Center for Health Sciences, SRI International, Menlo Park, CA, USA.
Center for Health Sciences, SRI International, Menlo Park, CA, USA.
Sleep Med Rev. 2018 Jun;39:12-24. doi: 10.1016/j.smrv.2017.06.009. Epub 2017 Jul 1.
Insomnia disorder is very common in adolescents; it is particularly manifest in older adolescents and girls, with a prevalence comparable to that of other major psychiatric disorders (e.g., depressive disorders). However, insomnia disorder in adolescence is poorly characterized, under-recognized, under-diagnosed, and under-treated, and the reason for the female preponderance for insomnia that emerges after puberty is largely unknown. Insomnia disorder goes beyond an individual complaint of poor sleep or a sleep state misperception, and there is emerging evidence supporting the association of insomnia symptoms in adolescents with alterations in several bio-systems including functional cortical alterations and systemic inflammation. Insomnia disorder is associated with depression and other psychiatric disorders, and is an independent risk factor for suicidality and substance use in adolescents, raising the possibility that treating insomnia symptoms in early adolescence may reduce risk for these adverse outcomes. Cognitive behavioral treatments have proven efficacy for adolescent insomnia and online methods seem to offer promising cost-effective options. Current evidence indicates that insomnia in adolescence is an independent entity that warrants attention as a public health concern in its own right.
失眠障碍在青少年中非常常见；它在年龄较大的青少年和女孩中表现尤为明显，其患病率与其他主要精神障碍（例如抑郁障碍）相当。然而，青少年失眠障碍的特征描述不足，认识不足，诊断不足，治疗不足，而且青春期后女性失眠患病率较高的原因在很大程度上尚不清楚。失眠障碍不仅仅是个体抱怨睡眠质量差或睡眠状态感知错误，而且有越来越多的证据支持青少年失眠症状与包括皮质功能改变和全身炎症在内的几个生物系统改变之间的关联。失眠障碍与抑郁和其他精神障碍有关，是青少年自杀和物质使用的独立危险因素，这表明在青少年早期治疗失眠症状可能会降低这些不良后果的风险。认知行为治疗已被证明对青少年失眠有效，而在线方法似乎提供了有希望的具有成本效益的选择。目前的证据表明，青少年失眠是一种独立的实体，作为自身的公共卫生关注点值得关注。
