丙泊酚治疗失眠的研究进展

Research Progress of Propofol in the Treatment of Insomnia

关键词:  丙泊酚  睡眠改善  失眠机制  镇静剂  神经调控

Key words:  propofol  improved sleep  the mechanism of insomnia  sedative  nerve regulation

摘要:

失眠作为一种常见而复杂的睡眠障碍,其病因涉及神经生物学、认知行为、内分泌调节及环境因素的多重交互作用。近年来,尽管苯二氮?类和非苯二氮卓类药物在临床失眠治疗中发挥着重要作用,但其副作用、依赖性及对正常睡眠结构扰乱的问题依然突出。因此,探索新的睡眠调控药物成为研究热点。丙泊酚作为一种常用于全身麻醉的静脉给药药物,其镇静作用主要依赖于对GABA_A受体的增强作用。近年来,部分理论和初步试验显示,通过精细调控给药方案,丙泊酚有望在改善失眠方面发挥潜在效应。本综述介绍了丙泊酚的药理学特性、失眠病理机制及二者间可能的交互影响；分析了丙泊酚在降低过度觉醒状态、平衡睡眠—觉醒系统、调节神经网络及减弱内分泌应激过程中可能的作用机制；讨论了丙泊酚与现有传统催眠药物的异同及在给药模式上的优化策略；最后,对未来通过精准给药与联合治疗实现安全、有效睡眠改善的前景进行了展望。

Abstract:

Insomnia, as a common yet complex sleep disorder, arises from the multifaceted interplay of neurobiological, cognitive-behavioral, endocrine, and environmental factors. In recent years, although benzodiazepines and non-benzodiazepine drugs have played a significant role in clinical insomnia treatment, their side effects, dependency risks, and disruption of normal sleep architecture remain major concerns. Consequently, exploring novel sleep-regulating medications has become a research hotspot. Propofol, an intravenous anesthetic widely used in general anesthesia, exerts its sedative effects primarily by enhancing GABA_A receptor activity. Emerging theoretical and preliminary experimental evidence suggests that, with precise dosing regimens, propofol may hold potential in improving insomnia. This review outlines the pharmacological properties of propofol and the pathological mechanisms of insomnia, along with their potential interactions. It examines propofol’s possible mechanisms in reducing hyperarousal, balancing the sleep-wake system, modulating neural networks, and attenuating endocrine stress responses. Additionally, the review compares propofol with conventional hypnotics and discusses optimized administration strategies. Finally, it explores future prospects for achieving safe and effective sleep improvement through precision dosing and combination therapies.