Therapeutische Umschau. Revue thérapeutique
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Neurological sleep disorders are common in the general population and may have a strong impact on quality of life. General practitioners play a key role in recognizing and managing sleep disorders in the general population. They should therefore be familiar with the most important neurological sleep disorders. ⋯ Although narcolepsy is considered as a rare disease, recent discoveries in narcolepsy research provided insight in the function of brain circuitries involved in sleep wake regulation. REM sleep behavioral parasomnia (RBD) is increasingly recognized to represent an early manifestation of neurodegenerative disorders, in particular evolving synucleinopathies. Early diagnosis may thus open new perspectives for developing novel treatment options by targeting neuroprotective substances.
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Chronic insomnia, i. e. complaints about prolonged sleep onset, difficulties in maintaining sleep, early morning awakening and associated impairments of daytime functioning afflicts approximately 10 % of the population in most Western industrialized countries. Chronic insomnia can be due to somatic disorders, mental disorders, intake of medications, legal or illicit drugs. One third of all patients with chronic insomnias suffers from primary insomnia, a diagnosis which is given when none of the above mentioned factors can be identified as a causal factor. ⋯ Several published meta-analyses from the last two decades showed that these techniques, especially in their combined form, can be considered as evidence-based. It was shown that they are as effective as pharmacological therapy in the short-term and in the long-run even superior to pharmacotherapy. Cognitive-behavioral techniques for the therapy of insomnia can be used very successfully by trained physicians and psychotherapists.