Double-board-certified neurologist and sleep medicine physician at Virginia Mason Franciscan Health in Seattle, Washington.
Second-year internal medicine resident at Virginia Mason Medical Center in Seattle, Washington.
AMA J Ethics. 2024 Oct 1;26(10):E763-770. doi: 10.1001/amajethics.2024.763.
This commentary on a case describes how social determinants of health also contribute to insomnia and then suggests how to balance risks and benefits of different strategies for managing chronic insomnia. Behaviorally induced insufficient sleep syndrome can exacerbate morning side effects of prescription sleep aids, and there are potentially serious long-term risks (eg, dementia, falls, death) associated with chronic benzodiazepine use. Before trying sleeping pills, chronic insomnia should be treated with cognitive behavioral therapy.
这篇病例评论描述了健康的社会决定因素如何导致失眠，然后提出了如何平衡管理慢性失眠的不同策略的风险和收益。行为诱导的睡眠不足综合征会加重处方助眠药物的早晨副作用，而长期使用苯二氮䓬类药物存在潜在的严重风险（例如痴呆、跌倒、死亡）。在尝试安眠药之前，应采用认知行为疗法来治疗慢性失眠。
