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DOI: 10.1055/s-0028-1109967
© Georg Thieme Verlag KG Stuttgart · New York
Schlafstörungen bei schizophrenen Erkrankungen
Bedeutung und Optionen einer multimodalen HilfestellungSleep Disorders in SchizophreniaImportance and Options for a Multi-Dimensional SupportPublication History
Publication Date:
11 January 2010 (online)

Zusammenfassung
Ein- und Durchschlafstörungen und Störungen der zirkadianen Rhythmik finden sich sehr häufig im Rahmen schizophrener Erkrankungen. Schlafstörungen treten als Frühzeichen der Erstmanifestation sowie des Rezidivs auf und stehen in Beziehung zu Positivsymptomen und der Desorganisation des Denkens. In der schlafpolygrafischen Untersuchung finden sich bei schizophrenen Patienten typischerweise eine verlängerte Einschlaflatenz, eine Reduktion der Schlafeffizienz und eine Reduktion des Tiefschlafs, wobei speziell die Störungen des Tiefschlafs die neokortikale Plastizität und die Kognition negativ beeinflussen können. Im klinischen Alltag finden die erheblichen Schlafstörungen oft nicht die notwendige Berücksichtigung, zumal z. B. ältere Neuroleptika wie Haloperidol sogar die zirkadiane Rhythmik und damit den Schlaf-/Wachrhythmus Schizophrener negativ beeinflussen können. In der Übersicht werden daher zum besseren Verständnis die pathophysiologischen Veränderungen des Schlafes im Rahmen schizophrener Erkrankungen und deren potenzielle Auswirkungen diskutiert. Bezüglich der Therapie werden neben psychoedukativen Bausteinen auch schlafmedizinisch sinnvolle Neuroleptikabehandlungen diskutiert. Kenntnisse über Veränderungen des Schlafes im Rahmen schizophrener Erkrankungen ermöglichen die Berücksichtigung schlafhygienischer Maßnahmen im Therapieverlauf, die unter Umständen den Behandlungsverlauf positiv beeinflussen können.
Abstract
Difficulties initiating and maintaining sleep as well as circadian rhythm disorders are very common in schizophrenia. Sleeping disorders occur as early signs of the first manifestation of illness as well as early signs of relapse. They bear a relation to positive symptoms and disorganisation of thought. Polysomnographic investigations with schizophrenic patients typically demonstrate a prolonged sleep-onset latency and a decrease in sleep efficiency and slow wave sleep. In particular, distortions of deep sleep can affect neocortical plasticity and cognition negatively. The considerable sleeping disorders are often not sufficiently taken into account in clinical routine. Particularly older antipsychotic medication like Haloperidol can affect the circadian and sleep-wake rhythms negatively. Therefore, pathophysiological changes of sleep within the scope of schizophrenic disorders and their potential implications are discussed in this outline. Regarding therapy, psychoeducative approaches are discussed as well as the administration of antipsychotic medication in accordance with the recommendations of sleep medicine professionals.
Schlüsselwörter
Schlafstörungen - Schizophrenie - zirkadianer Rhythmus - Schlafhygiene
Key words
sleep disorders - schizophrenia - circadian rhythm - sleep hygiene
Literatur
- 1
Wittchen H U, Krause P, Höfler M. et al .
NISAS-2000: The „Nationwide Insomnia Screening and Awareness Study”. Prevalence and
interventions in primary care.
Fortschr Med Orig.
2001;
119 (1)
9-19
MissingFormLabel
- 2
Benca R M, Obermeyer W H, Thisted R A. et al .
Sleep and psychiatric disorders: a meta-analysis.
Arch Gen Psychiatry.
1992;
49
651-668
MissingFormLabel
- 3
Benca R M.
Sleep in psychiatric disorders.
Neurol Clin.
1996;
14 (4)
739-764
MissingFormLabel
- 4
Häfner H, an der Heiden W.
The course of schizophrenia in the light of modern follow-up studies: the ABC and
WHO studies.
Eur Arch Psychiatry Clin Neurosci.
1999;
249 (Suppl 4)
14-26
MissingFormLabel
- 5
Herz M I, Melville C.
Relapse in schizophrenia.
Am J Psychiatry.
1980;
137 (7)
801-805
MissingFormLabel
- 6
Chemerinski E, Ho B C, Flaum M. et al .
Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in
schizophrenia.
Compr Psychiatry.
2002;
43 (5)
393-396
MissingFormLabel
- 7
Kim S F, Huang A S, Snowman A M. et al .
Antipsychotic drug-induced weight gain mediated by histamine H 1 receptor-linked activation
of hypothalamic AMP-kinase.
Proc Natl Acad Sci U S A.
2007;
104 (9)
3456-3459
MissingFormLabel
- 8
Winkelman J W.
Schizophrenia, obesity, and obstructive sleep apnea.
J Clin Psychiatry.
2001;
62 (1)
8-11
MissingFormLabel
- 9
Hohl-Radke F, Dewes D, Staedt J.
Schlafstörungen und periodische Beinbewegungen bei Patienten mit Schizophrenien und
schizoaffektiven Psychosen. Korrelation mit dem Lebensalter und mit der Dauer der
Antipsychotikaeinnahme.
NeuroGer.
2006;
1 (2)
85-92
MissingFormLabel
- 10
Ganguli R, Reynolds 3rd
C F, Kupfer D J.
Electroencephalography sleep in young, never-medicated schizophrenics. A comparison
with delusional and nondelusional depressives and with healthy controls.
Arch Gen Psychiatry.
1987;
44 (1)
36-44
MissingFormLabel
- 11
Jus K, Bouchard M, Jus A K. et al .
Sleep EEG studies in untreated, long-term schizophrenic patients.
Arch Gen Psychiatry.
1973;
29
386-390
MissingFormLabel
- 12
Lauer C J, Schreiber W, Pollmächter T. et al .
Sleep in schizophrenia: a polysomnographic study on drug-naive patients.
Neuropsychopharmacology.
1997;
16
51-60
MissingFormLabel
- 13
Stern M, Fram D H, Wyatt R. et al .
All-night sleep studies of acute schizophrenics.
Arch Gen Psychiatry.
1969;
20 (4)
470-477
MissingFormLabel
- 14
Martin J L, Jeste D V, Ancoli-Israel S.
Older schizophrenia patients have more disrupted sleep and circadian rhythms than
age-matched comparison subjects.
Psychiatr Res.
2005;
39 (3)
251-259
MissingFormLabel
- 15
Wulff K, Joyce E, Middleton B. et al .
The Suitability of actigraphy, diary data, and urinary melatonin profiles for quantitative
assessment of sleep disturbances in schizophrenia: A case Report.
Chronobiology International.
2006;
23 (1&2)
485-495
MissingFormLabel
- 16
Yang C, Winkelman J W.
Clinical significance of sleep EEG abnormalities in chronic schizophrenia.
Schizophr Res.
2006;
82 (2 – 3)
251-260
MissingFormLabel
- 17
Wulff K, Joyce E M, Middleton B. et al .
Circadian activity and sleep cycle disturbances in schizophrenia patients in comparison
to unemployed healthy controls.
Int J Neuropsychopharmacology.
2008;
11 (Suppl 1)
150
MissingFormLabel
- 18 Deutsche Gesellschaft für Psychiatrie Psychotherapie und Nervenheilkunde .S3 Praxisleitlinien in Psychiatrie und Psychotherapie. Band 1. Behandlungsleitlinie
Schizophrenie. Darmstadt; Steinkopff Verlag 2006
MissingFormLabel
- 19
Tandon R, Shipley J E, Taylor S. et al .
Electroencephalographic sleep abnormalities in schizophrenia. Relationship to positive/negative
symptoms and prior neuroleptic treatment.
Arch Gen Psychiatry.
1992;
49 (3)
185-194
MissingFormLabel
- 20
Benson K L, Faull K L, Zarcone V P.
Evidence for the role of serotonin in the regulation of slow wave sleep in schizophrenia.
Sleep.
1991;
14
133-139
MissingFormLabel
- 21
Salín-Pascual R J, Herrera-Estrella Jr M, Galicia-Polo L. et al .
Low delta sleep predicted a good clinical response to olanzapine administration in
schizophrenic patients.
Rev Invest Clin.
2004;
56 (3)
345-350
MissingFormLabel
- 22
Benson K L, Sullivan E V, Lim K O. et al .
Slow wave sleep and computed tomographic measures of brain morphology in schizophrenia.
Psychiatry Res.
1996;
60
25-134
MissingFormLabel
- 23
Benson K L, Zarcone V P.
Rapid eye movement sleep in schizophrenia and depression.
Arch Gen Psychiatry.
1993;
50
474-483
MissingFormLabel
- 24
Caldwell D F, Domingo E F.
Electroencephalographic and eye movement patterns during sleep in chronic schizophrenic
patients.
Electroencephalogr Clin Neurophysiol.
1967;
22 (5)
414-420
MissingFormLabel
- 25
Feinberg I, Braun M, Koresko R L. et al .
Stage 4 sleep in schizophrenia.
Arch Gen Psychiatry.
1969;
21 (3)
262-266
MissingFormLabel
- 26
Hiatt J F, Floyd T C, Katz P H. et al .
Further evidence of abnormal non-rapid-eye-movement sleep in schizophrenia.
Arch Gen Psychiatry.
1985;
42
797-802
MissingFormLabel
- 27
Poulin J, Daoust A M, Forest G. et al .
Sleep architecture and its clinical correlates in first episode and neuroleptic-naive
patients with schizophrenia.
Schizophr Res.
2003;
62 (1 – 2)
147-153
MissingFormLabel
- 28
Lauer C J, Krieg J C.
Slow-wave sleep and ventricular size: Effects of antipsychotic comparative study in
schizophrenia and major depression.
Psychiatry.
1998;
44 (2)
121-128
MissingFormLabel
- 29
Forest G, Poulin J, Daoust A M. et al .
Attention and non-REM sleep in neuroleptic-naive persons with schizophrenia and control
participants.
Psychiatry Res.
2007 15;
149(1–3)
33-40
MissingFormLabel
- 30 Baldessarini R J. Drugs for the treatment of psychiatric disorders. Hardman JG, Limbird LE The Pharmacological Basis of Therapeutics New York; McGraw-Hill 1996: 399-459
MissingFormLabel
- 31
Hoffmann R, Hendrickse W, Rush A J. et al .
Slow-wave activity during non-REM sleep in men with schizophrenia and major depressive
disorders.
Psychiatry Res.
2000;
95
215-225
MissingFormLabel
- 32
Hudson J l, Lipinski J F, Keck P E. et al .
Polysomnographic characteristics of schizophrenia in comparison with mania and depression.
Biol Psychiatry.
1993;
34
191-193
MissingFormLabel
- 33
Kempenaers C, Kerkhofs M, Linkowski P. et al .
Sleep EEG variables in young schizophrenic and depressive patients.
Biol Psychiatry.
1988;
24 (7)
828-833
MissingFormLabel
- 34
Keshavan M S, Reynolds C F, Miewald J. et al .
Delta sleep deficits in schizophrenia.
Arch Gen Psychiatry.
1998;
55
443-448
MissingFormLabel
- 35
Salin-Pascual R J, Herrera-Estrella M, Galicia-Polo L. et al .
Low delta sleep predicted a good clinical response to olanzapine administration in
schizophrenic patients.
Rev Invest Clin.
2004;
56 (3)
345-350
MissingFormLabel
- 36
Tekell J L, Hoffmann R, Hendrickse W. et al .
High frequency EEG activity during sleep: characteristics in schizophrenia and depression.
Clin EEG Neurosci.
2005;
36 (1)
25-35
MissingFormLabel
- 37
Zarcone V P, Benson K L, Berger P A.
Abnormal rapid eye movement latencies in schizophrenia.
Arch Gen Psychiatry.
1987;
44
4548
MissingFormLabel
- 38
Luby E D, Caldwell D F.
Sleep deprivation and EEG slow wave activity in chronic schizophrenia.
Arch Gen Psychiatry.
1967;
17 (3)
361-364
MissingFormLabel
- 39
Dijk D J, Brunner D P, Borbély A A.
Time course of EEG power density during long sleep in humans.
Am J Physiol.
1990;
258
R650-R661
MissingFormLabel
- 40
Borbély A A, Baumann F, Brandeis D. et al .
Sleep deprivation: effect on sleep stages and EEG power density in man.
Electroencephalogr Clin Neurophysiol.
1981;
51
483-493
MissingFormLabel
- 41
Massimini M, Huber R, Ferrarelli F. et al .
The sleep slow oscillation as a traveling wave.
J Neurosci.
2004;
24 (31)
6862-6870
MissingFormLabel
- 42
Steriade M, Contreras D, CurroDossi R. et al .
The slow (< 1 Hz) oscillation in reticular thalamic and thalamocortical neurons: scenario
of sleep rhythm generation in interacting thalamic and neocortical networks.
J Neurosci.
1993;
13 (8)
3284-3299
MissingFormLabel
- 43 Staedt J, Riemann D. Pathophysiologie der Insomnie. Staedt J & Riemann D Diagnostik und Therapie von Schlafstörungen Stuttgart; Kohlhammer Verlag 2007: 25-31
MissingFormLabel
- 44
Hill S, Tononi G.
Modeling sleep and wakefulness in the thalamocortical system.
J Neurophysiol.
2005;
93 (3)
1671-1698
MissingFormLabel
- 45
Feinberg I, Thode H C, Chugani H T. et al .
Gamma distribution model describes maturational curves for delta wave amplitude, cortical
metabolic rate and synaptic density.
J Theor Biol.
1990;
142 (2)
149-161
MissingFormLabel
- 46
Huber M.
Felice Ghilardi, Marcello Massimini, Giulio Tononi Local sleep and learning.
Nature.
2004;
430
78-81
MissingFormLabel
- 47
Benington J H, Frank M G.
Cellular and molecular connections between sleep and synapticplasticity.
Prog Neurobiol.
2003;
69
71-101
MissingFormLabel
- 48
Hoffman K L, McNaughton B L.
Sleep on it: cortical reorganization after-the-fact.
Trends Neurosci.
2001;
25
1-2
MissingFormLabel
- 49
Maquet P.
The role of sleep in learning and memory.
Science.
2001;
294
1048-1052
MissingFormLabel
- 50
Steriade M, Timofeev I.
Neuronal plasticity in thalamocortical networks during sleep and waking oscillations.
Neuron.
2003;
37
563-576
MissingFormLabel
- 51
Stickgold R, Hobson J A, Fosse R. et al .
Sleep, learning, and dreams: off-line memory reprocessing.
Science.
2001;
294
1052-1057
MissingFormLabel
- 52
Walker M P.
A refined model of sleep and the time course of memory formation.
Behav Brain Sci.
2005;
28 (1)
51-64
MissingFormLabel
- 53
Peigneux P, Laureys S, Fuchs S. et al .
Are spatial memories strengthened in the human hippocampus during slow wave sleep?.
Neuron.
2004;
44 (3)
535-545
MissingFormLabel
- 54
Friston K J.
The disconnection hypothesis.
Schizophr Res.
1998;
30 (2)
115-125
MissingFormLabel
- 55
Stephan K E, Baldeweg T, Friston K J.
Synaptic plasticity and dysconnection in schizophrenia.
Biol Psychiatry.
2006;
59 (10)
929-939
MissingFormLabel
- 56
Walker M P, Stickgold R.
Sleep, Memory and Plasticity.
Annu Rev Psychol.
2006;
57
139-166
MissingFormLabel
- 57
Scheuerecker J, Ufer S, Zipse M. et al .
Cerebral changes and cognitive dysfunctions in medication-free schizophrenia – An
fMRI study.
J Psychiatr Res.
2008;
42 (6)
469-476
MissingFormLabel
- 58
Goder R, Boigs M, Braun S. et al .
Impairment of visuospatial memory is associated with decreased slow wave sleep in
schizophrenia.
J Psychiatr Res.
2004;
38 (6)
591-599
MissingFormLabel
- 59
Danos P.
Pathology of the thalamus and schizophrenia – an overview.
Fortschr Neurol Psychiatr.
2004;
72 (11)
621-634
MissingFormLabel
- 60
Martin J L, Jeste D V, Caliguri M P. et al .
Actigraphic estimates of circadian rhythms and sleep/wake in older schizophrenia patients.
Schizophr.
2001;
47 (1)
77-86
MissingFormLabel
- 61
Wirz-Justice A, Bromundt V, Cajochen C.
Circadian disruption and psychiatric disorders: the importance of entrainment.
Sleep Med Clin.
2009;
4 (2)
273-282
MissingFormLabel
- 62 Staedt J, Riemann D. Chronopsychopharmakologie. Staedt J & Riemann D Diagnostik und Therapie von Schlafstörungen Stuttgart; Kohlhammer Verlag 2007: 113-117
MissingFormLabel
- 63
Mai L M, Shieh K R, Pan J T.
Circadian changes of serum prolactin levels and tuberoinfundibular dopaminergic neuron
activities in ovariectomized rats treated with or without estrogen: the role of the
suprachiasmatic nuclei.
Neuroendocrinology.
1994;
60 (5)
520-526
MissingFormLabel
- 64
Takahashi K, Lin J S, Sakai K.
Neuronal activity of histaminergic tuberomammillary neurons during wake-sleep states
in the mouse.
J Neurosci.
2006;
26 (40)
10292-10298
MissingFormLabel
- 65
Wetter T C, Lauer C J, Gillich G. et al .
The electroencephalographic sleep pattern in schizophrenic patients treated with clozapine
or classical antipsychotic drugs.
J Psychiatr Res.
1996;
30 (6)
411-419
MissingFormLabel
- 66
Nofzinger E A, Kammen D P, Gilbertson M W. et al .
Electroencephalographic sleep in clinically stable schizophrenic patients: two-weeks
versus six-weeks neuroleptic-free.
Biol Psychiatry.
1993;
33 (11 – 12)
829-835
MissingFormLabel
- 67
Ayalon van L, Hermesh H, Dagan Y.
Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal
by risperidone and melatonin.
Chronobiol Int.
2002;
19 (5)
947-959
MissingFormLabel
- 68
Wirz-Justice A, Werth E, Savaskan E. et al .
Haloperidol disrupts, clozapine reinstates the circadian rest-activity cycle in a
patient with early-onset Alzheimer disease.
Alzheimer Dis Assoc Disord.
2000;
14 (4)
212-215
MissingFormLabel
- 69
Wirz-Justice A, Haug H J, Cajochen C.
Disturbed circadian rest-activity cycles in schizophrenia patients: an effect of drugs?.
Schizophr Bull.
2001;
27 (3)
497-502
MissingFormLabel
- 70
Viyoch J, Matsunaga N, Yoshida M. et al .
Effect of haloperidol on mPer1 gene expression in mouse suprachiasmatic nuclei.
J Biol Chem.
2005;
280 (8)
6309-6315
MissingFormLabel
- 71
Salín-Pascual R J, Herrera-Estrella M, Galicia-Polo L. et al .
Olanzapine acute administration in schizophrenic patients increases delta sleep and
sleep efficiency.
Biol Psychiatry.
1999;
46 (1)
141-143
MissingFormLabel
- 72
Sharpley A L, Vassallo C M, Cowen P J.
Olanzapine increases slow-wave sleep: evidence for blockade of central 5-HT(2C) receptors
in vivo.
Biol Psychiatry.
2000;
47 (5)
468-470
MissingFormLabel
- 73
Sharpley A L, Vassallo C M, Pooley E C. et al .
Allelic variation in the 5-HT2C receptor (HT2RC) and the increase in slow wave sleep
produced by olanzapine.
Psychopharmacology.
2001;
153 (2)
271-272
MissingFormLabel
- 74
Hinze-Selch D, Mullington J, Orth A. et al .
Effects of clozapine on sleep: a longitudinal study.
Biol Psychiatry.
1997;
42 (4)
260-266
MissingFormLabel
- 75
Haffmans J, Oolders H, Hoencamp E. et al .
Sleep quality in schizophrenia and the effects of atypical antipsychotic medication.
Acta Neuropsychiatrica.
2004;
16 (6)
281-289
MissingFormLabel
- 76
Yamashita H, Morinobu S, Yamawaki S. et al .
Effect of risperidone on sleep in schizophrenia: a comparison with haloperidol.
Psychiatry Res.
2002;
109 (2)
137-142
MissingFormLabel
- 77
Seeburg D P, Liu X, Chen C.
Frequency-dependent modulation of retinogeniculate transmission by serotonin.
J Neurosci.
2004;
24 (48)
10950-10962
MissingFormLabel
- 78
Smith B N, Sollars P J, Dudek F E. et al .
Serotonergic modulation of retinal input to the mouse suprachiasmatic nucleus mediated
by 5-HT1B and 5-HT7 receptors.
J Biol Rhythms.
2001;
16 (1)
25-38
MissingFormLabel
- 79
Luthringer R, Staner L, Noel N. et al .
A double-blind, placebo-controlled, randomized study evaluating the effect of paliperidone
extended-release tablets on sleep architecture in patients with schizophrenia.
Int Clin Psychopharmacol.
2007;
22 (5)
299-308
MissingFormLabel
- 80
Idzikowski C, Mills F J, Glennard R.
5-Hydroxytryptamine-2 antagonist increases human slow wave sleep.
Brain Res.
1986;
378 (1)
164-168
MissingFormLabel
- 81
Idzikowski C, Cowen P J, Nutt D. et al .
The effects of chronic ritanserin treatment on sleep and the neuroendocrine response
to L-tryptophan.
Psychopharmacology.
1987;
93 (4)
416-420
MissingFormLabel
- 82
Cohrs S, Rodenbeck A, Guan Z. et al .
Sleep-promoting properties of quetiapine in healthy subjects.
Psychopharmacology.
2004;
174 (3)
421-429
MissingFormLabel
- 83 Staedt J, Riemann D. Insomnie bei Restless-legs-Syndrom (RLS) und periodischen Beinbewegungen im Schlaf
(PLMS). Staedt J & Riemann D Diagnostik und Therapie von Schlafstörungen Stuttgart; Kohlhammer Verlag 2007: 34-42
MissingFormLabel
- 84
Duggal H S, Mendhekar D N.
Clozapine-associated restless legs syndrome.
J Clin Psychopharmacol.
2007;
27 (1)
89-90
MissingFormLabel
- 85
Kraus T, Schuld A, Pollmacher T.
Periodic leg movements in sleep and restless legs syndrome probably caused by olanzapine.
J Clin Psychopharmacol.
1999;
19 (5)
478-479
MissingFormLabel
- 86
Pinninti N R, Mago R, Townsend J. et al .
Periodic restless legs syndrome associated with quetiapine use: a case report.
J Clin Psychopharmacol.
2005;
25 (6)
617-618
MissingFormLabel
- 87
Wetter T C, Brunner J, Bronisch T.
Restless legs syndrome probably induced by risperidone treatment.
Pharmacopsychiatry.
2002;
35 (3)
109-111
MissingFormLabel
- 88
Neeper S A, Benson K L, Faull K F. et al .
Periodic leg movements in schizophrenia: Incidence and correlates.
Sleep Res.
1992;
21
154
MissingFormLabel
- 89
Diehl A, Braus D F, Büchel C. et al .
Tardive dyskinesia: pergolid, a possible therapeutic option.
Psychiatr Prax.
2003;
30 (6)
333-337
MissingFormLabel
- 90
Jaskiw G E, Popli A P.
A meta-analysis of the response to chronic L-dopa in patients with schizophrenia:
therapeutic and heuristic implications.
Psychopharmacol.
2004;
171 (4)
365-374
MissingFormLabel
- 91
Pajonk F G, Berner D, Kaizl I. et al .
The effects of physical exercise on brain morphology in patients with schizophrenia.
Schiz Res.
2008;
98 (Suppl 1)
129-130
MissingFormLabel
- 92
McCurry S M, Gibbons L E, Logsdon R G. et al .
Nighttime insomnia treatment and education for Alzheimer’s disease: a randomized,
controlled trial.
J Am Geriatr Soc.
2005;
53 (5)
793-802
MissingFormLabel
- 93 Staedt J, Riemann D. Allgemeine Psychotherapie von Schlafstörungen. Staedt J & Riemann D Diagnostik und Therapie von Schlafstörungen Stuttgart; Kohlhammer Verlag 2007: 127-162
MissingFormLabel
- 94
Morin C M, Culbert J P, Schwartz S M.
Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy.
Am J Psychiatry.
1994;
151 (8)
1172-1180
MissingFormLabel
- 95
Murtagh D R, Greenwood K M.
Identifying effective psychological treatments for insomnia: a meta-analysis.
J Consult Clin Psychol.
1995;
63 (1)
79-89
MissingFormLabel
- 96
Smith M T, Perlis M L, Park A. et al .
Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia.
Am J Psychiatry.
2002;
159 (1)
5-11
MissingFormLabel
- 97
Jacobs G D, Pace-Schott E F, Stickgold R. et al .
Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled
trial and direct comparison.
Arch Intern Med.
2004;
164 (17)
1888-1896
MissingFormLabel
- 98 Bäuml J, Pitschel-Walz G. Psychoedukation bei schizophrenen Erkrankungen. Stuttgart; Schattauer Verlag 2003
MissingFormLabel
- 99
Zhang L, Samet J, Caffo B. et al .
Power spectral analysis of EEG activity during sleep in cigarette smokers.
Chest.
2008;
133 (2)
427-432
MissingFormLabel
- 100
Staedt J, Pless-Steinkamp C, Herfeld F. et al .
Einfluss erhöhter Lichtintensität auf die Verweildauer von stationär behandelten depressiven
Patienten.
Nervenheilkunde.
2009;
28 (4)
223-226
MissingFormLabel
- 101
Bootzin R R, Nicassio P M.
Behavioral treatments for insomnia.
Progress in Behavior Modification.
1978;
6
1-41
MissingFormLabel
- 102
Anderson M W, Zendell S M, Rosa D P. et al .
Comparison of sleep restriction therapy and stimulus control in older insomniacs:
an update.
Sleep Res.
1988;
17
144
MissingFormLabel
- 103
Brooks J O, Friedman L, Bliwise D L. et al .
Use of wrist actigraph to study insomnia in older adults.
Sleep.
1993;
16
151-155
MissingFormLabel
- 104
Cervana K, Dauvilliers Y, Espa F. et al .
Effect of cognitive behavioral therapy for insomnia on sleep architecture and sleep
EEG power spectra in psychophysiological insomnia.
J Sleep Res.
2004;
13
385-393
MissingFormLabel
- 105
Edinger J, Hoelscher T, Marsh G. et al .
A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults.
Psychology and Aging.
1992;
7
282-289
MissingFormLabel
- 106
Friedman L, Bilswise D L, Yesavage J A. et al .
A preliminary study comparing sleep resstriction treatments for insomnia in older
adults.
J Gerontology.
1991;
46
1-8
MissingFormLabel
- 107
Hoelscher T J, Edinger J D.
Treatment of sleep-maintenance insomnia in older adults: sleep period reduction, sleep
education, and modified stimulus control.
Psychology and Aging.
1988;
3
258-263
MissingFormLabel
- 108
Morin C M, Kowatch R A, Wade J B.
Behavioral management of sleep disturbances secondary to chronic pain.
J Behav Ther Exp Psychiat.
1989;
20
295-302
MissingFormLabel
- 109
Morin C M, Kowatch R A, Barry T. et al .
Cognitive-behavior therapy for late-life insomnia.
J Consulting and Clinical Psychology.
1993;
61
137-146
MissingFormLabel
- 110
Rubinstein M L, Rothenberg S A, Maheswaran S. et al .
Modified sleep restriction therapy in middle-aged and elderly chronic insomniacs.
Sleep Res.
1990;
19
276
MissingFormLabel
- 111
Spielman A J, Saskin P, Thorpy M J.
Treatment of chronic insomnia by restriction of time in bed.
Sleep.
1987;
10 (1)
45-56
MissingFormLabel
- 112 Bernstein D A, Borkovec T D. Progressive Relaxation Training: A Manual for Helping Professions. Champaign, IL; Research Press 1973
MissingFormLabel
- 113
Öst L G.
Applied relaxation: description of a coping technique and review of controlled studies.
Behav Res Ther.
1987;
25 (5)
397-409
MissingFormLabel
Prof. Dr. Jürgen Staedt
Klinik für Psychiatrie
Psychotherapie und Psychosomatik-Memory Clinic
Vivantes Klinikum Spandau
Neue Bergstr. 6
13585 Berlin
Email: juergen.staedt@vivantes.de