Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Dec 2011
[Joint recommendations of the Association of German Faculties (MFT) and the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute for the education of hospital hygiene at German universities].
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Dec 2011
[Sleep disorders during infancy and childhood].
Several different systems are used to classify sleep disorders. The International Classification of Sleep Disorders (ICSD-2), established in 2005 by the American Academy of Sleep Medicine (AASM), utilizes eight different categories [1]: insomnias, sleep-related breathing disorders, hypersomnias, circadian rhythm disorders, parasomnias, sleep-related movement disorders, isolated symptoms/normal variants/unresolved issues, as well as other sleep disorders. ⋯ Several sleep disorders, for example, obstructive sleep apnea, have been observed to cause physical diseases as well as growth and developmental problems [2, 3]. Thus, it is essential to detect the problem early, to obtain a differentiated diagnosis, and initiate appropriate therapeutic measures.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Dec 2011
[Sleep medicine services in Germany].
The increase in sleep medicine services has paralleled the increased in nocturnal ventilation therapy in patients with sleep apnea. Even if the sleep medicine expertise did increase in the past, this is not sufficient to cover the increasing demand for sleep medicine services. To serve patients with nonrestorative sleep, a clinical algorithm showing the pathway from the clinical interview to sleep laboratory investigations is available. ⋯ There is a network of qualified sleep centers for stationary and ambulatory care, but their work is becoming more difficult under increasing health care economic pressure. Sleep medicine needs a solid structural and financial basis to provide good coverage of high quality health care service. New sleep medicine service centers for ambulatory care with a better network structure linked with other medical specialties and with offers for preventive medicine can serve all patients with sleep disorders over long periods of time.
-
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Dec 2011
[Biological principles of sleep and wake].
Electrophysiologically measurable sleep is divided into rapid eye movement (REM) sleep and nonREM sleep--the latter is further structured into several sleep stages, including deep sleep. This internal sleep regulation is explained by the reciprocal interaction model that was validated in 1975. The interdependence of not only the reciprocal discharge of cholinergic REM-on, but also serotonergic and noradrenergic (REM-off) cell populations distributed over the brain stem results in the alternating pattern of nonREM and REM sleep. ⋯ With the help of the orexin system, the flip-flop model explains why both sleep and wake can be sustained over longer periods. Dependency on age and physiological short and long sleepers are the most prominent variations of normal sleep behavior. Newer therapeutic concepts in sleep medicine have taken into consideration these biological basics, e.g., in the selection of sleep medication and in the development of new sleep-inducing medications.