失眠症是一种常见疾病,但患病率估计因所采用的定义不同而不同。一项研究估计,在加拿大,2002 年 330 万人受到失眠症影响,而在巴西睡眠干扰的患病率估计为 37%。[5]Tjepkema M. Insomnia. Health Reports. 2005;17:9-25.http://www.statcan.gc.ca/studies-etudes/82-003/archive/2005/8707-eng.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/16335690?tool=bestpractice.com[6]Blay SL, Andreoli SB, Gastal FL. Prevalence of self-reported sleep disturbance among older adults and the association of disturbed sleep with service demand and medical conditions. Int Psych. 2008;20:582-595.http://www.ncbi.nlm.nih.gov/pubmed/18053289?tool=bestpractice.com一项在瑞典进行的群体研究发现,在所有年龄组中,40% 的人患有失眠症。[7]Liljenberg B, Almqvist M, Hetta J, et al. Age and the prevalence of insomnia in adulthood. Eur J Psychiatry 1989;3:5-12.英国一项研究显示,失眠症通常是一种长期疾病,特别是对于老年人。结果表明,在接受为期 1 年监测的老年人中,69% 仍然患有该疾病,而在较年轻的年龄组中,持续睡眠问题的患病率为 44%。[8]Morphy H, Dunn KM, Lewis M, et al. Epidemiology of insomnia: a longitudinal study in a UK population. Sleep 2007;30:274-280.http://www.ncbi.nlm.nih.gov/pubmed/17425223?tool=bestpractice.com
据估计,美国 10% 至 30% 的人群可能患有失眠症。[9]Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6:97-111.http://www.ncbi.nlm.nih.gov/pubmed/12531146?tool=bestpractice.com[10]Johnson EO, Roehrs T, Roth T, et al. Epidemiology of alcohol and medication as aids to sleep in early adulthood. Sleep. 1998;21:178-186.http://www.ncbi.nlm.nih.gov/pubmed/9542801?tool=bestpractice.com在每个年龄组中,报告睡眠异常时,女性比男性更主观。[11]Breslau N, Roth T, Rosenthal L, et al. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996;39:411-418.http://www.ncbi.nlm.nih.gov/pubmed/8679786?tool=bestpractice.com[12]Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry. 1985;42:225-232.http://www.ncbi.nlm.nih.gov/pubmed/2858188?tool=bestpractice.com[13]Lindberg E, Janson C, Gislason T, et al. Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status? Sleep. 1997;20:381-387.http://www.ncbi.nlm.nih.gov/pubmed/9302720?tool=bestpractice.com在美国,已预计事故和工作效率低下每年会造成 1000 亿美元的损失。[14]Stoller MK. Economic effects of insomnia. Clin Ther. 1994;16:873-897.http://www.ncbi.nlm.nih.gov/pubmed/7859246?tool=bestpractice.com失眠症随年龄增加而增加,但它可能与老年人健康状况差而不是衰老进程相关。[15]Cochen V, Arbus C, Soto ME, et al. Sleep disorders and their impacts on healthy, dependent, and frail older adults. J Nutr Health Aging. 2009;13:322-329.http://www.ncbi.nlm.nih.gov/pubmed/19300867?tool=bestpractice.com[16]Benca RM, Ancoli-Israel S, Moldofsky H. Special considerations in insomnia diagnosis and management: depressed, elderly, and chronic pain populations. J Clin Psychiatry. 2004;65(suppl 8):26-35.http://www.ncbi.nlm.nih.gov/pubmed/15153065?tool=bestpractice.com精神疾病,特别是焦虑和抑郁是最常见的合并症。[12]Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry. 1985;42:225-232.http://www.ncbi.nlm.nih.gov/pubmed/2858188?tool=bestpractice.com[17]Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention? JAMA. 1989;262:1479-1484.http://www.ncbi.nlm.nih.gov/pubmed/2769898?tool=bestpractice.com慢性病患者(如糖尿病、冠心病(CAD)、充血性心力衰竭(CHF)、慢性呼吸疾病)的失眠症发生率高于普通人群。[18]Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999;22(suppl 2):S347-S353.http://www.ncbi.nlm.nih.gov/pubmed/10394606?tool=bestpractice.com[19]Ohayon MM, Roth T. What are the contributing factors for insomnia in the general population? J Psychosom Res. 2001;51:745-755.http://www.ncbi.nlm.nih.gov/pubmed/11750297?tool=bestpractice.com[20]Katz DA, McHorney CA. Clinical correlates of insomnia in patients with chronic illness. Arch Intern Med. 1998;158:1099-1107.http://archinte.ama-assn.org/cgi/content/full/158/10/1099http://www.ncbi.nlm.nih.gov/pubmed/9605781?tool=bestpractice.com[21]Mallon L, Broman JE, Hetta J. Sleep complaints predict coronary artery disease mortality in males: a 12-year follow-up study of a middle-aged Swedish population. J Intern Med. 2002;251:207-216.http://www3.interscience.wiley.com/cgi-bin/fulltext/118956209/HTMLSTARThttp://www.ncbi.nlm.nih.gov/pubmed/11886479?tool=bestpractice.com尤其是疼痛障碍似乎与失眠症有特别强的相关性。[16]Benca RM, Ancoli-Israel S, Moldofsky H. Special considerations in insomnia diagnosis and management: depressed, elderly, and chronic pain populations. J Clin Psychiatry. 2004;65(suppl 8):26-35.http://www.ncbi.nlm.nih.gov/pubmed/15153065?tool=bestpractice.com[22]McCracken LM, Iverson GL. Disrupted sleep patterns and daily functioning in patients with chronic pain. Pain Res Manag. 2002;7:75-79.http://www.ncbi.nlm.nih.gov/pubmed/12185371?tool=bestpractice.com疼痛程度升高通常发生在睡眠异常之前,且睡眠困难似乎会加剧疼痛症状。[23]Nicassio PM, Wallston KA. Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. J Abnorm Psychol. 1992;101:514-520.http://www.ncbi.nlm.nih.gov/pubmed/1500608?tool=bestpractice.com