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长新冠患者伴睡眠障碍的管理:全科医生实用建议。

Management of long-COVID-19 patients with sleep disorders: practical advice to general practitioners.

机构信息

Farhat HACHED Hospital, Heart Failure (LR12SP09) Research Laboratory, University of Sousse, Sousse, Tunisia.

Faculty of Medicine of Sousse, Laboratory of Physiology, University of Sousse, Sousse, Tunisia.

出版信息

Libyan J Med. 2023 Dec;18(1):2182704. doi: 10.1080/19932820.2023.2182704.

Abstract

Given the high prevalence of sleep disorders (e.g. insomnia) among long-COVID-19 patients (LC19Ps), approaches to tackle these disorders should not only depend on sleep specialists, but they should also involve general practitioners (GPs). Indeed, according to the World Health Organization, GPs should be on the front line in the management of LC19Ps. However, in real practice, little data with regard to the management of LC19Ps are available for GPs, which represents an embarrassing situation. Thus, the main aim of this correspondence was to provide GPs with some advice related to the management of sleep disorders in LC19Ps. The pieces advice presented in this correspondence are related to: Early and accurate recognition of sleep disorders, General recommendations to manage sleep disorders in LC19Ps (e.g. encouraging vaccination against the virus); and Specific recommendations, such as improving sleep hygiene (patients' behavior and diet), psychological or behavioral therapies (stimulus control therapy, relaxation, sleep restriction), promising tools (heart coherence, neurofeedback), and pharmacological treatment. The authors of this correspondence deeply believe that given the undesirable side effects associated with the use of hypnotics, the pharmacological approach must only be a "last resort". The authors believe that an important percentage of pharmacological prescriptions could be avoided if more focus is put on educating GPs to provide LC19Ps with more tools to deal with sleep disorders. The pieces advice presented in this correspondence are indispensable to resume the normal life of LC19Ps and to promote their mental health recovery.

摘要

鉴于长新冠患者(LC19P)中睡眠障碍(例如失眠)的高发率,解决这些障碍的方法不仅应依赖于睡眠专家,还应包括全科医生(GP)。实际上,根据世界卫生组织的建议,GP 应在 LC19P 的管理中处于第一线。然而,在实际实践中,GP 可用于管理 LC19P 的数据很少,这是一个令人尴尬的情况。因此,本通信的主要目的是为 GP 提供一些有关 LC19P 睡眠障碍管理的建议。本通信中提出的建议涉及:早期和准确识别睡眠障碍、管理 LC19P 睡眠障碍的一般建议(例如鼓励接种病毒疫苗);以及具体建议,例如改善睡眠卫生(患者的行为和饮食)、心理或行为疗法(刺激控制疗法、放松、睡眠限制)、有前途的工具(心脏相干性、神经反馈)和药物治疗。本通信的作者深信,鉴于催眠药物使用相关的不良副作用,药物治疗方法必须只是“最后的手段”。如果更加注重教育 GP,为 LC19P 提供更多工具来处理睡眠障碍,那么就可以避免很大一部分药物处方。本通信中提出的建议对于恢复 LC19P 的正常生活和促进他们的心理健康恢复是不可或缺的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e9f/9970199/646b77753464/ZLJM_A_2182704_F0001_OC.jpg

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