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Guter Schlaf im besten Alter

Sleep well in the prime of life

  • Menopause und Frauengesundheit
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Dieser Beitrag behandelt Ursachen, Folgen und Behandlungsmöglichkeiten von Schlafstörungen, insbesondere bei Frauen in der Menopause. Neben einem Überblick über die physiologischen Mechanismen der Schlafregulation und die Funktion der sog. inneren Uhr erfolgt eine detaillierte Darstellung altersbedingter Veränderungen sowie geschlechtsspezifischer Unterschiede der Steuerung des Schlaf-Wach-Rhythmus. Hinsichtlich der Behandlung von Schlafstörungen wird vertieft auf die negativen Auswirkungen einer übertriebenen Aufmerksamkeit auf den Schlaf sowie auf den schlaffördernden Effekt einer ausreichenden Tageslichtexposition eingegangen. Neben verhaltensmedizinischen Interventionen bestehen auch Möglichkeiten zur medikamentösen Unterstützung des Schlafs, z. B. über Hormonsubstitution, etwa bei altersbedingtem Melatoninmangel oder durch Gabe von Östrogen oder Progesteron bei menopausalen und postmenopausalen Frauen. Daneben kommt in bestimmten Situationen auch ein Einsatz von verschreibungspflichtigen Schlafmitteln, hier insbesondere von Benzodiazepinagonisten, in Frage. Bei Versagen dieser Therapieoptionen sollte eine Überweisung in ein spezialisiertes schlafmedizinisches Zentrum erfolgen, um andere organische Erkrankungen auszuschließen.

Abstract

This article deals with the causes, sequelae and treatment options for sleep disorders, particularly for women in the menopause. In addition to an overview of physiological mechanisms of sleep regulation and the function of the so-called internal clock, a detailed presentation of age-related alterations and sex-specific differences in the control of the sleep-wake rhythm is given. With respect to the treatment of sleep disorders, an in-depth investigation of the negative effects of an exaggerated attention on sleep and the sleep-promoting effect of sufficient exposure to daylight are presented. In addition to behavioral medical interventions, there are also possibilities for pharmaceutical support of sleep, e.g. using hormone substitution in age-related melatonin deficiency or administration of estrogen or progesterone for menopausal and postmenopausal women. In certain situations the use of prescription only soporifics, particularly benzodiazepine agonists is also possible. If these treatment options are unsuccessful, referral to a specialized sleep disorders center should be undertaken in order to exclude other organic diseases.

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  1. Zentrum für Innere Medizin, SP Pneumologie, Schlafmedizinisches Zentrum, Klinikum der Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland

    W. Cassel

  2. Frauenarztpraxis Dr. Cassel & Dr. Wagner, Gießen, Deutschland

    P. Cassel

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W. Cassel erhält Vortrags- und Autorenhonorare von der Medice Arzneimittel Püttner GmbH, Vortragshonorare und Honorare für Beratungstätigkeiten von der Vanda Pharmaceuticals Deutschland GmbH und Vortragshonorare von der Amgen GmbH. P. Cassel gibt an, dass kein Interessenkonflikt besteht.

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L. Kiesel, Münster

A.O. Mueck, Tübingen

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Cassel, W., Cassel, P. Guter Schlaf im besten Alter. Gynäkologische Endokrinologie 17, 49–55 (2019). https://doi.org/10.1007/s10304-018-0221-z

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