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| Chronic insomnia
baffles sleep experts
| |
Millions of Americans lie awake at night counting sheep - or have a
stiff drink or pop an allergy
pill, hoping it will make them drowsy. But experts agree all that
self-medicating is a bad idea, and the causes of chronic insomnia remain mysterious.
Almost a third of adults have trouble sleeping, and about 10 percent
have symptoms of daytime impairment that signal true insomnia.
Sufferers readily cite the resulting problems: walking around in a fog,
as memory and other cognitive functions slow. Dozing off at the wheel or at work.
Depression. Lack of energy.
But for all the complaints, scientists know surprisingly little about
what causes chronic insomnia, its health consequences and how best to
treat it, a panel of specialists brought together by the National
Institutes of Health concluded Wednesday.
Two things are clear, the panel found: Chronic insomnia is a major
public health problem. And too many people are using unproven therapies,
even while there are a few treatments that do work.
The hope is that the report will dispel some of what panelist Dr. Sean Caples of the Mayo Clinic
decried as "misinformation and myths."
Among the panel's findings:
_Cognitive/behavioral therapy - a psychology-based treatment that
trains people to reduce anxiety and take other sleep-promoting steps - is
very effective, and doesn't cause side effects. But it can be hard to find
health providers trained in the techniques. Insomniacs should check with
board-certified sleep specialists and psychologists.
_Newer prescription sleep pills called Sonata, Ambien and Lunesta work
without many of the side-effect concerns of older agents known as
benzodiazepines. One study of Lunesta showed effectiveness with six months
of use, but more research on long-term use of all three is needed, as
chronic insomnia can linger for years.
_The most commonly used treatments are alcohol and
over-the-counter
sedating antihistamines like Benadryl. Alcohol use actually disrupts
quality sleep, and antihistamines can cause lingering daytime sedation and
other cognitive problems.
_The most common prescription insomnia medicine is an older, sedating
antidepressant called trazodone, even though there's no good evidence that
it offers more than a two-week benefit, and it comes with side effects.
_There is no evidence backing the effectiveness of the popular dietary
supplements melatonin and valerian to fight insomnia.
(Agencies) |
每天晚上都有數(shù)百萬美國(guó)人躺在床上數(shù)羔羊，難以入睡；他們或者喝烈酒，或者吃片過敏藥，希望這樣能有助睡眠。然而，睡眠研究專家們一致認(rèn)為，自作主張胡亂吃藥并不是解決失眠的好方法。導(dǎo)致慢性失眠的原因目前還是一個(gè)謎。
幾乎有三分之一的成年人存在睡眠障礙，而且大約百分之十的人在白天精神恍惚，這表明他們確實(shí)患上了失眠癥。
提到失眠帶來的問題，失眠癥患者往往能脫口而出：走路就像霧中漫步，跌跌撞撞；記憶力減退，反應(yīng)遲鈍；開車和工作時(shí)瞌睡連連；精神消沉，沒有活力。
上周三（6月15日），一個(gè)由美國(guó)健康研究院召集的專家小組得出這樣的結(jié)論：要不是人們?cè)孤曒d道，科學(xué)家們對(duì)導(dǎo)致失眠的原因、失眠對(duì)健康帶來的危害以及治愈失眠癥的方法的了解少得驚人。
這個(gè)研究小組發(fā)現(xiàn)，起碼有兩點(diǎn)是確定無疑的：一、慢性失眠是一個(gè)事關(guān)公眾身體健康的大問題；二、盡管目前有一些行之有效的治療方法，還是有不少人使用未經(jīng)驗(yàn)證的療法。
這份報(bào)告有望能消除那些被小組成員——梅奧診所的肖恩·卡普里斯斥為誤傳和荒唐的說法。
專家小組發(fā)現(xiàn)：
●
認(rèn)知/行為療法。這是一種心理療法，能讓人減輕憂慮，轉(zhuǎn)而采取其它有助睡眠的措施。這種方法非常有效，而且沒有副作用。但是，目前還很難找到能提供這種治療方法的醫(yī)生。失眠癥患者應(yīng)首先咨詢那些通過了委員會(huì)認(rèn)證的失眠研究專家和心理學(xué)家。
●
新的處方失眠藥，如索納塔、思諾思和魯尼斯塔等安眠藥，這些藥物不會(huì)產(chǎn)生如以前的苯二氮平類短效性安眠藥帶來的副作用。一項(xiàng)針對(duì)魯尼斯塔的研究顯示，該藥的服用時(shí)間在六個(gè)月之內(nèi)，效果都不錯(cuò)。但是，一如慢性失眠仍將困擾人類多年，針對(duì)這三種藥長(zhǎng)期服用的療效還需進(jìn)行更多的研究。
●
目前應(yīng)用最廣泛的治療方法是飲酒和服用諸如苯海拉明一類的非處方鎮(zhèn)靜性抗組氨藥物。而實(shí)際上，飲酒會(huì)破壞睡眠質(zhì)量，服用抗組氨藥物則會(huì)使人在白天長(zhǎng)時(shí)間處于鎮(zhèn)靜狀態(tài)，容易引起其它感知問題。
●
最常用的治療失眠癥的處方藥是一種名為三唑酮的已使用多年的鎮(zhèn)靜性抗抑郁藥物。但是，現(xiàn)在還沒有充分的證據(jù)表明其功效可以持續(xù)兩個(gè)星期以上，況且它還有副作用。
●目前也還沒有證據(jù)表明廣受歡迎的膳食補(bǔ)充劑褪黑素和纈草根可以有效治療失眠癥。
（中國(guó)日?qǐng)?bào)網(wǎng)站譯） |
Updated: 2005-06-21 10:34