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发作性睡病的治疗

Author
Thomas E Scammell, MD
Section Editor
Ruth Benca, MD, PhD
Deputy Editor
April F Eichler, MD, MPH
Translators
彭丹涛, 主任医师，教授

引言

将近半数的发作性睡病患者报告，其嗜睡和猝倒严重影响了自身的日常生活，包括学校、工作、婚姻或社会生活[1,2]。主要的治疗方法是短暂的日间小睡和药物治疗[3]。

发作性睡病患者常同时伴有可加重其日间嗜睡的下列疾病：阻塞性睡眠呼吸暂停、睡眠期周期性肢动、片段化睡眠和/或快动眼睡眠相(rapid eye movement, REM)行为障碍；认识到这一点很重要。首先治疗这些睡眠障碍，然后再着重于改善发作性睡病引起的嗜睡，常常对患者有帮助。本专题假设已对共存的睡眠障碍进行了治疗，将总结发作性睡病及其症状的治疗。发作性睡病的诊断和神经生物学将单独讨论。 (参见“发作性睡病的临床特征和诊断”)

非药物性治疗

几种非药物性干预措施可能对发作性睡病患者有益：

●避免某些药物–发作性睡病患者应避免使用某些药物。可加重日间嗜睡的药物包括：苯二氮卓类药物、阿片类药物、抗精神病药和乙醇。诸如茶碱或过量的咖啡因等其他药物可引起失眠，这可加重日间嗜睡。此外，哌唑嗪和其他α-1受体拮抗剂可加重猝倒。

●小睡/睡眠卫生–行为干预经常有助于对发作性睡病进行最佳控制。在恰当的时间小睡1-2次、每次20分钟，常能改善嗜睡1-3小时，但某些患者仅能从长时间的小睡中获益[4]。如果能够安排，在工作场所或学校进行短暂小睡经常有帮助。睡眠剥夺可能加重发作性睡病的症状；因此，应建议患者保持规律且充足的睡眠安排[5]。

          

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-21.
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