Abstract

Background

Insomnia disorder is a prevalent, often unrecognized condition that affects millions. This clinical disorder is characterized by difficulty initiating or maintaining sleep over a sustained period. In fact, insomnia disorder affects much more than sleep; it increases the risk of developing serious medical and psychiatric comorbidities and can exacerbate existing conditions. The association between insomnia disorder and serious medical and psychiatric comorbidities are complex and directionality is not yet fully understood. There remain gaps in the treatment landscape for insomnia disorder.

Methods

We performed a narrative review of the published literature to identify challenges, unmet needs, and burden associated with insomnia disorder.

Results

In this article, we describe the substantial burden that insomnia disorder poses on patients, the healthcare system, and society in the US. This article explores the factors attributable to this burden including limited provider knowledge, inadequate treatment options, and unknown long-term impacts of off-label treatments.

Conclusions

Several recommendations are proposed to address these challenges and improve patient outcomes through efforts to: (1) establish the societal value of treatment; (2) improve the clinical understanding of insomnia disorder; and (3) prioritize development of and access to effective treatments that do not pose addiction potential or tolerability issues.

中文翻译：

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失眠症的挑战与机遇

摘要

背景

失眠症是一种普遍存在的、经常未被识别的疾病，影响着数百万人。这种临床疾病的特征是难以在持续的时间内开始或维持睡眠。事实上，失眠症的影响远不止睡眠。它增加了发生严重医学和精神疾病的风险，并可能加剧现有状况。失眠症与严重的医学和精神合并症之间的关联是复杂的，方向性尚未完全了解。失眠症的治疗领域仍然存在差距。

方法

我们对已发表的文献进行了叙述性回顾，以确定与失眠症相关的挑战、未满足的需求和负担。

结果

在本文中，我们描述了失眠症对美国患者、医疗保健系统和社会造成的巨大负担。本文探讨了造成这种负担的因素，包括提供者知识有限、治疗选择不足以及标签外治疗的未知长期影响。

结论

提出了几项建议来应对这些挑战并通过努力改善患者预后：（1）确立治疗的社会价值；(2)提高临床对失眠症的认识；(3) 优先开发和获得不会造成潜在成瘾或耐受性问题的有效治疗方法。