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首页> 外文期刊>Journal of Thoracic Disease >Insomnia and cognitive behavioural therapy—how to assess your patient and why it should be a standard part of care
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Insomnia and cognitive behavioural therapy—how to assess your patient and why it should be a standard part of care

机译：失眠和认知行为治疗 - 如何评估您的患者以及为什么它应该是护理的标准部分

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Hippocrates recognized the importance of asking about sleep as long ago as 400 BC when he wrote “ sleep and watchfulness, both of them when immoderate, constitute disease ”. Disrupted sleep for any reason has immediate and long term consequences on physical and mental health. Insomnia disorder (“immoderate watchfulness”) remains the commonest sleep disorder in primary and secondary care with an estimated 5–10% of the adult population affected. While it is commonly comorbid with other physical and mental health problems, the new diagnostic classification has been helpfully simplified such that it is considered a disorder in itself. If it is the patient’s main concern, it warrants treatment. Patients and health professionals have often had limited teaching about effective strategies for insomnia which leaves many untreated and insomnia can be unfairly perceived as a challenging symptom to manage. The first line treatment is now well established as insomnia-specific cognitive behavioural therapy (CBTi) in the most recent US and European treatment guidelines. Over 25 years of high quality research have shown evidence for sustained improvements in sleep in those with insomnia alone or insomnia comorbid with other conditions. This is a simple CBT to deliver with better and safer outcomes than prescription hypnotics. Therefore, this review will cover the initial assessment of insomnia, including insomnia mimics, the selection of patients for treatment and the key components of CBT therapy. Finally, the review will cover evidence for different modes of delivery (online, self, help, group or individual face to face) in a variety of clinical settings.
机译：希波克拉底很久以前认识到睡觉的重要性，因为当他写“睡觉和注意到，他们都有疾病时，他们都是疾病”的时候，他就会询问睡眠。由于任何理由扰乱了睡眠，对身心健康有直接和长期后果。失眠障碍（“无偿观点”）仍然是初级和次级护理中最常见的睡眠障碍，估计5-10％的成年人口受影响。虽然它与其他身体和心理健康问题共同合并，但新的诊断分类已经有助于简化，使得它本身就被认为是一种疾病。如果是患者的主要问题，则保证治疗。患者和卫生专业人员经常有限的教学教学，对失眠的有效策略的教学，其中留下了许多未经处理的和失眠，可以被不公平地被认为是挑战的症状。第一线治疗现在在最近的美国和欧洲治疗指南中被确定为特异性特异性认知行为治疗（CBTI）。超过25年的高质量研究表明，在单独失眠或失眠与其他条件下的睡眠中持续改善的证据。这是一个简单的CBT，可以提供比处方催眠药更好，更安全的结果。因此，本综述将涵盖失眠症的初步评估，包括失眠模仿，选择治疗患者的选择和CBT疗法的关键组成部分。最后，审查将在各种临床环境中涵盖不同运输方式的证据（在线，自我，帮助，团体或个人面对面）。

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