The German Neurological Society (DGN) has updated the guideline "Insomnia in Neurological Diseases" (Insomnie bei neurologischen Erkrankungen). It differentiates between insomnia in headache, neurodegenerative movement disorders, multiple sclerosis, traumatic brain damage, epilepsy, neuromuscular diseases, stroke, as well as dementia and prion diseases.
In the case of insomnia in headaches, according to the guideline, in addition to symptom-oriented drug therapy, the use of combined cognitive behavioral therapy is now recommended, as well as light therapy and melatonin administration.
In Parkinson's disease, eszopiclone, doxepin, zolpidem, trazodone, ramelteon, and melatonin can be used. The subjective sleep quality can be improved with the antipsychotic pimavanserin and the antidepressants venlafaxine and nortriptyline.
According to the guideline, "Cognitive behavioral therapy for insomnia" (CBTi) is recommended for the treatment of insomnia in multiple sclerosis. A therapy attempt with melatonin is also possible.
The full details in German can be found here
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