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DOI: 10.1055/a-0820-0140
Non-REM Parasomnie
Normalvariante oder Erkrankung?Non-REM parasomniasPublication History
Publication Date:
01 April 2020 (online)
Zusammenfassung
Die Non-REM-Parasomnien umfassen das Schlafwandeln, den Nachtschreck und das verwirrte Erwachen. Sie sind verbunden mit Verhaltensauffälligkeiten, die aus dem Tiefschlaf heraus auftreten. Das Verhalten variiert dabei zwischen einem kurzen plötzlichen Aufrichten bis hin zu komplexen Handlungen, z. B. Kochen, Autofahren. In EEG-Untersuchungen und bildgebenden Studien konnte gezeigt werden, dass es während solcher Episoden zu einer Dissoziation von Wach und Schlaf kommt. Meist treten NREM-Parasomnien in der Kindheit und frühen Jugend auf und verschwinden mit dem Erwachsenwerden. In bis zu 2 % bis 4 % spielen sie aber auch bei Erwachsenen eine Rolle und haben nicht selten relevante psychosoziale Konsequenzen für die Betroffenen. Für die Diagnostik ist in solchen Fällen auch zum Ausschluss von Differenzialdiagnosen eine Polysomnografie obligat, auch wenn diese durch die Diagnosekriterien bisher nicht gefordert wird. Meist ist eine Behandlung der NREM-Parasomnie nicht erforderlich, diese sollte jedoch eingesetzt werden, wenn psychosoziale Konsequenzen durch die nächtlichen Ereignisse bestehen. Da randomisierte Studien bisher fehlen, beruhen die Behandlungsempfehlungen auf Expertenmeinungen und Untersuchungen von Fallserien.
Abstract
Non-REM parasomnias include sleepwalking, night terror and confusional arousal. They are associated with behavior during an incomplete arousal from slow wave sleep. The behavior varies between simply sitting up in the bed and complex behaviors like cooking or driving a car. EEG and imaging studies confirmed a coexistence of wake and sleep stages during NREM parasomnia episodes. Usually NREM parasomnias occur during childhood and early adolescence and disappear with aging. But in up to 2 % to 4 % they occur in adults with sometimes relevant psychosocial consequences. Mostly a treatment for NREM parasomnia is not necessary. Only in cases with psychosocial consequences a treatment should be implemented. While randomized studies are lacking, the treatment guidelines are based on expert opinions and results from case series.
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