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Background <p>Sleep disorders are considered to be a&#xa0;disease if they result in impaired performance or well-being during the day and must last for at least 1&#xa0;month according to ICD-10 and at least 3&#xa0;months according to ICD-11. The S3&#xa0;guideline on this topic was recently updated and published. Herewith, we explain the most important recommendations.</p> Methods <p>The key question was the effectiveness of various therapeutic procedures or interventions in people with insomnia. For this, a&#xa0;systematic literature search was carried out. In an interdisciplinary consensus, the recommendations were approved and the texts were created and authorized by the corresponding professional societies and AWMF (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”).</p> Key messages <p>The recommended diagnostic approach remained largely unchanged, but the list of causative medications and diseases was updated. Cognitive behavioral therapy for insomnia (CBT-I) should be recommended as the first treatment option, preferably as face-to-face therapy and also in the presence of comorbid physical or mental illnesses. Digital health applications have recently also been introduced here. Drug therapy can be offered when CBT‑I has not been sufficiently effective or is not feasible, with great reluctance in older people and not as long-term therapy. Treatment with antipsychotics without a&#xa0;corresponding psychiatric indication or sedating antihistamines are explicitly discouraged. Phytotherapeutics should not be recommended. This also applies to treatment lasting more than&#xa0;12 months with daridorexant. Melatonin should not be used long-term, as well. Treatment of insomnia with exercise, light, and artistic therapies can be considered.</p>

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Insomnie – Update der S3‑Leitlinie

  • 期刊论文

  • 发表日期：

    2025年6月6日

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  • Erika Baum,
  • Maximilian Philipp,
  • Kai Spiegelhalder

摘要

Background

Sleep disorders are considered to be a disease if they result in impaired performance or well-being during the day and must last for at least 1 month according to ICD-10 and at least 3 months according to ICD-11. The S3 guideline on this topic was recently updated and published. Herewith, we explain the most important recommendations.

Methods

The key question was the effectiveness of various therapeutic procedures or interventions in people with insomnia. For this, a systematic literature search was carried out. In an interdisciplinary consensus, the recommendations were approved and the texts were created and authorized by the corresponding professional societies and AWMF (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”).

Key messages

The recommended diagnostic approach remained largely unchanged, but the list of causative medications and diseases was updated. Cognitive behavioral therapy for insomnia (CBT-I) should be recommended as the first treatment option, preferably as face-to-face therapy and also in the presence of comorbid physical or mental illnesses. Digital health applications have recently also been introduced here. Drug therapy can be offered when CBT‑I has not been sufficiently effective or is not feasible, with great reluctance in older people and not as long-term therapy. Treatment with antipsychotics without a corresponding psychiatric indication or sedating antihistamines are explicitly discouraged. Phytotherapeutics should not be recommended. This also applies to treatment lasting more than 12 months with daridorexant. Melatonin should not be used long-term, as well. Treatment of insomnia with exercise, light, and artistic therapies can be considered.