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Übersichtsarbeit

Psychopharmakotherapie bei Ein- und Durchschlafstörungen im Kindes- und Jugendalter: Eine Übersicht

Published Online:December 14, 2017https://doi.org/10.1024/1422-4917/a000562

Abstract

Zusammenfassung. Ein- und Durchschlafstörungen sind mit einer Prävalenz von etwa 20 % eine relevante Symptomatik im Kindes- und Jugendalter. Aufgrund des mit Insomnien oftmals verbundenen verminderten psychosozialen Funktionsniveaus und des sich einstellenden Leidensdrucks ist eine suffiziente Behandlung notwendig. Zeigen sich Maßnahmen wie eine angemessene Schlafhygiene und andere nichtmedikamentöse Therapieansätze als nicht ausreichend, wird oftmals eine pharmakotherapeutische Behandlung in Betracht gezogen. Die vorliegende Arbeit bietet eine Literaturübersicht zum Einsatz verschiedener Substanzklassen in hypnotischer Indikation. Der Einsatz von Melatonin bei Kindern und Jugendlichen mit Autismus-Spektrum-Störungen ist zwischenzeitlich gut untersucht und ist mit einem positiven Effekt auf den Schlaf bei dieser Patientengruppe assoziiert. Hinsichtlich der Wirksamkeit und Verträglichkeit anderer Wirkstoffe bei primären Insomnien bzw. Schlafstörungen im Kontext anderer psychiatrischer Erkrankungen bei Minderjährigen besteht bislang eine geringe Evidenz. Daher sind zunächst nichtmedikamentöse Behandlungsstrategien vorzuziehen und eine Pharmakotherapie erst sekundär und nach kritischer Abwägung zu erwägen.


Pharmacotherapy for children and adolescents with sleep disorders: an overview

Abstract. Sleep difficulties are a relevant symptom in childhood and adolescence with a prevalence of approximately 20 %. Because of the reduced psychosocial functioning and the burden of suffering associated with insomnia, effective treatment strategies are needed. If interventions such as the implementation of an adequate sleep hygiene and other non-drug treatment approaches are not sufficient, pharmacotherapeutic treatment is often considered. The present work provides a literature overview on the use of different substance classes in hypnotic indications. The use of melatonin in children and adolescents with autism spectrum disorder has been well studied and is associated with a positive effect on sleep in this patient group. To date, there is little evidence regarding the efficacy and tolerability of other medication in primary insomnia or sleep disorders in the context of other psychiatric disorders in minors. For this reason, non-drug treatment strategies are preferred and pharmacotherapy is only to be considered secondarily after critical examination.

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