Parc Sanitari Sant Joan de Déu, Camí Vell de la Colonia 25, E-08830 Sant Boi de Llobregat, Barcelona, Spain; CIBERSAM, Centro de Investigación Biomédica en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain.
Actas Esp Psiquiatr. 2024 Feb;52(1):45-56.
This is a narrative review of sleep disorders, especially chronic insomnia, as a primary diagnosis or as a comorbid diagnosis associated with different psychiatric and organic diseases. The epidemiological evidence is reviewed, the diagnostic criteria most frequently used in clinical practice are examined, and a series of therapeutic recommendations for the correct treatment of this pathology is presented. Sleep disorders are very prevalent in the general population (one-third experiences difficulty with sleep initiation/maintenance at least once a week, and about 6-15% meet the criteria for insomnia disorders), but remain relatively poorly understood and frequently overlooked by healthcare professionals. Prevalence estimates of insomnia disorder vary between 5% and 20%. Sleep disorders co-exist with psychiatric and medical conditions with an interactive and bidirectional relationship. About 70-80% of psychiatric patients show some sleep disturbance and there is a correlation between the severity of the sleep disturbance and the severity of the psychopathology. Untreated sleep disorders increase the risk of cardiovascular events, cognitive impairment, motor vehicle accidents, obesity, diabetes, and efficiency and safety at work, leading to increased all-cause healthcare utilization and being a strong predictor of sick leave or disability pension and poor quality of life. Sleep disorders can cause drowsiness or excessive daytime sleepiness, which can lead to functional impairment in 15% of the general adult population. Sleep quality should be a routine target in the evaluation of patients with psychiatric and non-psychiatric diseases to ensure sleep health based on early diagnosis and adequate therapeutic approaches.
这是一篇关于睡眠障碍的叙述性综述，特别是慢性失眠症，作为主要诊断或与不同精神和器质性疾病相关的合并诊断。审查了流行病学证据，检查了临床上最常使用的诊断标准，并提出了一系列治疗建议，以正确治疗这种病理。睡眠障碍在普通人群中非常普遍（三分之一的人每周至少有一次入睡/维持睡眠困难，约 6-15%符合失眠症障碍标准），但仍相对了解不足，经常被医疗保健专业人员忽视。失眠症的患病率估计在 5%至 20%之间。睡眠障碍与精神和医学疾病共存，具有相互作用和双向关系。大约 70-80%的精神病人表现出一些睡眠障碍，睡眠障碍的严重程度与精神病理学的严重程度相关。未经治疗的睡眠障碍会增加心血管事件、认知障碍、机动车事故、肥胖、糖尿病和工作效率和安全性的风险，导致全因医疗保健利用率增加，并成为病假或残疾养老金和生活质量差的强有力预测因素。睡眠障碍可导致嗜睡或白天过度嗜睡，这会导致 15%的普通成年人口功能受损。睡眠质量应该是评估精神和非精神疾病患者的常规目标，以确保基于早期诊断和充分治疗方法的睡眠健康。
