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[精神病学与心理治疗中的睡眠医学]

[Sleep medicine in psychiatry and psychotherapy].

作者信息

Zeising Marcel, Thiedemann Christian, Pollmächer Thomas

机构信息

Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Krumenauerstr. 25, 85049, Ingolstadt, Deutschland.

Universitätsklinik für Neurologie, Landeskrankenhaus-Universitätskliniken Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.

出版信息

Nervenarzt. 2022 Mar;93(3):313-324. doi: 10.1007/s00115-022-01262-w. Epub 2022 Feb 24.

Abstract

Sleep medicine is a cross-disciplinary subject with high relevance for psychiatry and psychotherapy. The three most common sleep disorders (insomnia, sleep apnea syndrome and restless legs syndrome) are presented here with practical relevance. Cognitive behavioral therapy is the treatment of choice for insomnia, whereas symptomatic drug treatment (especially with GABA receptor agonists) should be used with caution. Sleep-related breathing disorders have a high prevalence of around 24% among psychiatric inpatients in Germany. Typical symptoms of obstructive sleep apnea syndrome should lead to a staged diagnostic process and, if necessary, cardiorespiratory polysomnography. It is not unusual for restless legs syndrome to be caused by psychopharmacological treatment. The primary form was usually treated with dopamine or dopamine agonists but due to the risk of augmentation, alternatives should be considered more often.

摘要

睡眠医学是一门与精神病学和心理治疗高度相关的跨学科科目。这里介绍了三种最常见的睡眠障碍(失眠、睡眠呼吸暂停综合征和不宁腿综合征)及其实际相关性。认知行为疗法是治疗失眠的首选方法,而对症药物治疗(尤其是使用GABA受体激动剂)应谨慎使用。在德国,睡眠相关呼吸障碍在精神科住院患者中的患病率约为24%,较高。阻塞性睡眠呼吸暂停综合征的典型症状应引发分阶段的诊断过程,必要时进行心肺多导睡眠图检查。不宁腿综合征由精神药物治疗引起的情况并不少见。原发性形式通常用多巴胺或多巴胺激动剂治疗,但由于有病情加重的风险,应更多地考虑使用其他替代方法。

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