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<p>Insomnia, especially chronic insomnia, is a&#xa0;common condition that is also listed as a&#xa0;separate clinical entity in the new International Classification of Diseases (ICD). The diagnosis of chronic insomnia is based on the patient’s own and third-party medical history, questionnaires on sleep and quality of life, a&#xa0;sleep–wake log, and, if necessary, a&#xa0;measurement of sleep quality. In addition, other factors that disrupt sleep as well as other sleep disorders must be ruled out, if necessary in a&#xa0;sleep laboratory. Cognitive behavioral therapy should be used as a&#xa0;preventive measure and as the first step in treatment. However, there is a&#xa0;lack of structured, comprehensive services. Therefore, digital services can also be used. Moderate to severe insomnia often requires treatment with sleep-promoting medication, as is also stipulated in the guidelines. However, there is a&#xa0;lack of structured, individualized treatment pathways. The authors recommend step-by-step treatment, starting with mild sleep-promoting agents such as melatonin and progressing to hypnotics such as daridorexant. Drug therapy is successful when it is used in a&#xa0;targeted manner and under medical supervision. Since the care situation for people with insomnia is inadequate, there is a&#xa0;need for more education of those affected and the medical profession, as well as collaboration between family doctors, general practitioners, specialists, and sleep medicine physicians.</p>

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„Ich kann nicht schlafen!“ – Insomnie als häufigste nichtkörperliche Schlafstörung

  • 期刊论文

  • 发表日期：

    2025年10月10日

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  • Ingo Fietze

摘要

Insomnia, especially chronic insomnia, is a common condition that is also listed as a separate clinical entity in the new International Classification of Diseases (ICD). The diagnosis of chronic insomnia is based on the patient’s own and third-party medical history, questionnaires on sleep and quality of life, a sleep–wake log, and, if necessary, a measurement of sleep quality. In addition, other factors that disrupt sleep as well as other sleep disorders must be ruled out, if necessary in a sleep laboratory. Cognitive behavioral therapy should be used as a preventive measure and as the first step in treatment. However, there is a lack of structured, comprehensive services. Therefore, digital services can also be used. Moderate to severe insomnia often requires treatment with sleep-promoting medication, as is also stipulated in the guidelines. However, there is a lack of structured, individualized treatment pathways. The authors recommend step-by-step treatment, starting with mild sleep-promoting agents such as melatonin and progressing to hypnotics such as daridorexant. Drug therapy is successful when it is used in a targeted manner and under medical supervision. Since the care situation for people with insomnia is inadequate, there is a need for more education of those affected and the medical profession, as well as collaboration between family doctors, general practitioners, specialists, and sleep medicine physicians.