Schneider Diane L
Department of Medicine, Division of General Medicine and Geriatrics, University of California, San Diego, USA.
Geriatrics. 2002 May;57(5):24-6, 29, 32 passim.
Insomnia is a problem in all stages of life but is particularly common after age 65. A number of factors--including advanced age, psychosocial influences, medical illness, and the use of medications and alcohol--may disturb sleep architecture. Evaluation of insomnia in the older patient requires a careful history and physical examination, supplemented by a sleep diary. Treatment of underlying conditions and nonpharmacologic improvements in sleep hygiene are first-line therapy, but pharmacologic agents such as benzodiazepines, nonbenzodiazepine hypnotics, or antidepressants may be needed. Nonbenzodiazepines with rapid elimination may offer a lower side-effect profile than other hypnotic agents when used for insomnia in the older population.
失眠在人生的各个阶段都是一个问题，但在65岁以后尤为常见。许多因素——包括高龄、心理社会影响、疾病以及药物和酒精的使用——都可能扰乱睡眠结构。对老年患者失眠的评估需要详细的病史和体格检查，并辅以睡眠日记。治疗潜在疾病和非药物改善睡眠卫生是一线治疗方法，但可能需要使用苯二氮䓬类药物、非苯二氮䓬类催眠药或抗抑郁药等药物。在老年人群中用于治疗失眠时，快速消除的非苯二氮䓬类药物可能比其他催眠药物副作用更小。
