[Non-restorative sleep and insomnia. Diagnostic and therapeutic options for psychiatry and psychotherapy].
Over the last few years, a shift in paradigm has taken place in the diagnosis and therapy of insomnia. Traditionally, treatment focused on improving night sleep, i.e. shortening sleep latency and prolonging total sleep time. Modern approaches aim at improving or restoring the recuperative value of sleep and ensuring daytime functioning on a social, psychological and professional level. Based on the guidelines "Non-restorative Sleep" of the German Society of Sleep Research and Sleep Medicine, this article presents a clinical algorithm for the diagnosis and therapy of non-restorative sleep with predominant insomnia. The term "non-restorative sleep" permits us to view the restorative value of sleep and the resulting daytime functioning of the individual afflicted with insomnia as the focus for the diagnosis of and therapy for insomnia. This algorithm is suitable for the clinical practice of outpatient psychiatric and psychotherapeutic services as well as for psychiatric inpatients. The main features for psychiatrists and psychotherapists in the diagnosis and therapy of non-restorative sleep are underlying psychiatric-psychological factors or secondary psychiatric sequelae of chronic primary insomnias. For primary, organic and psychiatric insomnias, a broad spectrum of psychopharmacological and cognitive behavioral methods can be applied either alone or in combination.
Riemann
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D
Abteilung für Allgemeine Psychiatrie und Psychotherapie mit Poliklinik, Universitätsklinik der Albert-Ludwigs-Universität Freiburg. dieter_riemann@psyallg.ukl.uni-freiburg.de
Voderholzer
U
U
Berger
M
M
D000465:Algorithms; D002940:Circadian Rhythm; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D038801:International Classification of Diseases; D017286:Polysomnography; D011379:Prognosis; D011570:Psychiatry; D011613:Psychotherapy; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*
D006993:Hypnotics and Sedatives
Nichterholsamer Schlaf und Insomnie. Diagnostische und therapeutische Optionen für Psychiatrie und Psychotherapie.