Der schlaf und seine cholinerge beeinflussbarkeit bei patienten mit primarer alkoholabhangigkeit im subakuten entzug

Sleep disturbances of alcoholics while actively drinking and at the beginning of, and during, abstinence were frequently reported. Gillin et al. (1994) were able to show that patients with primary alcoholism without secondary depression have a heightened REM sleep pressure at the beginning of abstinence. We investigated 41 patients with primary alcoholism during subacute withdrawal in the sleep laboratory; in 17 of these patients the cholinergic REM sleep induction test (CRIT) with 10 mg galanthamine was performed additionally. In comparison to age and gender matched healthy control patients had a heightened REM sleep pressure including shortened REM latency and increased REM density. A decrease of serotonergic neurotransmission and/or a cholinergic subsensitivity in the frame of the reciprocal cholinergic-aminergic interaction model of the non-REM- and REM- sleep-regulation are proposed as being the neuro-chemical mechanism to explain the results. Follow-up investigations will clarify whether the sleep abnormalities in alcoholism are state- or trait-markers and whether they are suitable to predict the relapse risk.