全科医生对共病性失眠和睡眠呼吸暂停的管理。
General practitioner management of comorbid insomnia and sleep apnoea.
机构信息
PhD, Research Associate, Adelaide Institute for Sleep Health (AISH): A Centre of Research Excellence, College of Medicine and Public Health, Flinders University, SA; Research Associate, National Centre for Sleep Health Services Research (NCSHSR): An NHMRC Centre of Research Excellence, Flinders University, SA.
PhD, MBBS, Senior Research Fellow, Discipline of General Practice, University of Adelaide, SA.
出版信息
Aust J Gen Pract. 2023 Sep;52(9):607-612. doi: 10.31128/AJGP-12-22-6648.
BACKGROUND
Insomnia and obstructive sleep apnoea are the two most common sleep disorders and frequently co-exist. Patients with comorbid insomnia and sleep apnoea experience worse daytime function, mental health and physical health than patients with either disorder alone. General practitioners may face unique challenges in the assessment and management of this prevalent and debilitating condition.
OBJECTIVE
This article aims to provide an overview of the prevalence, consequences, assessment and management of patients with comorbid insomnia and sleep apnoea in Australian general practice.
DISCUSSION
Patients with either insomnia or sleep apnoea should be assessed for both conditions. Treatments for both disorders should be offered to patients with both conditions. The recommended treatment for insomnia is cognitive behavioural therapy, whereas the recommended first-line treatment for moderate and severe obstructive sleep apnoea is lifestyle/weight management advice (where relevant) and continuous positive airway pressure therapy.
背景
失眠和阻塞性睡眠呼吸暂停是两种最常见的睡眠障碍，且常同时存在。与仅存在一种疾病的患者相比，同时患有失眠和睡眠呼吸暂停的患者日间功能、心理健康和身体健康状况更差。全科医生在评估和管理这种普遍且使人虚弱的疾病时可能会面临独特的挑战。
目的
本文旨在概述澳大利亚全科实践中同时患有失眠和睡眠呼吸暂停的患者的患病率、后果、评估和管理。
讨论
应评估患有失眠或睡眠呼吸暂停的患者是否同时患有这两种疾病。应向同时患有这两种疾病的患者提供这两种疾病的治疗方法。失眠的推荐治疗方法是认知行为疗法，而中重度阻塞性睡眠呼吸暂停的推荐一线治疗方法是生活方式/体重管理建议（如有相关）和持续气道正压通气治疗。
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