Psychotherapie der Schlafstörungen

Schlafstörungen treten im Verlauf des Alterns vermehrt auf und neigen zur Chronifizierung. Mithilfe der Kognitiven Verhaltenstherapie der Insomnie (CBT-I) lassen sich nichtorganische Schlafstörungen in ihrer Entstehung und Aufrechterhaltung besser verstehen und mit gezielten Interventionen mildern oder beseitigen. Es ist oft die bessere Alternative zur langzeitigen Verschreibung von Schlafmitteln.

Abstract

Sleep disorders increase in prevalence and intensity with aging and often become chronic. Cognitive Behavioral Therapy of Insomnia (CBT-I) and the 3P model of insomnia allows to differentiate between predisposing, precipitating and perpetuating factors influencing insomnia and to attenuate their effects. This treatment usually is the better alternative to long-term prescription of hypnotic medication. Its principles are outlined here.

Key words

Insomnia - CBT-I - behavior therapy - Sleep restriction - stimulus control

Schlüsselwörter

Schlaf - Insomnie - Kognitive Verhaltenstherapie - CBT-I - Schlafrestriktion - Stimuluskontrolle

Publication History

Article published online:
03 December 2020

• Literatur

• 1 Thünker J, Pietrowsky R. Alpträume. Göttingen: Hogrefe; 2011
• 2 Born J, Wilhelm I. System consolidation of memory during sleep. Psychol Res 2012; 76: 192-203
• 3 Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev 2019; 99: 1325-1380
• 4 Backhaus J, Junghanns K, Born J. et al. Impaired declarative memory consolidation during sleep in patients with primary insomnia: Influence of sleep architecture and nocturnal cortisol release. Biol Psych 2006; 60: 1324-1330
• 5 Reinberg AE. Chronobiologie médicale, Chronothérapeutique. Paris: Flammarion; 2003
• 6 Uber C, Ancoli-Israel S, Chesson A. et al. The AASM Manual for the Scoring of Sleep and Associated Events. Darien IL. USA: American Academy of Sleep Medicine. 2012
• 7 Späth-Schwalbe E, Hundenborn C, Kern W. et al. Nocturnal wakefulness inhibits growth hormone (GH)-releasing hormone-induced GH secretion. J Clin Endocrinol Metabol 1995; 80: 214-219
• 8 Born J, Wagner U. Memory consolidation during sleep: role of cortisol feedback. Ann N Y Acad Sci 2004; 1032: 198-201
• 9 Späth-Schwalbe E, Uthgenannt D, Voget G. et al. Corticotropin-releasing hormone-induced adrenocorticotropin and cortisol secretion depends on sleep and wakefulness. J Clin Endocrinol Metabol 1993; 77: 1170-1173
• 10 Fries E, Dettenborn L, Kirschbaum C. The cortisol awakening response (CAR): facts and future directions. Int J Psychophysiol 2009; 72: 67-73
• 11 American Psychiatric Association, APA. Diagnostic Criteria from DSM-5. Arlington, VA: APA; 2013
• 12 Morin CM. Insomnia. New York, USA: Guilford Press; 1993
• 13 Riemann D. Backhaus. J. Behandlung von Schlafstörungen. Weinheim: Beltz PVU. 1996
• 14 Edinger JD, Carney CE. Overcoming Insomnia. Oxford: University Press;; 2008
• 15 Crönlein T. Primäre Insomnie. Göttingen: Hogreve. 2013
• 16 Spiegelhalder K, Hajak G, Riemann D. Nichtorganisch bedingte Schlafstörungen (ICD-10 F5. In: Voderholzer U, Hohagen F, Hrsg Therapie psychischer Erkrankungen, State of the Art 13. Aufl München: Urban & Fischer; 2018: 357-364
• 17 van Straten A. et al. Cognitive and behavioral therapies in the treatment of insomnia. A meta-analysis. Sleep Med Rev 2018; 38: 3-16
• 18 Riemann D, Baum E, Cohrs S. et al. S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. Kapitel „Insomnie bei Erwachsenen“. Somnologie 2017; 21: 2-44
• 19 Spielman A, Caruso L, Glovinsky P. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am 1987; 10: 541-553
• 20 Wampold BE, Imel ZE. The great psychotherapy debate. 2^nd. Edition New York: Taylor and Francis; 2015
• 21 Gumenyuk V, Belcher R, Roth T. Differential sleep, sleepiness, and neurophysiology in the insomnia phenotypes of shift work disorder. Sleep 2015; 38: 119-126