Luis F. Buenaver, PhD Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 1-108, Baltimore, MD 21287, USA.
Curr Treat Options Neurol. 2007 Sep;9(5):325-36.
Insufficient sleep is an under-recognized public health problem that is projected to increase in the next decade as the US population ages. Chronic insomnia alone impacts 10% to 15% of adults. Epidemiologic data indicate that pain, fatigue, and mood disturbance are common correlates of persistent insomnia. Rates of most sleep disorders are substantially elevated in rheumatologic diseases, with chronic insomnia impacting at least 50% of patients. Clinicians treating patients with rheumatologic disorders should screen for sleep disorders and possess a basic knowledge of sleep physiology and empirically based intervention approaches. Sleep disturbances occurring within the context of chronic medical illnesses, including rheumatologic diseases, do not typically respond to primary disease and/or pain management interventions. Identification of co-occurring sleep disorders followed by aggressive treatment is recommended and has the potential to improve quality of life, ameliorate pain, and improve psychosocial adaptation to the primary illness. In this report, we briefly highlight that sleep disturbance increases risk for both comorbidities and symptoms associated with rheumatologic diseases, we identify specific sleep disorders commonly encountered in rheumatologic populations, and we discuss pharmacologic and behavioral treatment approaches for the most common sleep disorder observed in rheumatologic conditions, chronic insomnia.
睡眠不足是一个未被充分认识的公共卫生问题，预计在下一个十年随着美国人口老龄化，该问题将会加剧。单纯的慢性失眠症会影响 10%至 15%的成年人。流行病学数据表明，疼痛、疲劳和情绪障碍是持续失眠的常见相关因素。大多数睡眠障碍的发病率在风湿性疾病中显著升高，慢性失眠症至少影响 50%的患者。治疗风湿性疾病患者的临床医生应筛查睡眠障碍，并对睡眠生理学和基于经验的干预方法有基本的了解。在慢性内科疾病（包括风湿性疾病）背景下发生的睡眠障碍通常不会对主要疾病和/或疼痛管理干预产生反应。建议识别同时存在的睡眠障碍，然后进行积极治疗，这有可能提高生活质量、缓解疼痛，并改善对主要疾病的社会心理适应。在本报告中，我们简要强调了睡眠障碍会增加风湿性疾病相关合并症和症状的风险，我们确定了在风湿性人群中常见的特定睡眠障碍，并讨论了在风湿性疾病中观察到的最常见的睡眠障碍——慢性失眠症的药物和行为治疗方法。
