中文Insomnia is difficulty getting to sleep or staying asleep, or having nonrefreshing sleep for at least 1 month.
Causes, incidence, and risk factors
Primary insomnia refers to insomnia that is not caused by any known physical or mental condition.
Insomnia is caused by many different things. The most common causes of insomnia are:
- Alcohol
- Anxiety
- Coffee
- Stress
Secondary insomnia is caused by a medical condition. Depression is a very common cause of secondary insomnia. Often, insomnia is the symptom that causes people with depression to seek medical help.
Symptoms
- Difficulty falling asleep on most nights
- Feeling tired during the day or falling asleep during the day
- Not feeling refreshed when you wake up
- Waking up several times during sleep
People who have primary insomnia tend to keep thinking about getting enough sleep. The more they try to sleep, the greater their sense of frustration and distress, and the more difficult sleep becomes.
Signs and tests
Your health care provider will do a physical exam and ask you questions about your current medications, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.
Polysomnography, an overnight sleep study, can help rule out other types of sleep disorders (such as sleep apnea).
Treatment
The following tips can help improve sleep. This is called sleep hygiene.
- Avoid caffeine, alcohol, or nicotine before bed.
- Don’t take daytime naps.
- Eat at regular times each day (avoid large meals near bedtime).
- Exercise at least 2 hours before going to bed.
- Go to bed at the same time every night.
- Keep comfortable sleeping conditions.
- Remove the anxiety that comes with trying to sleep by reassuring yourself that you will sleep or by distracting yourself.
- Use the bed only for sleep and sex.
Do something relaxing just before bedtime (such as reading or taking a bath) so that you don’t dwell on worrisome issues. Watching TV or using a computer may be stimulating to some people and interfere with their ability to fall asleep.
If you can’t fall asleep within 30 minutes, get up and move to another room. Engage in a quiet activity until you feel sleepy.
One method of preventing worries from keeping you awake is to keep a journal before going to bed. List all issues that worry you. By this method, you transfer your worries from your thoughts to paper. This leaves your mind quieter and more ready to sleep.
If you follow these recommendations and still have insomnia, your doctor may prescribe medications such as benzodiazepines.
Expectations (prognosis)
You should be able to sleep if you practice good sleep hygiene. See a doctor if you have chronic insomnia that does not improve.
It is important to remember that your health is not at risk if you do not get 6 – 8 hours of sleep every day. Different people have different sleep requirements. Some do fine on 4 hours of sleep a night, while others only thrive if they get 10 – 11 hours.
Sleep requirements also change with age. Listen to your body’s sleep signals and don’t try to sleep more or less than is refreshing for you.
Complications
Daytime sleepiness is the most common complication, though there is some evidence that lack of sleep can also lower your immune system’s ability to fight infections. Sleep deprivation is also a common cause of auto accidents — if you are driving and feel sleepy, take a break.
Calling your health care provider
Call your doctor if chronic insomnia has become a problem.
(from U.S. National Library of Medicine)
失眠在医学上指的是一个月以上持续地很难入睡、睡的不沉、或睡觉醒来后精力没有得到恢复。
病因
第一类的失眠指的是不是由任何已知的生理或精神问题造成的。失眠是由多种原因造成的。最主要的原因如下：
- 酒精
- 焦虑
- 咖啡
- 压力
第二类失眠是由健康问题造成的。 抑郁症是一个很常见的原因。通常失眠是抑郁症患者寻求医治的症状。
症状
- 大部分的晚上都有困难入睡
- 白天感到疲惫或打瞌睡
- 醒来以后不觉得精力恢复
- 睡觉当中会醒来好几次
有第一类失眠症的人会尽力去睡觉。 但他们越是尽力，越感到挫折和紧张，从而越难入睡。
测验
医生会给你体检并问你的医疗状况、用的药物、和病史。通常用这些方法，医生就可以诊断你是否得了失眠症。
下面是一些可以帮助你睡眠的窍门。这叫做睡眠卫生。
- 睡觉前避免咖啡因、酒精、和尼古丁
- 白天不要睡觉
- 饮食定时（避免觉前吃的太多）
- 锻炼在睡觉前至少两个小时。
- 每晚在同一个时间睡觉
- 保持舒适的卧床
- 拿掉因努力入睡带来的焦虑。你可以告诉自己一定会睡着的或不去想睡觉的事。
- 只有在睡觉或做爱时才到床上
睡觉前做些放松的动作（如读书或泡澡）让你不去想烦心的事。看电视或上机对有些人是刺激性的并会影响他们的入睡。
如果你半个小时还不能入睡的话，就起来到另一个房间。做些让你安静的事情帮助你入睡。(译者注：我的办法是读圣经里面的故事，会帮助我的头脑安静下来。）
一个帮你拿掉焦虑的办法是睡觉前写日记。把所有让你操心的东西都列出来。这样你就把这些东西从你的头脑移到纸上。帮助你头脑安静下来容易入睡。
如果你用了上述方法还不能入睡，你的医生可以给你开安眠药。
期望
如果你保持良好的睡眠卫生，你应该能够入睡。如果你的失眠没有减轻，你应该去看医生。
重要的是如果不能每天都有六到八个小时的睡眠，你的健康并不会受到影响。每个人需要的睡眠都不一样。有些人只需要每晚四小时的睡眠，而有些人却需要10到11个小时的睡眠。
需要的睡眠随年龄而变化。倾听你身体的睡眠信号，不要睡的过多或过少。能让你精力恢复的睡眠是恰到好处的。
并发症
白天疲惫是最常见的并发症，不过也有证据表明缺乏睡眠会降低免疫系统抵抗感染的能力。缺乏睡眠也是造成车祸的一个常见问题。如果你开车想睡觉，最好停下来休息一下。
找医生
如果长期的失眠成了问题，赶紧找你的医生。
(译自美国国家医学图书馆（U.S. National Library of Medicine)的一篇文章)