Roth Thomas, Roehrs Timothy
Division of Sleep Medicine, Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, Michigan, USA.
Clin Cornerstone. 2003;5(3):5-15. doi: 10.1016/s1098-3597(03)90031-7.
Insomnia is a symptom of difficulty initiating and maintaining sleep or experiencing nonrefreshing sleep and is associated with daytime consequences. Although insomnia is typically secondary to a medical, psychiatric, circadian, or sleep disorder, it can also be a primary disorder. Primary insomnia is estimated to occur in 25% of all chronic insomnia patients. It is hypothesized to be a disorder of hyperarousal, which has been supported by research on the autonomic nervous system and hypothalamic-pituitary-adrenal axis function. Chronic insomnia is prevalent in 10% of the adult population. Age, sex, medical and psychiatric disease, and shift work all represent an increased risk of chronic insomnia. The morbidity of insomnia varies as a function of etiology. While transient insomnia produces sleepiness and impairment in psychomotor performance, chronic insomnia is associated with absenteeism, frequent accidents, memory impairment, and greater health care utilization. The most consistent impact of insomnia is a high risk of depression.
失眠是一种在开始或维持睡眠时存在困难，或经历无法使人恢复精力的睡眠的症状，且与日间后果相关。尽管失眠通常继发于医学、精神、昼夜节律或睡眠障碍，但它也可能是一种原发性疾病。据估计，原发性失眠在所有慢性失眠患者中占比25%。据推测，它是一种过度觉醒障碍，这一观点已得到自主神经系统及下丘脑 - 垂体 - 肾上腺轴功能研究的支持。慢性失眠在10%的成年人口中普遍存在。年龄、性别、医学和精神疾病以及轮班工作均会增加慢性失眠的风险。失眠的发病率因病因不同而有所差异。短暂性失眠会导致嗜睡和精神运动表现受损，而慢性失眠则与旷工、频繁事故、记忆障碍以及更高的医疗保健利用率相关。失眠最一致的影响是患抑郁症的高风险。
