Zusammenfassung
Das komplexe biologische Phänomen Schwangerschaft geht mit deutlichen Veränderungen des Schlafs einher. Ein- und Durchschlafstörungen, Atmungsstörungen und das Restless-Legs-Syndrom treten gehäuft auf. Melatonin ist einerseits der beste Biomarker unserer zirkadianen Rhythmik und fördert Schlaf, erfüllt andererseits auch als stärkstes bekanntes Antioxidans wichtige biologische Funktionen in der Reproduktion. Selbst der Geburtszeitpunkt und die Wehentätigkeit hängen mit nächtlichen Melatoninspiegeln zusammen. Die Säuglings- und Kleinkindphase beeinflusst den mütterlichen Schlaf deutlicher und anders als den Schlaf der Väter. Dem Eintritt der Menopause gehen niedrige nächtliche Melatoninspiegel voraus und sie bedeuten oft dramatisch verschlechterten Schlaf. Älter-Werden in einem industriell entwickelten Umfeld geht besonders für Frauen oft mit chronobiologisch nachteiligem Mangel an Tageslichtexposition in der Aktivitätsphase und erhöhter Kunstlichtexposition in der Ruhephase einher. Eine schlafmedizinisch fundierte Beratung kann schweren Schwangerschaftskomplikationen vorbeugen und die oft von Schlafproblemen geprägte Stillzeit einfacher machen. Schlaf, Gesundheit und Lebensqualität älterer Patientinnen können durch die Integration von psychologischen, schlafmedizinischen und chronobiologischen Faktoren in die frauenärztliche Versorgung verbessert werden.
Abstract
Pregnant women experience profound changes in sleep. The prevalence of sleep disorders such as insomnia, sleep apnoea and restless legs syndrome, which are potentially harmful for the unborn child, rises sharply in pregnancy. Melatonin is a strong marker of our circadian rhythm and promotes sleep. It also exhibits an extremely strong antioxidant potential, which makes it extremely important for the development of new life. Even the intensity and timing of labour and parturition correspond to melatonin levels. Nursing and infant age impact maternal sleep differently and more profoundly than they do paternal sleep. The menopausal transition is preceded by lowered nocturnal melatonin levels and frequently leads to dramatically worsened sleep. Aging females are more affected by the sleep-impairing side effects of modern life like low illumination levels during daytime and increased artificial light in the nocturnal resting period. Integrating sleep medicine into patient care can prevent serious pregnancy complications and lessen sleep disruptions during the nursing period. Sleep, health and quality of life of aging female patients can be improved through the integration of psychological, chronobiological and sleep medical factors into gynecological patient care.
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W. Cassel erhält Vortrags und Autorenhonorare von der Medice Arzneimittel Pütter GmbH und Vortagshonorare und Honorare für Beratungstätigkeiten von der Vanda Pharmaceuticals Deutschland GmbH. P. Cassel gibt an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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Klaus Friese, Oberaudorf
Gisela Gille, Lüneburg
Katrin Schaudig, Hamburg
Anneliese Schwenkhagen, Hamburg
Klaus Vetter, Berlin
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Cassel, W., Cassel, P. Schlafstörungen in der Gynäkologie: Schwangerschaft, Geburt, Stillzeit, Älter-Werden. Gynäkologe 54, 783–790 (2021). https://doi.org/10.1007/s00129-021-04844-y
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DOI: https://doi.org/10.1007/s00129-021-04844-y