Nicholson A N
Drugs. 1986 Feb;31(2):164-76. doi: 10.2165/00003495-198631020-00005.
Sleep disturbance has become a subject of serious study only over the past few years, but even so there is already an increasing awareness of the nature of insomnia and a greater understanding of the role which hypnotics should play in clinical medicine. An hypnotic may be used to shorten sleep onset when there is difficulty in falling asleep, to reduce nocturnal wakefulness, or to provide an anxiolytic effect during the next day when insomnia is accompanied by a marked element of anxiety. The purpose of an hypnotic is to meet one or more of these clinical problems; to ensure that the patient is given the most useful medication, consideration must be given to duration of activity. This depends on the absorption, distribution and elimination characteristics of the drug. It is now appreciated that the most appropriate use of hypnotics is in the individual with insomnia of recent origin. An hypnotic with the most relevant pharmacokinetic profile should be used for the shortest period of time and then only as required, while low doses will ensure freedom from adverse effects. The place of hypnotics in chronic insomnia remains less certain. Their careful use may well be of benefit, though it must be part of a well defined clinical strategy. Assessment of the patient is essential to identify any specific conditions which would impair sleep.
睡眠障碍只是在过去几年才成为认真研究的课题，但即便如此，人们对失眠的本质已有了越来越多的认识，并且对催眠药在临床医学中应发挥的作用有了更深入的理解。当入睡困难时，催眠药可用于缩短入睡时间，减少夜间觉醒，或者当失眠伴有明显焦虑成分时，在次日提供抗焦虑作用。催眠药的目的是解决这些临床问题中的一个或多个；为确保给患者使用最有效的药物，必须考虑药物的活性持续时间。这取决于药物的吸收、分布和消除特性。现在人们认识到，催眠药最恰当的使用对象是近期出现失眠的个体。应使用药代动力学特征最相关的催眠药，且用药时间应最短，然后仅按需使用，同时低剂量将确保无不良反应。催眠药在慢性失眠中的作用仍不太明确。谨慎使用它们可能会有益处，不过这必须是明确的临床策略的一部分。对患者进行评估对于识别任何可能损害睡眠的特定状况至关重要。
