Alkol kullanım bozukluklarında uyku örüntüsü ve uyku bozuklukları

Uykusuzluğun, alkol bağımlılığı sürecinde önemli bir rol oynadığı varsayılmaktadır. Önemli klinik ve ekonomik sonuçları olan uyku sorunları, alkol bağımlılarında bağımlı olmayan bireylere göre daha sıktır. Alkol bağımlılarında hem alkol kullanım dönemleri, hem de yoksunluk dönemleri boyunca hemen her tip uyku sorunu sık olarak görülmektedir. Bu bireylerde sağlıklı kontrollere göre tipik olarak uykuya dalma süreleri uzamakta, uyku etkinliği düşmekte, uyku süresi kısalmakta ve yavaş dalga uykusu azalmaktadır. Ek olarak uykuları bölünmüş yapıdadır ve REM uykusu süresi artmış ya da azalmış olabilir. Uyku değişiklikleri alkol alma sonlandıktan sonra aylar, hatta yıllar boyunca sürebilir ve son çalışmalar uyku mimarisindeki belli değişimlerin, nesnel uyku yakınmaları gibi, alkol bağımlılığında relapsı öngördüğünü göstermektedir. Alkol içmeyi bırakanlarda bozulmuş uykuyu düzeltmek ve normale döndürmek için az sayıda farmakolojik ve farmakolojik olmayan yöntem çalışılmışken; benzodiyazepin-lerin, bazı hipnosedatiflerin veya serotonin geri alım inhibitörlerinin kullanılması önerilmemektedir. Uyku, uyku anormallikleri ve alkol bağımlılığı ilişkisinin aydınlatılması, alkol bağımlısı hastalarda uykuyu düzeltmek üzere yeni tedavi yaklaşımlarının geliştirilmesi ve yoksunluk süresince uykuyu etkileyen yoksunluk reaksiyonlarının önlenmesi için daha çok sayıda çalışmaya gereksinme vardır. Bu yazı, alkol kullanım bozuklukları ile uyku örüntüsü ilişkisini değerlendiren araştırma ve gözden geçirme yazıları incelenerek hazırlanmış ve okuyucuya alkol bağım-lılığı sürecinin her aşamasında uyku ile ilişkili bozuklukların önemini anımsatma ve tedavi yöntemleri ile ilgili literatür bilgisini özetleme amacı güdülmüştür.

Sleep pattern and sleep disorders in alcohol use disorders

Insomnia has been hypothesized to play an important role in the course of alcoholism. Sleep problems, which can have significant clinical and economic consequences, are more common among alcoholics than nonalcoholics. During both drinking periods and withdrawal, alcoholics commonly experience virtually every type of problems about sleep. Typically, these individuals take a longer time to fall asleep and have decreased sleep efficiency, shorter sleep duration and reduced amounts of slow wave sleep when compared with healthy controls. In addition, their sleep patterns are fragmented and the amount of REM sleep may be reduced or increased. Sleep changes can persist during months or years of abstinence, and recent studies indicate that certain alterations in sleep architecture, as well as subjective sleep complaints, predict relapse to alcoholism. While only a few pharmacological and nonpharmacological strategies to improve or normalise disturbed sleep in individuals who have recovered from alcoholism have been studied, the use of benzodiazepines, some other hypnosedatives or selective serotonin reuptake inhibitors is not recommended. Further studies are needed to clarify the relationship between sleep, sleep abnormalities and alcoholism, and to establish new approaches to improve sleep in alcohol-dependent patients and to prevent withdrawal reactions that affect sleep during abstinence. This article has been written by using information obtained from previous research and reviews that focused on the relationship between alcohol use disorders and sleep pattern, and it aims to remind the reader about the sleep disturbances associated with alcoholism process and to summarize the related treatment approaches in the literature.

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