Humans sleep through one third of their lives. The body needs sleep to regenerate, form new cells, and strengthen memory and the immune system. Accordingly, sleep disorders have a high negative impact on health. Improved sleep hygiene and effective therapy management can help to ensure that the patient can once again sleep restfully through the night.
About 6.3% of the Swiss population suffer from a pathological sleep disorder [1]. The number of sufferers who have moderate problems sleeping is significantly higher again, at 22.9%. This can include difficulty falling asleep, growing up at night, or even non-restful sleep. When the environment comes to rest, an extremely large amount happens within the body. Pollutants are removed, the immune system is strengthened and the memory is strengthened. Nerve connections activated during the day are strengthened, unused ones are weakened. If sleep is too short or not restful, a feeling of tiredness and irritability occurs in the morning. Chronic sleep deprivation promotes the development of hypertension, depression, dementia, type 2 diabetes, and obesity [2].
As a rule, humans need seven to eight hours of sleep per night. However, the need for sleep is very individual. Therefore, some people get by on six hours of sleep, whereas others need up to nine or ten hours. More than half of all sleep disorders are precursors or accompanying symptoms of psychiatric diseases. In addition to problems falling asleep and sleeping through the night, patients with depression typically awaken in the early hours of the morning. In anxiety disorders, falling asleep is particularly disturbed, and in patients with dementia, the distribution of sleep is often altered. However, neurological diseases such as multiple sclerosis, Parkinson’s disease and epilepsies are also frequently associated with significant sleep disturbances. Nocturnal breathing disorders affect approximately 2-5% of the population. Sleep apnea causes a decrease in the amount of oxygen in the blood, resulting in a wake-up response from the body. Not only does this disrupt sleep continuity – it also puts the body on heightened alert with a significant stress response [2].
Improve sleep hygiene
Basically, the treatment management of sleep disorders is oriented to the cause. If organic diseases or psychological disorders are present, these must be treated. Additionally, improved sleep hygiene can pave the way to better and more restful sleep. These include, for example:
- Regular sleeping hours
- A quiet, darkened, rather cool bedroom
- Do not go to bed until tired
- Evening rituals
- Relaxation techniques
Stimulants, late dinners, or other sleep-disrupting factors should be avoided.
Drug treatment in focus
Pharmacological measures can support improved sleep hygiene. As a general rule, however, use sleeping pills as sparingly and for as short a time as possible. Drugs with a longer duration of action are suitable for sleep disorders. However, they should not cause impairment the next day. Acute sleep disorders that arise due to short-term high stress can be treated for a limited time. Often, the development of a chronic sleep disorder can also be stopped in this way.
For acute sleep disorders, benzodiazepines, which develop a sleep-promoting effect by binding to GABA receptors, among others, are an option. However, since they can be addictive, they should be used for a maximum of three to four weeks. Antihistamines, especially of the older generation, are also suitable for the treatment of sleep disorders. However, since a habituation effect may occur, an omission attempt should be made after three days. The use of melatonin is becoming increasingly popular. The natural hormone predominantly controls the sleep-wake rhythm and is therefore particularly suitable for people in whom this is disturbed, for example, by shift work. It is not uncommon for herbal medicines to be prescribed, especially for mild sleep disorders. Its effect is slow and light. For this, they do not lead to habituation or hangover.
Literature:
- https://de.statista.com/statistik/daten/studie/429364/umfrage/verbreitung-von-schlafproblemen-in-der-schweiz (last accessed on 20.09.2021)
- www.neurologen-und-psychiater-im-netz.org/psychiatrie-psychosomatik-psychotherapie/erkrankungen/schlafstoerungen/was-sind-schlafstoerungen (last accessed on 20.09.2021)
InFo NEUROLOGY & PSYCHIATRY 2021; 19(5): 22.
