Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-11T09:59:41.180Z Has data issue: false hasContentIssue false
  • English
  • Français

Repercusiones para la salud pública y tratamiento del insomnio

Published online by Cambridge University Press:  12 May 2020

W. C. Dement  and
R. Pelayo
W. C. Dement
Affiliation:
Centro de Investigación de los Trastornos del Sueño de la Universidad de Stanford, Palo Alto, EEUU
R. Pelayo
Affiliation:
Centro de Investigación de los Trastornos del Sueño de la Universidad de Stanford, Palo Alto, EEUU
Get access

Resumen

Un número creciente de personas está preocupado por su sueño en Estados Unidos. Hay una cantidad estimada de 40 millones de ciudadanos estadounidenses con trastornos crónicos del sueño. El coste de los trastornos del sueño para la sociedad se ha estimado en más de 90.000 millones de dólares estadounidenses. A pesar de este enorme coste para la sociedad, la falta de atención al manejo médico de este problema sigue siendo muy extendida. Esto se combina con una financiación inadecuada de la investigación de los trastornos del sueño. Se dispone de tratamientos para mejorar el insomnio. Estos tratamientos incluyen diferentes regímenes conductuales y farmacológicos que se pueden utilizar por separado o en combinación. El tratamiento acertado requiere un conocimiento completo del diagnóstico diferencial del insomnio. El mayor reto de salud pública en el manejo del insomnio es cómo desarrollar programas educativos efectivos que permitan al público general mejorar su sueño. Esto requerirá mayor cooperación de los suministradores de asistencia primaria y el gobierno. Los trastornos del sueño son el problema de salud pública más importante no consignado en los Estados Unidos.

Keywords

insomniotrastornos del sueñosalud públicaepidemiologíaterapéuticahipnóticos
Type
Revisión
Information
European Psychiatry (Ed. Española) , Volume 4 , Issue 7 , October 1997 , pp. 421 - 431
Copyright
Copyright © European Psychiatric Association 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografia

Atlas Task Force. Recording and scoring leg movements. Sleep 1993; 16 (8): 748–59.Google Scholar
Bartholini, C. Growing aspects of hypnotic drugs. In: Sauvanet, IP et al, eds. Imidiazopyridincs in Sleep Disorders. New York: Raven Press, 1988: 1–9Google Scholar
Besset, A, Tafti, M, Villemin, E, Borderies, P, Billiard, M. Effects of zolpidem on the architecture and cyclical structure of sleep in poor sleepers. Drugs Exp Clin Res 1995; 2 (4): 161–9.Google Scholar
Bliwise, DL. Treating insomnia: pharmacological and nonpharmacological approaches. J Psychoactive Drugs 1991; 23 (4) 335–41.CrossRefGoogle ScholarPubMed
Brooks, JO3d, Friedman, L, Bliwise, DL, Yesavage, JA. Use of the wrist actigraph to study insomnia in older adults. Sleep 1993; 16 (2): 151–5.CrossRefGoogle ScholarPubMed
Chambers, MJ. Actigraphy and insomnia: a closer look. Sleep 1994; 7 (5): 405–8.CrossRefGoogle Scholar
Czeisler, CA, Alian, JS, Stogatz, et al. Bright light resets the human circadian pacemaker independent of the sleepwake cycle. Science 1986; 233: 667–71.CrossRefGoogle Scholar
Diagnostic Classification Steering Committee, Thropy, MJ, Chairman. International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester, Minnesota: American Sleep Disorders Association, 1990.Google Scholar
Ferber, RA. Solve your Child's Sleep Problem. New York: Simon and Schuster, 1985.Google Scholar
Gallup Organization: Sleep in America: a National Survey of US Adults. Princeton, NJ, 1991.Google Scholar
Gallup Organization. Doctors’ (300) Experience and Behavior with Insomnia Patients. The Gallup Organization, 1993: 1–97Google Scholar
Gallup Organization. Sleep in America: 1995. The Gallup Organization, November, 1995.Google Scholar
Gillin, JC, Spinweber, CL, Johnson, LC. Rebound insomnia: a critical review. J Clin Psychopharmacol 1989; 9: 161–72.CrossRefGoogle ScholarPubMed
Guilleminault, C, Clerk, A, Black, Jet al. Non-drug treatment triais in psychophysiologic insomnia. Arch Intern Med 1995; 155 (8): 838–44.CrossRefGoogle Scholar
Haimov, I, Lavie, P, Laudon, Met al. Melatonin replacement therapy of elderly insomniacs. Sleep 1995; 18 (7) : 598–603.CrossRefGoogle ScholarPubMed
Hauri, PJ, Wisbey, J. Wrist actigraphy in insomnia. Sleep 1992; 15 (4): 293–301.CrossRefGoogle ScholarPubMed
Hohagen, F, Rink, K, Kappler, Cet al. Prevalence and treatment of insomnia in general practice. A longitudinal study. Euro Arch Psychiatry Clin Neurosci 1993; 242 (6): 329–36.CrossRefGoogle ScholarPubMed
Jan, JE, Espezel, H, Appleton, RE. The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994; 36 (2): 97–107.CrossRefGoogle ScholarPubMed
Kaplan, PW, Alien, RP, Buchholz, DW, Walters, JK. A double- blind, placebo-controlled study of the treatment of periodic limb movements in sleep using carbidopa/levodopa and propoxyphene. Sleep 1993; 16 (8) : 717–23.CrossRefGoogle ScholarPubMed
Medical Letter. The Melatonin. 1995; 37 (962): 111–12.Google Scholar
Merlotti, L, Roehrs, T, Zorick, F, Roth, T. Rebound insomnia: duration of use and individual differences. J Clin Psychopharm 1991; 11 (6): 368–73.CrossRefGoogle ScholarPubMed
Morin, CM, Culbert, JP, Schwartz, SM. Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry 1994; 151: 1172–80.Google ScholarPubMed
National Commission on Sleep Disorders Research: Wake up America. Dement, WC, Chairman. Washington, DC: National Institute of Health, 1993.Google Scholar
O’Keeffe, ST, Noel, J, Lavan, JN. Restless legs syndrome in the elderly. Postgrad Med J 1993; 69 (815): 701–3.CrossRefGoogle ScholarPubMed
Oboler, SK, Prochazka, AV, Meyer, TJ. Leg symptoms in outpatient veterans. West J Med 1991; 155 (3): 256–9.Google ScholarPubMed
Ohayon, M, Caulet, M. Insomnia and pyschotropic drug consumption. Prog Neuropsychopharmacol Biol Psychiatry 1995; 19 (3): 421–31.CrossRefGoogle Scholar
Partinen, M. Epidemiology of sleep disorders. In; Kryger, M, Roth, T, Dement, WC, eds. Principais and Practice o f Sleep Medicine. Philadelphia: WB Saunders, 1994: 426–36Google Scholar
Pillitteri, JL, Kozlowski, LT, Person, DC, Spear, ME. Overthe- counter sleep aids: widely used but rarely studied. J Subst Abuse 1994; 6 (3); 315–23.CrossRefGoogle Scholar
Practice parameters for the use of actigraphy in the clinical assessment of sleep disorders. Sleep 1995; 18 (4): 285–7.CrossRefGoogle Scholar
Practice parameters for the use of polysomnography in the evaluation of insomnia. Sleep 1995; 18 (1): 55–7.Google Scholar
Radecki, SE, Brunton, SA. Management of insomnia in office-based practice. National prevalence and therapeutic pattems. Arch Family Med 1993; 2 (11): 1129–34.CrossRefGoogle Scholar
Reite, M, Buysse, D, Reynolds, C, Mendelson, W. The use of polysomnography in the evaluation of insomnia. Standards of Practice Committee, American Sleep Disorders Association. Sleep 1195; 18 (1); 58–70.CrossRefGoogle Scholar
Roehrs, T, Merlotti, L, Zorick, F, Roth, T. Rebound insomnia in normais and patients with insomnia after abrupt and tapered discontinuation. Psychopharmacology 1992; 108: 67–71.CrossRefGoogle Scholar
Rosekind, MR. The epidemiology and occurrence of insominia. J Clin Psychiatry 1992; 53 (suppl): 4–6.Google Scholar
Roth, T, Roehrs, T, Vogel, G. Zolpidem in the treatment of transient insomnia: a double-blind, randomized comparison with placebo. Sleep 1995; 18 (4): 246–51.CrossRefGoogle ScholarPubMed
Sadeh, A, Hauri, PJ, Kripke, DF, Lavie, P. The role actigraphy in the evaluation of sleep disorders. Sleep 1995; 18 (4): 288–302.CrossRefGoogle ScholarPubMed
Shorr, RI, Bauwens, SF. Diagnosis and treatment of outpatient insomnia by psychiatric and nonpsychiatric physicians. Am J Med 1992; 193 (1): 78–82.CrossRefGoogle Scholar
Sloan, EP, Hauri, P, Bootzin, R, Morin, C, Stevenson, M, Shapiro, CM. The nuts and bolts of behavioral therapy for insomnia. J Psychosom Res 1993; 37 (suppl 1): 19–37.CrossRefGoogle ScholarPubMed
Spielman, AJ, Saskin, P, Thorpy, MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep 1987; 10 (1): 45–56.Google ScholarPubMed
Stoller, MK. Economic effects of insomnia. Clin Ther 1994; 16: 873–96.Google ScholarPubMed
Young, T, Palta, M, Dempsey, Jet al. Occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230–35.CrossRefGoogle ScholarPubMed