睡眠日必备知识 睡眠障碍最详细国际分类

1979年，美国睡眠障碍中心协会和睡眠心理生理研究协会发表了睡眠和唤醒障碍诊断标准。后来由美国、欧洲、日本和拉丁美洲等国家和地区的睡眠学会在此基础上进行整理修订，形成了睡眠障碍的国际分类(intemational classification of sleep disorders，ICSD)。1997年又在原来版本的基础上进行了修订，增加了许多新的内容。新的国际分类将睡眠障碍分为4大类，即睡眠障碍，深眠状态，精神、神经或其他内科疾患伴发的睡眠障碍，以及拟建议的睡眠障碍。

现将睡眠障碍的国际分类(ICSD 1997)列举如下：

（一）睡眠障碍

1.内因性睡眠障碍(intrinsic sleep disorders)

(1)心理生理性失眠(psychophysiologic insomnia)

(2)主观感觉性失眠(sleep state mispemeption)

(3)特发性失眠(idiopathic insomnia)

(4)发作性睡病(narcolepsy)

(5)复发性睡眠过度(recurrent hypersomnia)

(6)特发性睡眠过度(idiopathic hypersomnia)

(7)创伤后睡眠过度(post-traumatic hypersomnia)

(8)阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome)

(9)中枢性睡眠呼吸暂停综合征(central sleep apnea syndrome)

(10)中枢性肺泡换气不足综合征(central alveolar hypoventilation syndrome)

(11)周期性肢体运动障碍(periodic limb movement disorder)

(12)不宁腿综合征(restless legs syndrome)

(13)尚未分型的内因性睡眠障碍

2.外因性睡眠障碍(extrinsic sleep disorder)

(1)睡眠卫生不良(inadequate sleep hygiene)

(2)环境性睡眠障碍(environmental sleep disorder)

(3)高空性失眠(altitude insomnia)

(4)睡眠调节障碍(adiustment sleep disorder)

(5)睡眠不足综合征(insufficient sleep syndrome)

(6)设限性睡眠障碍(1imit-setting sleep disorder)

(7)入睡相关性障碍(sleep-onset association disorder)

(8)食物过敏性失眠(food allergy insomnia)

(9)夜食(夜饮)综合征(nocturnal eating/drinking syndrome)

(10)催眠药物依赖性睡眠障碍(hypnotic-dependent sleep disorder)

(11)兴奋剂依赖性睡眠障碍(stimulant-dependent sleep disorder)

(12)酒精依赖性睡眠障碍(alcohol-dependent sleep disorder)

(13)毒素诱发睡眠障碍(toxin-dependent sleep disorder)

(14)尚未分型的外因性睡眠障碍

3.昼夜生物节律睡眠障碍(circadian-rhythm sleep disorders)

(1)时区改变综合征(time zone change(jet lag)syndrome)

(2)倒班工作睡眠障碍(shift work sleep disorder)

(3)不规律的睡眠-醒觉模式(irregular sleep-wake pattern)

(4)睡眠时相延迟综合征(delayed sleep-phase syndrome)

(5)睡眠时相提前综合征(advanced sleep-phase syndrome)

(6)非24小时睡眠-醒觉模式(non-24-hour sleep-wake disorder)

(7)尚未分型的昼夜生物节律睡眠障碍

（二）深眠状态(parasomnias)

1.唤醒障碍(arousal disorders)

(1)错乱性唤醒(confusional arousals)

(2)睡行症(sleep walking)

(3)睡惊(夜惊)(sleep terrors)

2.睡眠-醒觉转换障碍(sleep-wake transition disorders)

(1)节律性运动障碍(rhythmic movement disorder)

(2)睡眠惊跳(sleep starts)

(3)睡语症(sleep talking)

(4)夜间腿部痛性痉挛(nocturnal leg cramps)

3.常与REM睡眠伴发的深眠状态(parasomnias usually associated with rem sleep)

(1)梦魇(nightmares)

(2)睡眠瘫痪(sleep paralysis)

(3)睡眠相关****勃起障碍(impaired sleep-related penile erections)

(4)睡眠相关痛性勃起(sleep-related painful erections)

(5)REM睡眠伴发窦性停搏(REM sleep-related sinus arrest)

(6)REM睡眠伴发行为障碍(REM sleep behavior disorder)

4.其他深眠状态(other parasomnias)

(1)睡眠磨牙(sleep bruxism)

(2)睡眠遗尿(sleep enuresis)

(3)睡眠相关异常吞咽综合征(sleep-related abnormal swallowing syndrome)

(4)夜间阵发性肌张力不全(nocturnal paroxysmal dvstonia)

(5)原因不明夜间猝死综合征(sudden unexplained noctumal death syndrome)

(6)原发性打鼾(primary snoring)

(7)婴儿呼吸暂停(infant sleep apnea)

(8)先天性中枢性换气不足综合征(congenital central hypoventilation syndrome)

(9)婴儿猝死综合征(sudden infant death syndrome)

(10)良性新生儿睡眠肌阵挛(benign neonatal sleep myoclonus)

(11)其他深眠状态(尚未分型)

（三）伴发精神神经或其他内科问题的睡眠障碍(sleep disorders associated with mental，neurologic，or other medical disorders)

1.精神障碍伴发睡眠障碍(associated with mental disorder)

(1)精神病伴睡眠障碍(psychoses)

(2)心境障碍伴睡眠障碍(mood disorders)

(3)焦虑障碍伴睡眠障碍(anxiety disorders)

(4)惊恐障碍伴睡眠障碍(panic disorders)

(5)酒精中毒伴睡眠障碍(alcoho1)

2.伴发神经系统障碍的睡眠障碍(associated with neurologic disorders)

(1)脑变性病伴发睡眠障碍(cerebral degenerative disorders)

(2)痴呆伴发睡眠障碍(dementia)

(3)帕金森氏病伴发睡眠障碍(parkinsonism)

(4)家族性致死性失眠(fatal familial insomnia)

(5)睡眠相关性癫痫(sleep-related epilepsy)

(6)睡眠期癫痫电发放持续状态(electrical status epileptieus of sleep)

(7)睡眠相关性头痛(sleep-related headache)

3.与其他内科问题相关(associated with other medical disorders)

(1)昏睡病(sleeping sickness)

(2)夜间心脏缺血伴睡眠障碍(nocturnal cardiac ischemia)

(3)慢性阻塞性肺部疾病伴睡眠障碍(chronic obstructive pulmonary disease)

(4)睡眠相关性哮喘(sleep-related asthma)

(5)睡眠相关性胃食道反流伴睡眠障碍(sleep-related gastroesophageal reflux)

(6)消化性溃疡伴睡眠障碍(peptic ulcer disease)

(7)纤维肌痛伴睡眠障碍(fibromyalgia)

（四）拟建议的睡眠障碍(proposed sleep disorders)

1.短时睡眠者(short sleeper)

2.长时睡眠者(long sleeper)

3.亚醒觉综合征(subwakefulness syndrome)

4.断续性肌阵挛(fragmentary myoclonus)

5.睡眠多汗症(sleep hyperhidrosis)

6.经期伴发睡眠障碍(menstrual-associated sleep disorders)

7.妊娠期伴发睡眠障碍(pregnancy-associated sleep disorders)

8.恐怖性入睡前幻觉(terrifying hypnagogic hallucinations)

9.睡眠相关性神经源性呼吸困难(sleep-related neurogenic tachypnea)

10.睡眠相关性喉痉挛(sleep-related laryngospasm)

11.睡眠窒息综合征(sleep choking syndrome)