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1、Sleep Disorders In Older AdultsHarrison G. Bloom, M.D. Director, International Geriatrics Clinical Education and Consultation Service International Longevity Center-USA New York, NY 翻译:唐莉,I N T E R N A T I O N A L L O N G E V I T Y C E N T E R - U S A,老年人睡眠障碍,哈里森.布鲁姆医学博士 国际老年医学临床教育中心主任 国际长寿中心，纽约,Con
2、sensus Conference to Develop Guidelines for the Assessment and Treatment of Sleep Disorders in Older AdultsILC-USA December 6 & 7, 2007,Made possible by an unrestricted grant from Takeda Pharmaceuticals North America,I N T E R N A T I O N A L L O N G E V I T Y C E N T E R - U S A,老年睡眠障碍评估和治疗的共识和指南 2
3、007年12月67日,“If sleep doesnt serve an absolutely vital function it is the biggest mistake that evolution has ever made.”,如果睡眠不能完全恢复人体的活力和机能将是极大的错误，而这种错误在不断发生。,Goal,Develop consensus guidelines that are practical and relevant to the primary care practitioner in an ambulatory setting.,目标,形成和初级保健医生共识的医疗
4、开发的实用性与基础护理相关的治疗背景,Guidelines,Evidence BasedBest Practices,指导思想,以实践为依据,Gallup Survey on Sleep and Healthy AgingOctober, 2005,睡眠和健康的民意调查2005年10月,Gallup Survey Objective,Document older adults awareness and attitudes on a range of issues: Knowledge of the importance of sleep Sleep behaviors and coping
5、mechanisms Attitudes toward sleep and aging,民意调查目的,老年人对睡眠问题的意识和态度： 睡眠的重要性睡眠行为和应对机制对于睡眠和衰老的态度,Survey Goal,Use survey results to help encourage discussion among healthcare professionals about sleep problems within the aging population.,调查目的,通过调查结果鼓励医疗保健专家关注讨论老年人睡眠障碍,Methodology,The Gallup Organization
6、 interviewed 1,003 Americans 50 years of age and older via randomtelephone surveys.Results are nationally representative of all adults age 50 and older.,方法学,盖洛普通过电话随机调查了1003位50岁以上的美国老年人调查结果能够代表美国50岁以上人群的意见,Summary of Findings:Older adults recognize the importance of sleep,研究结果摘要：,中老年人意识到睡眠的重要性,睡眠的重要
7、性,大部分老年人相信睡眠对健康非常重要,One in two (47%) report they are getting less then seven hours a sleep a night One in three (34%) feel they need more sleep than they are currently getting,Sleep Patterns,睡眠模式,二分之一(47%)的老年人一夜睡眠不足7小时三分之一(34%)的老年人认为他们需要比现在睡眠时间更长的睡眠,45% feel they need more sleep today than when they
8、 were younger24% agree that getting more than 9 hours of sleep a night is a sign of laziness,Attitudes Toward Sleep,睡眠的态度,45%的人感觉需要比他们年轻时更多的睡眠24%的人认为睡眠时间超过9个小时是懒惰的表现,One in three (33%) report using at least one “sleep aid” in the past month18% reported using the respective “sleep aid” every night,Re
9、ported use of “sleep aids”,辅助睡眠方法的应用,三分之一（33%）的人在过去一个月内至少一次使用过辅助睡眠方法18%的人每晚使用各种辅助睡眠方法,Respondents reported usage of seven,OTC antihistamines or cold meds OTC sleep aids Melatonin Herbal remedies,Alcohol Audio tapes Rx meds not prescribed to help with sleep problems,老年人七种常用的辅助睡眠方法,非处方抗组织胺或感冒药 非处方辅助睡眠
10、 褪黑素 草药 酒精 录音带 治疗睡眠障碍的处方和非处方药,One in four (25%) believes she/he has a sleep problem72% who feel they have a sleep problem have spoken to their healthcare providersMore than half (53%) who have spoken with their healthcare providers are not receiving treatment25% of people who feel they have a sleep
11、problem report taking Rx sleep medication,Treatment of Sleep Problems,睡眠障碍的治疗,四分之一（25%）的人认为自己有睡眠障碍 72%感觉自己有睡眠障碍的人已经报告了医生一半以上（53%）报告过医生的人未得到治疗 25%认为自己有睡眠障碍的人正在服用处方睡眠药,处方睡眠药安全吗?,Most Frequently Cited Safety Concerns,Not knowing long-term effects of drug (73%) Becoming addicted (68%) Next-day groggines
12、s (67%) Interactions with other medications (63%) Next-day “hangover” feeling (63%),最常见的安全隐患,长期药效不详(73%)成瘾性(68%次日感觉头昏(67%)对其他药物的影响(63%)次日“宿醉”感(63% ),“It aint so much what we dont know that gets us into trouble as what we do know that aint so.”,我们遇到的困难不是我们所能预料的,Sleep: A marker of Physical and Mental
13、Health in the Elderly Kathryn J. Reid, et al,Objective: The objective of this study was to determine the occurrence and recognition of common sleep-related problems and their relationship to health-related quality-of-life measures in the elderly.,Am J Geriatr Psychiatry 14:10,October 2006,睡眠：老年人身心健康
14、的标志,目的：这项研究的目的是确定常见睡眠相关问题的发生和鉴别，以及睡眠与健康生活质量的关系。,TABLE 2. Five-Item Sleep Questionnairea1. Do you feel excessively sleepy during the day? Yes No 2. Do you find yourself falling asleep when youdo not want to? Yes No 3. Do you snore frequently and loudly or stopbreathing? Yes No 4. If yes to 3, do you
15、feel unrefreshed on awakening? Yes No 5. Do you have difficulty falling asleep, staying asleep,or being able to sleep? Yes No-aData collection for educational data was initiated after enrollment had begun at the first several project sites (N1,323). For other demographic variables, the full sample size is 1,503.,Am J Geriatr Psychiatry 14:10,October 2006,表2.睡眠问卷中的五个问题 1.你感觉白天嗜睡吗？ 2.当你不想睡的时候你会睡着吗？ 3.你频繁和大声打鼾或有呼吸中断吗？ 4.如果第三题你选择是，那么你在醒来的时候会觉得睡眠不解乏吗？ 5.你有入睡困难、易醒吗？,
