Doghramji Paul P, Lieberman Joseph A, Gordon Marc L
Health Services, Ursinus College, Collegeville, PA, USA.
J Fam Pract. 2007 Nov;56(11 Suppl Stay):S17-31; quiz S32.
Sleep is a physiologic state that performs an essential restorative function and facilitates learning and memory consolidation. When sleep is disrupted for more than a short time, normal daily functions decline. Mood, attention, and behavior deteriorate. Sleepiness and disrupted sleep can result from a large number of pathological disorders. Currently, 88 sleep disorders are listed in the International Classification of Sleep Disorders, as established by the American Academy of Sleep Medicine, and sleep disorders adversely affect more than an estimated 70 million Americans. Most of these disorders can be classified as causing insomnia and/or hypersomnia. Insomnia results from disorders that cause difficulty with falling asleep and staying asleep; examples are hyperarousal, circadian dysrhythmia, and homeostatic dysregulation. In contrast, hypersomnia refers to difficulty in staying awake and is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep. Hypersomnia can result from several primary sleep disorders, including narcolepsy, sleep apnea, restless legs syndrome, idiopathic hypersomnia, and periodic limb movement disorder. The effects of some of these sleep disorders and other chronic illnesses on daytime sleepiness are measured using the Epworth Sleepiness Scale. Narcolepsy was found to cause some of the highest measures of excessive sleepiness. This supplement uses a case-based approach to describe the underlying pathology and symptoms of narcolepsy. Differential diagnosis of narcolepsy and current treatment options will be discussed.
睡眠是一种生理状态，具有重要的恢复功能，并有助于学习和记忆巩固。当睡眠被长时间干扰时，正常的日常功能就会下降。情绪、注意力和行为都会恶化。睡眠障碍和睡眠中断可能由大量病理疾病引起。目前，美国睡眠医学学会制定的《国际睡眠障碍分类》中列出了88种睡眠障碍，睡眠障碍对估计超过7000万美国人产生了不利影响。这些障碍大多可归类为导致失眠和/或嗜睡。失眠是由导致入睡困难和维持睡眠困难的疾病引起的；例如，过度觉醒、昼夜节律失调和内稳态失调。相比之下，嗜睡是指难以保持清醒，其特征是白天反复出现过度嗜睡或夜间睡眠延长。嗜睡可能由几种原发性睡眠障碍引起，包括发作性睡病、睡眠呼吸暂停、不宁腿综合征、特发性嗜睡和周期性肢体运动障碍。其中一些睡眠障碍和其他慢性疾病对白天嗜睡的影响使用爱泼华嗜睡量表进行测量。发现发作性睡病会导致一些最高程度的过度嗜睡。本补充资料采用基于病例的方法来描述发作性睡病的潜在病理和症状。将讨论发作性睡病的鉴别诊断和当前的治疗选择。
