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h2:nth-child(1){font-size:35px}.aboutus_37_t b{}.index_title{font-weight:bold}.aboutus_37_t b{font-family:poppins;-webkit-text-stroke-color: #df2219; -webkit-text-stroke-width: 3px; }.hjzf_news_44_wrapper > li:first-child{flex:0 0 22%}.news_44_list_con > div.news_44_list_con_box > div.index_text{display: -webkit-box;-webkit-line-clamp:5;overflow: hidden;-webkit-box-orient: vertical;min-height:auto;margin-top:10%;font-size:14px;line-height:30px}.other_184{background-attachment:fixed}.aboutus_37_right li{}.aboutus_37_t b{}.aboutus_37_right li:before{display:none}.aboutus_37_con> p{text-indent:35px}.index_sub_title{font-family:'Poppins'}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_wrapper > div.foot_contact.text-center > h2{font-family:'Poppins'}.products_52_wrapper_img{}.products_52_wrapper li{}.products_52_wrapper li a{}#products-52_1891 > section > div > div > div > ul > li > a > h2{}.products_52_wrapper li p{}.mobiles_sidebar{margin:0;bottom:30%;margin-right:2%}.foot_contact:before{left:-30px}.index_sub_title a{font-size:20px;font-weight:bold; display: -webkit-box; -webkit-line-clamp: 1; overflow: hidden; -webkit-box-orient: vertical;}.other_184_right{right:0%!important}.HJZF_contact_inquiry{display:none}.hj_navbar_nav > li > a > h2:before{bottom:-10px}.nav_li.on>a h2{color:#666!important}.container-fluid{padding-top:20px;padding-bottom:20px}.other_184_right{padding:4vw!important}.other_184_right>.index_sub_title{font-size:30px}#news-44_1891 > section > div > div > div > ul > li > div > div.index_text{font-size:15px;line-height:30px;}.other_184_right>.con{display: -webkit-box;-webkit-line-clamp: 6;overflow: hidden; -webkit-box-orient: vertical;font-size:16px; }.other_184_pagination{width:90%!important}.banner_27_zyzfw{}#aboutus-23_1891 > section > div > div > div > ul > li:nth-child(4){display:none}.main_page{margin-bottom:30px}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(2) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a33459267b.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li > a{padding-left:40px}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(3) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a3da6b7b25.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(4) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a3de1203e0.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(5) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a3e542b9b2.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(7) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a404e4f07f.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(8) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a40aeb969e.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(9) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a40d9cb427.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(6) > a{background:url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a414b9e0eb.png) no-repeat left}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(1) > a{padding-left:20px}.HJZF_Z__inner_product_categroy5 ul li:nth-child(3).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(3):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a460f311bd.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(2).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(2):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a48b540dfc.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(4).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(4):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a493b84d10.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(5).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(5):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a494b51680.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(6).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(6):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a49a1d87b4.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(7).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(7):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a495a3efa9.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(8).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(8):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a49b8a011c.png) no-repeat left!important}.HJZF_Z__inner_product_categroy5 ul li:nth-child(9).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(9):hover a{background:#df2219 url(/pcuploadfiles/60.247.152.80/webid1891/Mod/202110/617a49d5447bd.png) no-repeat left!important}#aboutus-37_1891 > section > div > div > div:nth-child(2) > ul > li > p{font-size:16px}.other_184_right > .index_sub_title{font-weight:bold}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_b > a:nth-child(5),#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_b > a:nth-child(6){display:none}.foot_contact h2{font-size:28px;line-height:1.5}.HJZF_Z__inner_product_categroy5 li a{padding: 10px 20px 10px 36px;}@media (max-width:1440px) and (min-width:1366px) {.in_banner img{}.hjzf2_z_aboutus_23{}.hjzf2_z_aboutus_23_wrapper li{}.hjzf2_z_aboutus_23_wrapper li:hover{}.aboutus_13_left> .index_text{}.hjzf2_z_aboutus_23 a.more,.hjzf2_z_aboutus_23_text{}#aboutus-23_1891 > section > div > div > div > div.index_title.pb40.text-center.wow.fadeInDown{}.hjzf2_z_aboutus_23_wrapper li span img{}.runlin_banner{}.runlin_banner_left{}.runlin_banner_right{}.runliin_top_email{}.runlin_email.first{}.runlin_des + .more{}.runlin_left li{}.runlin_yiji > span h3{}.submit_runlin_search{}.nav_drop{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > div.runlin_des > b{}.hjzf2_z_products_list_left a.index_btn{}.other_runlin_search{}.runlin_box{}.HJZF_Z__innerContent{}.HJZF_Z__inner_product_categroy5_title{}.HJZF_Z__Breadcrumbs{}body > div:nth-child(5) > div.container > div.HJZF_Z__Breadcrumbs > div > div{}.runlin_banner_right{}.main_newslist3 .newslist_img{}.inner_pro_info{}.inner_pro_info:after{}.runlin_left_inner > div > ul:hover{}.runlin_left_inner{}.runlin_left{}.runlin_left_inner > div > ul:hover span h3{}.index_wrapper{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > a{}#HJZF_Z__innerBanner{}body > div.HJZF_Z__innerBanner.HJZF_Z__innerBanner2{}#HJZF_Z__wrapper > div.HJZF_Z__innerBanner.HJZF_Z__innerBanner2{}.zq_contactus>#HJZF_Z__wrapper>#HJZF_Z__innerBanner{}#payment > div > section.hidden-xs.hidden-sm.hidden-md.col-lg-3.HJZF_Z__inner--left > div > div.HJZF_Z__inner--left__content > div.InsidePages_left_content-main > ul{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > h2:nth-child(1){}.aboutus_37_t b{}.index_title{}.aboutus_37_t b{}.hjzf_news_44_wrapper > li:first-child{}.news_44_list_con > div.news_44_list_con_box > div.index_text{}.other_184{}.aboutus_37_right li{}.aboutus_37_t b{}.aboutus_37_right li:before{}.aboutus_37_con> p{}.index_sub_title{}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_wrapper > div.foot_contact.text-center > h2{}.products_52_wrapper_img{}.products_52_wrapper li{}.products_52_wrapper li a{}#products-52_1891 > section > div > div > div > ul > li > a > h2{}.products_52_wrapper li p{}.mobiles_sidebar{}.foot_contact:before{}.index_sub_title a{}.other_184_right{}.HJZF_contact_inquiry{}.hj_navbar_nav > li > a > h2:before{}.nav_li.on>a h2{}.container-fluid{}.other_184_right{}.other_184_right>.index_sub_title{}#news-44_1891 > section > div > div > div > ul > li > div > div.index_text{}.other_184_right>.con{}.other_184_pagination{}.banner_27_zyzfw{}#aboutus-23_1891 > section > div > div > div > ul > li:nth-child(4){}.main_page{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(2) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(3) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(4) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(5) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(7) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(8) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(9) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(6) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(1) > a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(3).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(3):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(2).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(2):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(4).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(4):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(5).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(5):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(6).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(6):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(7).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(7):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(8).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(8):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(9).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(9):hover a{}#aboutus-37_1891 > section > div > div > div:nth-child(2) > ul > li > p{}.other_184_right > .index_sub_title{}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_b > a:nth-child(5),#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_b > a:nth-child(6){}.foot_contact h2{}.HJZF_Z__inner_product_categroy5 li a{}}@media (max-width:1365px) and (min-width:768px) {.in_banner img{}.hjzf2_z_aboutus_23{}.hjzf2_z_aboutus_23_wrapper li{}.hjzf2_z_aboutus_23_wrapper li:hover{}.aboutus_13_left> .index_text{}.hjzf2_z_aboutus_23 a.more,.hjzf2_z_aboutus_23_text{}#aboutus-23_1891 > section > div > div > div > div.index_title.pb40.text-center.wow.fadeInDown{}.hjzf2_z_aboutus_23_wrapper li span img{}.runlin_banner{}.runlin_banner_left{}.runlin_banner_right{}.runliin_top_email{}.runlin_email.first{}.runlin_des + .more{}.runlin_left li{}.runlin_yiji > span h3{}.submit_runlin_search{}.nav_drop{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > div.runlin_des > b{}.hjzf2_z_products_list_left a.index_btn{}.other_runlin_search{}.runlin_box{}.HJZF_Z__innerContent{}.HJZF_Z__inner_product_categroy5_title{}.HJZF_Z__Breadcrumbs{}body > div:nth-child(5) > div.container > div.HJZF_Z__Breadcrumbs > div > div{}.runlin_banner_right{}.main_newslist3 .newslist_img{}.inner_pro_info{}.inner_pro_info:after{}.runlin_left_inner > div > ul:hover{}.runlin_left_inner{}.runlin_left{}.runlin_left_inner > div > ul:hover span h3{}.index_wrapper{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > a{}#HJZF_Z__innerBanner{}body > div.HJZF_Z__innerBanner.HJZF_Z__innerBanner2{}#HJZF_Z__wrapper > div.HJZF_Z__innerBanner.HJZF_Z__innerBanner2{}.zq_contactus>#HJZF_Z__wrapper>#HJZF_Z__innerBanner{}#payment > div > section.hidden-xs.hidden-sm.hidden-md.col-lg-3.HJZF_Z__inner--left > div > div.HJZF_Z__inner--left__content > div.InsidePages_left_content-main > ul{}body > div:nth-child(5) > div.runlin_banner > div.runlin_box > div > div > div > div > div.runlin_banner_right > h2:nth-child(1){}.aboutus_37_t b{}.index_title{}.aboutus_37_t b{}.hjzf_news_44_wrapper > li:first-child{flex:0 0 100%}.news_44_list_con > div.news_44_list_con_box > div.index_text{}.other_184{}.aboutus_37_right li{}.aboutus_37_t b{}.aboutus_37_right li:before{}.aboutus_37_con> p{}.index_sub_title{}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_wrapper > div.foot_contact.text-center > h2{}.products_52_wrapper_img{}.products_52_wrapper li{}.products_52_wrapper li a{}#products-52_1891 > section > div > div > div > ul > li > a > h2{}.products_52_wrapper li p{}.mobiles_sidebar{}.foot_contact:before{}.index_sub_title a{}.other_184_right{}.HJZF_contact_inquiry{}.hj_navbar_nav > li > a > h2:before{}.nav_li.on>a h2{}.container-fluid{}.other_184_right{}.other_184_right>.index_sub_title{}#news-44_1891 > section > div > div > div > ul > li > div > div.index_text{}.other_184_right>.con{display: -webkit-box;-webkit-line-clamp: 3;overflow: hidden; -webkit-box-orient: vertical; }.other_184_pagination{}.banner_27_zyzfw{}#aboutus-23_1891 > section > div > div > div > ul > li:nth-child(4){}.main_page{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(2) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(3) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(4) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(5) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(7) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(8) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(9) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(6) > a{}body > div:nth-child(10) > div > div > section.hidden-xs.hidden-sm.hidden-md.col-xs-12 > div > ul > li:nth-child(1) > a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(3).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(3):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(2).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(2):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(4).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(4):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(5).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(5):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(6).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(6):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(7).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(7):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(8).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(8):hover a{}.HJZF_Z__inner_product_categroy5 ul li:nth-child(9).on a, .HJZF_Z__inner_product_categroy5 ul li:nth-child(9):hover a{}#aboutus-37_1891 > section > div > div > div:nth-child(2) > ul > li > p{}.other_184_right > .index_sub_title{}#bottom-35_1891 > section > div > div > div > div.hjzf_bottom_35_b > a:nth-child(5),#bottom-35_1891 > section > div 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岁月无声,失眠有痕——老年慢性失眠的药物治疗
  2024/02/26| 阅读次数:882

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拥有婴儿般的睡眠,是老年人最奢求的睡眠质量。俗话常说,老了没瞌睡。其实,很多老年人不是没瞌睡,而是又困乏又睡不着,寂静深夜里这种痛苦困扰着大部分老年人。


长期慢性失眠会导致老年人社会功能下降,跌倒风险及跌倒相关死亡率增加,对老年人的健康和生活质量具有重要影响。


关于老年慢性失眠的西药治疗,我们一起来看看指南怎么说?


一线药物:非苯二氮卓类药物

唑吡坦(A1)

使用唑吡坦5mg~10mg睡前顿服治疗睡眠起始困难及睡眠维持困难性失眠。

主要不良反应包括遗忘、头晕、镇静、头痛、恶心、幻觉及味觉倒错。唑吡坦不规范停药可能出现症状反弹。另外,对于服药时间距起床间隔时间小于8h、使用10mg等较高剂量的患者,起床后可能出现过度困倦,且长期或大量使用宿醉效果和耐受性会增加。

唑吡坦对于伴有慢性阻塞性肺疾病(COPD)和轻中度阻塞性睡眠呼吸暂停(OSA)的老年失眠患者较为安全,首先推荐使用。

右佐匹克隆(A1)


可用于治疗睡眠起始困难(入睡困难)或睡眠维持困难性失眠。睡前顿服剂量1mg~3mg的临床研究支持其有效性。右佐匹克隆的常见不良反应有头晕、口干、头痛、镇静和味觉异常等。与唑吡坦一样,对于COPD及轻中度OSA 失眠患者可首先推荐。

佐匹克隆和右佐匹克隆都是非苯二氮卓类的镇静安眠药物,右佐匹克隆是佐匹克隆的右旋单一异构体,人体对其耐受较好、不容易中毒,而且其对改善睡眠的效果也更好,所以现在临床上更常使用右佐匹克隆。佐匹克隆和右佐匹克隆都有中枢抑制作用,由于起效比较快,所以应在睡前服用。服药后的第2天应谨慎从事一些危险性的动作,比如操作仪器或者是驾驶等。这两种药物都不能与酒精同服。



苯二氮卓类药物(B2)

患有OSA、COPD、肝肾功能不全、共济失调、肌肉疾病的患者应慎用。对于高碳酸血症明显的COPD 和限制性通气障碍失代偿期患者禁用。


艾司唑仑(B2)

1mg-2mg,睡前服用。通过抑制中枢神经发挥助眠作用,在临床治疗老年失眠中广泛应用。老年人对本药较敏感,开始时用小剂量,并注意调整剂量。


阿普唑仑(B2)

开始时用小剂量,0.2mg/次,睡前服用。
常见不良反应有嗜睡、头昏、乏力等。如果伴随的焦虑症状不明显,白天尽量不要用此药,可适当增加白天活动。


氯硝西泮(C2)

一般0.5mg~1mg/次,睡前 10min服用。
常见不良反应有嗜睡、头昏、共济失调、行为紊乱、异常兴奋、神经过敏易激惹(反常反应)、肌力减退。老年人中枢神经系统对本品较敏感,应谨慎使用。

地西泮(C2)

2.5mg~5mg,睡前服用。
不良反应常见头晕、头痛等,并存在药物依赖性和成瘾性,在药物骤停后易出现精神障碍。目前临床上一般不用于治疗失眠。


劳拉西泮(B2)

每日剂量为1mg~2mg,单次服用,入睡前给药。
常用于治疗焦虑及其伴发的失眠。


褪黑素类药物(B1)

褪黑素是由松果体产生的胺类激素,其分水平受外界光线强度影响,具有诱导睡眠的作用。褪黑素缓释剂能够补充部分生理状态下褪黑素水平的降低,主要用于治疗年龄大于55岁的中老年慢性失眠患者。

近年来针对褪黑素受体研发的一些药物,如雷美替胺、阿戈美拉汀,能够缩短睡眠潜伏期,后者还具有调整昼夜节律和抗焦虑等方面的作用。雷美替胺可以改善COPD及轻中度OSA 失眠患者的睡眠质量,且不增加呼吸紊乱事件,耐受良好。


食欲素受体拮抗剂(A1)

可用于治疗睡眠维持困难性失眠(夜间觉醒或早醒)患者,但目前在国内未上市。


抗抑郁药物

多塞平(B2)

3mg及6mg顿服可用于治疗睡眠维持困难性失眠。
不良反应多见体位性低血压、心动过速、房室传导阻滞、口干、瞳孔散大、视力模糊、腹胀、 便秘、尿潴留、皮肤干燥、面部潮红等。老年人应谨慎使用。

曲唑酮(B1)


剂量(25mg~50mg)开始。常见不良反应:低血压。


米氮平(B1)

3.75mg~15.00mg/d,用于老年抑郁伴失眠患者。体重增加的副作用明显,肥胖的老年人慎用。


氟西汀、帕罗西汀、舍曲林、西酞普兰、氟伏沙明、艾司西酞普兰(B1)

通过治疗抑郁和焦虑障碍而改善失眠症状,一般建议在白天使用。


文拉法辛、度洛西汀(B1)

通过治疗抑郁和焦虑障碍而改善失眠症状,适用于疼痛伴随失眠的患者。一般建议在白天使用。

温馨提示:


由于老年人对药物的反应、代谢和排泄都与中青年人不同,老年人的治疗药物选择应尽量遵循以下原则:


  • 起始剂量为最低有效剂量

  • 疗程尽可能短

  • 可酌情安排间歇给药

  • 尽可能选择半衰期较短和白天镇静作用较少的药物

  • 能单用则不联用


我们提倡老年人在遇到健康问题时,首先应该选择到正规医院就医,并在专业医师的指导下,治疗、用药。


参考文献:中国老年学和老年医学学会.老年慢性失眠慢病管理指南.中西医结合研究,2023,15(5):311-324.



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