What Is Insomnia? Symptoms, Causes, Diagnosis, Treatment, and Prevention

您知道睡眠不好的一夜会让您感到多么糟糕。现在将一个糟糕的夜晚乘以几周甚至几个月，很容易理解为什么失眠能给人们造成巨大的身心损失。

经过definition, even having just a few restless night of sleep qualifies as a bout of insomnia, per the National Heart, Lung, and Blood Institute. (1）In and of itself, a night or two of bad sleep isn’t a critical problem. But one or two nights of bad sleep can easily turn into a persistent problem. And it’s the repetitive nights of continued sleep woes that are the biggest drain on the body and brain.

有关的：当您不睡觉时，您的身体和思想会发生什么

If you struggle to sleep, you’re not alone. Estimates suggest approximately 10 percent of adults suffer from chronic insomnia and between 15 and 35 percent of adults suffer from some level of short-term insomnia lasting anywhere from a few days to up to three months, according to the American Academy of Sleep Medicine. (2）

这些数字令人担忧，因为睡眠是身体健康的基础之一。如果您没有得到所需的沉睡，则可能会危及健康。

有关的：How Much Sleep Do You Really Need Each Night?

“流行病学研究表明,缺乏睡眠s associated with obesity, diabetes, and heart disease, even老年痴呆症，”说Sara Nowakowski，博士，是加尔维斯顿德克萨斯大学医学分公司的临床心理学家和睡眠研究员。失眠的其他后果包括增加精神病和机动车事故的风险。在健康方面，她补充说：“睡眠与饮食和其他生活方式行为一样重要。”

That’s why dealing with insomnia and getting the help you need is critical. So how do you know if you have insomnia, and how do you treat it if you do have it? Read on to get answers to your most pressing questions.

What Is Insomnia: Defining Both Acute and Chronic Insomnia

失眠是最常见的睡眠障碍。与许多其他医疗状况不同，它具有相对简单的定义。“失眠意味着无法入睡，”神经科医生的医学博士Gerard J. Meskill说sleep disorders休斯敦的全面睡眠医学伙伴专家。失眠的特征包括无法入睡，整夜都不会睡着，并且早晨醒来。

更具体地说，有两种类型的失眠：急性和慢性。急性失眠意味着您仅在短时间内睡觉，即使这仅意味着一晚。梅斯基尔博士说：“实际上，每个人都会偶尔会急性失眠。”但是，根据日记的一项研究胸部。（（3）

Acute insomnia can still be a problem, however, because if ignored and not addressed it can lead to longer-term chronic insomnia.

Chronic insomnia is more severe and involves difficulty sleeping three or more days per week over the course of three months. Individuals with chronic insomnia also report disruptions in their daytime functioning, including sleepiness, irritability, or anxiety, or difficulty paying attention, focusing on tasks, or remembering, Dr. Nowakowski says.

While acute insomnia can usually be solved without professional help, the same isn’t true forpeople with chronic insomnia。These individuals need to work with a trained professional, and the sooner they bring someone on board, the more quickly they can stop problems from becoming even more severe and thus taking longer to solve.

了解有关急性和慢性失眠的更多信息

Determining if you have insomnia usually isn’t difficult. In most cases, you know if you’re not sleeping well. “Most patients see me already knowing their diagnosis,” Meskill says.

But there are also some people who may not be aware that they have insomnia. “It’s possible that these people have so much going on that they might perceive symptoms of daytime fatigue as a result of other chronic health conditions or a busy schedule,” she says.

Taking 30 minutes or longer to fall asleep at night suggests you have insomnia, according to MedlinePlus. (4）当涉及到深夜觉醒时，大多数人每天晚上都有一些。但是，如果您的持续时间超过几秒钟或几分钟（也就是说，您已经完全清醒并且无法入睡 - 这表明失眠，约翰·霍普金斯医学（Johns Hopkins Medicine）指出。（（5）

在您打算（因此，缩短夜晚的总睡眠时间）的清晨醒来也可能是失眠的标志。（1）

请记住，成人每晚需要七个或更长时间的睡眠时间。睡眠需求有个体差异：有些人只需要七个小时就能感到完全休息，而另一些人则需要接近九个小时。而且每个人都会不时睡个好觉。但是，如果您经常上床睡觉后仅四到五个小时醒来，这是一个问题，这是一个问题，疾病控制与预防中心（CDC）说。（（6）

除了难以在晚上入睡，入睡或太早醒来外，常见的失眠症状包括：（2）

• Fatigue
• 聚焦或集中的问题
• Poor memory
• Mood disturbance
• Daytime sleepiness
• 低动力或能量
• Increased errors or accidents

If you’re at all concerned about your sleep issues, talk with your doctor. Your doctor can then direct you to a qualified sleep specialist.

Learn More About the Symptoms of Insomnia

失眠不仅有一个原因 - 可能是由许多因素引起的。

根据国家睡眠基金会的说法，这些原因可以包括：（7）

• Medical conditions, such as arthritis, asthma, chronic pain,睡眠呼吸暂停，，，，and neurological conditions (includingParkinson’s disease）
• Medication
• Psychiatric conditions, such as depression, anxiety,schizophrenia，，，，attention deficit hyperactivity disorder (ADHD)，，，，and躁郁症（（失眠can also contribute to or raise your risk for焦虑和抑郁。）
• Dietary habits, such as consuming heavy meals too close to when you go to sleep, or consuming too much caffeine or alcohol
• Nicotineuse
• 时差
• 不健康的睡眠习惯，例如不一致或不规则的睡眠时间表

有关的：How to Fix Your Sleep Schedule

To better understand how insomnia develops and its causes in a specific individual, sleep experts often use what’s called the “Spielman model” or “3P behavioral model” of insomnia. It helps sleep doctors chart various factors that might触发失眠，，，，and account for any possible contributing causes.

Per past research, here’s what each “P” means, and how each can potentially contribute to insomnia: (8）

1. 诱发因素该类别包括大多数心理，生物学和社会因素，这些因素可能会使您更容易失眠。For example, anxiety, being a woman (because statistics show insomnia is more common in women than in men), and hyperarousal (meaning that you’re at greater risk of anxiety or have a higher wake drive than normal) are all predisposing psychological or biological factors. Predisposing social factors include an unconventional work schedule, and also a bed partner whose sleep schedule doesn’t align with yours, notes previous research. (9）
2. Precipitating FactorsThese are new and often stress-related events that trigger insomnia. For instance, you might be dealing with stress at work, financial worries, bad news about something important in life, or travel. Pain, depression, illnesses, and medication may also play into this, and all of these factors can lead to chronic insomnia. Note though, that an ongoing medical issue, like chronic pain or untreatedobstructive sleep apneaMeskill说，可以作为沉淀和永久性因素。
3. 永久因素These are generally behaviors or beliefs people have adopted that either maintain their sleep difficulties or make them worse, all of which perpetuate chronic insomnia. This could include changes in daytime behaviors — many people take naps or try to sleep in later, which can in some cases make insomnia worse — or beliefs about sleep that fuel the insomnia flame. For instance, people with insomnia often develop anxieties connected to their bed, fear about not sleeping, and even worries about how lack of sleep will affect their daytime routines. Medical issues, as Meskill mentioned above, can also fall into this category.

尽管在某些情况下，这些原因中的任何一种可能是有问题的，可以引发失眠，但对于大多数难以入睡的人来说，这些类别中的各种因素的结合都会导致失眠。

Learn More About What Causes Insomnia

在许多情况下，您的医生将能够告诉您是否仅通过与您交谈而患有失眠。除了讨论您的医学和家族史外，您的医生还会询问您的睡眠习惯和模式。描述症状时，重要的是要与医生清晰清晰。

To help with this, many sleep experts recommend that you keep an accurate sleep journal or “sleep history” for two weeks (or more) before visiting a doctor to talk about your insomnia, notes the Cleveland Clinic. (10）在上床睡觉时写下，大约需要多长时间才能入睡，醒来时，以及任何中晚上觉醒的频率和持续时间。所有这些信息都可以帮助您的医生确定您是否患有失眠以及如何最好地管理它。（（Note: Write all of this information down in the morning, after you’ve gotten up for the day. If you’re trying to document middle-of-the-night arousals as they happen, you could be making the awakenings worse.)

大多数情况下，您的初级保健提供者可以评估和诊断这些失眠的症状。He or she may, however, refer you to a sleep specialist if your symptoms are complex, or for certain treatments.

Your doctor or sleep specialist will also likely perform a medical exam. Your doctor will listen to your heart and lungs, and perform other routine screening measures for health problems that could be causing your insomnia.

Your doctor may also order some follow-up tests that can help determine the cause of your insomnia. These could includeblood teststo check for medical issues or an actigraphy test, a small device that you wear while sleeping to measure your sleeping patterns. (1)

失眠doesn’t mean you don’t sleep at all; it can come and go from night to night, week to week, or month to month. You might experience several weeks or months of poor sleep, followed by a period of relatively easeful slumber.

Again, doctors tend to differentiate between “acute” and “chronic” insomnia based on its duration. Chronic insomnia is three or more nights of poor sleep each week for a period of three months or longer. Acute insomnia is anything that falls below those time thresholds.

对于那些处理慢性失眠症的人，研究发现复发很普遍。2019年8月发表在《期刊》上的一项研究Sleep发现，在康复的慢性失眠症患者中，大约57％的人在四年内复发。（（11）

在注意到失眠症状后，改变行为并获得治疗（如有必要）尽快解决该问题可以帮助缩短持续时间。继续在睡眠周围练习健康的习惯（例如坚持一致的床和唤醒时间，并在睡觉前限制筛查）也有助于使失眠症复发。（1）

失眠sufferers, especially those with the chronic type, might feel like there’s no hope in sight. “Many people think they’re broken and can’t be fixed,” Nowakowski says. Yet the good news is that insomnia can be overcome and sufferers really can learn how to sleep again, as current treatment therapies are highly effective. It just takes time, patience, and some effort.

For people with acute insomnia, tried-and-true sleep hygiene strategies, like keeping consistent wake and sleep times, avoiding stimulating activities before bed, and shutting down electronic devices 30 to 60 minutes before bed, usually help sleep problems and often alleviate them completely. They’re the same strategies that, unsurprisingly, are recommended to prevent insomnia.

Meskill说，一旦睡眠问题变得长期慢性，这些策略在扭转睡眠困难方面并不那么有效 - 尽管通常仍然建议它们以防止失眠变得更糟并帮助其他治疗更有效。

Cognitive Behavioral Therapy

Although prescription medication may be used in some cases,失眠的认知行为疗法（（CBTi) — a type of psychotherapy or talk therapy — is now considered the gold standard for chronic insomnia treatment. “CBTi is generally recommended as first-line therapy for chronic insomnia,” saysSheila Tsai, MD，，，，pulmonologist and section head of sleep medicine at National Jewish Health in Denver.

With CBTi, you’re essentially retraining your brain and body on how to sleep. “People with chronic insomnia develop an aversion to their bed and bedroom and the act of sleeping,” Meskill says. CBTi works to erase that aversion by training people to use techniques specifically targeting the psychological factors associated with insomnia, such as having negative emotions and worries about not being able to sleep.

CBTI可以涉及呼吸技术，肌肉放松做法以及其他可以帮助您入睡的补充疗法。它还可能涉及改变您的睡眠套路或卧室环境，从而促进健全的睡眠。（1）

Although doing CBTi with a trained specialist in person is the best option, online programs can also be effective, especially with people who are self-motivated and highly disciplined, or who live someplace where there is no CBTi specialist, Meskill says.

克服慢性失眠需要多长时间取决于每个人。对于某些人来说，这种疗法可能会在短短几周内逆转睡眠问题，而另一些则需要几个月的时间。Nowakowski说，就像其他健康状况一样，也有复发的机会，这就是为什么要记住您在CBTI中学习的行为技能并在睡眠再次开始破坏时进行练习的行为技巧很重要的原因。

药物选择

处方sleeping pillsdo play a role in insomnia management, but they should be used with caution and only for a short period of time. They can come with serious side-effects and they can be habit forming if relied on for too long, notes the Mayo Clinic. (12）“Taking these on a frequent basis can lead to physical dependency, so that when you go to sleep you need more to fall asleep or just can’t sleep without them,” Dr. Tsai says.

Benzodiazepines，催眠和orexin receptor antagonists根据Mayo诊所，所有可以养成习惯的药物。（（13）

尽管如此，药物还是有助于防止短期失眠变成慢性问题，或者为了帮助慢性失眠症患者开发更健康的睡眠方式。这个想法是，您使用药物几个晚上来恢复健康的睡眠时间表，然后在您陷入良好的常规中后放下药丸。

许多人还伸手去拿式睡眠辅助工具，例如melatonin。Our bodies naturally produce melatonin, a hormone that triggers a series of reactions that help our brains and bodies fall asleep. It’s available as a supplement and does not carry the same risk as other prescription sleep aids of becoming addictive, according to past research. (14）

了解有关失眠治疗和疗法的更多信息

预防失眠

压力and anxiety are potent sleep slayers. If the stuff you’re doing before bed (or while you’re in bed) causes you to feel anxious — whether you’re watching the news, sending work emails, or scrolling your social media feeds — you’ll want to avoid those activities before they start messing with your slumber, notes the Anxiety and Depression Association of America. (15）

除了避免焦虑触发因素外，这些习惯或行为还可以帮助您保持睡眠状况：

• 每天都在同一时间起床，即使在周末
• 定期体力活动，，，，which includes walking and other low-impact exercises (but avoid vigorous exercise too close to bedtime, which tends to wake up and energize your body)
• Avoid taking long or frequent naps
• 限制您的咖啡因和酒精摄入量
• 睡觉前不要吃重饭
• 避免尼古丁

最后，创建一致的就寝时间仪式可能会有所帮助，这有助于向您的大脑和身体发出信号，表明该睡觉了。Mayo Clinic说，您可能正在洗澡，然后读书，或者做一些轻便的瑜伽并听音乐。（（16）

As mentioned above, mental health problems, such as depression or anxiety, can fuel insomnia. It makes sense that if you have a lot of anxiety, it will be tougher to relax and fall asleep. But poor sleep can contribute to mental health problems, too.

睡眠在维持大脑健康中起关键作用。研究表明，这些功能之一是每晚将毒素从大脑中清除。（（17）睡眠还可以补充脑细胞中的能量储存。因此，根据过去的研究，睡眠中断会对大脑的日常过程造成严重破坏，例如思考和调节您的情绪，这可能导致心理问题。（（18，，，，19）

睡眠不良的影响并未降级到大脑。从研究中有证据表明，失眠可能会以促进肥胖和高血压的方式破坏食欲和激素。（（20）

Chronic insomnia has also been linked to increased risk of the following problems: (1)

• Asthma
• Heart disease
• 怀孕并发症
• 慢性疼痛恶化
• 削弱了免疫系统

了解有关睡眠与心理健康之间复杂关系的更多信息

大约25%的人口的经历t least one bout of acute insomnia each year, according to a 2018 study from the University of Pennsylvania. That same study also found that about 1 in 4 of these folks will develop persistent or chronic insomnia. (21）

国家睡眠基金会报告说，由于研究的患病率高达10％至30％，慢性失眠可能会更加普遍。（（22）

Statistics on “short sleep,” meaning those who sleep less than seven hours each night, find that men are very slightly more likely to get insufficient sleep than women. Also, people who are obese, as well as those who smoke or who do not exercise, are much more likely to sleep less than seven hours compared with people who do not check those boxes, according to the CDC. (23）

一些the latest research on insomnia has looked at its connections with other diseases or disorders, and especially diseases of the nervous system and brain. For example, there’s evidence that insomnia is both an early warning sign and a possible contributor to brain diseases like Alzheimer’s, notes the National Sleep Foundation. (24）

还有一些研究表明，即使弹奏钢琴（例如弹奏钢琴），也可以帮助您学习。（（25）

Sleep is so important to overall health that a lack of it is linked, directly or indirectly, to almost every health condition. In some cases, insomnia is thought to be a cause or contributing factor to a condition — or makes others symptoms worse. And for many conditions, other symptoms (like pain, anxiety, itching, and胃灼热，除其他许多）使入睡和导致失眠更加困难。

失眠最紧密相关的某些条件包括（14）：

• 心理健康障碍，包括抑郁和焦虑
• 高血压和心脏病
• Cancer
• Chronic pain
• Parkinson’s disease
• 阿尔茨海默氏病
• Thyroid disorders
• Obesity

失眠Can Affect Anyone — Even the Rich and Famous

每个人都容易受到影响stressors以及可能引发失眠的生活方式习惯。RenéeZellweger说，作为演员的即时行程和旅行给她带来了睡眠问题。金·卡特尔（Kim Cattrall）由于与失眠症的斗争而不得不取消表演。

他们的故事和其他备受瞩目的人的故事提醒我们，无论一天预订什么都需要睡觉。

了解更多与我们其他人一样与失眠作斗争的名人的更多信息

Favorite Orgs for Essential Insomnia Info

American Academy of Sleep Medicine (AASM)

The mission of the AASM is to promote health by promoting better sleep. The organization carries out this mission through advocacy, education, and research, and by publishing practice standards. The AASM website includes information for sleep medicine providers and insomnia patients about cognitive behavioral therapy for insomnia, as well as information on advocacy efforts.

American Sleep Association

The American Sleep Association is a nonprofit dedicated to improving public health by promoting awareness about the importance of sleep and facts about sleep disorders. You’ll find information on sleep health in general along with insomnia.

国家睡眠基金会

国家睡眠基金会着重于促进健康和福祉的睡眠教育和倡导。请查看基金会的网站，了解有关失眠和其他睡眠障碍的信息，以及有关每个人都应该知道的健康睡眠的提示。

最喜欢的失眠倡导小组

项目睡眠

项目睡眠是非营利组织，致力于提高睡眠障碍意识并为睡眠障碍者提供帮助。该集团奖励奖学金旨在为患有睡眠障碍的学生提供奖学金，并举办活动以提高人们对睡眠障碍的认识和睡眠健康的重要性。该小组还传播有关如何支持睡眠障碍研究的信息。

Favorite Insomnia Telemedicine Resources

aasm sleeptm

AASM’s SleepTM is a telemedicine system designed to connect sleep medicine professionals, accredited sleep centers, and medical equipment providers with patients who would otherwise not have access to these types of specialists. Appointments take place via video conferencing. There’s an option to incorporate your personal sleep data from SleepTM’s unique sleep tracking app.

Favorite Insomnia Blogs and Podcasts

睡眠医生

睡眠医生博客由临床心理学家迈克尔·J·布鲁斯（Michael J.查找Breus博士的博客文章有关新的失眠研究，管理睡眠障碍的技巧以及睡眠卫生建议，以帮助防止问题开始。Breus还发布了他推荐的睡眠设备和产品列表。

Favorite Products and Tech for People Who Have Trouble Sleeping

更好的睡眠委员会（BSC）

The Better Sleep Council is the consumer-education arm of the国际睡眠产品协会（（the organization of mattress and bedding manufacturers that represents the sleep products industry). BSC’s purpose is to provide education for consumers about sleep, health, and the products that are involved (like mattresses, bedding, and more). BSC is run by bedding and sleep experts across the mattress and bedding industry. Find resources on the site about how to pick out a mattress, mattress upkeep, what else in your bedroom promotes a good night’s sleep, and more.

Pzizz

Pzizz is a noise machine app that personalizes a mix of music optimized for sleep, voice narrations, and sound effects for each user. Your unique “playlist” is developed according to clinical sleep interventions and psychoacoustics research. The audio sequence you hear is intended to help quiet your mind and help you sleep.

Relax & Sleep Well

这个催眠和冥想应用程序是由自助音频作者格伦·哈罗德（Glenn Harrold）创建的。该应用程序具有催眠疗法和冥想录音，旨在减轻压力和焦虑，并帮助您入睡。该应用程序被评为顶级睡眠应用程序之一American Sleep Association。

以及其他报告马克汉姆·海德（Markham Heid）。