Center for Sleep Disorders, Pulmonary Disease and Critical Care Associates, 10710 Charter Dr, Ste 310, Columbia, MD 21044, USA.
Chest. 2010 Jun;137(6):1449-63. doi: 10.1378/chest.09-1485.
Insomnia disorder and obstructive sleep apnea are the two most common sleep disorders among adults. Historically, these conditions have been conceptualized as orthogonal, or insomnia has been considered a symptom of sleep apnea. Insomnia researchers have sought to exclude participants at risk for sleep-related breathing disorders (SRBD), and vice versa. In recent years, however, there has been a growing recognition of co-occurring insomnia disorder and SRBD and interest in the prevalence, consequences, and treatment of the two conditions when they co-occur. Although plagued by inconsistent diagnostic criteria and operational definitions, evidence from clinical and research samples consistently suggests high rates of comorbidity between the two disorders. More important, insomnia disorder and SRBD have additive negative effects. To date, only a few studies have explored the combined or sequential treatment of the conditions. Results support the importance of an integrated, interdisciplinary approach to sleep medicine. This article reviews the empirical literature to date and provides clinical recommendations as well as suggestions for future research.
失眠障碍和阻塞性睡眠呼吸暂停是成年人中最常见的两种睡眠障碍。从历史上看，这些病症被认为是相互独立的，或者失眠被认为是睡眠呼吸暂停的一种症状。失眠症研究人员试图排除有睡眠相关呼吸障碍 (SRBD) 风险的参与者，反之亦然。然而，近年来，人们越来越认识到失眠障碍和 SRBD 的同时发生，并对这两种病症同时发生的患病率、后果和治疗方法产生了兴趣。尽管受到不一致的诊断标准和操作定义的困扰，但来自临床和研究样本的证据一致表明，这两种病症的共病率很高。更重要的是，失眠障碍和 SRBD 具有累加的负面影响。迄今为止，只有少数研究探讨了这两种病症的联合或序贯治疗。研究结果支持采用综合的跨学科方法来治疗睡眠医学。本文回顾了迄今为止的实证文献，并提供了临床建议以及对未来研究的建议。
