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<p>With the introduction of ICD-11 in 2022, chronic insomnia was officially recognized as an independent disorder, no longer just a&#xa0;symptom of other conditions such as depression. This classification allows for targeted treatment, even when comorbid conditions are present. Epidemiological data indicate that around 10% of the population suffers from persistent difficulties falling and staying asleep, often accompanied by daytime fatigue and exhaustion. Interestingly, many individuals significantly underestimate their actual sleep duration. Specialized procedures help facilitate the diagnosis of chronic insomnia outside of sleep laboratories. One key tool is the ALiBABA checklist, which provides a&#xa0;structured assessment of various insomnia-related aspects and integrates the Insomnia Severity Index (ISI) to determine severity. Additionally, ambulatory actigraphy is employed as an alternative to traditional sleep lab evaluations, allowing for real-world sleep data collection over multiple nights. The preferred treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I), which has the highest level of scientific evidence (grade&#xa0;A). Pharmacological options like benzodiazepines and Z‑drugs are only recommended for short-term use. For long-term management, options include extended-release melatonin (recommended for individuals over&#xa0;55) and dual orexin receptor antagonists (DORAs), such as daridorexant. These medications work by blocking the orexin system, thereby reducing nighttime wakefulness while demonstrating good tolerability without dependence risk.</p>

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Die chronisch insomnische Störung – oft mehr Schlaf als man glaubt!

  • 期刊论文

  • 发表日期：

    2025年7月21日

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  • Michael Saletu,
  • Doris Moser

摘要

With the introduction of ICD-11 in 2022, chronic insomnia was officially recognized as an independent disorder, no longer just a symptom of other conditions such as depression. This classification allows for targeted treatment, even when comorbid conditions are present. Epidemiological data indicate that around 10% of the population suffers from persistent difficulties falling and staying asleep, often accompanied by daytime fatigue and exhaustion. Interestingly, many individuals significantly underestimate their actual sleep duration. Specialized procedures help facilitate the diagnosis of chronic insomnia outside of sleep laboratories. One key tool is the ALiBABA checklist, which provides a structured assessment of various insomnia-related aspects and integrates the Insomnia Severity Index (ISI) to determine severity. Additionally, ambulatory actigraphy is employed as an alternative to traditional sleep lab evaluations, allowing for real-world sleep data collection over multiple nights. The preferred treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I), which has the highest level of scientific evidence (grade A). Pharmacological options like benzodiazepines and Z‑drugs are only recommended for short-term use. For long-term management, options include extended-release melatonin (recommended for individuals over 55) and dual orexin receptor antagonists (DORAs), such as daridorexant. These medications work by blocking the orexin system, thereby reducing nighttime wakefulness while demonstrating good tolerability without dependence risk.