姑息治疗中的失眠概述
- Authors
- Jeremy M Hirst, MD, PhD, FAPM, FAPA
Jeremy M Hirst, MD, PhD, FAPM, FAPA
- Professor of Psychiatry and Behavioral Neurosciences
- Associate Director, Palliative Care Psychiatry
- University of UC San Diego Health
- Director of Psychiatry & Psychosocial Services; Patient & Family Support Services
- University of California San Diego, Moores Cancer Center
- Scott A Irwin, MD, PhD
Scott A Irwin, MD, PhD
- Associate Professor of Psychiatry
- Director, Supportive Care Services
- Samuel Oschin Comprehensive Cancer Institute
- Cedars-Sinai Medical Center
- Section Editors
- Susan D Block, MD
Susan D Block, MD
- Editor-in-Chief — Palliative Care
- Section Editor — Psychosocial Issues
- Professor of Psychiatry
- Harvard Medical School
- Ruth Benca, MD, PhD
Ruth Benca, MD, PhD
- Section Editor — Insomnia
- Professor and Chair, Department of Psychiatry and Human Behavior
- University of California, Irvine
- Deputy Editor
- Diane MF Savarese, MD
Diane MF Savarese, MD
- Senior Deputy Editor — UpToDate
- Deputy Editor — Oncology and Palliative Care
- Clinical Instructor of Medicine
- Harvard Medical School
- Translators
- 陈贵海, 主任医师，教授
陈贵海, 主任医师，教授
- 安徽医科大学附属巢湖医院神经内科
引言
失眠是一种睡眠障碍疾病，表现为尽管患者有适当的机会睡眠，但难以入睡或维持睡眠，和/或睡眠无恢复性和无提神作用[1]。在初级保健患者中，失眠是非常常见的医疗主诉，在接受姑息治疗的患者中也是如此，有研究表明，姑息治疗患者的失眠患病率超过70%[2,3]。失眠可带来多种后果，对生存质量和实现正常功能的能力有消极影响。此外，失眠是发生精神疾病的强预测指标。 (参见“失眠概述”，关于‘后果’一节)
在姑息治疗背景下，失眠经常与其他症状共存，如疼痛、抑郁和焦虑，且往往相互加重，导致生存质量降低[4]。接受姑息治疗患者在功能状态方面和在慢性疾病中所处的病程阶段可能有所差异。因此，对于这些患者的处理和治疗应当个体化。失眠的概述和一般性治疗的方法，以及姑息治疗的概述和姑息治疗患者的评估都将单独讨论。
●(参见“失眠概述”)
●(参见“亚专科舒缓治疗的获益、服务与模式”)
●(参见“舒缓治疗中常见非疼痛症状的处理概述”和“Overview of comprehensive patient assessment in palliative care”)
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