Abstract
Zusammenfassung. Mit diesem Übersichtsartikel soll die gegenwärtige Evidenz zur Diagnostik und Wirksamkeit der Behandlungsmethoden der nicht-organischen Insomnie dargestellt werden. Bei der Diagnostik gilt es vor allem, Differenzialdiagnosen individuell zu prüfen und wenn vorhanden zu behandeln. Bei der eigentlichen Insomniebehandlung ist besonders zu betonen, dass die medikamentöse Behandlung nur einen Wirksamkeitsnachweis erbringt bei der Kurzzeitbehandlung mit einer Dauer von weniger als vier Wochen. Die bestwirksame Behandlung der Insomnie stellt die störungsspezifische kognitiv-behaviorale Psychotherapie (CBT-I) dar. CBT-I sollte daher möglichst jedem Patienten mit Insomnie zugänglich sein.
Abstract. This review article presents current evidence on the diagnosis and efficacy of treatment methods for non-organic insomnia. In diagnostics, it is particularly important to examine differential diagnoses individually and, if available, to treat them. Regarding the actual insomnia treatment, it should be emphasized that drug treatment provides proof of efficacy only in short-term treatments lasting less than four weeks. The most effective treatment for insomnia is disorder-specific cognitive-behavioral psychotherapy (CBT-I). CBT-I should therefore be accessible to every patient with insomnia.
Résumé. Les données actuelles sur le diagnostic et l’efficacité des méthodes de traitement de l’insomnie non organique sont présentées. Dans le domaine du diagnostic, il est particulièrement important de vérifier individuellement les diagnostics différentiels et, le cas échéant, de les traiter. Avec le traitement de l’insomnie réelle, il est particulièrement important de souligner que le traitement médicamenteux ne fournit la preuve de l’efficacité que dans le traitement à court terme avec une durée inférieure à quatre semaines. Le traitement le plus efficace de l’insomnie est la psychothérapie cognitivo-comportementale spécifique au trouble (TCC-I). La TCC-I devrait donc être accessible au plus grand nombre possible de patients souffrant d’insomnie.
Bibliografie
, Insomnische Störungen: Herausforderungen und offene Fragen.
Somnologie 2013; 17: 6–14.: Neurodegenerative disorders and sleep.
Sleep Med Clin 2018; 13: 63–70.: Alcohol disrupts sleep homeostasis.
Alcohol . 2015; 49: 299–310., : Sleep and circadian rhythm dysregulation in schizophrenia.
Prog Neuropsychopharmacol Biol Psychiatry 2013; 43: 209–216.: Prevalence of seasonal depression in a prospective cohort study.
Eur Arch Psychiatry Clin Neurosci 2018. doi: 10.1007/s00406-018-0921-3. [Epub ahead of print]: Chronobiological therapy for mood disorders.
Curr Psychiatry Rep 2015; 17: 95., : Impact of sleep complaints and depression outcomes among participants in the Standard Medical Intervention and Long-Term Exercise Study of Exercise and Pharmacotherapy for Depression.
J Nerv Ment Dis 2014; 202: 167–171., : Hyperarousal and sleep reactivity in insomnia: current insights.
Nat Sci Sleep 2018; 10: 193–201.: Sleep-related disorders in children with attention-deficit hyperactivity disorder: preliminary results of a Full Sleep Assessment Study.
CNS Neurosci Ther 2016; 22: 906–914.: The relationship between sleep and behavior in autism spectrum disorder (ASD): a review.
J Neurodev Disord 2014; 6: 44.WHO – World Health Organization WHO : Internationale Klassifikation psychischer Störungen ICD-10 Kapitel V (F). Diagnostische Kriterien für Forschung und Praxis. Bern; Huber: 2016.Einschlaf- oder Durchschlafstörungen | OBSAN [Internet] . Available from: https://www.obsan.admin.ch/de/indikatoren/einschlaf-oder-durchschlafstoerungen; letzter Zugriff: 22.09.2018., : National sleep foundation’s sleep time duration recommendations: Methodology and results summary.
Sleep Heal 2015; 1: 40–43.: Delayed sleep-wake phase disorder.
J Thorac Dis 2018; 10 (Suppl 1): S103–S111.: Prevalence of different parasomnias in the general population.
Sleep Med 2010; 11: 1031–1034., : European guideline for the diagnosis and treatment of insomnia.
J Sleep Res 2017; 26: 675–700.: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.
Psychiatry Res 1989; 28: 193–213.: Assessment of depression: the depression inventory.
Mod Probl Pharmacopsychiatry 1974; 7: 151–169.: A brief measure for assessing generalized anxiety disorder.
Arch Intern Med 2006; 166:1092.: Validation of the fatigue severity scale in a Swiss cohort.
Sleep 2008; 31:1601–1607.: Item response anaysis of a shortened German version of the morningness–eveningness scale.
Chronobiol Int 2015; 32: 1173–1182.: How does sleep restriction therapy for insomnia work? A systematic review of mechanistic evidence and the introduction of the Triple-R model.
Sleep Med Rev 2018; pii: S1087–0792(18)30079–0. doi: 10.1016/j.smrv.2018.07.005. [Epub ahead of print]: Visual impairment and circadian rhythm disorders.
Dialogues Clin Neurosci 2007; 9: 301–314., : Overcoming insomnia: protocol for a large-scale randomised controlled trial of online cognitive behaviour therapy for insomnia compared with online patient education about sleep.
BMJ Open 2018; 8: e025152., : Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials.
J Psychosom Res 2016; 89: 1–6.: Complementary therapies in medicine hypnotherapy for insomnia : A systematic review and meta-analysis of randomized controlled trials.
Complement Ther Med 2015; 23: 719–732., : Quality of life improvements after acceptance and commitment therapy in nonresponders to cognitive behavioral therapy for primary insomnia.
Psychother Psychosom 2014; 83: 371–373.: Music for insomnia in adults (Review).
Cochrane Database Syst Rev 2015; 13; CD010459., : Updated clinical evidence of Chinese herbal medicine for insomnia: A systematic review and meta-analysis of randomized controlled trials.
Sleep Med 2015; 16: 1462–1481.: Acupressure effect on sleep quality: A systematic review and meta-analysis.
Sleep Med Rev 2018; 37: 24–34., : A systematic review of acupuncture for sleep quality in people with insomnia.
Complement Ther Med 2016; 26: 11–20.
