【正文】 or shortterm use (no more than 4 weeks) in the majority of cases ? Discontinue slowly ? Be alert for rebound insomnia/withdrawal symptoms ? Advise patients of the interaction with alcohol and other sedating drugs ? Avoid the use of hypnotics in patients with respiratory disease or severe hepatic impairment and in addictionprone individuals Prescribing Guidelines, The Maudsley, 2023 The efficacy and safety of drug treatments for chronic insomnia in adults: a metaanalysis of RCTs J Gen Intern Med. 2023 Sep。後來藥不夠時(shí)她就到另一家醫(yī)院的精神科開藥。長(zhǎng)期下來，白天不但會(huì)常頭暈，而且越來越?jīng)]耐性，常常提不起勁來，感覺自己快要垮了，近半年來已經(jīng)把休假請(qǐng)光，還請(qǐng)了不少病假，最近才由朋友介紹到精神科看門診。62(suppl 10):1826. Greater Impaired Function Impact of Insomnia on Physical and Emotional Health and Social Functioning 35557595C on t rol I n s om n i aB o d y Pa i nG en er al H eal t hM en t al H eal t hR o l e E m o t i o n alR o l e Ph y s i c alS o c i al F u n c t i o n i n gV i t al i t yPh y s i c al F u n c t i o n i n g*Scale ranges from 0 to 100, with higher scores reflecting greater quality of life. Adapted from Zammit GK et al. Sleep 1999。56:332–343. AncoliIsrael S, Roth T. Sleep. 1999。 ? BZD receptor agonists是否依賴性與成癮性均優(yōu)於傳統(tǒng)的 BZD，雖有報(bào)告 *，仍有待更多資料檢驗(yàn)。 nonBDZ: minutes。28:10491057. Chronic Insomnia: Consequences ? Some evidence suggests a relationship between chronic insomnia and impaired memory, cognitive functioning, and depressed mood Chronic Insomnia Consequences ? Associated with high health care utilization ? Direct and Indirect Costs: estimated in the tens of billions of dollars annually Quality of Life ?Reduces quality of life ?Hinders social functioning ?Related to impaired work performance NIH Statement. Sleep. 2023。慢性失眠及 安眠藥物的使用 財(cái)團(tuán)法人佛教慈濟(jì)綜合醫(yī)院精神醫(yī)學(xué)部 佛教慈濟(jì)大學(xué)精神科 林喬祥醫(yī)師 個(gè)案描述一 ? 28歲的王先生，唸?？茣r(shí)期開始就有經(jīng)常睡不好，經(jīng)常得要躺超過一個(gè)小時(shí)才能入睡，遇到有考試壓力或者和朋友之間有些爭(zhēng)執(zhí)時(shí)就更不好睡，就算睡著了，一有聲響很容易就醒過來，又得躺好一陣子才能再入睡。 Katz and McHorney 1998 Chronic Insomnia: Epidemiology Prevalence ? 30% of general population plains of sleep disruption ? 10% has daytime functional impairment Natural History ? Few studies describe the course and duration of insomnia Incidence ? Very little is known about chronic insomnia’ s incidence ? Only a few studies have examined incidence Risk Factors Higher prevalence of insomnia in: ? Women (especially postmenopausal) ? Divorced, separated, widowed adults ? Psychiatric and physical illnesses Other risk factors include cigarette smoking, alcohol, coffee consumption, and numerous prescription drugs NIH Statement. Sleep. 2023。 95% CI: , 。 The prevalence, using amount and characters of BZD users from 2023 to 2023 Year 2023 2023 2023 2023 年盛行率 (%) 男性 女性 平均年齡 (years) 95%CI (~) (~) (~) (~) 男性 (~) (~) (~) (~) 女性 (~) (~) (~) (~) 每千人日 DDD 男性 女性 臺(tái)灣鎮(zhèn)靜安眠類藥品使用盛行率以及相關(guān)後遺癥之研究 ,行政院衛(wèi)生署管制藥品管理局九十六年度委託科技研究計(jì)畫報(bào)告 ,民國(guó) 97年 The prescrib