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摘要


失眠是常見的臨床問題且成因複雜,對身心健康會造成許多不良影響且易合併憂鬱症等疾病,依定義及研究方法的不同,估計慢性失眠約占成年人口的10%-30%。目前失眠的診斷仍為臨床診斷,可以用PSG、MSLT、actigraphy等實驗室檢查來輔助診斷。慢性失眠的產生涉及睡眠調節機轉,包括Process S(睡眠恆定)和Process C(日夜節律),和維持覺醒及促進睡眠的神經系統。近一、二十年來的研究進一步了解到除了維持清醒的腦區和促進睡眠的腦區外,睡眠調節機轉還涉及食慾素/下視丘泌素(orexin/hypocretin)系統。在治療方面目前有藥物或非藥物治療方法可用來治療失眠,但合併藥物及非藥物治療的臨床效果更佳。

並列摘要


Insomnia is a common with complex etiological factors, and can have serious consequences, such as increased risk of depression etc. Prevalence of chronic insomnia is estimated as 10-30% in general adult population, depending on different definitions and methodologies. Diagnosis of insomnia is essentially a clinical diagnosis, and could be aided by laboratory examinations such as PSG, MSLT or actigraphy. Chronic insomnia could be understood in terms of dysfunction of sleep regulation mechanisms which include process S(sleep homeostasis) and process C(circadian rhythm), as well as nervous systems responsible for wake-promoting and sleep-promoting functions respectively. In addition, recent studies reveal the importance of orexin/hypocretin system. Management of insomnia consists of pharmacological and non-pharmacological therapies, and combined therapy is clinically a better recommendation than one of the above-mentioned therapies alone.

參考文獻


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed, American Psychiatric Publishing Inc, 2013.
American Academy of Sleep Medicine: ICSD-2 International classification of sleep Disorders 2nd ed. Diagnostic and coding manual. Westchester IL, American Academy of Sleep Medicine, 2005.
Ohayon MM, Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002;6:97-111.
Spielman AJ, Caruso LS, Glovinsky PB: A behavioral perspective on insomnia treatment. Psychiatr Clin North Am 1987;10:541-53.
Schutte-Rodin S, Broch L, Buysse D, et al: Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008;15:487-504.

被引用紀錄


蔡明蒨、黃敏寧、李歡芳、方靜如、賴惠玲(2022)。以生理指標驗證音樂對失眠改善成效之系統性文獻回顧與統合分析精神衛生護理雜誌17(1),23-32。https://doi.org/10.6847/TJPMHN.202204_17(1).04
宋婕、林富煌、簡戊鑑、鍾其祥、吳彧(2020)。睡眠障礙合併酒癮住院流行病學特性與重複住院影響因子Journal of Data Analysis15(5),1-20。https://doi.org/10.6338/JDA.202010_15(5).0001
張沛緁、藍菊梅(2023)。正念視覺化練習於失眠者的應用諮商與輔導(452),18-19。https://www.airitilibrary.com/Article/Detail?DocID=16846478-N202308010015-00007

延伸閱讀


  • 廖以誠(2018)。失眠症血管醫學防治季刊(31),19-21。https://doi.org/10.6527/PVM.201803_(31).0006
  • 許世杰(2018)。睡眠精神醫學~失眠睡不著!中華民國內膜異位症婦女協會會刊25(9&10),11-12。https://doi.org/10.6498/EA.201810_25(9_10).5
  • 鄭泰安(1990)。常常失眠怎麼辦?健康世界(175),46-54。https://doi.org/10.6454/HW.199007.0046
  • 思凱(2002)。Amnesia諮商與輔導(196),41-41。https://www.airitilibrary.com/Article/Detail?DocID=a0000014-200204-x-196-41-41-o
  • 劉婉俐(1994)。Innocent中外文學22(9),178-178。https://doi.org/10.6637/CWLQ.1994.22(9).178-178

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