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首页> 外文期刊>Sleep medicine reviews >Insomnia in central neurologic diseases--occurrence and management.
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Insomnia in central neurologic diseases--occurrence and management.

机译：中枢神经系统疾病的失眠-发生和管理。

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The objective of this review is to highlight the impact of insomnia in central neurological disorders by providing information on its prevalence and give recommendations for diagnosis and treatment. Insomnia in neurological disorders is a frequent, but underestimated symptom. Its occurrence may be a direct consequence of the disease itself or may be secondary to pain, depression, other sleep disorders or the effects of medications. Insomnia can have a significant impact on the patient's cognitive and physical function and may be associated with psychological distress and depression. Diagnosis of insomnia is primarily based on medical history and validated questionnaires. Actigraphy is a helpful diagnostic tool for assessing the circadian sleep-wake rhythm. For differential diagnosis and to measure the duration of sleep full polysomnography may be recommended. Prior to initiating treatment the cause of insomnia must be clearly identified. First line treatment aims at the underlying neurologic disease. The few high quality treatment studies show that short term treatment with hypnotics may be recommended in most disorders after having ruled out high risk for adverse effects. Sedating antidepressants may be an effective treatment for insomnia in stroke and Parkinson's disease (PD) patients. Melatonin and light treatment can stabilize the sleep-wake circadian rhythm and shorten sleep latency in dementias and PD. Cognitive behavioral therapy (CBT) can be effective in treating insomnia symptoms associated with most of the central neurological diseases. The prevalence and treatment of insomnia in neurological diseases still need to be studied in larger patient groups with randomized clinical trials to a) better understand their impact and causal relationship and b) to develop and improve specific evidence-based treatment strategies.
机译：这篇综述的目的是通过提供失眠的患病率信息来强调失眠对中枢神经系统疾病的影响，并提出诊断和治疗的建议。神经系统疾病中的失眠是一种常见的症状，但被低估了。它的发生可能是疾病本身的直接后果，也可能是继发于疼痛，抑郁，其他睡眠障碍或药物作用的继发因素。失眠可能会对患者的认知和身体机能产生重大影响，并且可能与心理困扰和沮丧相关。失眠的诊断主要基于病史和经过验证的问卷。书法是评估昼夜节律的有用诊断工具。为了鉴别诊断和测量睡眠时间，可能建议进行多导睡眠监测。在开始治疗之前，必须明确确定失眠的原因。一线治疗针对潜在的神经系统疾病。少数高质量的治疗研究表明，在排除了不良反应的高风险后，在大多数疾病中都建议使用催眠药进行短期治疗。镇静抗抑郁药可能是中风和帕金森氏病（PD）患者失眠的有效治疗方法。褪黑激素和光疗可以稳定痴呆症和PD的觉醒昼夜节律并缩短睡眠潜伏期。认知行为疗法（CBT）可有效治疗大多数中枢神经系统疾病相关的失眠症状。在较大的患者群体中，仍需通过随机临床试验研究失眠在神经系统疾病中的患病率和治疗方法，以便a）更好地了解失眠的影响和因果关系，以及b）制定和改进基于证据的特定治疗策略。

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