Download PDF
Dtsch Med Wochenschr 2015; 140(17): 1265-1271
DOI: 10.1055/s-0041-102917
Dossier
Schlafstörungen
© Georg Thieme Verlag KG Stuttgart · New York

Schlafstörungen – ein praktischer Leitfaden

Grundlagen, Basis-Diagnostik, einfache Maßnahmen und EmpfehlungenSleep disorders: principles, basic diagnostics and elementary measures and recommendations
Martin Gerlach
1   Medizinische Klinik mit Kardiologie, Lungenheilkunde und Schlafmedizin, Agaplesion Bethesda Krankenhaus Wuppertal gGmbH
,
Bernd Sanner
1   Medizinische Klinik mit Kardiologie, Lungenheilkunde und Schlafmedizin, Agaplesion Bethesda Krankenhaus Wuppertal gGmbH
› Author Affiliations
Further Information

Publication History

Publication Date:
25 August 2015 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Schlafstörungen gehen einher mit Einschränkungen der Leistungsfähigkeit im sozialen und beruflichen Bereich sowie Ausbildung akuter und chronischer Krankheiten. Die Prävalenz ist hoch. Der volkswirtschaftliche Schaden wird als bedeutend eingeschätzt. Der überwiegende Teil der unter dem Begriff „Schlafstörungen“ zusammengefassten Krankheitsentitäten ist gut behandelbar und damit als prognostisch günstig einzustufen. Die Diagnose kann in vielen Fällen ohne apparative Zusatzdiagnostik allein durch Anamnese und klinische Untersuchung entscheidend eingekreist werden. Hierzu sind allerdings schlafmedizinische Basiskenntnisse erforderlich, die dieser Artikel vermitteln will.

Abstract

Sleep disorders are frequent. Economic costs and impairment of quality of life can be substantial. Usually, patients suffer from insomnia or hypersomnia. Several effective therapeutic options are available. Sleep disorders appear independently or accompany a multitude of organic and psychiatric diseases. Fatigue has to be distinguished from sleep disorders clearly. For classification, the ICSD-3, published by the American Academy of Sleep Medicine, is used. Patients should be explicitly asked for their sleep quality, for many do not report actively. Patient’s history and clinical examination usually narrow the diagnosis to a large extent. Clinical diagnostics should be carried out according to the diagnostic algorithm by the German Sleep Society (DGSM). An optimal sleep hygiene and if necessary weight reduction are crucial and can prevent chronification and health consequences. In addition, assistive technology, drug therapy, behaviour therapy, and in few cases surgery are available.

Schlüsselwörter

Schlafstörungen - Insomnie - Hypersomnie

Keywords

sleep disorders - insomnia - hypersomnia
 

  • Literatur

  • 1 Allen RP, Picchietti DL, Garcia-Borreguero D et al. Restless legs syndrome / Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria – history, rationale, description, and significance. Sleep Med 2014; 15: 860-873
    CrossrefPubMedGoogle Scholar
  • 2 Ancoli-Israel S, Richardson GS, Mangano RM et al. Long-term use of sedative hypnotics in older patients with insomnia. Sleep Med 2005; 6: 107-113
    CrossrefPubMedGoogle Scholar
  • 3 Berger K, Kurth T. RLS epidemiology – frequencies, risk factors and methods in population studies. Mov Disord 2007; 22 (Suppl. 18) S420-S423
    CrossrefPubMedGoogle Scholar
  • 4 Buchner NJ, Sanner BM, Borgel J et al. Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk. Am J Respir Crit Care Med 2007; 176: 1274-1280
    CrossrefPubMedGoogle Scholar
  • 5 Chang AM, Aeschbach D, Duffy JF et al. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U.S.A 2015; 112: 1232-1237
    CrossrefPubMedGoogle Scholar
  • 6 Deutsche Gesellschaft für Schlafforschung und Schlafmedizin. Kartenübersicht der akkreditierten Schlaflabore. http://www.dgsm.de/schlaflabore_liste.php (letzter Zugriff 22.7.2015)
    Google Scholar
  • 7 Groeger JA, Zijlstra FRH, Dijk DJ. Sleep quantity, sleep difficulties and their perceived consequences in a representative sample of some 2000 British adults. J Sleep Res 2004; 13: 359-371
    CrossrefPubMedGoogle Scholar
  • 8 Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev 2002; CD001520
    PubMedGoogle Scholar
  • 9 Hillman DR, Murphy AS, Pezzullo L. The economic cost of sleep disorders. Sleep 2006; 29: 299-305
    PubMedGoogle Scholar
  • 10 Hublin C, Kaprio J, Partinen M et al. Sleep bruxism based on self-report in a nationwide twin cohort. J Sleep Res 1998; 7: 61-67
    CrossrefPubMedGoogle Scholar
  • 11 Jilek C, Krenn M, Sebah D et al. Prognostic impact of sleep disordered breathing and its treatment in heart failure: an observational study. Eur J Heart Fail 2011; 13: 68-75
    CrossrefPubMedGoogle Scholar
  • 12 Kolla BP, Auger RR. Jet lag and shift work sleep disorders: how to help reset the internal clock. Cleve Clin J Med 2011; 78: 675-684
    CrossrefPubMedGoogle Scholar
  • 13 Leach MJ, Page AT. Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Med Rev 2014; 24C: 1-12
    PubMedGoogle Scholar
  • 14 Lim J, Lasserson TJ, Fleetham J et al. Oral appliances for obstructive sleep apnoea. Cochrane Database Syst Rev 2006; CD004435
    PubMedGoogle Scholar
  • 15 Marin JM, Carrizo SJ, Vicente E et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005; 365: 1046-1053
    CrossrefPubMedGoogle Scholar
  • 16 McNicholas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 2008; 5: 154-160
    CrossrefPubMedGoogle Scholar
  • 17 Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 2002; 53: 547-554
    CrossrefPubMedGoogle Scholar
  • 18 Peter H, Penzel T, Peter JH. Enzyklopädie der Schlafmedizin. Heidelberg: Springer Medizin Verlag; 2007
    CrossrefGoogle Scholar
  • 19 Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-143
    CrossrefPubMedGoogle Scholar
  • 20 Randerath WJ, Verbraecken J, Andreas S et al. Non-CPAP therapies in obstructive sleep apnoea. Eur Respir J 2011; 37: 1000-1028
    CrossrefPubMedGoogle Scholar
  • 21 Sack RL, Auckley D, Auger RR et al. Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep 2007; 30: 1460-1483
    PubMedGoogle Scholar
  • 22 Schlack R, Hapke U, Maske U et al. Frequency and distribution of sleep problems and insomnia in the adult population in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56: 740-748
    PubMedGoogle Scholar
  • 23 Somers VK, White DP, Amin R et al. Sleep apnea and cardiovascular disease. Circulation 2008; 118: 1080-1111
    CrossrefPubMedGoogle Scholar
  • 24 Sonnenmoser M. Schlafstörungen: Kognitive Verhaltenstherapie als Mittel der ersten Wahl. http://www.aerzteblatt.de/archiv/81284/Schlafstoerungen-Kognitive-Verhaltenstherapie-als-Mittel-der-ersten-Wahl (letzter Zugriff 22.7.2015)
    Google Scholar
  • 25 Steinberg R, Weeß HG, Landwehr R. Schlafmedizin – Grundlagen und Praxis. 1.. Aufl. Bremen: Unimed; 2000
    Google Scholar
  • 26 Deutsche Gesellschaft für Neurologie. S1-Leitlinie „Restless-Legs-Syndrom (RLS) und Periodic Limb Movement Disorder (PLMD). http://www.awmf.org/uploads/tx_szleitlinien/030-081l_S1_Restless-Legs-Syndrom_RLS_2012_1.pdf (letzter Zugriff 22.7.2015)
    CrossrefGoogle Scholar
  • 27 Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin. S3-Leitlinie „Müdigkeit“, Langfassung. http://www.awmf.org/uploads/tx_szleitlinien/053-002l_S3_Muedigkeit_2011-verlaengert.pdf (letzter Zugriff 22.7.2015)
    Google Scholar
  • 28 S3-Leitlinie „Nicht erholsamer Schlaf – Schlafstörungen“. Langfassung, Version 2009, in Überarbeitung Deutsche Gesellschaft für Schlafmedizin; http://www.awmf.org/uploads/tx_szleitlinien/063-001l-abgelaufen.pdf (letzter Zugriff 22.7.2015)
    Google Scholar
  • 29 Walsh JK, Engelhardt CL. The direct economic costs of insomnia in the United States for 1995. Sleep 1999; 22 (Suppl. 02) S386-S393
    PubMedGoogle Scholar
  • 30 Young T, Palta M, Dempsey J et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-1235
    Google Scholar
  • 31 Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-1239
    CrossrefPubMedGoogle Scholar
  • 32 American Academy of Sleep Disorders. The International Classification of Sleep Disorders – Third Edition (ICSD-3). Darien IL: 2014
    CrossrefGoogle Scholar
  • 33 WHO. International Statistical Classification of Diseases and Related Health Problems. 10th Revision http://apps.who.int/classifications/icd10/browse/2015/en (letzter Zugriff 22.7.2015)
    CrossrefGoogle Scholar
  • 34 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) DSM-IV-TR. 4th. Washington DC: 2000
    CrossrefGoogle Scholar
  • 35 Redline S, Budhiraja R, Kapur V et al. The scoring of respiratory events in sleep: reliability and validity. J Clin Sleep Med 2007; 3: 169-200
    PubMedGoogle Scholar
  • 36 Huynh N, Manzini C, Rompré PH, Lavigne GJ. Weighing the potential effectiveness of various treatments for sleep bruxism. J Can Dent Assoc 2007; 73: 727-730
    PubMedGoogle Scholar
  • 37 Mignot EJ. A practical guide to the therapy of narcolepsy and hypersomnia syndromes. Neurotherapeutics 2012; 739-752
    PubMedGoogle Scholar