失眠多久才算病？全方位拆解 6 条国际建议、14 种安眠药与香港轮候实况 2026

• 香港公立系统实际有没有提供 CBT-I。 本文所凭的资料只有医管局收费表一份，不包括立法会文件或审计署报告。本文只能说「医管局没有以此名义公布过这项服务」。
• 赛马会乐眠无忧计划研究以外的收费，以及计划的结束日期。 营运机构网站均无公布。
• 香港有多少个 CBT-I 服务提供者。 本文所引来源只包括一个机构的自家网站。
• 香港的安眠药处方量、依赖发生率及副作用发生率。 药物办公室页面是定性说明，全页没有任何分母或发生率。
• 英国精神药理学会共识声明的原文措辞。 本文未取得该文件，文中关于它的一切只限于 NICE MTG70 及 AASM 2017 指引各自对它的描述。
• 英国基层医疗的第一线用语原文。 本文只引述 MTG70。
• AASM 指引有没有更新版。 本文引用的是 2021 年及 2017 年两份。
• 美国内科医师学会 2016 年指引原文不在本文所引来源之内。这不代表它没有「强烈」级别的 CBT-I 建议——AASM 2017 的背景一节写明它有，而且范围更阔。
• 该试验每个时间点每组的可分析人数。 论文以加权模型报告百分比，未刊出分母，因此不能由百分比倒推人数。
• 「抑郁发生率较对照组低 42%」这个表述本文没有采用。 论文报告的是风险比 0.58，「低 42%」是由 1 − 0.58 换算，并非论文自己刊出的数字。
• 医管局 HK$10,000 费用上限是否涵盖慢性失眠。 收费表没有界定「慢性疾病」的范围。
• 医管局精神科的分流准则。 医管局公布的是轮候时间及各分流类别的个案数目，不是分流准则。
• 睡眠窒息症的诊断、检查适应症或治疗。 本文只转述与失眠及安眠药直接相关的部分；相关内容见本站另一篇专文。

英文来源没有中文版，译文为本文摘译，非来源原文。

〔注1〕ICSD-3 慢性失眠定义，由 AASM 2017 指引转述：

Insomnia disorder is defined in the International Classification of Sleep Disorders, Third Edition as a complaint of trouble initiating or maintaining sleep which is associated with daytime consequences and is not attributable to environmental circumstances or inadequate opportunity to sleep. The disorder is identified as chronic when it has persisted for at least three months at a frequency of at least three times per week. When the disorder meets the symptom criteria but has persisted for less than three months, it is considered short-term insomnia. Occasional, short-term insomnia affects 30% to 50% of the population. The prevalence of chronic insomnia disorder in industrialized nations is estimated to be at least 5% to 10%.

〔注2〕同上，紧接一句：

In medically and psychiatrically ill populations, as well as in older age groups, the prevalence is significantly higher.

〔注3〕卫生防护中心「男性心理问题 — 失眠」：

由于失眠可以成为慢性病，因此当失眠持续一个月以上就要找医生作诊断和治疗。

〔注4〕药物办公室该页在成因清单使用「例如」、「包括」等字眼，属举例式而非穷尽式；该表列名之外仍可能有其他药物。

〔注5〕AASM 2021 指引对建议强度的定义（摘要版与正文版）：

Each recommendation statement is assigned a strength ("strong" or "conditional"). A "strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "conditional" recommendation is one that requires that the clinician use clinical knowledge and experience, and to strongly consider the patient's values and preferences to determine the best course of action.

A "strong" recommendation is one that clinicians should follow for almost all patients (ie, something that might qualify as a quality measure).

〔注6〕AASM 2017 指引背景一节对 ACP 2016 指引的描述：

In May 2016, the American College of Physicians published its own clinical practice guideline for the management of chronic insomnia. This guideline makes two major recommendations. The first is that all patients with chronic insomnia receive CBT-I as the initial treatment intervention. This is a strong recommendation based on moderate quality evidence.

〔注7〕AASM 2021 指引的提供方式范围声明：

There was insufficient evidence to make recommendations for specific delivery methods (eg, individual, group, internet, self-help, video) for any of the treatments.

〔注8〕同上，方法一节：

The review did not include comparisons of different interventions or combinations of pharmacotherapy with behavioral and psychological therapy.

指引全份唯一一句头对头的说法，是睡眠卫生一条底下同一研究内的观察（within the same study CBT-I was superior to sleep hygiene alone），出自单一项研究。

〔注9〕NICE MTG70：

Usual treatment for people with sleep problems is advice about sleep hygiene. Sleeping pills may also be considered if insomnia symptoms are likely to resolve soon. If insomnia symptoms are not likely to resolve soon, best practice is to refer for face-to-face CBT‑I, although its availability in the UK is limited. This clinical pathway is outlined in the British Association for Psychopharmacology (BAP) consensus statement on insomnia. People who may be at higher risk of other sleep disorders including sleep apnoea should have a medical assessment before referral to Sleepio.

MTG70 建议 1.1 至 1.3：

1.1 Sleepio is recommended as a cost saving option for treating insomnia and insomnia symptoms in primary care for people who would otherwise be offered sleep hygiene or sleeping pills.

1.2 For people who may be at higher risk of other sleep disorder conditions, such as in pregnancy, or in people with comorbidities, a medical assessment should be done before referral to Sleepio.

1.3 More research or data collection is recommended on Sleepio for people who are eligible for face-to-face cognitive behavioural therapy for insomnia (CBT‑I) in primary care. This is because there is limited clinical evidence to show how effective Sleepio is compared with face-to-face CBT‑I.

〔注10〕MTG70「Why the committee made these recommendations」：

Sleepio is a digital self-help programme that includes CBT‑I. It could therefore increase patients' access to CBT‑I. It also increases the options available to GPs treating insomnia.

Clinical evidence shows that Sleepio reduces insomnia symptoms compared with sleep hygiene and sleeping pills. There is no direct evidence of its effectiveness compared with face-to-face CBT‑I, so further research is recommended in this context.

At a price of £45 per person, Sleepio is cost saving compared with usual treatment in primary care. This is based on an analysis of primary care resource use data before and after Sleepio was introduced in 9 GP practices. Healthcare costs were lower at 1 year, mostly because of fewer GP appointments and sleeping pills prescribed.

〔注11〕建议 1 及其 Remarks：

We recommend that clinicians use multicomponent cognitive behavioral therapy for insomnia for the treatment of chronic insomnia disorder in adults.

Remarks: This recommendation is based primarily on studies in which CBT-I was delivered by a trained professional to patients with and without comorbid conditions.

建议 6 及其 Remarks：

We suggest that clinicians not use sleep hygiene as a single-component therapy for the treatment of chronic insomnia disorder in adults.

Remarks: Although sleep hygiene is not recommended as a single-component approach (ie, the only treatment) for patients with chronic insomnia disorder, sleep hygiene may be included in multicomponent interventions.

〔注12〕睡眠限制治疗的安全说明：

Clinicians should note that this treatment may be contraindicated in certain populations such as those working in high risk occupations (eg, heavy machinery operators or drivers) or those predisposed to mania/hypomania poorly controlled seizure disorders or excessive daytime sleepiness.

（原句在来源中缺一个逗号，本文照原文引录。）

〔注13〕刺激控制的安全说明：

The TF noted that stimulus control may need to be adapted for safety in some patient populations, such as those at high risk for falls, with mobility issues, or using sedative-hypnotics.

〔注14〕药物办公室该页「治疗」一节：

如果尽管采取这些措施后，失眠仍然持续并影响日常功能，请咨询您的医生。医生可以识别根本原因并推荐适当的治疗，其中可能包括认知行为疗法、强化睡眠习惯或药物治疗。

〔注15〕《非传染病直击》2018年3月号：

Most insomnia can be effectively treated through medications, or cognitive behavioural interventions to identify and correct maladaptive behaviours or thoughts about sleep.

It can also be prevented from recurrence by paying attention to 'sleep hygiene' (Box 1).

However, insomnia is often under-recognised and under-treated in both children and adult populations despite its impact on daily functioning and quality of life.

〔注16〕卫生防护中心「怎样处理失眠？」七项，中文原文：

生活要有规律，尤其作息要定时

不要吸烟

定时作适量运动，但睡前不宜有剧烈运动

勿太饿或太饱就寝，含咖啡因的饮品例如咖啡、可乐或茶等亦不宜睡前饮用

营造一个舒适的睡眠环境，如保持宁静、室内光线和温度适中

放松心情，如练习冥想、听听轻柔的音乐、或睡前用暖水洗澡

如果真的不能入睡时，不要勉强睡眠，可起来做些小事情至再次想睡时才去睡

该清单之前有两句限定：该页先写「应先找出失眠的原因，然后作出根治。」，然后才说「如果只是短暂性的失眠」可采取一些药物以外的方法。

同页清单之后紧接一句：

若失眠持续或没有改善时，切勿自行服用未经医生处方的成药，应请教你的医生，他会帮你找出失眠原因，并会按照你的情况给予所需的治疗。

〔注17〕Chen 等 2025 试验的对象与招募：

This was a randomized, assessor-blind, parallel group-controlled trial conducted in Chinese youth (aged 15−25 years) with insomnia disorder and subclinical depression. Potential participants were recruited from universities, high schools, and communities in mainland China and Hong Kong from September 9, 2019 to November 25, 2022.

Between September 9, 2019, and November 25, 2022, 708 participants (407 females [57%]; mean age, 22.1 years [SD = 1.9]) were randomly allocated to app-based CBT-I group (n = 354) or app-based HE group (n = 354).

Participants were randomly assigned (1:1) to 6-week app-based CBT-I or 6-week app-based health education (HE) delivered through smartphones.

〔注18〕主要指标：

Thirty-seven participants (10%) in the intervention group and 62 participants (18%) in the control group developed new-onset MDD throughout the 12-month follow-up, with a hazard ratio of 0.58 (95% confidence interval 0.38–0.87; p = 0.008). The number needed to treat to prevent MDD at 1 year was 10.9 (6.8–26.6).

〔注19〕主要与次要指标的界定：

The primary outcome was time to onset of MDD. The secondary outcomes included depressive symptoms and insomnia at both symptom and disorder levels.

失眠缓解率三个时间点的原文：

At post-intervention, the weighted percentage of remitters based on clinical interviews in app-based CBT-I group was higher than that of the app-based HE group (52% versus 28%; relative risk [RR] 1.83 [95% CI 1.49–2.24]; p < 0.001) after controlling for strata variables and accounting for the missing data patterns.

Improvements achieved in the app-based CBT-I group were well sustained throughout the follow-up period, with higher remission rates than the controls at both 6-month (56% versus 44%; RR 1.27 [1.08–1.48]; p = 0.003) and 12-month follow-ups (57% versus 48%; RR 1.17 [1.01–1.35]; p = 0.03).

〔注20〕缓解的定义：

Remission of insomnia disorder was determined by the following criteria: (1) no functional impairments or distress with sleep, (2) insomnia symptoms less than three times per week for at least 1 month, and (3) sleep-promoting medication use less than once per week in the past month. Although the use of sleep-promoting medication is not a standard criterion for diagnosing insomnia disorder, it may mask the underlying symptoms and was thus taken into account in the current study.

Remission rates of insomnia were analyzed using a weighted generalized estimating equations model.

〔注21〕论文限制一节：

First, participants in our study included a mix of individuals with and without a prior history of MDD, with 48% (339/708) of participants reporting a history of prior MDD.

〔注22〕同上，最后一句：

Last, the modest sample size of adolescents (<18 years, n = 10) limits the generalizability of the findings to this age group.

安全性：

No adverse events related to the interventions were reported.

论文利益申报：YKW 曾收取 Eisai Co, Ltd 的讲课及顾问费用，并获 Lundbeck HK Ltd 及 Aculys Pharma, Inc 赞助（与本研究无关）；CMM 曾获 Idorsia、Eisai 及 Lallemand Health Solutions 的研究支持，收取 Idorsia、Eisai 及 Haleon 的个人费用，并自 Mapi Research Trust 收取版税（与本研究无关）；JHZ 曾为 BestCare & SuMian BioTech Co, Ltd 提供顾问服务；JWYC 曾为研究范围以外的海外会议收取 Eisai Co., Ltd 的个人费用及 Lundbeck HK Ltd 的旅费资助。

〔注23〕系统性文献回顾的分母：

The literature search identified 1,244 studies; 124 studies met the inclusion criteria, and 89 studies provided data suitable for statistical analyses. Evidence for the following interventions is presented in this review: cognitive-behavioral therapy for insomnia, brief therapies for insomnia, stimulus control, sleep restriction therapy, relaxation training, sleep hygiene, biofeedback, paradoxical intention, intensive sleep retraining, and mindfulness.

〔注24〕建议 1 底下的分母：

The TF identified 66 randomized controlled trials (RCTs) in adult patients diagnosed with chronic insomnia disorder that compared CBT-I to wait-list, minimal interventions, or placebo therapies. Forty-nine of the studies provided data suitable for meta-analyses for at least one critical outcome.

AASM 2017 指引：

GRADE recommendation strengths do not refer to the magnitude of treatment effects in a particular patient, but rather, to the strength of evidence in published data.

〔注25〕AASM 2017 指引的防误读说明：

It is essential that the recommendations which follow be interpreted within the appropriate context of clinical practice. Readers will note that all specific recommendations fall within the "weak" (for or against) classification of the GRADE system. This should not be construed to mean that no sleep-promoting medications are clearly efficacious or indicated in the treatment of chronic insomnia. Hypnotic medications, along with management of comorbidities and non-pharmacological interventions such as CBT, are an important therapeutic option for chronic insomnia.

同上，建议强度定义：

A WEAK recommendation reflects a lower degree of certainty in the outcome and appropriateness of the patient-care strategy for all patients, but should not be construed as an indication of ineffectiveness.

The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources.

〔注26〕同上，降级理由：

Downgrading the quality of evidence for these treatments is predictable in GRADE, due to the funding source for most pharmacological clinical trials and the attendant risk of publication bias; the relatively small number of eligible trials for each individual agent; and the observed heterogeneity in the data.

〔注27〕zolpidem 一条的 Remarks 是十四条之中唯一不止一句、亦是唯一带有监管机构后续行动的一条，整条照录：

Remarks: This recommendation is based on trials of 10 mg doses of zolpidem. N.B. Although 10 mg. was the recommended starting dosage for adults at the time of initial approval, the FDA has subsequently lowered the recommended starting dosage of immediate-release zolpidem products to 5 mg. Further, the FDA has recommended a reduction of starting dosage for extended-release forms of zolpidem from 12.5 mg to 6.25 mg.

〔注28〕melatonin 一条的 Remarks 所述剂量为 2 mg，相关三项研究只纳入超过 55 岁人士（原文作 only older adults (> 55 years)）。同一段 Summary 另有三句：证据质素为 very low；工作小组判断益处与害处大致相等（the task force judged the benefits to be approximately equal to harms）；工作小组认为大多数知情病人会选择使用 melatonin 多于不用（the majority of well-informed patients would use melatonin over no treatment）。

〔注29〕AASM 2017 指引背景一节对 BAP 共识声明的描述：

Limited evidence and toxicity concerns were cited for other prescription and non-prescription agents, although prolonged-release melatonin was recommended as a first-line treatment for insomnia in persons over 55 years.

〔注30〕同上，剂量范围声明：

Finally, the literature review, meta-analyses, and recommendations are based only on FDA-approved doses. This should not be interpreted as a recommendation for the use of a specific dose in clinical practice.

同上，指引自设范围：

The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition.

〔注31〕药物办公室该页：

在香港，大多数用于治疗失眠症的药物均属处方药物，并需在医生监督下服用。

请勿在没有专业意见的情况下自行用药或服用非处方安眠药。

〔注32〕同上，处方原则：

安眠药是一种作用于中枢神经系统以诱导睡眠的药物。这些药物并不能解决失眠的根本原因，应由医生处方，尽可能使用最低有效剂量和最短的疗程。它们适用于短期管理严重和影响日常生活的失眠症。

同页亦有正面一句：

苯二氮䓬类药物能缩短入睡时间、减少在半夜醒来的情况和增加整体睡眠时间。

苯二氮䓬类的使用门槛与疗程上限（两句相连）：

由于病人会对苯二氮䓬类药物产生药物耐受性、药物依赖和戒断症状，所以苯二氮䓬类药物仅应用于治疗严重、影响日常生活或给患者带来极度痛苦的失眠症。

苯二氮䓬类药物用作安眠药时，应使用最低有效剂量，并尽可能采用最短及不超过四周的疗程。

〔注33〕⚠️ 此栏不可拆开读。中文版该句是一整句，主语由头到尾都是儿童及青少年，整句照录：

一般不建议儿童及青少年使用水合氯醛，如需使用，必须在专科医生的监督下进行，治疗时间应尽可能缩短，且不得超过两周的最长疗程。

英文版在此处与中文版不同：英文版把疗程上限切成独立一句（Treatment should be for the shortest duration possible and should not exceed the maximum treatment period of 2 weeks.），因此英文版读得出一个不限于儿童的通则，中文版读不出。本文以中文版为准，并在此标明差异。

〔注34〕镇静性抗组织胺的慎用名单，差异在英文版自己的正文与表格之间，不是中英文之间：中文版六项（前列腺增生、狭角性青光眼、哮喘、支气管炎、肝肾功能不全、重症肌无力），正文与副作用表两处都齐；英文版正文同样六项齐全（Sedating antihistamines should be used with caution in patients with prostatic hyperplasia, narrow-angle glaucoma, asthma, bronchitis, liver or renal dysfunction, myasthenia gravis），但同页副作用表只列四项（Caution in patients with asthma, bronchitis, narrow angle glaucoma, prostatic hypertrophy）。本文采用六项名单，两个语文版本的正文都支持，并在此标明表格与正文的差异。

〔注35〕佐匹克隆与唑吡坦：

然而，现时仍然没有足够的证据，以支持佐匹克隆在药物耐受性、药物依赖性或戒断症状方面较苯二氮䓬类药物具有任何临床优势。

有报导指酒石酸唑吡坦具有类似苯二氮䓬类药物的镇静特性，但相对有较少的抗焦虑和肌肉松弛的特性。唑吡坦起效迅速且催眠作用持续时间短，但并没有足够的证据显示它相比于短效的苯二氮䓬类药物，在引致「宿醉感觉」、药物耐受性、戒断症状或药物依赖性方面有任何的优势。

DORA：

双食欲素受体拮抗剂 (DORA) 是一种中枢神经系统抑制剂，即使按照处方使用，仍可能损害日间清醒度。部分患者停药后，其中枢神经系统抑制作用可能持续数日。

水合氯醛停药：

长期接受水合氯醛治疗的患者不应突然停药，应逐步减少水合氯醛的使用剂量。

〔注36〕「服用安眠药的一般建议」六项，中文原文：

仅在医疗监督下使用。

务必以最短疗程使用最低有效剂量。

了解药物名称和剂量。

服药后不要驾驶或操作机器。

服用安眠药物期间避免饮酒。

如果失眠症状持续，请咨询医生以寻求替代治疗。

两个版本的次序不同：英文版最后两项的次序与中文版相反，因此本文不用「第几项」来指认。

〔注37〕医管局收费表列出一系列具名服务项目，而 CBT、Cognitive、insomnia 三个字在该页各出现 0 次，同时「Psychiatric day hospital」出现 2 次、注脚「N7」出现 7 次——证明本文确实读到该页的服务名称。

⚠️ 但专科门诊轮候时间公开数据集不能用来做同一个判断，本文亦不用它作此用途。该数据集共 288 行，栏位只有 date_id_from、date_id_to、cluster、specialty、Category、Description、Value；specialty 全域只有八个值，Description 全域只有五个字串。它根本没有「服务名称」这一个栏位——任何服务的名称都不会出现。就算每一个联网都在做 CBT-I，这个数据集都会一模一样。一个「共 288 行」的精确数字，很容易令一个空的检查看起来像做过搜索，所以本文在此写明它不是。

〔注38〕医管局收费表，两句相连：

People who have financial difficulties in paying medical expenses at the public sector may apply for medical fee waiver.

In addition to the medical fee waiving mechanism, the HA establishes a second safety net by introducing a HK$10,000 cap on public medical fees and charges without requiring financial assessment with effect from 1 January 2026. The new measure aims at easing the financial burden faced by patients suffering from sudden severe illnesses or chronic illnesses.

注脚 N7：

N7 Each chargeable unit covers a duration of 4 weeks per drug item.

〔注39〕《非传染病直击》Key Messages 及正文：

Most insomnia can be effectively treated and prevented from recurrence by paying attention to good 'sleep hygiene'. If insomnia has been interfering with your daytime functioning, please consult your family doctor.

Thus, never use alcohol as a sleeping aid and be sure to discuss with your family doctor before taking any sleeping medications.

〔注40〕⚠️ 关于这两句的可核对性。该网站是伺服器端预先产生 HTML，该站页面内容大多在自己那一页的呈现文字层读得到；但这两句不在该层。本文核对该站导览可达的十八条路径，两句在十八条路径的呈现文字层一次都没有出现（0/18），只在伺服器送出的位元组（页面内嵌的全站文字字典）中出现，十八条路径每条都载有同一份字典。因此本文无法提供一条可让读者自行开启核对的网址。同意书一句在字典的 researchConsentForm 项下（该文件自题「香港中文大学医学院精神科学系参加者知情同意书」，副题「在社区中验证失眠认知行为治疗的有效性」）；使用条款一句在 terms 项下。导览上「免责声明」连往 /disclaimer，而该页实际显示的是主办及协办机构免责声明连结一览，并非该份使用条款。要核对，请直接向计划索取该两份文件。

该站另有两句含「免费」的描述：「欢迎预约免费的小睡及光照体验，透过不同方式认识睡眠。」及「参与各种乐眠无忧活动，还有机会得到免费小礼物!」

〔注41〕计划网站：

大多数的失眠问题都是有方法可以处理及可治愈的。可是，社区上针对睡眠问题的支援却十分有限，同时，市民对于睡眠问题的求助行为及认识亦很少。

计划亦自述：

赛马会乐眠无忧计划由香港赛马会慈善信托基金捐助，是香港首个针对睡眠问题的社区推广计划。

本平台采用「失眠的认知行为治疗」(Cognitive Behavioral Therapy for Insomnia, CBT-I)，CBT-I 是一套治疗失眠的建议首选方案，疗效甚至比药物更加持久。

〔注42〕《非传染病直击》2018年3月号：

In Hong Kong, the Population Health Survey 2014/15 of the Department of Health interviewed over 12 000 non-institutionalised persons aged 15 and above and found that close to half (48.0%) of them had experienced sleep disturbance, namely 'difficulty in falling asleep within 30 minutes', 'intermittent awakenings or difficulty in maintaining sleep during the night', and 'early morning awakening and unable to sleep again', during the 30 days preceding the survey.

As shown in Figure 3, the proportions of having experienced these sleep disturbances three or more times a week in the 30 days preceding the survey were 6.8%, 7.3% and 6.0% respectively. Overall, females and people aged 65 and above were more likely to have experienced sleep disturbance.

Figure 3 的十二个数值为图上所印的资料标签，本文以 600 dpi 逐格读出，非由条形长度估算。该图第三条的名称用复数 Early morning awakenings，而同一页正文引述同一项时用单数 early morning awakening；本文表格照图上所印。

〔注43〕同上，国际梯度（该段在原文中排在 48.0% 那段之前）：

…prevalence of insomnia varied from as low as 6% with stringent criteria to diagnose insomnia, to 10-15% in people reported insomnia symptoms with daytime consequences (e.g. because of fatigue), and further up to 48% in those having any insomnia symptoms (Figure 2).

该刊在 Figure 2 下方注明此梯度「Modified from Ohayon 2002」；本文按其自注转述，未取得该原始文献。

〔注44〕同上，求助比例：

In Hong Kong, studies reported that only about 10% of children and adolescents and 40% of adults with insomnia reported having sought treatment for insomnia.

While a substantial proportion of insomniacs had sought treatment using complementary and alternative medicine (such as Chinese herbal medicine and acupuncture), some turned to over-the-counter sleeping aids or even alcohol for relief. Of note, alcohol aids sleep is a common misconception. In fact, alcohol disrupts normal sleep pattern depriving the drinker of a sound and restful sleep.

〔注45〕卫生防护中心「睡眠知识小测试」：

晚上响亮并持续地打鼻鼾而白天感到睡意是睡眠窒息症（一个常见而又严重的睡眠疾病）的主要病征。睡眠窒息症的其他病征，包括在睡眠中经常出现呼吸停顿及继而急速地呼吸的现象。睡眠窒息症的患者由于得不到足够而宁静的睡眠，他们日间的表现也会受到严重的影响。睡眠窒息症亦有可能导致高血压、心脏病、心脏病发和中风。不过，若患者得到适当的治疗，他/她是可以过著正常的生活的。

很多人尽管在晚上能如常地睡，但在白天还是会不经意地打捆，这可能是患上了某种睡眠病的征兆。在美国约有四千万人患上各种睡眠病，例如睡眠窒息症、失眠、发作性睡眠病和不安腿综合症。如果患上了睡眠病又不去治疗，会减低日间的办事效率、增加发生意外的机会和增加患上疾病及较早死亡的风险。

〔注46〕同上：

正确。发作性睡眠病的患者无论晚上睡得多足够和睡得多好，白天在任何时间和任何情况都会不能自控地睡著。发作性睡眠病的病征除了突然的渴睡外，也会在白天渴睡、肌肉无力和晚上睡得不好。

〔注47〕同上：

正确。不安腿综合症的患者在坐著和躺卧时（特别是在晚上），腿部有时甚至手臂会有麻痹的感觉。患者为了减轻不舒服和疼痛，便会不停地伸展或移动腿部，结果令晚上睡不好或不能入睡，而在日间又会感到很想睡和不能在日间充份工作。

〔注48〕《非传染病直击》：

However, insomnia can become a chronic problem with cycles of relapse and remission or persistent symptoms, especially when it co-exists with chronic diseases or mental illnesses, substance abuse, chronic pain, or other sleep disorders (such as obstructive sleep apnoea and restless leg syndrome).

引录体例：本文的 「」 同时担任两个角色——来源原文的引录，以及本文自己的用语标记（例如「弱」、「有条件」、「建议不要使用」、「安眠药没有用」）。独立成行的引文区块一律为来源原文。