Vgontzas A N, Kales A
Department of Psychiatry, Penn State University, College of Medicine, Hershey, Pennsylvania 17033, USA.
Annu Rev Med. 1999;50:387-400. doi: 10.1146/annurev.med.50.1.387.
Sleep disorders are very prevalent in the general population and are associated with significant medical, psychological, and social disturbances. Insomnia is the most common. When chronic, it usually reflects psychological/behavioral disturbances. Most insomniacs can be evaluated in an office setting, and a multidimensional approach is recommended, including sleep hygiene measures, psychotherapy, and medication. The parasomnias, including sleepwalking, night terrors, and nightmares, have benign implications in childhood but often reflect psychopathology or significant stress in adolescents and adults and organicity in the elderly. Excessive daytime sleepiness is typically the most frequent complaint and often reflects organic dysfunction. Narcolepsy and idiopathic hypersomnia are chronic brain disorders with an onset at a young age, whereas sleep apnea is more common in middle age and is associated with obesity and cardiovascular problems. Therapeutic naps, medications, and supportive therapy are recommended for narcolepsy and hypersomnia; continuous positive airway pressure, weight loss, surgery, and oral devices are the common treatments for sleep apnea.
睡眠障碍在普通人群中非常普遍，并且与严重的医学、心理和社会干扰相关。失眠是最常见的。当失眠为慢性时，它通常反映了心理/行为障碍。大多数失眠患者可以在门诊环境中进行评估，建议采用多维度方法，包括睡眠卫生措施、心理治疗和药物治疗。异态睡眠，包括梦游、夜惊和噩梦，在儿童期具有良性影响，但在青少年和成年人中通常反映精神病理学或重大压力，在老年人中则反映器质性病变。白天过度嗜睡通常是最常见的主诉，并且常常反映器质性功能障碍。发作性睡病和特发性嗜睡症是在年轻时发病的慢性脑部疾病，而睡眠呼吸暂停在中年更为常见，并且与肥胖和心血管问题相关。对于发作性睡病和嗜睡症，建议采用治疗性小睡、药物治疗和支持性治疗；持续气道正压通气、减肥、手术和口腔矫治器是睡眠呼吸暂停的常见治疗方法。
