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Guter Schlaf im besten Alter

Zeitschrift:: Journal für Gynäkologische Endokrinologie/Schweiz > Ausgabe 3/2020

Autoren:: Dipl.-Psych. W. Cassel, P. Cassel

Wichtige Hinweise

Dieser Beitrag wurde in der Zeitschrift Gynäkologische Endokrinologie 2019 · 17:49–55, https://doi.org/10.1007/s10304-018-0221-z erstveröffentlicht. Zweitpublikation mit freundlicher Genehmigung der Autoren.

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.

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Provencio I, Jiang G, de Grip WJ, Hayes WP, Rollag MD (1998) Melanopsin: an opsin in melanophores, brain, and eye. Proc Natl Acad Sci U S A 95(1):340–345 CrossRef

Mohawk JA, Takahashi JS (2011) Cell autonomy and synchrony of suprachiasmatic nucleus circadian oscillators. Trends Neurosci 34(7):349–358. https://doi.org/10.1016/j.tins.2011.05.003 CrossRefPubMedPubMedCentral

Stahl SM, Muntner N (2013) Stahl’s essential psychopharmacology. Neuroscientific basis and practical application, 4. Aufl. Cambridge medicine. Cambridge University Press, Cambridge

Stahl SM (2014) Mechanism of action of tasimelteon in non-24 sleep-wake syndrome: treatment for a circadian rhythm disorder in blind patients. CNS Spectr 19(6):475–478. https://doi.org/10.1017/S1092852914000637 CrossRefPubMed

Liu J, Clough SJ, Hutchinson AJ et al (2016) MT1 and MT2 melatonin receptors: a therapeutic perspective. Annu Rev Pharmacol Toxicol 56:361–383. https://doi.org/10.1146/annurev-pharmtox-010814-124742 CrossRefPubMed

Zulley J (2014) Biologische Rhythmen, Schlaf und Jet Lag. Ther Umsch 71(11):631–635. https://doi.org/10.1024/0040-5930/a000603 CrossRefPubMed

Kunz D, Schmitz S, Mahlberg R, Mohr A, Stoter C, Wolf KJ, Herrmann WM (1999) A new concept for melatonin deficit: on pineal calcification and melatonin excretion. Neuropsychopharmacology 21(6):765–772. https://doi.org/10.1016/S0893-133X(99)00069-X CrossRefPubMed

Donaldson PJ, Grey AC, Maceo Heilman B, Lim JC, Vaghefi E (2017) The physiological optics of the lens. Prog Retin Eye Res 56:e1–e24. https://doi.org/10.1016/j.preteyeres.2016.09.002 CrossRefPubMed

Charman WN (2003) Age, lens transmittance, and the possible effects of light on melatonin suppression. Ophthalmic Physiol Opt 23(2):181–187 CrossRef

10.

Turner PL, Mainster MA (2008) Circadian photoreception: ageing and the eye’s important role in systemic health. Br J Ophthalmol 92(11):1439–1444. https://doi.org/10.1136/bjo.2008.141747 CrossRefPubMedPubMedCentral

11.

Campbell SS, Kripke DF, Gillin JC, Hrubovcak JC (1988) Exposure to light in healthy elderly subjects and Alzheimer’s patients. Physiol Behav 42(2):141–144 CrossRef

12.

Pail G, Huf W, Pjrek E, Winkler D, Willeit M, Praschak-Rieder N, Kasper S (2011) Bright-light therapy in the treatment of mood disorders. Neuropsychobiology 64(3):152–162. https://doi.org/10.1159/000328950 CrossRefPubMed

13.

Lambert GW, Reid C, Kaye DM, Jennings GL, Esler MD (2002) Effect of sunlight and season on serotonin turnover in the brain. Lancet 360(9348):1840–1842 CrossRef

14.

Tan D‑X, Manchester LC, Esteban-Zubero E, Zhou Z, Reiter RJ (2015) Melatonin as a potent and inducible endogenous antioxidant: synthesis and metabolism. Molecules 20(10):18886–18906. https://doi.org/10.3390/molecules201018886 CrossRefPubMedPubMedCentral

15.

Scholtens RM, van Munster BC, van Kempen MF, de Rooij SEJA (2016) Physiological melatonin levels in healthy older people: a systematic review. J Psychosom Res 86:20–27. https://doi.org/10.1016/j.jpsychores.2016.05.005 CrossRefPubMed

16.

Karasek M, Winczyk K (2006) Melatonin in humans. J Physiol Pharmacol 57 Suppl 5:19–39

17.

Terrón MP, Delgado-Adámez J, Pariente JA et al (2013) Melatonin reduces body weight gain and increases nocturnal activity in male Wistar rats. Physiol Behav 118:8–13. https://doi.org/10.1016/j.physbeh.2013.04.006 CrossRefPubMed

18.

Lemoine P, Nir T, Laudon M, Zisapel N (2007) Prolonged-release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects. J Sleep Res 16(4):372–380. https://doi.org/10.1111/j.1365-2869.2007.00613.x CrossRefPubMed

19.

Fischer D, Lombardi DA, Marucci-Wellman H, Roenneberg T (2017) Chronotypes in the US - influence of age and sex. PLoS ONE 12(6):e178782. https://doi.org/10.1371/journal.pone.0178782 CrossRefPubMedPubMedCentral

20.

Gómez-Santos C, Saura CB, Lucas JAR et al (2016) Menopause status is associated with circadian- and sleep-related alterations. Menopause 23(6):682–690. https://doi.org/10.1097/GME.0000000000000612

21.

Gursoy AY, Kiseli M, Caglar GS (2015) Melatonin in aging women. Climacteric 18(6):790–796. https://doi.org/10.3109/13697137.2015.1052393 CrossRefPubMed

22.

Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV (2004) Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 27(7):1255–1273 CrossRef

23.

Zhang B, Wing Y‑K (2006) Sex differences in insomnia: a meta-analysis. Sleep 29(1):85–93 CrossRef

24.

Baker FC, Kahan TL, Trinder J, Colrain IM (2007) Sleep quality and the sleep electroencephalogram in women with severe premenstrual syndrome. Sleep 30(10):1283–1291 CrossRef

25.

Joffe H, White DP, Crawford SL et al (2013) Adverse effects of induced hot flashes on objectively recorded and subjectively reported sleep: results of a gonadotropin-releasing hormone agonist experimental protocol. Menopause 20(9):905–914. https://doi.org/10.1097/GME.0b013e31828292d1 CrossRefPubMedPubMedCentral

26.

Savard M‑H, Savard J, Caplette-Gingras A et al (2013) Relationship between objectively recorded hot flashes and sleep disturbances among breast cancer patients: investigating hot flash characteristics other than frequency. Menopause 20(10):997–1005. https://doi.org/10.1097/GME.0b013e3182885e31 CrossRefPubMed

27.

Freedman RR, Roehrs TA (2007) Sleep disturbance in menopause. Menopause 14(5):826–829. https://doi.org/10.1097/GME.0b013e3180321a22 CrossRefPubMed

28.

van Someren EJW (2006) Mechanisms and functions of coupling between sleep and temperature rhythms. In: Kalsbeek A (Hrsg) Hypothalamic integration of energy metabolism, Bd. 153. Elsevier, Amsterdam, S 309–324

29.

Pinkerton JV, Abraham L, Bushmakin AG, Cappelleri JC, Komm BS (2016) Relationship between changes in vasomotor symptoms and changes in menopause-specific quality of life and sleep parameters. Menopause 23(10):1060–1066. https://doi.org/10.1097/GME.0000000000000678 CrossRefPubMed

30.

Leeangkoonsathian E, Pantasri T, Chaovisitseree S, Morakot N (2017) The effect of different progestogens on sleep in postmenopausal women: a randomized trial. Gynecol Endocrinol 33(12):933–936. https://doi.org/10.1080/09513590.2017.1333094 CrossRefPubMed

31.

Cintron D, Lahr BD, Bailey KR et al (2018) Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Menopause 25(2):145–153. https://doi.org/10.1097/GME.0000000000000971 CrossRefPubMedPubMedCentral

32.

Caufriez A, Leproult R, L’Hermite-Balériaux M, Kerkhofs M, Copinschi G (2011) Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. J Clin Endocrinol Metab 96(4):E614–E623. https://doi.org/10.1210/jc.2010-2558 CrossRefPubMed

33.

Stevenson JC, Chines A, Pan K, Ryan KA, Mirkin S (2015) A pooled analysis of the effects of conjugated estrogens/bazedoxifene on lipid parameters in postmenopausal women from the selective estrogens, menopause, and response to therapy (SMART) trials. J Clin Endocrinol Metab 100(6):2329–2338. https://doi.org/10.1210/jc.2014-2649 CrossRefPubMed

34.

Schüssler P, Kluge M, Adamczyk M et al (2018) Sleep after intranasal progesterone vs. zolpidem and placebo in postmenopausal women—a randomized, double-blind cross over study. Psychoneuroendocrinology 92:81–86. https://doi.org/10.1016/j.psyneuen.2018.04.001 CrossRefPubMed

35.

Freeman EW, Sammel MD, Boorman DW, Zhang R (2014) Longitudinal pattern of depressive symptoms around natural menopause. JAMA Psychiatry 71(1):36–43. https://doi.org/10.1001/jamapsychiatry.2013.2819 CrossRefPubMedPubMedCentral

36.

Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL (2006) Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles. Arch Gen Psychiatry 63(4):385–390. https://doi.org/10.1001/archpsyc.63.4.385 CrossRefPubMed

37.

Bromberger JT, Kravitz HM, Chang Y‑F, Cyranowski JM, Brown C, Matthews KA (2011) Major depression during and after the menopausal transition: study of Women’s Health Across the Nation (SWAN). Psychol Med 41(9):1879–1888. https://doi.org/10.1017/S003329171100016X CrossRefPubMedPubMedCentral

38.

Burleson MH, Todd M, Trevathan WR (2010) Daily vasomotor symptoms, sleep problems, and mood: using daily data to evaluate the domino hypothesis in middle-aged women. Menopause 17(1):87–95. https://doi.org/10.1097/gme.0b013e3181b20b2d CrossRefPubMed

39.

Bjørngaard JH, Bjerkeset O, Romundstad P, Gunnell D (2011) Sleeping problems and suicide in 75,000 Norwegian adults: a 20 year follow-up of the HUNT I study. Sleep 34(9):1155–1159. https://doi.org/10.5665/SLEEP.1228 CrossRefPubMedPubMedCentral

40.

Givens ML, Malecki KC, Peppard PE et al (2015) Shiftwork, sleep habits, and metabolic disparities: results from the survey of the health of wisconsin. Sleep Health 1(2):115–120. https://doi.org/10.1016/j.sleh.2015.04.014 CrossRef

41.

Trauer JM, Qian MY, Doyle JS, Rajaratnam SMW, Cunnington D (2015) Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med 163(3):191–204. https://doi.org/10.7326/M14-2841 CrossRefPubMed

42.

Bassetti CL, Đogaš Z, Peigneux P (Hrsg) (2014) ESRS European sleep medicine textbook. 2014. European sleep research society, Regensburg

43.

Bastien CH, Ceklic T, St-Hilaire P, Desmarais F, Pérusse AD, Lefrançois J, Pedneault-Drolet M (2014) Insomnia and sleep misperception. Pathol Biol 62(5):241–251. https://doi.org/10.1016/j.patbio.2014.07.003 CrossRefPubMed

44.

Obayashi K, Saeki K, Iwamoto J et al (2012) Positive effect of daylight exposure on nocturnal urinary melatonin excretion in the elderly: a cross-sectional analysis of the HEIJO-KYO study. J Clin Endocrinol Metab 97(11):4166–4173. https://doi.org/10.1210/jc.2012-1873 CrossRefPubMed

45.

Danilenko KV, Putilov AA, Russkikh GS, Duffy LK, Ebbesson SO (1994) Diurnal and seasonal variations of melatonin and serotonin in women with seasonal affective disorder. Arctic Med Res 53(3):137–145 PubMed

46.

van Bommel WJM (2006) Non-visual biological effect of lighting and the practical meaning for lighting for work. Appl Ergon 37(4):461–466. https://doi.org/10.1016/j.apergo.2006.04.009 CrossRefPubMed

47.

Boivin DB, Czeisler CA (1998) Resetting of circadian melatonin and cortisol rhythms in humans by ordinary room light. Neuroreport 9(5):779–782 CrossRef

48.

Bonmati-Carrion MA, Arguelles-Prieto R, Martinez-Madrid MJ, Reiter R, Hardeland R, Rol MA, Madrid JA (2014) Protecting the melatonin rhythm through circadian healthy light exposure. Int J Mol Sci 15(12):23448–23500. https://doi.org/10.3390/ijms151223448 CrossRefPubMedPubMedCentral

49.

Luthringer R, Muzet M, Zisapel N, Staner L (2009) The effect of prolonged-release melatonin on sleep measures and psychomotor performance in elderly patients with insomnia. Int Clin Psychopharmacol 24(5):239–249. https://doi.org/10.1097/YIC.0b013e32832e9b08 CrossRefPubMed

50.

Wade A, Downie S (2008) Prolonged-release melatonin for the treatment of insomnia in patients over 55 years. Expert Opin Investig Drugs 17(10):1567–1572. https://doi.org/10.1517/13543784.17.10.1567 CrossRefPubMed

51.

Mets MAJ, Volkerts ER, Olivier B, Verster JC (2010) Effect of hypnotic drugs on body balance and standing steadiness. Sleep Med Rev 14(4):259–267. https://doi.org/10.1016/j.smrv.2009.10.008 CrossRefPubMed

52.

Otmani S, Metzger D, Guichard N, Danjou P, Nir T, Zisapel N, Katz A (2012) Effects of prolonged-release melatonin and zolpidem on postural stability in older adults. Hum Psychopharmacol 27(3):270–276. https://doi.org/10.1002/hup.2219 CrossRefPubMed

53.

Otmani S, Demazières A, Staner C et al (2008) Effects of prolonged-release melatonin, zolpidem, and their combination on psychomotor functions, memory recall, and driving skills in healthy middle aged and elderly volunteers. Hum Psychopharmacol 23(8):693–705. https://doi.org/10.1002/hup.980 CrossRefPubMed

54.

Wade AG, Farmer M, Harari G et al (2014) Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer’s disease: a 6-month, randomized, placebo-controlled, multicenter trial. Clin Interv Aging 9:947–961. https://doi.org/10.2147/CIA.S65625 CrossRefPubMedPubMedCentral

55.

Martínez-Campa C, Menéndez-Menéndez J, Alonso-González C et al (2017) What is known about melatonin, chemotherapy and altered gene expression in breast cancer. Oncol Lett 13(4):2003–2014. https://doi.org/10.3892/ol.2017.5712 CrossRefPubMedPubMedCentral

56.

Danilov A, Kurganova J (2016) Melatonin in chronic pain syndromes. Pain Ther 5(1):1–17. https://doi.org/10.1007/s40122-016-0049-y CrossRefPubMedPubMedCentral

57.

Grossman E (2013) Should melatonin be used to lower blood pressure? Hypertens Res 36(8):682–683. https://doi.org/10.1038/hr.2013.29 CrossRefPubMed

58.

García JJ, López-Pingarrón L, Almeida-Souza P et al (2014) Protective effects of melatonin in reducing oxidative stress and in preserving the fluidity of biological membranes: a review. J Pineal Res 56(3):225–237. https://doi.org/10.1111/jpi.12128 CrossRefPubMed

59.

Hajak G, Lemme K, Zisapel N (2015) Lasting treatment effects in a postmarketing surveillance study of prolonged-release melatonin. Int Clin Psychopharmacol 30(1):36–42. https://doi.org/10.1097/YIC.0000000000000046 CrossRefPubMed

60.

Mong JA, Baker FC, Mahoney MM, Paul KN, Schwartz MD, Semba K, Silver R (2011) Sleep, rhythms, and the endocrine brain: influence of sex and gonadal hormones. J Neurosci 31(45):16107–16116. https://doi.org/10.1523/JNEUROSCI.4175-11.2011 CrossRefPubMedPubMedCentral

61.

Popovic RM, White DP (1998) Upper airway muscle activity in normal women: influence of hormonal status. J Appl Physiol 84(3):1055–1062. https://doi.org/10.1152/jappl.1998.84.3.1055 CrossRefPubMed

62.

Pengo MF, Won CH, Bourjeily G (2018) Sleep in women across the life span. Chest 154(1):196–206. https://doi.org/10.1016/j.chest.2018.04.005 CrossRefPubMedPubMedCentral

63.

Verthein U, Martens MS, Raschke P, Holzbach R (2013) Langzeitverschreibung von Benzodiazepinen und Non-Benzodiazepinen. Gesundheitswesen 75(7):430–437. https://doi.org/10.1055/s-0032-1321756 CrossRefPubMed

64.

Hoffmann F, Glaeske G (2014) Benzodiazepinhypnotika, Zolpidem und Zopiclon auf Privatrezept: Verbrauch zwischen 1993 und 2012. Nervenarzt 85(11):1402–1409. https://doi.org/10.1007/s00115-014-4016-8 CrossRefPubMed

65.

Brandt J, Leong C (2017) Benzodiazepines and Z‑drugs: an updated review of major adverse outcomes reported on in epidemiologic research. Drugs R D 17(4):493–507. https://doi.org/10.1007/s40268-017-0207-7 CrossRefPubMedPubMedCentral

66.

Allen RP (2014) Restless legs syndrome/Willis Ekbom disease: evaluation and treatment. Int Rev Psychiatry 26(2):248–262. https://doi.org/10.3109/09540261.2014.904279 CrossRefPubMed

Titel: Guter Schlaf im besten Alter
Autoren:: Dipl.-Psych. W. Cassel
P. Cassel
Publikationsdatum: 30.04.2020
DOI: https://doi.org/10.1007/s41975-020-00138-z
Verlag: Springer Vienna
Zeitschrift: Journal für Gynäkologische Endokrinologie/Schweiz Revue de Endocrinologie Gynécologique
Ausgabe 3/2020
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500

Springer Medizin Österreich

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Guter Schlaf im besten Alter

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