医学
失眠症
慢性失眠
重症监护医学
药物治疗
认知行为疗法
不利影响
苯二氮卓
精神科
认知
心理治疗师
睡眠障碍
心理学
药理学
内科学
受体
作者
Charles M. Morin,Ruth M. Benca
出处
期刊:The Lancet
[Elsevier]
日期:2012-03-01
卷期号:379 (9821): 1129-1141
被引量:723
标识
DOI:10.1016/s0140-6736(11)60750-2
摘要
Insomnia is a prevalent complaint in clinical practice that can present independently or comorbidly with another medical or psychiatric disorder. In either case, it might need treatment of its own. Of the different therapeutic options available, benzodiazepine-receptor agonists (BzRAs) and cognitive-behavioural therapy (CBT) are supported by the best empirical evidence. BzRAs are readily available and effective in the short-term management of insomnia, but evidence of long-term efficacy is scarce and most hypnotic drugs are associated with potential adverse effects. CBT is an effective alternative for chronic insomnia. Although more time consuming than drug management, CBT produces sleep improvements that are sustained over time, and this therapy is accepted by patients. Although CBT is not readily available in most clinical settings, access and delivery can be made easier through use of innovative methods such as telephone consultations, group therapy, and self-help approaches. Combined CBT and drug treatment can optimise outcomes, although evidence to guide clinical practice on the best way to integrate these approaches is scarce.
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