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Die Bedeutung des Schlafs für gesunde Alkoholkonsumenten und alkoholabhängige Patienten

Importance of sleep in healthy consumers of alcohol and alcohol-dependent patients

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Zusammenfassung

Die Auswirkungen von Alkohol auf den Schlaf und das Schlaf-EEG bei Gesunden und Alkoholabhängigen in den verschiedenen Phasen der Abhängigkeit werden dargestellt. Gesunde schlafen zunächst besser. Eine höhere Dosis kann aber zur Durchschlafstörung in der 2. Nachthälfte führen. Alkohol interagiert mit einer vorhergehenden Schlafdeprivation oder -restriktion.

Schlafstörungen finden sich häufiger bei Alkoholkranken als bei Gesunden und können die Entwicklung einer Alkoholerkrankung begünstigen. Bei Alkoholkranken finden sich in allen Phasen der Erkrankung Einschlafstörungen und eine verminderte Gesamtschlafzeit sowie überzufällig häufig andere Schlafstörungen, wie Schlafapnoe-Syndrom oder periodische Beinbewegungen im Schlaf. . Es fanden sich Prädiktoren für ein erhöhtes Rückfallrisiko bei abstinenten Alkoholkranken.

Die Neurobiologie des Schlafs und der Alkoholabhängigkeit wird diskutiert. Eine wichtige Bedeutung kommt hierbei dem cholinerg-aminergen reziproken Interaktionsmodell der REM- und Non-REM-Schlafregulation zu. Therapeutische Implikationen werden diskutiert.

Summary

This article deals with the effects of alcohol on sleep and sleep EEG of healthy individuals and alcohol-dependent patients during different phases of alcohol dependency.

Healthy individuals initially experience an improvement in sleep, although a greater quantity of alcohol can lead to problems of sleep maintenance during the second half of the night. Preexisting sleep deprivation or sleep restriction potentiates the effects of alcohol.

Alcohol-dependent patients are found to be more prone to sleep problems than healthy individuals, which can facilitate the development of alcoholism. These patients experience difficulty falling asleep and suffer from a reduced total sleep time during all phases of the disorder, often accompanied by other sleep disorders such as sleep apnea syndrome or periodic leg movements during sleep. Certain predictors for the risk of relapse in abstinent alcoholics have been identified.

Neurobiological findings in sleep and alcohol dependency are discussed. The cholinergic-aminergic reciprocal interaction model of REM and non-REM sleep regulation is significant in this context. Therapeutic implications are discussed.

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Danksagung

Die in der Übersichtsarbeit erwähnte polysomnographische Studie bei Alkoholabhängigkeit unserer Arbeitsgruppe wurde durch das BMBF unterstützt (BMBF FKZU1 E B 9413).

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  1. Abteilung für Psychiatrie und Psychotherapie mit Poliklinik, Universitätsklinik für Psychiatrie und Psychosomatik, Freiburg i. Br.

    H. Gann, D. van Calker, B. Feige & D. Riemann

  2. Abteilung für Psychiatrie und Psychotherapie mit Poliklinik, Universitätsklinik für Psychiatrie und Psychosomatik, Hauptstraße 5, 79104, Freiburg i. Br.

    H. Gann

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Gann, H., van Calker, D., Feige, B. et al. Die Bedeutung des Schlafs für gesunde Alkoholkonsumenten und alkoholabhängige Patienten. Nervenarzt 75, 431–441 (2004). https://doi.org/10.1007/s00115-003-1637-8

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