Insomnia

被引:153
作者
Sateia, MJ [1 ]
Nowell, PD [1 ]
机构
[1] Dartmouth Hitchcock Sleep Disorders Ctr, Dartmouth Med Sch, Lebanon, NH 03756 USA
关键词
D O I
10.1016/S0140-6736(04)17480-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Effective management of insomnia begins with recognition and adequate assessment. Family doctors and other health care providers such as practice nurses and psychologists should routinely enquire about sleep habits as a component of overall health assessment. Identification and treatment of primary psychiatric disorders, medical conditions, circadian disorders, or specific physiological sleep disorders-eg, sleep apnoea and periodic limb movement disorder-are essential steps in management of insomnia. Conditioned aspects of insomnia can be primary (psychophysiological insomnia) or may complicate sleep disturbance owing to other causes. Approved hypnotic drugs have clearly been shown to improve subjective and objective sleep measures in various short-term situations. Despite widespread use of standard hypnotics and sedating antidepressants for chronic insomnia, their role for this indication still remains to be further defined by research evidence. Non-pharmacological treatments, particularly stimulus control and sleep restriction, are effective for conditioned aspects of insomnia and are associated with durable long-term improvement in sleep.
引用
收藏
页码:1959 / 1973
页数:15
相关论文
共 173 条
  • [91] Are periodic leg movements associated with clinical sleep disturbance?
    Mendelson, WB
    [J]. SLEEP, 1996, 19 (03) : 219 - 223
  • [92] LONG-TERM FOLLOW-UP OF CHRONIC INSOMNIA
    MENDELSON, WB
    [J]. SLEEP, 1995, 18 (08) : 698 - 701
  • [93] Diagnostic and Statistical Manual of Mental Disorders
    Mittal, Vijay A.
    Walker, Elaine F.
    [J]. PSYCHIATRY RESEARCH, 2011, 189 (01) : 158 - 159
  • [94] Moldofsky H, 2002, SLEEP MEDICINE, P471
  • [95] A systematic review of non-pharmacological therapies for sleep problems in later life
    Montgomery, P
    Dennis, J
    [J]. SLEEP MEDICINE REVIEWS, 2004, 8 (01) : 47 - 62
  • [96] MONTGOMERY P, 2002, COCHRANE LIB
  • [97] Sleep in patients with chronic primary insomnia during long-term zolpidem administration and after its withdrawal
    Monti, JM
    Monti, D
    Estevez, F
    Giusti, M
    [J]. INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY, 1996, 11 (04) : 255 - 263
  • [98] THE EFFECT OF MIDAZOLAM ON TRANSIENT INSOMNIA
    MONTI, JM
    BOUSSARD, M
    OLIVERA, S
    LABRAGA, P
    ALVARINO, F
    [J]. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 1993, 44 (06) : 525 - 527
  • [99] Pramipexole in the treatment of restless legs syndrome: a follow-up study
    Montplaisir, J
    Denesle, R
    Petit, D
    [J]. EUROPEAN JOURNAL OF NEUROLOGY, 2000, 7 : 27 - 31
  • [100] Nonpharmacological treatment of late-life insomnia
    Morin, CM
    Mimeault, V
    Gagné, A
    [J]. JOURNAL OF PSYCHOSOMATIC RESEARCH, 1999, 46 (02) : 103 - 116