Pregledni rad
Disturbances of Sleep and Wakefulness and Their Treatment
Danilo Hodoba
Sažetak
Disturbances of sleep and wakefulness by
their incidence, etiology and clinical features, as well as by
their influence on other medical conditions and ways of treatment,
surpass the frame of essential knowledge of the majority
of medical professionals. Thus, the most important entities
within the sleep medicine are concisely presented in
groups according to the international classification as: disturbances
of initiating and maintaining sleep with the main representatives:
insomnia, restless leg syndrome and periodic
leg movements (RLS and PLM); disorders in maintaining
wakefulness or hypersomnia with the main representatives:
narcolepsy and apnea syndrome in sleep; disturbances in
sleep-wake rhythm with representatives: Jet lag in crossing
time zones and shift work; and sleep disturbances connected
with particular phases of sleep and/or partial awakening
(parasomnia) represented by sleepwalking, sleep terror and
noctural enuresis. Accentuated are significant etiopathogenetic
facts connected with sleep-wake disturbances, including
new data, what in some cases enables causal therapeutic
approach. The principles of pharmacological treatment
comprehend confirmed experiences for indicated states, from
the application of benzodiazepine receptor agonists and some
antidepressants for insomnia, to dopaminergic agonists for
RLS/PLM, melatonin for biorhythm disorders, modafilin for
treating sleepiness, and tricyclic antidepressants for treating
cataleptic attacks in narcolepsy. The principles of pharmacological
treatment have led to cognitive behavioral techniques,
exclusively efficacious use of CPAP in obstructive sleep apnea
syndrome, as well as possible usability of chronopharmacological
approach in treating insomnia. Light therapy is presented
as a method of re-synchronization of a disturbed biorhythm,
but also as a counter-measure for sleepiness during
night shifts. Out of other accepted counter-measures for night
shift sleepiness, a night nap and vecaminic drinks are
stressed. The optimal time of sleep during the day in night
shift workers is discussed as well.
Ključne riječi
disturbances of sleep and wakefulness; treatment
Hrčak ID:
19972
URI
Datum izdavanja:
25.9.2002.
Posjeta: 7.969 *