非苯二氮䓬类药物治疗失眠共病睡眠呼吸暂停的临床效果评价研究新进展  

Advance in Evaluation of the Clinical Efficacy of Non-benzodiazepine Drugs in Treating Comorbid Insomnia and Sleep Apnea

作　　者：董孟龙 林志烽 范孟孟 薛盛文 刘宇航 王怡 程金湘 DONG Menglong;LIN Zhifeng;FAN Mengmeng;XUE Shengwen;LIU Yuhang;WANG Yi;CHENG Jinxiang(Department of Neurology,the Second Affiliated Hospital of Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院神经内科,陕西省西安市710038

出　　处：《中国全科医学》2024年第35期4388-4396,共9页Chinese General Practice

基　　金：国家重点研发计划“常见多发病防治研究”专项(2021YFC2501400,2021YFC2501405)。

摘　　要：失眠共病睡眠呼吸暂停(COMISA)是一种高患病率的临床综合征,其特点是同时伴有失眠和阻塞性睡眠呼吸暂停,且相比单独失眠或睡眠呼吸暂停(OSA)患者,其导致的日间功能和生活质量的损害更为严重。非苯二氮䓬类药物(NBZDs)可改善失眠症状、提高睡眠质量,是治疗失眠的一线用药,但因其可能会增加呼吸暂停低通气指数(AHI)和恶化OSA严重程度而不推荐用于OSA治疗。目前,NBZDs对COMISA的治疗效果尚不明确,还有待深入研究。因此,本文采用系统回顾的方式,整理了OSA和COMISA患者使用NBZDs的相关文献,分析NBZDs对AHI、氧减指数、睡眠质量等多个指标的影响,评价了佐匹克隆、右佐匹克隆、唑吡坦及扎来普隆等药物治疗的临床效果及安全性,旨在为COMISA患者如何合理使用NBZDs提供借鉴。Comorbid insomnia and sleep apnea is a highly prevalent disorder characterized by both insomnia and sleep apnea,leading to more severe impairment of daytime function and quality of life than in patients with either insomnia or obstructive sleep apnea(OSA)alone.Non-benzodiazepine drugs(NBZDs)are frontline medications for insomnia treatment,as they can improve insomnia symptoms and enhance sleep quality.However,they are not recommended for OSA treatment due to their potential to increase the apnea-hypopnea index(AHI)and worsen the severity of sleep-disordered breathing.Currently,the therapeutic effects of NBZDs on COMISA are not well-established and require further investigation.Therefore,this article adopts a systematic review approach to compile relevant literature on the use of NBZDs in patients with OSA and COMISA,analyzing the impact of NBZDs on various indicators such as AHI,oxygen desaturation index,and sleep quality.It evaluates the clinical efficacy and safety of medications including zopiclone,eszopiclone,zolpidem,and zaleplon in the treatment of COMISA,aiming to provide guidance on the rational use of NBZDs for these patients.

关 键 词：失眠共病睡眠呼吸暂停 佐匹克隆 右佐匹克隆 唑吡坦 扎来普隆 综述 

分 类 号：R741[医药卫生—神经病学与精神病学] R563.8[医药卫生—临床医学]