Neubauer David N
Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Box 151, Baltimore, MD 21224, USA.
Continuum (Minneap Minn). 2013 Feb;19(1 Sleep Disorders):50-66. doi: 10.1212/01.CON.0000427213.00092.c1.
This article provides an overview of current strategies for evaluating and treating patients who experience chronic insomnia.
The US Food and Drug Administration (FDA) has approved several medications for the treatment of insomnia that incorporate a variety of pharmacodynamic and pharmacokinetic properties, thus allowing the development of a customized therapeutic approach. FDA-approved medications include γ-aminobutyric acid-modulating benzodiazepine receptor agonists, a melatonin receptor agonist, and a histamine receptor agonist. Psychological and behavioral techniques combined as cognitive-behavioral therapy also have been shown to be effective in the treatment of chronic insomnia.
Insomnia is the most common sleep disturbance and represents a chronic condition for many people. Difficulty falling asleep and maintaining sleep are highly prevalent problems in patients with neurologic disorders. Multiple factors typically contribute to insomnia. Accordingly, a rather broad approach to evaluating patients is warranted. Evidence-based guidelines support the use of cognitive and behavioral strategies and selected medications in the treatment of patients with chronic insomnia.
本文概述了评估和治疗慢性失眠患者的当前策略。
美国食品药品监督管理局（FDA）已批准了几种用于治疗失眠的药物，这些药物具有多种药效学和药代动力学特性，从而能够制定定制的治疗方法。FDA批准的药物包括γ-氨基丁酸调节苯二氮䓬受体激动剂、褪黑素受体激动剂和组胺受体激动剂。心理和行为技术结合的认知行为疗法也已被证明对治疗慢性失眠有效。
失眠是最常见的睡眠障碍，对许多人来说是一种慢性疾病。入睡困难和维持睡眠困难在神经系统疾病患者中非常普遍。多种因素通常导致失眠。因此，有必要采用较为广泛的方法来评估患者。循证指南支持使用认知和行为策略以及特定药物治疗慢性失眠患者。
