失眠(症)

最后审阅: 23 四月 2022
最后更新: 15 六月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 同眠者的陈诉
  • 入睡延迟
  • 多次或长时间觉醒
更多 关键诊断因素

其他诊断因素

  • 功能受损
  • 事故
  • 睡眠时间缩短
  • 日间小睡
  • 甲状腺毒症
  • 慢性疼痛
  • 不安腿综合征
  • 扁桃体或舌增大
  • 小颌畸形和颌后缩畸形
  • 咽腔狭窄
其他诊断因素

危险因素

  • 女性
  • 高龄
  • 慢性疾病
  • 慢性疼痛(如髋关节损伤)
  • 精神疾病
  • 酒精或物质滥用
  • 兴奋剂使用
  • 睡眠卫生不佳
  • 外伤性脑损伤
  • 药物治疗
  • 近期跨时区旅行
  • 夜班工作
  • 甲状腺失调
  • 参与精英运动
  • 久坐行为
更多 危险因素

诊断性检查

首要检查

  • 匹兹堡睡眠质量指数 (PSQI)
  • 失眠严重程度指数 (ISI)
  • 斯坦福嗜睡量表 (SSS)
  • Epworth 嗜睡量表
  • 雅典失眠量表(Athens Insomnia Scale, AIS)
更多 首要检查

需考虑的检查

  • 多导睡眠图 (PSG)
  • 活动记录仪检查
  • 睡眠日记
  • 促甲状腺素 (TSH)
更多 需考虑的检查

治疗流程

急症处理

急性失眠症

持续性治疗

慢性失眠症

撰稿人

作者

John W. Winkelman, MD, PhD

Chief, Sleep Disorders Clinical Research Program

Department of Psychiatry

Massachusetts General Hospital

Professor of Psychiatry

Harvard Medical School

Boston

MA

利益声明

JWW has received honoraria for consulting to Avadel, CVS, Eisai, and Merck, and research grants from Merck and the RLS Foundation.

鸣谢

Dr John W. Winkelman would like to gratefully acknowledge Dr Teofilo Lee-Chiong and Dr Vipin Malik, previous contributors to this topic.

利益声明

TLC is the Chief Medical Liaison for Philips, a company that makes devices to treat sleep apnoea. VM received research funding from Philips Respironics for a study on COPD-OSA overlap.

同行评议者

Karl Doghramji, MD

Director

Sleep Disorders Center

Thomas Jefferson University Hospital

Philadelphia

PA

利益声明

KD is a speaker for Sanofi-Aventis, King Pharmaceuticals, Takeda Pharmaceuticals, Sepracor, and Pfizer; a consultant for Sanofi-Aventis, Takeda Pharmaceuticals, Sepracor, Pfizer, and Neurocrine Biosciences; and has stock in Merck.

Chiadi U. Onyike, MD, MHS

Assistant Professor

Geriatric Psychiatry and Neuropsychiatry

The Johns Hopkins Hospital

Baltimore

MD

利益声明

CUO declares that he has no competing interests.

Roy Goldberg, MD

Medical Director

Kings Harbor Multicare Center

Bronx

NY

利益声明

RG declares that he has no competing interests.

Craig Sawchuk, MD

Affiliate Assistant Professor

Department of Psychiatry and Behavioral Sciences

University of Washington Medical Center

Seattle

WA

利益声明

CS declares that he has no competing interests.

David Cunnington, MD

Director

Melbourne Sleep Disorders Centre

Melbourne

Victoria

Australia

利益声明

DC has received consulting fees from Sanofi-Aventis and Lundbeck, and honoraria for speaking from Sanofi-Aventis.

  • 鉴别诊断

    • 不安腿综合征
    • 周期性肢体运动障碍 (PLMD)
    • 阻塞性睡眠呼吸暂停 (OSA)
    更多 鉴别诊断
  • 指南

    • 英国精神药理协会关于失眠、异态睡眠障碍和昼夜节律障碍循证治疗的共识声明:更新
    • 慢性失眠障碍和阻塞性睡眠呼吸暂停的管理
    更多 指南
  • 患者教育信息

    Insomnia

    Sleep apnoea in adults (obstructive)

    更多 患者教育信息
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