晚上休息好本是理所当然的,然而不幸的是,一部分人想要获得良好睡眠并不容易。这些人患有睡眠障碍,包括常见的失眠和较为罕见的诸如REM睡眠行为障碍。以下是8种困扰成年人的最常见睡眠障碍,你有中招吗?
失眠
失眠是指无法入睡或无法保持睡眠状态,导致睡眠不足。又称入睡和维持睡眠障碍,为各种原因引起入睡困难、睡眠深度或频度过短、早醒及睡眠时间不足或质量差等,是一种常见病。
病因:压力过大、某些药物所致、焦虑或抑郁。滥用药物或酒精。
症状:入睡及保持睡眠困难。每个人都经历过睡眠不佳的糟糕夜晚,失眠是一种慢性问题,而不是急性问题。美国约翰·霍普金斯大学医学院精神病学副教授DavidNeubauer博士表示,.睡眠困难持续至少3个月可诊断为失眠症。如果3个星期睡眠不足会感觉像生活在地狱,而3个月睡眠不足一定会觉得像被困在地狱的交通高峰期。
治疗:往往采用认知行为疗法和/或药物。
发生率:大约三分之一的美国人存在失眠现象。
1.INSOMNIA
Causes:Highlevelsofstress;certainmedications;anxietyordepression.Drugsoralcoholabuse.
Symptoms:Difficultyfallingasleepandthenmaintainingthatsleep.Whileeveryonehasabadnightofsleepeverysooften,insomniaisachronicissue,notacute.AccordingtoDr.DavidNeubauer,anassociateprofessorinthedepartmentofpsychiatryatJohnsHopkinsMedicalCenter,apersonneedstosufferfrominsomniasymptomsforatleastthreemonthsstraighttobediagnosedwiththedisorder.Ifthreeweeksoflittlerestfeelslikehell,threemonthsmustfeellikebeingstuckinhell’srush-hourtraffic.
Treatment:Cognitivebehavioraltherapyand/ormedicationareoftenprescribed.
Occurrence:Aboutone-thirdofallAmericanssufferfrominsomnia."IfyoumadealistofthemostcommonsleepdisordersinAmerica,itwouldgosomethinglikeinsomnia,insomnia,insomnia,sleepapnea,insomnia,andthenalltherest,"explainsNeubauer.
睡眠呼吸暂停症
睡眠呼吸暂停症是指在连续7h睡眠中发生30次以上的呼吸暂停,每次气流中止10s以上(含10s),或平均每小时低通气次数(呼吸紊乱指数)超过5次,而引起慢性低氧血症及高碳酸血症的临床综合征.可分为中枢型、阻塞型及混合型。
睡眠-呼吸暂停综合征的高危险群,包括肥胖、呼吸道结构狭窄、年纪大肌肉松弛、扁桃腺增生、下颚短小,或长期抽烟导致呼吸道水肿的人,此类病患睡觉时会喉咙阻塞以致吸不到空气。
病因:呼吸道全部或部分堵塞。
症状:白天嗜睡,晨起头痛,以及记忆力、注意力、判断力和警觉力下降。如果睡在这类人群旁边可以体会到其响亮鼾声、。睡眠呼吸暂停症可能会导致你每晚停止呼吸多次。奇怪的是,大多数存在呼吸暂停症的人直到被告之、才意识这个问题。
治疗方法:治疗睡眠呼吸暂停症最常用的是CPAP呼吸机(持续气道正压通气),该设备可将空气源源不断送入呼吸道。
发生率:大约1/5的成年人患有至少轻度的睡眠呼吸暂停症。
SLEEPAPNEA
Causes:Acompleteorpartialblockageofthethroat.
Symptoms:Daytimesleepiness,morningheadaches,and—asanypersonwhohasattemptedtosleepbesidesomeonewithapneacanattest—excessivelyloudsnoring.Apneamaycauseyoutostopbreathingmultipletimespernight.Oddlyenough,mostpeoplewhohaveapneadon’trealizethere’saproblemuntilsomeonetellsthem.BobRusso,anITsoftwareprojectmanager,wasdiagnosedwithapnea10yearsago.Heonlywenttoaspecialistafterhishusbandnot-so-subtlyinformedRussothathewasn’tgettingsleepbecauseofthesnoring."Whenyoulivewithsomethingforsolong,it'sjustnormalwhenyouwakeupwithaheadache,oryoufallasleepinamovie.Butthosearesigns.SowhenIreadthelistIsaid‘IguessIdohavethis.’IthoughtIwasrestingandfeelingwell,"saidRusso.
Treatment:ThemostcommontreatmentforapneaisaCPAP(continuouspositiveairwaypressure)machine,whichkeepsaperson’sthroatopenviaasteadystreamofair.
Occurrence:Aboutoneinfiveadultssufferfromatleastamildformofapnea.
不安腿综合征
不安腿综合征(RLS)系指小腿深部于休息时出现难以忍受的不适,运动、按摩可暂时缓解的一种综合征,又称“不安肢综合征”,早在1672年,英国医生ThomasWillis首次描述了不安腿综合征,该病又称为Ekbom综合征,其临床表现通常为夜间睡眠时,双下肢出现极度的不适感,迫使患者不停地移动下肢或下地行走,导致患者严重的睡眠障碍。该病虽然对生命没有危害,但却严重影响患者的生活质量。国外的流行病学资料表明其患病率为总人口的1%~10%,我国的患病率估计在1.2%~5%,中老年常见。
病因:专家们目前不知道是什么原因导致RLS,但理论认为它是遗传性的。同时药物也会导致RLS。孕妇有时也会受到RLS影响。
症状:静息状态下出现难以名状的肢体不适感,而迫使肢体(不只是腿部)发生不自主运动。常发生在傍晚或休息时间。有关专家称,患有RLS的患者每个夜晚可以踢动或移动数百次。
治疗:经常锻炼,减少咖啡因和酒精的摄入。在严重情况下,可遵医嘱进行药物治疗。
发生率:约10%的人群中受到RLS的影响。多见于女性。
RESTLESSLEGSYNDROME
Causes:Expertsaren’tsurewhatcausesRLS,buttheorizethatit’shereditary.MedicationshavealsobeenknowntocauseRLS.PregnantwomensometimessufferfromRLS.
Symptoms:Anirresistibleurgetomovethelimbs,notjustlegs.Oftenoccursintheeveningorduringperiodsofrest.NeubauersaysthatthosewhohaveRLScankickormovehundredsoftimesanight,everysinglenight.
Treatment:Regularexercise;reductionincaffeineandalcohol.Forseverecases,medicationcanbeprescribed.
Occurrence:About10%ofthepopulationsuffersfromRLS.It’smorecommoninwomen.
REM睡眠行为障碍
REM睡眠行为障碍是一种发生在REM睡眠中的睡眠行为异常,是一种最常见的睡眠行为障碍。常伴有精神压抑、过度饮酒、脑血管疾病和变性性神经系统疾病等。
病因:丧失正常REM睡眠时伴有的肌张力抑制。
症状:在睡眠中突然激烈地运动。如在床上翻来覆去,从床上跳下来。
治疗:通常建议药物治疗。
发生率:极为罕见的,发生率低于1%。
REM SLEEP BEHAVIOR DISORDER
Causes: The mechanism in the brain that prevents motor movement while sleeping doesn’t function properly.
Symptoms: Sudden and intense movement during sleep. People with REM sleep behavior disorder have been known to thrash in bed, jump out of bed, and even tackle furniture that may or may not deserve it.
Treatment: Medication is often advised.
Occurrence: Extremely rare; less than one percent of the population.
嗜眠症
嗜眠症是一种神经性疾病,它能引起不可抑制性睡眠发生。
病因:大脑中控制REM睡眠部位产生异常。
症状:这些睡眠阶段会经常发生,且发生的时间多不合适宜,例如当说话,吃饭或驾车时。尽管睡眠可以发生在任何时间,但最常发生的是在不活动或单调,重复性活动阶段,当发生在从事活动的时间段,就会有发生危险的可能性。
治疗:常建议药物治疗。
发生率:每年不到20万成年人被诊断罹患此症。
NARCOLEPSY
Causes: Abnormalities in the parts of the brain that control REM sleep.
Symptoms: While people with narcolepsy can suddenly fall asleep at the most inopportune moments, most spend their days in a weird middle ground of sleep. "They don’t have a differentiation between wide awake and sleeping," says Neubauer. Jenn Coleman, an administrative assistant in DC with narcolepsy, laments that she is unable to stay awake during even the most stimulating environments, like Vegas trips and concerts. Those with narcolepsy can also suffer from cataplexy, a condition that leads to fainting-like episodes brought on by emotional reactions to anything from a song to a joke.
Treatment: Medication is often advised.
Occurrence: Less than 200,000 adults are diagnosed per year.
梦游症
梦游症是睡眠中自行下床行动,而后再回床继续睡眠的怪异现象。在神经学上是一种睡眠障碍,症状一般为在半醒状态下在居所内走动,但有些患者会离开居所或作出一些危险的举动。
病因:睡眠不足或睡眠质量低,一些药物,疾病或发热引发。
症状:睡眠中自行下床行动,而后再回床继续睡眠的怪异现象。
治疗:减少睡觉环境附近的液体,保持安静的睡眠环境,保持有规律的睡眠时间表。
发生率:有趣的是,梦游症最常见于儿童,具体原因未知。专家认为,梦游症跟大脑的发育有关。似乎深度睡眠与浅度睡眠转换之间出现了问题。
SLEEPWALKING
Causes: Lack of sleep or inefficient sleep. Some medications. Illness or fever.
Symptoms: Walking while sleeping. Other signs are difficulty waking and abusing Danishes in the middle of the night. "One night I woke up standing in the kitchen over a mangled box of apple Danish," explains Todd Schultz, a 34-year-old nurse and frequent sleepwalker. "Apparently I got out of bed, walked to the bathroom and grabbed my toothbrush, and then brought it to the kitchen and used it as a fork to eat the Danish."
Treatment: Reducing liquids near bedtime. A quiet sleep environment and maintaining a regular sleep schedule.
Occurrences: Other than tales of assaulting baked goods, an interesting aspect of sleepwalking is that it’s most common in children, and no one is quite sure why. Neubauer’s theory is that it has something to do with brain development. "There seems to be vulnerability when switching gears between deeper sleep and lighter levels of sleep," he explains. "Almost like they slip gears and fall into sleep limbo."
夜惊
夜惊的典型表现归纳起来有:睡眠中突然尖叫、啼哭,时哭时止,或定时啼哭,甚则通宵达旦,神情极度恐惧,汗出,呼吸急促,心率加快,一般在醒时对夜惊发作一事通常表现为没有记忆。白天安静,多无发热、呕吐、泄泻、口疮、疖肿、外伤等表现。发作次数不定,一般连续发作数日或数十日,或隔数日发作1次。
夜惊的典型表现归纳起来有:睡眠中突然尖叫、啼哭,时哭时止,或定时啼哭,甚则通宵达旦,神情极度恐惧,汗出,呼吸急促,心率加快,一般在醒时对夜惊发作一事通常表现为没有记忆。白天安静,多无发热、呕吐、泄泻、口疮、疖肿、外伤等表现。发作次数不定,一般连续发作数日或数十日,或隔数日发作1次。
病因:睡眠不足,疾病和/或一些药物的影响。
症状:睡眠中突然猛烈醒来并尖叫。在出现夜惊时人们往往没有完全清醒,因此一旦他们醒来使之平静下来非常困难。此外,夜惊和梦魇不同, 专家称梦魇与情感有关系,而夜惊往往只是恐惧和危险的具体概念。
治疗:改善睡眠环境,如果夜惊症状非常严重给予药物治疗。
发生率:最常见于儿童,成年人很少患有这种疾病。创伤后应激障碍人群更容易发生夜惊。
SLEEP TERRORS
Causes: Sleep deprivation, illness and/or, some medications.
Symptoms: Screaming and violent, short bursts of movement during sleep. When a person has a sleep terror episode they aren't fully awake, therefore it can be extremely difficult to calm them down once they do wake up. Also, despite the name, sleep terrors and nightmares aren't that similar. "Nightmares have an emotional narrative; sleep terrors are often simply a very crystallized notion of fear and danger," explains Neubauer.
Treatment: Improve sleep environment, medication is given if the terrors are extreme.
Occurrences: Most commonly impacts children; few adults suffer from this disorder. Those with PTSD are more likely to suffer from sleep terrors.
磨牙症
磨牙症是指睡眠时有习惯性磨牙或白昼也有无意识磨牙习惯者,随时间一点一点加重,是一种长期的恶性循环疾病。夜磨牙是中枢神经系统大脑皮质颌骨运行区的部分脑细胞不正常兴奋导致三叉神经功能紊乱,三叉神经支配咀嚼肌发生强烈持续性非功能性收缩,使牙齿发生嘎嘎响声的咀嚼运动。一般分为3型:磨牙型、紧咬型和混合型。人在6岁~13岁都处于换牙期,为适应上下牙齿磨合都会有磨牙现象。但是,过了换牙期的青少年和成人若常有磨牙的现象发生那就是一种病态。
病因:大多数专家认为由过度紧张和焦虑引发磨牙症状。
症状:在早晨醒来时头痛和/或巴疼痛。
治疗方法:避免嚼不属于食物的任何物品,因为它可使下巴握紧。大多数人以磨牙症最终采用了由牙医提供的防护牙托。
BRUXISM (TEETH GRINDING)
Causes: Most experts blame excessive stress and anxiety.
Symptoms: Headaches and/or a sore jaw when waking in the morning. Complaints from annoyed bedmates.
Treatment: Avoiding chewing any items that aren’t food, as it trains the jaw to clench. Most people with bruxism end up getting fitted with a mouth guard that can be provided by a dentist.
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