Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
Nat Sci Sleep. 2010 Jul 28;2:127-38. doi: 10.2147/nss.s6642. Print 2010.
Insomnia is the most prevalent sleep disorder worldwide. A number of studies evaluated the efficacy of pharmacological and nonpharmacological treatment approaches. To obtain long-term effects in the management of chronic insomnia, cognitive-behavioral therapy for insomnia (CBT-I) is the treatment of first choice, encompassing education about sleep and sleep hygiene, sleep restriction, stimulus control, relaxation techniques, and cognitive strategies to combat nocturnal ruminations. Short-term effects can easily be achieved by the administration of hypnotic drugs. Gaining access to all types of treatment can still be considered a problem, especially CBT-I seems to be available only at specialized centers but not in general health care. New approaches to treatment delivery seem to be necessary to provide adequate care for patients who may seek help or have not entered the health care system yet. Internet-based treatment options and stepped-care models might be feasible options for the future. Otherwise, the direct and indirect costs associated with insomnia might further increase for our societies, in addition to the personal impact on aspects of quality of life and impaired daytime functioning for each individual with insomnia. Besides, well-established psychological and pharmacological treatment options, alternative treatments like acupuncture might constitute new nonpharmacological possibilities. Randomized controlled studies are needed to evaluate the efficacy of this and other new approaches to treat insomnia.
失眠是全球最常见的睡眠障碍。许多研究评估了药物和非药物治疗方法的疗效。为了在慢性失眠的管理中获得长期效果，失眠认知行为疗法（CBT-I）是首选的治疗方法，包括睡眠和睡眠卫生教育、睡眠限制、刺激控制、放松技术以及认知策略来对抗夜间沉思。短期效果可以通过给予催眠药物轻松实现。获得所有类型的治疗仍然可以被认为是一个问题，特别是 CBT-I 似乎仅在专门中心提供，而不在一般医疗保健中提供。似乎需要新的治疗提供方法来为可能寻求帮助或尚未进入医疗保健系统的患者提供足够的护理。基于互联网的治疗选择和分级护理模式可能是未来可行的选择。否则，除了对每个失眠者的生活质量和白天功能受损方面的个人影响外，与失眠相关的直接和间接成本可能会进一步增加。除了经过充分验证的心理和药理学治疗选择外，像针灸这样的替代疗法可能构成新的非药物治疗选择。需要进行随机对照研究来评估这种方法和其他治疗失眠的新方法的疗效。
