Abstract:

Insomnia disorder is the most prevalent sleep disorder with high heterogeneityand can be divided into multiple subtypes. Significant differences may be found in symptoms, pathophysiology and therapeutic responsesacross its subtypes. Current classification methods for subtypes of insomnia disorder are mainly based on clinical characteristics of insomnia, subjective and objective sleep duration, and non-insomnia-related clinical characteristics.We systematically and comprehensively discussed the advantages, limitations and clinical significance of the above-mentioned three classification methods, and the differences in pathophysiological mechanism, treatment responses and clinical outcomes according to subtypes classified by each of the three, which will contribute to making an appropriatediagnosis, formulating an individualized treatment measure and developing more practical and operable classification methodsregardinginsomnia disorder, and may be seen as directions for deepening and meticulously exploring the pathophysiological mechanism of different subtypes of insomnia disorder.

Key words: Sleep disorders, Insomnia, Clinical study, Subtype, Review

摘要：

失眠障碍是临床最常见的具有高度异质性的睡眠障碍，可分为多个亚型。不同亚型的失眠障碍患者在症状特征、病理生理学和治疗反应性方面存在显著差异。目前关于失眠障碍亚型的分类方法主要有三种，分别是根据失眠临床特征的分型、根据主观与客观睡眠时长的分型及根据非失眠相关临床特征的分型。本文系统地探讨了三种分型方式的优势、局限性、临床意义，以及依据不同分类方式的失眠障碍亚型在病理生理机制、治疗应答、临床结局等方面的差异，有助于失眠障碍的精细化诊断及个体化治疗措施的实施，能为今后制订更加切合临床实际及操作性强的分类方法提供思路，为深化、细致地探讨不同亚型失眠障碍的病理生理机制提供方向。

关键词: 睡眠障碍, 失眠症, 临床研究, 亚型, 综述