医学英语.doc

? Insomnia Charles E. Henley 失 眠 (卡劳尔·布赖宁) Insomnia is more than just being unable to fall asleep. It is a subjective condition of insufficient or nonrestorative sleep despite an adequate opportunity to sleep. The Institute of Medicine and most current studies place the prevalence of insomnia at 30% to 40% in the general adult population. Although the need for sleep does not necessarily decrease with age, the incidence of sleep disturbances appears to increase with age, particularly among women. Actually, the elderly are more prone to sleep maintenance problems, whereas younger people tend to have trouble falling asleep. 失眠并不仅仅是无法入睡。失眠是在有足够睡眠机会时睡眠仍不充分或睡后精力无法恢复的一种主观病症。美国医学研究院和现有的多数研究都认为，失眠在普通成人中的流行率为30%至40%。虽然睡眠需要未必随年龄增长而减少，但睡眠障碍的发生率似乎是随年龄而增加的，特别是妇女。事实上，老年人更容易在睡眠维持方面出问题，而年轻人则往往是难以入睡。 I. Approach. I. 诊断思路： Insomnia represents a symptom of an underlying problem and is not in itself a disease entity. Sleep and alertness are regulated by a complex interaction between the bodys internal biologic clocks, the reticular activating system, and various influences such as light or anxiety that can interfere with the normal sleep cycles. The approach to diagnosis should recognize the potential for various causes and use history and special studies to determine the cause of the insomnia. 失眠是某种潜在疾病的一种症状，失眠本身并不是一种病质。睡眠和觉醒是众多复杂因素相互作用的结果，如人体内生物种、脑干网状激活体系统及其他各种可以影响正常睡眠周期的因素，如灯光、焦虑等。诊断时应该认清各种因素的影响力，并根据病史及其他特殊检查确定失眠原因。 A. Types of insomnia. A. 失眠类型。 Although more than one classification system for insomnia exists, a consensus seems to support dividing insomnia into transient (lasting a few days), short-term (lasting weeks), and long-term or chronic (lasting many weeks to months or years). The Association for the Psychophysiological Study of Sleep has classified insomnia as: 失眠分类方法不止一种，但公认的是将失眠分为暂时性（持续数天）、短期性（持续数周）和长期性或慢性（持续数周、月或年）这几种。睡眠社会心理生理研究协会将失眠分为以下几种： 1. Psychophysiologic, which covers the transient and short-term problems associated with situational factors such as concern