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<p>Sleep disorders are highly prevalent, including in correctional settings and represent an independent therapeutic challenge. This paper provides a&#xa0;systematic overview of the physiological, neurobiological and environmental foundations of sleep as well as the wide range of sleep disorders, particularly insomnia, sleep-related breathing disorders, circadian rhythm disturbances and comorbid conditions such as attention deficit/hyperactivity disorder (ADHD), schizophrenia and substance-induced disorders. It explores how institutional conditions, chronic stress, lack of structure and restricted autonomy contribute to the pathogenesis of sleep disturbances. The high prevalence of sleep-related complaints in prison (up to 70%) is well documented and necessitates a&#xa0;differentiated diagnostic approach incorporating clinical interviews, validated instruments and, if necessary, technical assessment tools. Nonpharmacological interventions, such as cognitive behavioral therapy for insomnia (CBT-I), physical activity, light therapy and hypnotherapy have shown high effectiveness even in custodial settings. In contrast, the frequent use of pharmacological treatment entails significant risks, including off-label use, dependence potential and liability issues in prescribing. The paper advocates a&#xa0;structured, multimodal treatment approach that takes the forensic-specific context and legal requirements into account. Sleep disorders should not be viewed merely as secondary symptoms but as distinct and clinically relevant conditions that warrant evidence-based treatment, even in correctional environments.</p>

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Schlafstörungen unter freiheitsentziehenden Bedingungen

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月1日

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  • Gregor Groß,
  • Susanne Stübner

摘要

Sleep disorders are highly prevalent, including in correctional settings and represent an independent therapeutic challenge. This paper provides a systematic overview of the physiological, neurobiological and environmental foundations of sleep as well as the wide range of sleep disorders, particularly insomnia, sleep-related breathing disorders, circadian rhythm disturbances and comorbid conditions such as attention deficit/hyperactivity disorder (ADHD), schizophrenia and substance-induced disorders. It explores how institutional conditions, chronic stress, lack of structure and restricted autonomy contribute to the pathogenesis of sleep disturbances. The high prevalence of sleep-related complaints in prison (up to 70%) is well documented and necessitates a differentiated diagnostic approach incorporating clinical interviews, validated instruments and, if necessary, technical assessment tools. Nonpharmacological interventions, such as cognitive behavioral therapy for insomnia (CBT-I), physical activity, light therapy and hypnotherapy have shown high effectiveness even in custodial settings. In contrast, the frequent use of pharmacological treatment entails significant risks, including off-label use, dependence potential and liability issues in prescribing. The paper advocates a structured, multimodal treatment approach that takes the forensic-specific context and legal requirements into account. Sleep disorders should not be viewed merely as secondary symptoms but as distinct and clinically relevant conditions that warrant evidence-based treatment, even in correctional environments.