Der zirkadiane Rhythmus steuert zentrale biologische Prozesse wie Schlaf, Hormonregulation
und Immunabwehr. Schlafstörungen beeinträchtigen die Lebensqualität und erhöhen die
Morbidität. Gerade in der Schmerz- und Palliativmedizin sind Schlafstörungen ein zentrales,
oft unterschätztes Symptom – es erfordert eine gezielte Diagnostik und eine individualisierte
Therapie. Dieser Beitrag fasst die aktuellen Erkenntnisse auf diesem Gebiet zusammen.
Abstract
The circadian rhythm regulates key biological processes such as sleep, hormone balance,
and immune defence. Sleep disorders are particularly prevalent among patients with
chronic or advanced diseases and are associated with significant physical and psychological
consequences. They impair quality of life, increase morbidity, and negatively affect
the immune system. Diagnosis involves a thorough medical and sleep-specific history,
supplemented by sleep diaries and screening questionnaires. Polysomnography remains
the gold standard, while wearables can provide useful indications but cannot fully
replace comprehensive diagnostics. Treatment should primarily focus on non-pharmacological
interventions and addressing underlying conditions, with medications used only as
adjuncts. Chronic pain and sleep deprivation interact, worsening patient outcomes.
In critically ill patients, especially in intensive care settings, sleep disorders
are common and increase the risk of delirium and
mortality. Light therapy and consideration of circadian rhythms in pain management
may improve treatment outcomes. Overall, sleep disorders represent a central and often
underestimated symptom in pain management and palliative care, necessitating targeted
diagnostics and individualized therapy. This article summarizes the current findings
in this field.
Schlüsselwörter
zirkadianer Rhythmus - chronische Erkrankungen - Palliative Care - Schmerz - Schlafstörungen
Keywords
circadian ryhthm - chronic disease - palliative care - sleep disorder
