Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Semin Neurol. 2021 Dec;41(6):781-794. doi: 10.1055/s-0041-1726364. Epub 2021 Nov 26.
Sleep disorders are highly relevant in clinical practice given their prevalence as well as their impact on health outcomes and quality of life. The most common concerns are excessive daytime sleepiness, insomnia, disordered breathing, and abnormal movements or behaviors during sleep. A detailed but targeted history is vital, particularly from the sleep partner/witness. In-laboratory sleep testing (polysomnography and multiple sleep latency test) remains vital in the diagnosis of certain sleep disorders (such as sleep-disordered breathing and central hypersomnia) and in specific populations (such as in children and individuals with comorbid medical disorders). Advances in technology have allowed for a variety of methods in assessing a patient's sleep, from compact devices to evaluate for sleep apnea, wrist actigraphy, and mobile device-based applications. As the pathophysiology of various sleep disorders becomes better elucidated, disease-specific medications have been developed for these conditions. Nonetheless, a multidisciplinary approach to management is necessary, including improving sleep hygiene and cognitive behavioral therapy.
睡眠障碍在临床实践中非常重要，因为它们的发病率高，对健康结果和生活质量有影响。最常见的问题是白天过度嗜睡、失眠、呼吸紊乱以及睡眠期间的异常运动或行为。详细但有针对性的病史至关重要，特别是来自睡眠伴侣/目击者的病史。在实验室进行睡眠测试（多导睡眠图和多次睡眠潜伏期测试）对于某些睡眠障碍（如睡眠呼吸障碍和中枢性嗜睡症）和特定人群（如儿童和伴有合并症的个体）的诊断仍然至关重要。技术的进步使得评估患者睡眠的方法多种多样，从用于评估睡眠呼吸暂停的紧凑型设备到腕部动作描记法和基于移动设备的应用程序。随着各种睡眠障碍的病理生理学得到更好的阐明，已经为这些疾病开发了特定的药物。尽管如此，仍需要采用多学科方法进行管理，包括改善睡眠卫生和认知行为疗法。
