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筛查和治疗患有睡眠/觉醒障碍的患者。

Screening & treating patients with sleep/wake disorders.

作者信息

Blythe Julianne, Doghramji Paul P, Jungquist Carla R, Landau Marc B, Valerio Teresa D, Ancoli-Israel Sonia, Auerbach Sanford H

机构信息

University of California, San Francisco, Sleep Disorders Center, San Francisco, California, USA.

出版信息

JAAPA. 2009 Dec;Suppl Sleep:1-17; quiz 19.

Abstract

Sleep/wake disorders are common, underdiagnosed, and associated with serious consequences. Patients tend not to mention sleep problems and clinicians often do not ask about them. Using a few simple screening questions and tools can uncover sleep/wake disorders that will respond to treatment. Consider asking about sleep during annual physicals and regular visits for chronic conditions. This is especially relevant when following patients with conditions linked to sleep/wake disorders. Educating patients about normal sleep and good sleep hygiene may improve sleep and prompt mention of unhealthy sleep/wake patterns.The use of CPAP leads to beneficial outcomes in OSA. Psychological and behavioral measures offer the best choice for patients with chronic insomnia. Bright light can help retrain the circadian rhythm in patients with circadian rhythm sleep disorders. Dopamine agonists are approved for treatment of RLS. Through a greater awareness of sleep/wake disorders and taking a proactive approach to patient questioning, diagnosis, education, and management, clinicians can better detect and treat sleep/wake disorders and improve patient outcomes and quality of life.

摘要

睡眠/觉醒障碍很常见,诊断不足,且会带来严重后果。患者往往不会提及睡眠问题,而临床医生通常也不会询问。使用一些简单的筛查问题和工具可以发现可通过治疗改善的睡眠/觉醒障碍。在年度体检以及慢性病定期就诊时,考虑询问睡眠情况。对于患有与睡眠/觉醒障碍相关疾病的患者,这一点尤为重要。对患者进行正常睡眠和良好睡眠卫生教育可能会改善睡眠,并促使他们提及不健康的睡眠/觉醒模式。持续气道正压通气(CPAP)的使用会给阻塞性睡眠呼吸暂停(OSA)患者带来有益效果。心理和行为措施为慢性失眠患者提供了最佳选择。强光有助于重新训练昼夜节律睡眠障碍患者的昼夜节律。多巴胺激动剂已被批准用于治疗不宁腿综合征(RLS)。通过提高对睡眠/觉醒障碍的认识,并积极主动地对患者进行询问、诊断、教育和管理,临床医生可以更好地检测和治疗睡眠/觉醒障碍,改善患者的治疗效果和生活质量。

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