN 9781118753361 (英语). 
  11. ^ Golub, R. M. Insomnia. JAMA. 2012, 307 (24): 2653–2653. PMID 22735439. doi:10.1001/jama.2012.6219. 
  12. ^ Trauer, James M.; Qian, Mary Y.; Doyle, Joseph S.; W. Rajaratnam, Shantha M.; Cunnington, David. Cognitive Behavioral Therapy for Chronic Insomnia. Annals of Internal Medicine. 9 June 2015, 163: 191–204. PMID 26054060. doi:10.7326/M14-2841. 
  13. ^ "Sleep Wake Disorders ." Diagnostic and statistical manual of mental disorders: DSM-5.. 5th ed. Washington, D.C.: American Psychiatric Association, 2013. -. Print.
  14. ^ 14.0 14.1 Roth, T.; Roehrs, T. Insomnia: Epidemiology, characteristics, and consequences. Clinical Cornerstone. 2003, 5 (3): 5–15. PMID 14626537. doi:10.1016/S1098-3597(03)90031-7. 
  15. ^ Insomnia – sleeplessness, chronic insomnia, acute insomnia, mental .... [2008-04-29]. (原始内容存档于March 29, 2008). 
  16. ^ Acute Insomnia – What is Acute Insomnia. Sleepdisorders.about.com. [2013-03-10]. 
  17. ^ Simon, Harvey. In-Depth Report: Causes of Chronic Insomnia. New York Times. [4 November 2011]. 
  18. ^ Consumer Reports; Drug Effectiveness Review Project. Evaluating New Sleeping Pills Used to Treat: Insomnia Comparing Effectiveness, Safety, and Price (PDF). Best Buy Drugs Consumer Reports (Consumer Reports). January 2012: 4 [4 June 2013]. 
  19. ^ Kertesz, R. S.; Cote, K. A. Event-Related Potentials During the Transition to Sleep for Individuals with Sleep-Onset Insomnia. Behavioral Sleep Medicine. 2011, 9 (2): 68–85. PMID 21491230. doi:10.1080/15402002.2011.557989. 
  20. ^ Doghramji, Karl. Clinical Management of Insomnia. Caddo, OK: Professional Communications, Inc. 2007: 28. ISBN 978-1-932610-14-7. 
  21. ^ Morin, Charles. Insomnia: A Clinician's Guide to Assessment and Treatment. New York, New York: Kluwer Academic/Plenum Publishers. 2003: 16. ISBN 0-306-47750-5. 
  22. ^ What Happens When You Sleep?. sleepfoundation.org. [2017-02-24]. 
  23. ^ Adler, C. H.; Thorpy, M. J. Sleep issues in Parkinson's disease. Neurology. 2005, 64 (12 Suppl 3): S12–S20. PMID 15994219. doi:10.1212/WNL.64.12_suppl_3.S12. 
  24. ^ Harvey, A. G.; Tang, N. (Mis)Perception of Sleep in Insomnia: A puzzle and a resolution. Psychological Bulletin. 2011, 138 (1): 77–101. PMC 3277880. PMID 21967449. doi:10.1037/a0025730. 

參考文獻[编辑]