药源性睡行症的常见致病药物及防治

Drug-induced sleepwalking:common causative drugs,prevention,and management

睡行症是一种在睡眠中出现的以行走或其他异常行为或活动为特征的睡眠障碍(sleep disorder),通常发生在非快速眼动睡眠的慢波期。由药物引起的睡行症称之为药源性睡行症。引起药源性睡行症的常见药物有镇静催眠药、抗精神病药物以及抗抑郁症药等。据称,药源性睡行症的发生由多因素所致,包括既往睡行症发作史,应用增加慢波睡眠的药物以及体内外刺激。药源性睡行症的发生机制尚不清楚,有人认为是某些神经递质如5羟-色胺、γ-氨基丁酸增加慢波睡眠所致。药源性睡行症防治原则包括:减少致病药物的剂量或停药,排除危险因素,加强环境安全及给予苯二氮类药物。

Sleepwalking is a sleep disorder characterized by walking or other unusual behaviors or activities during sleep, and it usually occurs during the slow-wave stages of non-rapid eye movement sleep. Sleepwalking caused by drugs is called drug-induced sleepwalking. The common drugs causing sleepwalking were sedative hypnotics, antipsychotic drug, antidepressant, and so on. It is said that the development of drug-induced sleepwalking may need a combination of factors ： a history of sleepwalking, a drug increasing slow-wave sleep, and a external and internal stimulus. The mechanism of drug-induced sleepwalking is not well understood. A hypothesis is proposed that some neurotransmitter such as serotonin and gamma-aminobutyric acid can increase slow-wave sleep, leading sleepwalk. The principle of treatment for drug-induced sleepwalking includes decrease in dosage or cessation of causative drugs, removal of risk factors, making safe environment, and administration with benzodiazepines.