第十集:睡眠問題
RTHK.HK
香港電台：醫生與你(2011)
第十集:睡眠問題
Sylvia,节目开始了
Sylvia, the show has started.
不好意思,林医生
Sorry, Dr. Lin.
昨天真的睡得麻麻的
I slept really poorly yesterday.
所以今天整天都集中不到精神
So I can't concentrate at all today.
睡眠又真的很重要
Sleep is really important.
睡眠不单止是最好的休息方法
Sleep is not only the best way to rest.
良好的睡眠习惯
Good sleep habits
更加可以帮助我们保持身体健康
It can help us maintain our physical health even more.
林医生,说起睡眠
Dr. Lin, speaking of sleep.
你知不知道香港原来有10%的小朋友
Did you know that there are actually 10% of children in Hong Kong?
经常有打鼻鼾这个问题
There is often a problem with snoring.
不止这样
Not just that.
这些小朋友里面
Among these little children
有1%至2%是有睡眠窒息症
1% to 2% have sleep apnea.
换句话说
In other words.
100个小朋友之中
Among 100 children.
就有一至两个是患上了睡眠窒息症
At least one or two have suffered from sleep apnea.
而近年来也多了人
In recent years, there have also been more people.
因为睡眠窒息这个问题而求疹
Seeking medical attention due to sleep apnea issues.
患者的年纪还越来越小
The patient's age is getting younger and younger.
所以家长千万不要忽视
So parents must not overlook it.
小朋友打鼻鼾的问题
The problem of children snoring.
为什么会患上睡眠窒息症
Why do people suffer from sleep apnea?
就是空气经过一个收缩了的上呼吸管道
It is just air passing through a narrowed upper respiratory tract.
而令到那里的组织正在震荡
And the organization there is in turmoil.
最常见的震荡单位就是吊钟
The most common oscillating unit is the pendulum.
震荡就出现声音
Sound is produced when there is vibration.
就是被寒的声音
It's just the sound of the cold.
睡眠窒息就是上呼吸管道的直径
Sleep apnea is the diameter of the upper respiratory tract.
是小了的,窄了的
It is smaller and narrower.
窄的成因其实很多种
There are many causes for being narrow.
最常见的儿童就是扁桃腺
The most common children are tonsils.
和鼻咽的增殖线大了
The adenoid tissue in the nasopharynx has enlarged.
最常见的扁桃腺发大原因
The most common reasons for enlarged tonsils.
第一就是鼻敏感
The first is nasal allergies.
因为鼻敏感就会有很多过敏性的发炎
Because of nasal allergies, there will be a lot of allergic inflammation.
发炎就会流到后面
Inflammation will spread to the back.
就似乎鼻咽的增殖线发大
It seems that the nasopharyngeal adenoids have enlarged.
或者经常性扁桃腺发炎
Or recurrent tonsillitis.
都会令到扁桃腺持续发大
Will cause the tonsils to remain enlarged.
这是最常见的
This is the most common.
有没有其他原因
Are there any other reasons?
当然有肥胖
Of course there is obesity.
脂肪积聚在这个位置
Fat accumulates in this area.
都会令到呼吸管道的直径是小了的
It will cause the diameter of the airways to be smaller.
另外你的舌头的位置
Also, the position of your tongue.
是太过退后了
It is too much of a retreat.
就会扎住呼吸管道
It will block the airways.
所以下颚小的小朋友
So, children with small lower jaws.
肌理就退后了
The texture has receded.
就会扎住呼吸管道
It will block the breathing passage.
或者我们上颚这里
Or we can go to the upper jaw here.
是很小的话
It's a very small thing.
也会令到吊钟退后了
It will also cause the clock to fall behind.
变成任何人下颚小
Become anyone with a small jaw.
或者上颚小
Or the upper jaw is small.
这两个都是有问题的
Both of these have issues.
当然另外就是肥胖不足的小朋友
Of course, there are also children who are underweight.
是容易一些有肠瘤窒息的
It is easier to have intestinal tumor suffocation.
主要是因为它控制
Mainly because it is under control.
你记住我们的上颚管道
Remember our upper jaw canal.
是纯粹靠肌肉维持它拉开的
It is purely maintained by muscle to keep it open.
如果睡眠不足的时候
If there is a lack of sleep
这个会影响这个拉力是小了的
This will affect the pulling force, which is reduced.
很容易睡眠窒息的
It's easy to suffocate during sleep.
今年七岁的Oscar
Seven-year-old Oscar.
一直都有打鼻汗的问题
I have always had a problem with nasal sweat.
很快吧
Soon.
我都看得到
I can see it all.
哥哥说有时很大声
Brother says it can be very loud sometimes.
有时小声
Sometimes softly.
有时大声
Sometimes loud.
有时没有
Sometimes there isn't.
很快睡着的
Fell asleep quickly.
睡完都觉得很难睡
Even after sleeping, it still feels hard to sleep.
有一次他就伤风
One time he caught a cold.
睡觉的时候
When sleeping
很辛苦呼吸得
Breathing is very difficult.
我就开始留意他
I started to pay attention to him.
发现他那个呼吸
Discover his breathing.
就真的很不畅顺
It really isn't going smoothly.
无端端突然就会
Suddenly, out of nowhere.
这样
This way.
我就很害怕
I am very scared.
我就第二天立刻带他去看医生
I immediately took him to see a doctor the next day.
要知道小朋友有没有幻想睡眠窒息
To know if the child has fantasy sleep apnea.
现时最有效的方法
The most effective method at present.
就是做睡眠多维图测试
It is to conduct a sleep multidimensional map test.
正常他应该睡得到
He should be able to sleep normally.
因为平时他都很快睡得着
Because he usually falls asleep very quickly.
进行睡眠多维图测试
Conduct a multi-dimensional sleep profile test.
医护人员会在小朋友身上
Medical staff will attend to the children.
接驳不同的感应器
Connecting different sensors
去监察他的脑电波
Go monitor his brainwaves.
口鼻空气流动情况
Airflow condition in the mouth and nose
氧气同样发弹含量
Oxygen also has explosive content.
鼻鼾
Snoring
以致胸腹和手脚的动作
Resulting in the movement of the chest, abdomen, hands, and feet.
正常来说
Normally speaking
我们的胸脯和肚腹
Our chest and abdomen.
是一起上吸
Let's use it together.
吸气
Inhale
一起下吸
Let's go down together.
喷气
Jet
但是当呼吸障碍的时候
But when there is a breathing obstruction
很多时候
Many times.
例如窒息的时候
For example, when choking.
你见到就是
What you see is what you get.
胸口上
On the chest
那时候
At that time
腹部就下
Below the abdomen.
腹部下的时候
When the abdomen is down.
胸口就上
Right on the chest.
这个是不正常的征状
This is an abnormal symptom.
第二就是数一下呼吸的速度
The second is to count the speed of your breathing.
正常来说
Generally speaking.
只有两岁以上的小朋友
Only children over the age of two.
睡了觉之后
After sleeping.
一分钟呼吸
One minute of breathing.
多于二十下的话
More than twenty times.
其实多数都是有呼吸的问题
In fact, the majority have breathing problems.
令到他呼吸快了
Causing his breathing to quicken.
好
Good
经过检查
After inspection
Oscar证实患上
Oscar confirmed to be suffering from.
中度的睡眠窒息症
Moderate sleep apnea.
听过睡眠窒息症
Have you heard of sleep apnea?
但是没想过他会有
But I never thought he would have it.
因为之前都说
Because it was said before.
老人家肥胖那些
Old people are overweight.
他又不是
He is not either.
两个人都不是
Neither of them are.
就不认为他是
Just don't think of him as...
六点钟的位置
The position of six o'clock.
就是肥胖的增殖线
It is the proliferation line of obesity.
最窄的位置
The narrowest position.
就是扁图线这个位置
It's this position of the flat profile line.
最重要就是扁图线的位置
The most important thing is the position of the flattened line.
很窄的位置
Very narrow space.
让腕部下沉
Let the wrist sink down.
然后呼吸缩气的时候
Then when breathing and exhaling.
就整个上呼吸管都关闭了
The entire upper airway has been closed off.
但个鼻腔的线不是很大
But the line of the nasal cavity is not very big.
但也要搁上去
But it also needs to be put up.
经常性打鼻鼾
Frequent snoring.
是一个最常见
It is the most common.
最有效的征状
The most effective symptoms.
跟家长知道
Let the parents know.
那个小朋友可能有问题
That child might have some issues.
观察晚上睡觉的时候
Observe when sleeping at night.
是不是有很多汗
Is there a lot of sweat?
坐在這裡吃完飯才走開,好嗎?
Is it okay to sit here and finish eating before leaving?
Oscar的性格是不定的
Oscar's personality is unpredictable.
不可以坐下,焦點一件事
You cannot sit down; focus on one thing.
我想是多於五分鐘
I think it is more than five minutes.
你自己快點做吧
Hurry up and do it yourself.
為甚麼有自己的選擇
Why have one's own choices?
做功課就是
Doing homework means
做一會兒,走一會兒
Rest for a while, walk for a while.
記性又…
Memory and...
叫他做幾件事
Tell him to do a few things.
可能要十多二十次
It might take more than ten to twenty times.
他才記得
He just remembered.
還有,容易睡覺
Also, it's easy to fall asleep.
經常都會累
Always feels tired.
早上起床還是很累
Waking up in the morning still feels very tiring.
睡眠特色影響最即刻的就是
The most immediate impact of sleep characteristics is...
他當晚影響睡眠質素是不好的
He had a negative impact on the quality of sleep that night.
經常睡醒
Frequently wakes up.
而第二天的專注力不好
The concentration wasn't good the next day.
變成他過度活躍
Become overly active.
影響認知功能
Affect cognitive function
所以他的成績變差了
So his grades have worsened.
中期和長期來說
In the medium and long term.
就說一個
Just say one.
我們知道睡眠窒息的小朋友
We know children with sleep apnea.
晚上的血壓會高了
Blood pressure tends to be higher in the evening.
所以嚴重一點
So it's a bit serious.
白天的血壓也會高了
Blood pressure will also be high during the day.
長期日夜血壓高的話
If blood pressure is high day and night for a long time.
就令到將來幾十年
Just to make the next few decades.
二、三十年之後
Twenty or thirty years later.
心臟病
Heart disease
中風的機會會提高
The chance of having a stroke will increase.
那邊的路線都很大
The routes over there are very wide.
兩邊都差不多碰到
Both sides are roughly touching.
整晚醒來
Waking up all night.
他的阿瓦索指數
His Avarice Index.
一個小時十六次
Sixteen times in one hour.
很多時候都是因為
Many times it is because
睡眠窒息而醒來
Waking up from sleep apnea.
國中的增值體
Value-added body in middle school
我想都會對他的病徵有幫助
I think it will help with his symptoms.
如果沒有了
If there is none.
有什麼特別的問題
Is there any special issue?
不會影響他的身體
It will not affect his body.
不會影響
Will not be affected.
因為那些磷巴腺只是身體
Because those lymph nodes are just part of the body.
其實很多磷巴腺中的一小部分
In fact, a small part of the phosphorubrum gland.
不會影響他的抵抗力
It will not affect his resistance.
林教授說除了做手術之外
Professor Lin said that besides performing surgery,
其實還有沒有其他的方法
Actually, are there any other methods?
去治療兒童睡眠窒息呢
Go treat children's sleep apnea.
對小朋友來說
For children
做手術切除扁桃腺
Surgery to remove the tonsils.
和鼻咽增殖腺
Adenoid hypertrophy
一定是第一選擇
It must be the first choice.
因為手術相對簡單
Because the surgery is relatively simple.
而且風險也相對低
And the risks are relatively low.
另外對於太肥或年紀太小
In addition, for those who are too overweight or too young.
不適合做手術的小朋友
Children who are unsuitable for surgery.
醫生有時候會建議
Doctors sometimes recommend.
他們使用正氣壓機
They use a positive pressure machine.
去改善睡眠窒息的問題
To improve the problem of sleep apnea.
正氣壓機主要是利用氣壓
The air pressure machine mainly utilizes air pressure.
撐開收窄了的呼吸管道
Open up the narrowed airways.
改善左膝的問題
Improving the issues with the left knee.
患上綜合症的Ethan
Ethan diagnosed with syndrome
睡眠窒息的原因
Causes of sleep apnea
是由於下顎太短
It is due to the lower jaw being too short.
以致條理吞後
To the extent that the order is swallowed afterward.
阻塞到上呼吸管道
Obstruction of the upper respiratory tract.
再加上年紀太小
Plus, they are too young.
所以現階段
So at this stage.
只是使用正氣壓機
Just use a positive air compressor.
去改善睡眠窒息的情況
To improve the situation of sleep apnea.
這是一件要每天都做的事情
This is something that needs to be done every day.
尤其對這個小朋友來說
Especially for this little child.
是很困難
It is very difficult.
因為不舒服
Because I feel unwell.
開始的時候他很不高興
At the beginning, he was very unhappy.
我們第一次嘗試
This is our first attempt.
在這裡做睡眠測驗的時候
When conducting a sleep test here
他踢了護士
He kicked the nurse.
大哭大鬧
Crying and making a fuss.
不肯帶
Not willing to bring.
後來過去的三個禮拜
The past three weeks.
我們每天都來廣華醫院
We go to Guanghua Hospital every day.
然後他慢慢就習慣了
Then he slowly got used to it.
正氣壓機是一個
The pneumatic machine is a
治標不治本的方法
A method that addresses the symptoms but not the root cause.
睡眠窒息有機會治本的
Sleep apnea can be fundamentally treated.
在兒童來說就是做手術
For children, it means having surgery.
切割邊路線
Cutting edge route
和鼻咽的增值線
And the accessory glands of the nasopharynx.
但是當然
But of course.
如果做了這個手術之後
If this surgery is done afterwards
還有一些手尾
There are still some loose ends.
以致睡眠窒息
Leading to sleep apnea.
指數不是完全正常的話
If the index is not completely normal.
就可以用正氣壓機幫助他
You can use the pneumatic press to help him.
特別是肥胖的小朋友
Especially children who are overweight.
正氣壓機來支援致血栓
The pneumatic press is used to support blood clots.
減肥才是治本的方法
Losing weight is the fundamental solution.
然後可以停止治療方式
Then the treatment method can be stopped.
所以變成了
So it became.
正氣壓機是一個輔助的方式
The pneumatic press is an auxiliary method.
我今天和Oscar
I am with Oscar today.
主要是割了扁桃線
Mainly had the tonsils removed.
和鼻咽的增值體
And the nasopharyngeal adenoids.
即是含巴線
It means the Ba line is included.
做完手術
Surgery completed.
一般來說
Generally speaking
都在八、九成以上
All are above 80% to 90%.
可以有改善
There can be improvements.
肥胖的話
If it's about being obese.
手術的成功率
Surgical success rate
就可能會低一些
It might be a bit lower.
因為它有其他引導的影響
Because it has the influence of other guides.
一般來說
Generally speaking
做完手術
Surgery completed.
你可以看到
You can see.
病人睡覺的時候
When the patient is sleeping.
避孕聲減少
Contraceptive sound reduction
口氣順暢了
The speech became smooth.
睡眠質素也好了
The quality of sleep has improved as well.
我覺得做完手術
I think after the surgery.
睡覺就睡好了
Just sleep well.
早上起床精神了
Waking up in the morning feels refreshing.
我的手術效果挺明顯的
The results of my surgery are quite obvious.
因為起碼睡覺的時候
Because at least when sleeping
沒有雜聲
No background noise.
或者呼吸不暢順
Or difficulty in breathing.
其實睡眠我覺得對小朋友很重要
I actually think sleep is very important for children.
因為最主要是影響到他的健康
Because it mainly affects his health.
如果改善了睡眠質素之後
If the quality of sleep improves afterwards.
可能他的健康會好一點
His health might get a little better.
吃東西會多一點
Eating will be a bit more.
集中力會好一點
Concentration will be better.
睡眠對每個人都很重要
Sleep is very important for everyone.
但不是每個人都睡得那麼好
But not everyone sleeps that well.
小時候媽媽說
When I was little, my mom said.
喝一杯熱鮮奶
Drink a cup of hot fresh milk.
就會睡得好一點
Then you will sleep a little better.
但其實沒有一個研究顯示
But in fact, there is no study that shows...
任何單一食物
Any single food
可以改善睡眠質素
Can improve sleep quality.
影響人的睡眠質素
Factors affecting sleep quality.
影響人體睡眠的
Factors affecting human sleep.
荷爾蒙退克激素
Hormone suppressive hormone
在晚上九點之後
After nine o'clock at night.
就會開始分泌
Will start to secrete.
晚上十一點至凌晨兩點
11 PM to 2 AM
就分泌得最旺盛
It's secreted most vigorously.
腦裏面的退克激素越多
The more stress hormones in the brain.
就會越容易睡得著
It will be easier to fall asleep.
飲食裏面的色胺酸
Tryptophan in food
當進入腦部的時候
When it enters the brain.
就會轉化成血清素
It will be converted into serotonin.
然後進一步轉化成退克激素
Then further convert into glucocorticoids.
理論上
In theory
多吃一些含有色胺酸的食物
Eat more foods that contain tryptophan.
例如魚類、肉類和芝士
For example, fish, meat, and cheese.
應該會睡得好一點
Should sleep a little better.
要睡得好一點
To sleep a little better.
更加要靠吃碳水化合物
Need to rely more on eating carbohydrates.
例如飯、麵和麵包
For example, rice, noodles, and bread.
因為碳水化合物
Because of carbohydrates.
可以令色胺酸
Can induce tryptophan.
更加容易進入大腦
Easier to enter the brain.
有研究指
Some studies indicate that
吃高碳水化合物
Eat high carbohydrates.
比起吃高蛋霸質晚餐的人
Compared to those who eat high-protein dinners.
容易睡得好一點
It's easier to sleep better.
所以只吃高色胺酸的食物
So only eat foods high in tryptophan.
是不夠的
It is not enough.
Sylvia
Sylvia
你昨晚睡得不好
You didn't sleep well last night.
稍後做完節目
Finish the program later.
早點回家休息吧
Get home early and rest.
我知道
I know.
但有點擔心
But I'm a bit worried.
擔心什麼呢
What are you worried about?
其實我試過
Actually, I have tried it.
明明很累很睏
Clearly very tired and sleepy.
但睡在床上
But sleeping in bed.
眼光光睡不著
Can't sleep with my eyes wide open.
其實挺辛苦的
It's actually quite hard.
香港人工作壓力大
Hong Kong people have high work pressure.
休息又不定時
Rest is irregular.
有不少人都有睡眠問題
Many people have sleep problems.
最近的研究更顯示
Recent studies have shown even more.
香港長者的失眠問題
Insomnia problems among elderly people in Hong Kong
是愈來愈嚴重
It is getting more and more serious.
很難睡得著
It's hard to fall asleep.
而且晚上醒幾次
And wake up a few times at night.
醒了又很難睡得著
It's hard to fall back asleep after waking up.
不知道是否失眠
Not sure if it's insomnia.
我經常玩起床找病
I often play the game of getting up to find illness.
在教組的時候
During the teaching group.
做了一個調查
Conducted a survey.
有885個長者參加了
A total of 885 elderly participants took part.
我們當中
Among us
其實發現了三個大問題
In fact, three major problems have been discovered.
第一就是他們睡不著
The first thing is that they can't sleep.
他很容易醒
He wakes up easily.
另外就是睡不長
Additionally, I can't sleep for long.
就是很早醒
Just woke up very early.
第三就是
The third is
他要很長時間才睡得著
It takes him a long time to fall asleep.
我們當中發現
We discovered among us.
其實在這家長者裡面
Actually, within this elderly care facility.
有48%
There is 48%.
他要多過半小時才睡得著
He takes more than half an hour to fall asleep.
而中間醒了之後
After waking up in the middle.
半小時都睡不著的
Haven't been able to fall asleep for half an hour.
有52%
There is 52%.
睡不著
Can't sleep.
早上起床就很累
Waking up in the morning feels very tiring.
很疲倦
Very tired.
如果睡不好
If you can't sleep well.
白天有朋友約你喝茶
A friend has invited you for tea during the day.
在茶樓很多人都會睡
Many people sleep in the tea house.
因為老人家
Because of the elderly.
開始會退化
Start to degenerate.
包括腦部
Including the brain.
腦部其實是控制人
The brain actually controls people.
睡覺和醒的
Sleeping and waking.
但如果你退化之後
But if you regress afterwards
他的腦下憂
His brain is under stress.
那個協調就失調
That coordination has become disordered.
除了影響退化激素之外
In addition to affecting degenerative hormones.
也會影響到其他荷爾蒙
It will also affect other hormones.
譬如脾質素
For example, spleen quality.
或者我們的體溫
Or perhaps our body temperature.
所以老人家睡覺
So the old man is sleeping.
就不能臨
Just can't be temporary.
而且經常醒
And often wakes up.
三月起床
Get up in March.
人很不舒服
The person is very uncomfortable.
睡不著
Can't sleep.
覺得人很暈
Feeling dizzy.
有糖尿
Has diabetes.
起床去廁所
Get up and go to the toilet.
去完廁所回家
Go home after using the restroom.
是不能睡的
Cannot sleep.
出來是不能睡的
You can't sleep when you come out.
不能睡的
Cannot sleep.
又請幾個小時
Please ask for a few more hours.
很辛苦
Very hard.
覺得人不能睡
I feel that people shouldn't sleep.
這裡很多人說
Many people say here.
年紀大當然不能睡
Of course, one can't sleep at an older age.
又退化了
Regressed again.
長者因為他生理上的退化
The elderly due to their physiological degeneration.
其實他的生理時鐘
In fact, his biological clock
我們說他吞早了
We say he swallowed too early.
意思就是說
It means.
其實他比年輕的時候
In fact, he is better than when he was young.
他早了睏
He was sleepy early.
但也早了起床
But it was also early to get up.
如果照回生理時鐘睡
If you sleep according to your biological clock.
其實是舊的
It's actually old.
但因為始終在城市生活
But because I have always lived in the city.
他早了睏
He is sleepy early.
譬如以前是九點鐘睡
For example, I used to go to bed at nine o'clock.
早了睏現在是七點鐘睏
It's early to sleep, it's already seven o'clock.
很難不去七點鐘睡
It's hard not to go to sleep at seven o'clock.
他仍然是九點鐘睡
He still goes to bed at nine o'clock.
不過生理時鐘
However, the biological clock.
他早了起床
He got up早了.
他就好像睡得少了
He seems to have slept less.
於是他就真的會覺得
So he would really feel.
睡得不夠
Not enough sleep.
不過這個本身就不是病
However, this itself is not an illness.
當然另外的情況
Of course, in other circumstances.
就是因為有些身體
It's just that some bodies...
有其他毛病
There are other problems.
令你睡得不好
Makes you sleep poorly.
譬如說是心臟的病
For example, it is a heart disease.
或者是空肺的毛病
Or it could be a problem with empty lungs.
他本來可能睡在那裡
He might have been sleeping there.
都氣喘的
Out of breath.
這些就會睡得不好
These will cause poor sleep.
另外的情況
Other circumstances
譬如抑鬱症
For example, depression.
因為失眠也是抑鬱症
Because insomnia is also depression.
其中一個很重要的病徵
One of the very important symptoms.
當然也包括胃口不好
Of course, it also includes a poor appetite.
或者情緒低落
Or feeling down.
我們主要都是這樣
We mainly do it this way.
區分這兩個
Distinguish between these two.
針對失眠和抑鬱症的關係
The relationship between insomnia and depression.
我們今天請來香港大學
Today we invited the University of Hong Kong.
精神醫學系的鍾醫生
Dr. Zhong from the Department of Psychiatry
和他的病人羅先生
and his patient Mr. Luo
上來和我們聊聊天
Come up and chat with us.
羅先生你好
Hello, Mr. Luo.
可否分享一下
Could you share a bit?
你過往失眠的情況
Your past experiences with insomnia.
我本身就是一個
I am one myself.
長期的失眠病患者
Long-term insomnia patients
三年前我感覺到身體不舒服
Three years ago, I felt unwell.
懷疑自己好像有癌症
I suspect that I might have cancer.
生活就極度灰暗
Life is extremely bleak.
後來經過鍾醫生的開解
Later, after being comforted by Dr. Zhong.
亦都經過電腦掃描
It has also been scanned by a computer.
證實了不是癌症
Confirmed it is not cancer.
心裡就舒緩了很多
I feel much more relaxed inside.
在一年的時間之內
Within a year.
病情都得到很多的緩解
The condition has greatly improved.
鍾醫生
Dr. Zhong
羅先生這個情況
Mr. Luo's situation.
是失眠引致抑鬱症
Insomnia leads to depression.
還是抑鬱症引致失眠呢
Is it depression that causes insomnia?
他的情況應該是
His situation should be.
長期失眠導致抑鬱症
Long-term insomnia leads to depression.
因為長期失眠的病人
Because of patients with chronic insomnia
會產生很多負面的心理狀況
It will generate many negative psychological conditions.
對於自己沒有信心
Lack of confidence in oneself.
什麼都不敢做
Dare not do anything.
腦部的功能都會差一點
The brain functions will be somewhat impaired.
所以有什麼困難出現
So what difficulties have arisen?
他處理困難的能力就差
His ability to handle difficulties is poor.
所以慢慢有可能導致抑鬱症
So gradually it may lead to depression.
鍾醫生 作為家人
Dr. Zhong as a family member.
我們怎樣留意家中的長者
How do we pay attention to the elderly at home?
有沒有因為失眠的問題
Is there a problem with insomnia?
引致情緒問題呢
Causing emotional problems?
如果就這樣失眠的話
If I continue to be insomniac like this.
他會累 沒什麼心思工作
He will get tired and has no intention to work.
但是如果他變得
But if he becomes
什麼都是負面 沒心思的
Everything is negative, no mood at all.
不開心的
Unhappy.
或者不外出 胃口差了
Maybe I won't go out; my appetite has decreased.
就可能是有抑鬱症
It could be depression.
如果這種情況下
If this situation arises
就要帶他去看醫生了
I am about to take him to see a doctor.
作為家人
As family.
也要多關心我們的長者
We should also pay more attention to our elders.
如果情況是一個生理時鐘的改變
If the situation is a change in the biological clock.
即是一個退化的情況
It is a regressive situation.
其實曬多點光
Actually, getting more sunlight.
我們在醫學上有證據顯示
We have evidence in medicine that shows
可以將生理時鐘退後
The biological clock can be set back.
實際上我鼓勵長者
In fact, I encourage the elderly.
黃昏的時候出去曬太陽
Going out to bask in the sun during dusk.
一方面也可以做運動
On one hand, it can also be exercise.
對身體也好
It's also good for the body.
你自然時鐘退後了一點
Your internal clock has been set back a little bit.
你也要晚一點才會醒來
You will wake up a little later too.
除了鼓勵長者曬太陽之外
In addition to encouraging the elderly to bask in the sun
近年也開始有團體使用
In recent years, there have also been groups using.
認知行為治療
Cognitive Behavioral Therapy
去改善長者失眠的問題
To improve the problem of insomnia in the elderly.
認知治療方面
Cognitive therapy aspects
長者對失眠存有一些觀念
Elderly people have certain beliefs about insomnia.
那些觀念只會令到他
Those concepts will only lead him to.
對失眠有更加大的壓力
Increased pressure on insomnia.
在壓力之下他更加難睡得到
He finds it even harder to sleep under pressure.
所以我們這個方法
So our method
就是針對去改變他對失眠的一些看法
It is aimed at changing his views on insomnia.
行為治療方面又分開三方面
Behavioral therapy is further divided into three aspects.
第一方面就是去改變
The first aspect is to change.
他一些不好的生活習慣
His bad lifestyle habits.
舉一個例子就是
For example,
晚上睡得不好
Did not sleep well at night.
我白天不用上班的
I don't have to work during the day.
我睡個晚覺補一下
I’ll take a nap to catch up on sleep.
對身體都會好一點
It will be better for the body.
其實是不對的
Actually, it is wrong.
我們嘗試去改變
We try to change.
一連串這些似是而非的
A series of these seemingly false assertions.
一些處理失眠的方法
Some methods to deal with insomnia.
另一個層面就是
Another aspect is that
我們嘗試去加強
We try to strengthen.
長者對睡眠的控制
Elderly control over sleep
第三方面
Third aspect
我們就教他一些放鬆運動
We will teach him some relaxation exercises.
因為睡眠是需要那個人
Because sleep requires that person.
在一個很放鬆的狀態
In a very relaxed state.
所以我們會教他一些放鬆的治療
So we will teach him some relaxation therapies.
讓他可以去做到這件事
Let him be able to do this.
午間睡一睡
Take a nap at noon.
晚間晚入睡
Go to bed late at night.
聽我說了
Listen to what I said.
聽聽看就挺好
Just listening is fine.
我們叫他下午不要睡
We told him not to take a nap in the afternoon.
又不要喝溶茶
Don't drink dissolved tea again.
不要睡沙發那些
Don't sleep on the sofa.
那我就
Then I will.
哎呀
Oh dear.
又好
Better again.
起床就睡了
Got up and went back to sleep.
兩三點起床就睡了
Woke up at two or three and then went back to sleep.
即是起床就睡了
As soon as I get up, I go back to sleep.
另外
Additionally
針對長者失眠問題
Addressing insomnia issues among the elderly.
期刊會在2003年
The journal will be in 2003.
就推出了全港第一個
It has launched the first one in Hong Kong.
專業為長者服務的
Professional services for the elderly.
長者優質睡眠服務計劃
Elderly Quality Sleep Service Plan
其實我們的計劃
Actually, our plan
是有一個先導者的角色
There is a role of a leader.
希望提升整個
Hope to improve the whole.
這個老人家社會
This elderly person's society.
對這個睡眠問題的關注
Attention to this sleep issue.
所以我們做了很多講座
So we held many lectures.
甚至在街頭的展覽
Even exhibitions on the streets.
另外一個就是我們為
Another one is that we are for
這個長者提供一個專業的服務
This elder provides a professional service.
從每個人的評估開始
Start with each individual's assessment.
然後才進行一些
Then proceed with some.
非藥物的治療
Non-drug treatment
也都有一個個別的
There is also an individual one.
個案的管理
Case management
也有一些小組的管理
There are also some management of small groups.
然後我們也將我們的經驗
Then we will also share our experience.
希望跟一些照顧長者的
I hope to connect with some caregivers for the elderly.
同工分享
Sharing among coworkers
就是將這個服務
It is to provide this service.
提供給全香港的老人家
Provided to the elderly in all of Hong Kong.
這個計劃實行八年以來
This plan has been in effect for eight years.
已經處理了差不多
It has been mostly handled.
四萬五千宗個案
Forty-five thousand cases.
當中八成的長者
Eighty percent of the elderly.
都可以有效地改善到
Can effectively improve to.
他們的睡眠狀況
Their sleep condition.
我們發覺我們接觸的老人家當中
We have noticed that among the elderly people we interact with.
很多人本身自己已經吃了一些
Many people have already eaten some themselves.
長期的西藥
Long-term Western medicine
譬如可能血壓藥
For example, it could be blood pressure medication.
糖尿藥那些
Diabetes medications and those.
其實他們都已經不想
In fact, they no longer want to.
額外再加一些西藥下去
Add some Western medicine on top of that.
我們就會將我們的小組裡面
We will put within our small group.
就深入一些元素
Delve deeper into some elements.
非藥物的治療手法來的
Non-drug therapeutic methods.
包括了老人家非常喜歡
Includes things that the elderly really like.
譬如說月位按摩
For example, lunar massage.
食療
Dietary therapy
他們都很喜歡的
They all really like it.
有些智慧
Some wisdom
在他們老人家的群體裡面
In their elderly group.
才會知道的東西
Things that can only be known.
他們在那個小組裡面
They are in that group.
就會拿出來分享
Then I will take it out to share.
大家可以互相得益
Everyone can benefit from each other.
就會那個功效
It will have that effect.
更加強
Strengthen further
醫學文獻上看來
According to medical literature
其實每個人需要睡覺的時間
In fact, everyone needs different amounts of sleep.
其實都不同的
Actually, they are all different.
所以你都沒有需要特別限定
So you don't have any specific restrictions.
說我一定要睡幾個小時
You said I must sleep for a few hours.
不過只要你睡醒覺之後
As long as you wake up after sleeping.
你是精神的
You are spiritual.
日間的生活是正常的
Daytime life is normal.
那個已經是足夠的睡眠了
That is already enough sleep.
林順朝教授
Professor Lin Shunzhiao
現代人真的很慘
Modern people are really unfortunate.
我聽聞很多人
I have heard that many people...
要吃了藥才能睡覺
I need to take medicine in order to sleep.
但我看你
But I see you.
又要看診
Time for another medical appointment.
又要做手術
Another surgery is needed.
又要做研究
Going to do research again.
有很多公職
There are many public positions.
每次入床
Every time I get into bed.
又非常精明
Also very shrewd.
你究竟是否需要睡覺的
Do you really need to sleep?
我也想不用睡覺
I also want to not sleep.
不過其實睡覺
However, actually sleeping.
不只是說量
Not just talking about quantity.
質素也很重要
Quality is also very important.
你一定有秘訣的
You must have some secret tips.
請雞雞告訴我
Please let the chicken tell me.
不算有什麼秘訣
It's not really a secret.
不過如果我們能夠做得坦蕩蕩
However, if we can do it openly and honestly.
沒有機心
No ulterior motive.
沒有成苦
No achievements lead to suffering.
自然就問心無愧
Naturally, one can have a clear conscience.
那就可以大覺睡覺了
Then you can sleep soundly.
你這幾個秘訣
These few tips of yours.
我一敗算
I am defeated.
今晚一定
Tonight for sure
立刻睡不著
Can't fall asleep immediately.
祝你有覺好睡
Wishing you a good sleep.
多謝
Thank you.
祝你生日快樂
Happy Birthday to you!
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