Azad Nahid, Byszewski Anna, Sarazin Francine F-A, McLean William, Koziarz Peter
Geriatric Assessment Unit, The Ottawa Hospital, General Campus, Ottawa, Canada.
Can J Clin Pharmacol. 2003 Summer;10(2):89-92.
Insomnia is common in hospitalized patients, who become significantly vulnerable to the adverse effects of the benzodiazepines (BZDs) used to treat this condition. Consequently, there has been a logical search for non-drug alternatives (NDAs) for the treatment of insomnia.
Inpatient insomnia cases were surveyed over the Summer of 1999. Our hypotheses were that an attitudinal difference exists between acute and chronic users of BZDs towards NDAs; and that inpatients who were prescribed BZDs have also received proper information about alternative therapies.
One hundred insomnia cases met the inclusion criteria. Fifty-one per cent were younger than age 65. Short acting BZDs were used in 88% of the cases. Fourty per cent of patients had started experiencing insomnia while in the hospital. Only 11% of patients received information about NDA therapy for insomnia. Eighty-two patients felt that NDAs were healthier, and the majority (n=67) responded that if an NDA were offered in the hospital, they would be willing to accept it. Female participants were more willing to consider NDAs (P<0.01). First time users of BZDs were by far more receptive to NDA remedies than were chronic users of BZDs (P<0.002). A significant number of participants who were receiving short-acting BZDs were willing to try an NDA (P<0.001). Participants interested in NDA therapies expressed preferences for for massage therapy, sleep hygiene, music and relaxation techniques (P<0.001).
Significant attitudinal differences are seen in several domains of patient characteristics. First time female users of BZDs and those taking short acting BZD were more willing to try an NDA. Educational programs are needed for appropriate evidence-based management protocols for insomnia.
失眠在住院患者中很常见，这类患者极易受到用于治疗该病症的苯二氮䓬类药物（BZDs）不良反应的影响。因此，人们一直在合理探寻治疗失眠的非药物替代方法（NDAs）。
在1999年夏季对住院失眠病例进行了调查。我们的假设是，BZDs的急性和慢性使用者对NDAs的态度存在差异；并且开具了BZDs的住院患者也已获得有关替代疗法的适当信息。
100例失眠病例符合纳入标准。51%的患者年龄小于65岁。88%的病例使用了短效BZDs。40%的患者在住院期间开始出现失眠。只有11%的患者获得了关于失眠的NDA疗法的信息。82名患者认为NDAs更健康，大多数患者（n = 67）回答说如果医院提供NDA，他们愿意接受。女性参与者更愿意考虑NDAs（P<0.01）。BZDs的首次使用者比BZDs的慢性使用者对NDA疗法的接受程度要高得多（P<0.002）。大量正在接受短效BZDs治疗的参与者愿意尝试NDA（P<0.001）。对NDA疗法感兴趣的参与者对按摩疗法、睡眠卫生、音乐和放松技巧表示出偏好（P<0.001）。
在患者特征的几个方面存在显著的态度差异。BZDs的首次使用女性和使用短效BZD的患者更愿意尝试NDA。需要开展教育项目，以制定适当的基于证据的失眠管理方案。
