[Patient suffers from insomnia. Proscribing bed rest].
Roughly every fifth patient attending the doctor's office complains of insomnia. The first thing that needs to be done is to determine whether a particular patient has primary insomnia of pathological significance, or a temporary disturbance of his/her sense of well-being, or whether the sleep disorder is a secondary consequence of some other somatic or psychiatric condition. For the treatment of insomnia in the doctor's office, a number of basic rules derived from behavioral medicine can be recommended, for example systematic self-observation and record-keeping in a sleep diary, reassurance as to the harmlessness of a temporary sleep problem, practicing relaxation to reduce the general level of activity, reduction of the time spent in bed, and sleep-deprivation treatment. For all of these forms of treatment, a good doctor-patient relationship is mandatory, in particular when--as is to be expected--setbacks occur, which should not be dramatized. A diagnosis-treatment diagram is presented, in which proposals for medication should also be integrated.
Hoffmann
R M
RM
Psychiatrische Klinik mit Poliklinik, Universität Erlangen-Nürnberg. Hoffmann@psych.med.uni-erlangen.de
Löchte
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B
Eglau
M
M
D001521:Behavior Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D012892:Sleep Deprivation; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000628:therapy*