Skip to main content
Erschienen in: Somnologie 3/2015

01.09.2015 | Original Contribution

Sleep pattern and insomnia among medical students

Effect of gender and dysfunctional beliefs and attitudes about sleep

verfasst von: MD, PhD, IBSM K. Joshi, D. Mishra, H. Dubey, R. Gupta

Erschienen in: Somnologie | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Earlier literature on the sleep patterns of students has suggested that these individuals often have erratic sleep patterns and around 8–9 % suffer from insomnia. Some of the literature on nonmedical university students reported that sleep patterns are subject to gender bias. However, only few reports examining sleep patterns among medical students are available. Moreover, dysfunctional beliefs and attitudes about sleep (DBAS) among medical students have never been examined.

Question

What are the sleep patterns of medical students? Are these affected by gender? What is the prevalence of clinical insomnia? How prevalent are DBAS among medical students and does gender effect these? Do DBAS influence the sleep patterns?

Materials and methods

For this study, first-, second- and third-year medical students were approached and requested to participate. Among 300 students, 200 agreed to participate and were included. A self-designed questionnaire for collecting demographic data and information on sleep patterns—both on weekdays and at weekends—was distributed. Participating students were also encouraged to provide information regarding substance use, insomnia and family history of sleep disturbances. Dysfunctional beliefs and attitudes about sleep (DBAS) were examined using the DBAS-16 questionnaire. Descriptive statistics were calculated. Chi-square was used to compare proportions and the independent sample t-test was used to compare means between two groups.

Results

Average age of the subjects was 19.8 ± 1.3 years. On weekdays, 70 % of subjects went to bed between 11 pm to 1.30 am. Usual waketime on weekdays was between 6 am and 7 am (69 %). At weekends, bedtime and waketime were delayed. In addition, an increase in total sleep time by 1.2 hours was observed at weekends (P < 0.001). Clinical insomnia could be diagnosed in 5 % of subjects. Gender did not affect sleep patterns or DBAS score. Of the included students, 86.6 % had dysfunctional beliefs. A discrepancy was observed between the DBAS-16 scores and sleep practices.

Conclusion

We found that medical students had delayed-type sleep patterns and 5 % suffered from clinically significant insomnia. Students’ sleep patterns remained unaffected by gender and DBAS, despite the fact that DBAS are common among these individuals.
Literatur
1.
Zurück zum Zitat Abdulghani HM, Alrowais NA, Bin-Saad NS et al (2012) Sleep disorder among medical students: relationship to their academic performance. Med Teach 34(1):37–41CrossRef Abdulghani HM, Alrowais NA, Bin-Saad NS et al (2012) Sleep disorder among medical students: relationship to their academic performance. Med Teach 34(1):37–41CrossRef
2.
Zurück zum Zitat Ajzen I, Brown TC, Carvajal F (2004) Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation. Pers Soc Psychol Bull 30:1108–1121CrossRefPubMed Ajzen I, Brown TC, Carvajal F (2004) Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation. Pers Soc Psychol Bull 30:1108–1121CrossRefPubMed
3.
Zurück zum Zitat Al-Eisa E, Buragadda S, Melam GR et al (2013) Association between physical activity and insomnia among saudi female college students. J Phys Ther Sci 25:1479–1482PubMedCentralCrossRefPubMed Al-Eisa E, Buragadda S, Melam GR et al (2013) Association between physical activity and insomnia among saudi female college students. J Phys Ther Sci 25:1479–1482PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Almohaya A, Qrmli A, Almagal N et al (2013) Sleep medicine education and knowledge among medical students in selected saudi medical schools. BMC Med Educ 13:133PubMedCentralCrossRefPubMed Almohaya A, Qrmli A, Almagal N et al (2013) Sleep medicine education and knowledge among medical students in selected saudi medical schools. BMC Med Educ 13:133PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Al-Sayed AA, Al-Rashoudi AH, Al-Eisa AA et al (2014) Sedative drug use among king Saud university medical students: a cross-sectional sampling study. Depress Res Treat 378738: doi:http://dx.doi.org/10.1155/2014/378738PubMedCentralPubMed Al-Sayed AA, Al-Rashoudi AH, Al-Eisa AA et al (2014) Sedative drug use among king Saud university medical students: a cross-sectional sampling study. Depress Res Treat 378738: doi:http://​dx.​doi.​org/​10.​1155/​2014/​378738PubMedCentralPubMed
6.
Zurück zum Zitat American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4. Aufl. (Text Revision (DSM-IV-TR). Text 1:943) American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4. Aufl. (Text Revision (DSM-IV-TR). Text 1:943)
7.
Zurück zum Zitat American Sleep Disorders Association (2005) The International classification of sleep disorders : diagnostic & coding manual. American Academy of Sleep Medicine, Westchester, IL American Sleep Disorders Association (2005) The International classification of sleep disorders : diagnostic & coding manual. American Academy of Sleep Medicine, Westchester, IL
8.
Zurück zum Zitat Angelone AM, Mattei A, Sbarbati M, Di Orio F (2011) Prevalence and correlates for self-reported sleep problems among nursing students. J Prev Med Hyg 52:201–208PubMed Angelone AM, Mattei A, Sbarbati M, Di Orio F (2011) Prevalence and correlates for self-reported sleep problems among nursing students. J Prev Med Hyg 52:201–208PubMed
9.
Zurück zum Zitat Asaoka S, Komada Y, Aritake S et al (2014) Effect of delayed sleep phase during university life on the daytime functioning in work life after graduation. Sleep Med 15:1155–1158CrossRefPubMed Asaoka S, Komada Y, Aritake S et al (2014) Effect of delayed sleep phase during university life on the daytime functioning in work life after graduation. Sleep Med 15:1155–1158CrossRefPubMed
10.
Zurück zum Zitat Assaad S, Costanian C, Haddad G, Tannous F (2014) Sleep patterns and disorders among university students in Lebanon. J Res Health Sci 14:198–204PubMed Assaad S, Costanian C, Haddad G, Tannous F (2014) Sleep patterns and disorders among university students in Lebanon. J Res Health Sci 14:198–204PubMed
11.
Zurück zum Zitat Bahammam AS, Alaseem AM, Alzakri AA et al (2012) The relationship between sleep and wake habits and academic performance in medical students: a cross-sectional study. BMC Med Educ 12:61PubMedCentralCrossRefPubMed Bahammam AS, Alaseem AM, Alzakri AA et al (2012) The relationship between sleep and wake habits and academic performance in medical students: a cross-sectional study. BMC Med Educ 12:61PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat Bahammam AS, Al-Khairy OK, Al-Taweel AA (2005) Sleep habits and patterns among medical students. Neurosci (Riyadh) 10:159–162 Bahammam AS, Al-Khairy OK, Al-Taweel AA (2005) Sleep habits and patterns among medical students. Neurosci (Riyadh) 10:159–162
13.
Zurück zum Zitat Carney CE, Edinger JD (2006) Identifying critical beliefs about sleep in primary insomnia. Sleep 29:444–453PubMed Carney CE, Edinger JD (2006) Identifying critical beliefs about sleep in primary insomnia. Sleep 29:444–453PubMed
14.
Zurück zum Zitat Carney CE, Edinger JD, Manber R et al (2007) Beliefs about sleep in disorders characterized by sleep and mood disturbance. J Psychosom Res 62:179–188CrossRefPubMed Carney CE, Edinger JD, Manber R et al (2007) Beliefs about sleep in disorders characterized by sleep and mood disturbance. J Psychosom Res 62:179–188CrossRefPubMed
15.
Zurück zum Zitat Carney CE, Edinger JD, Morin CM et al (2010) Examining maladaptive beliefs about sleep across insomnia patient groups. J Psychosom Res 68:57–65PubMedCentralCrossRefPubMed Carney CE, Edinger JD, Morin CM et al (2010) Examining maladaptive beliefs about sleep across insomnia patient groups. J Psychosom Res 68:57–65PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Chinawa JM, Chukwu BF (2014) Obu HA sleep practices among medical students in pediatrics department of university of Nigeria teaching hospital, Ituku/Ozalla, Enugu, Nigeria. Niger J Clin Pract 17:232–236CrossRefPubMed Chinawa JM, Chukwu BF (2014) Obu HA sleep practices among medical students in pediatrics department of university of Nigeria teaching hospital, Ituku/Ozalla, Enugu, Nigeria. Niger J Clin Pract 17:232–236CrossRefPubMed
17.
Zurück zum Zitat Crönlein T, Wagner S, Langguth B et al (2014) Are dysfunctional attitudes and beliefs about sleep unique to primary insomnia ? Sleep Med 15:1463–1467CrossRefPubMed Crönlein T, Wagner S, Langguth B et al (2014) Are dysfunctional attitudes and beliefs about sleep unique to primary insomnia ? Sleep Med 15:1463–1467CrossRefPubMed
18.
Zurück zum Zitat Crowley SJ, Van Reen E, LeBourgeois MK et al (2014) A longitudinal assessment of sleep timing, circadian phase, and phase angle of entrainment across human adolescence. Plos One 9:e112199PubMedCentralCrossRefPubMed Crowley SJ, Van Reen E, LeBourgeois MK et al (2014) A longitudinal assessment of sleep timing, circadian phase, and phase angle of entrainment across human adolescence. Plos One 9:e112199PubMedCentralCrossRefPubMed
19.
Zurück zum Zitat Dhyani M, Rajput R, Gupta R (2013) Hindi translation and validation of dysfunctional beliefs and attitudes about sleep (DBAS – 16). Ind Psychiatry J 22:80–85PubMedCentralCrossRefPubMed Dhyani M, Rajput R, Gupta R (2013) Hindi translation and validation of dysfunctional beliefs and attitudes about sleep (DBAS – 16). Ind Psychiatry J 22:80–85PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Edinger JD, Carney CE, Wohlgemuth WK (2008) Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. Behav Ther 39:406–416CrossRefPubMed Edinger JD, Carney CE, Wohlgemuth WK (2008) Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. Behav Ther 39:406–416CrossRefPubMed
22.
Zurück zum Zitat FeldmanHall O, Dalgleish T, Thompson R et al (2012) Differential neural circuitry and self-interest in real vs hypothetical moral decisions. Soc Cogn Affect Neurosci 7:743–751PubMedCentralCrossRefPubMed FeldmanHall O, Dalgleish T, Thompson R et al (2012) Differential neural circuitry and self-interest in real vs hypothetical moral decisions. Soc Cogn Affect Neurosci 7:743–751PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Fisman DN, Harris AD, Rubin M et al (2007) Fatigue increases the risk of injury from sharp devices in medical trainees: results from a case-crossover study. Infect Control Hosp Epidemiol 28:10–17CrossRefPubMed Fisman DN, Harris AD, Rubin M et al (2007) Fatigue increases the risk of injury from sharp devices in medical trainees: results from a case-crossover study. Infect Control Hosp Epidemiol 28:10–17CrossRefPubMed
24.
Zurück zum Zitat Fossum IN, Nordnes LT, Storemark SS et al (2014) The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype. Behav Sleep Med 12:343–357CrossRefPubMed Fossum IN, Nordnes LT, Storemark SS et al (2014) The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype. Behav Sleep Med 12:343–357CrossRefPubMed
25.
Zurück zum Zitat Genzel L, Ahrberg K, Roselli C et al (2013) Sleep timing is more important than sleep length or quality for medical school performance. Chronobiol Int 30:766–771CrossRefPubMed Genzel L, Ahrberg K, Roselli C et al (2013) Sleep timing is more important than sleep length or quality for medical school performance. Chronobiol Int 30:766–771CrossRefPubMed
26.
Zurück zum Zitat Giri P, Baviskar M, Phalke D (2013) Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western Maharashtra, India. Ann Med Health Sci Res 3:51–54PubMedCentralCrossRefPubMed Giri P, Baviskar M, Phalke D (2013) Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western Maharashtra, India. Ann Med Health Sci Res 3:51–54PubMedCentralCrossRefPubMed
27.
Zurück zum Zitat Gregory AM, Cox J, Crawford MR et al (2009) Dysfunctional beliefs and attitudes about sleep in children. J Sleep Res 18:422–426CrossRefPubMed Gregory AM, Cox J, Crawford MR et al (2009) Dysfunctional beliefs and attitudes about sleep in children. J Sleep Res 18:422–426CrossRefPubMed
28.
Zurück zum Zitat Kabrita CS, Hajjar-Muça TA, Duffy JF (2014) Predictors of poor sleep quality among Lebanese university students: association between evening typology, lifestyle behaviors, and sleep habits. Nat Sci Sleep 6:11–18PubMedCentralCrossRefPubMed Kabrita CS, Hajjar-Muça TA, Duffy JF (2014) Predictors of poor sleep quality among Lebanese university students: association between evening typology, lifestyle behaviors, and sleep habits. Nat Sci Sleep 6:11–18PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Kang J-H, Chen S-C (2009) Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan. BMC Public Health 9:248PubMedCentralCrossRefPubMed Kang J-H, Chen S-C (2009) Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan. BMC Public Health 9:248PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Luo M, Feng Y, Li T (2013) Sleep medicine knowledge, attitudes, and practices among medical students in Guangzhou, China. Sleep Breath 17:687–693CrossRefPubMed Luo M, Feng Y, Li T (2013) Sleep medicine knowledge, attitudes, and practices among medical students in Guangzhou, China. Sleep Breath 17:687–693CrossRefPubMed
31.
Zurück zum Zitat Monk TH, Buysse DJ, Kennedy KS et al (2003) Measuring sleep habits without using a diary: the sleep timing questionnaire. Sleep 26:208–212PubMed Monk TH, Buysse DJ, Kennedy KS et al (2003) Measuring sleep habits without using a diary: the sleep timing questionnaire. Sleep 26:208–212PubMed
32.
Zurück zum Zitat Morin CM, Blais F, Savard J (2002) Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behav Res Ther 40:741–752CrossRefPubMed Morin CM, Blais F, Savard J (2002) Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behav Res Ther 40:741–752CrossRefPubMed
33.
Zurück zum Zitat Morin CM, Vallières A, Ivers H (2007) Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep 30:1547–1554PubMedCentralPubMed Morin CM, Vallières A, Ivers H (2007) Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep 30:1547–1554PubMedCentralPubMed
34.
Zurück zum Zitat Nadorff MR, Salem T, Winer ES et al (2014) Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender. J Clin Sleep Med 10:1317–1323PubMedCentralPubMed Nadorff MR, Salem T, Winer ES et al (2014) Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender. J Clin Sleep Med 10:1317–1323PubMedCentralPubMed
35.
Zurück zum Zitat Okajima I, Nakajima S, Ochi M, Inoue Y (2014) Reducing dysfunctional beliefs about sleep does not significantly improve insomnia in cognitive behavioral therapy. Plos One 9:e102565PubMedCentralCrossRefPubMed Okajima I, Nakajima S, Ochi M, Inoue Y (2014) Reducing dysfunctional beliefs about sleep does not significantly improve insomnia in cognitive behavioral therapy. Plos One 9:e102565PubMedCentralCrossRefPubMed
36.
Zurück zum Zitat Pagnin D, de Queiroz V, Carvalho YTMS et al (2014) The relation between burnout and sleep disorders in medical students. Acad Psychiatry 38:438–444PubMed Pagnin D, de Queiroz V, Carvalho YTMS et al (2014) The relation between burnout and sleep disorders in medical students. Acad Psychiatry 38:438–444PubMed
37.
38.
Zurück zum Zitat Pikovsky O, Oron M, Shiyovich A et al (2013) The impact of sleep deprivation on sleepiness, risk factors and professional performance in medical residents. Isr Med Assoc J 15:739–744PubMed Pikovsky O, Oron M, Shiyovich A et al (2013) The impact of sleep deprivation on sleepiness, risk factors and professional performance in medical residents. Isr Med Assoc J 15:739–744PubMed
39.
Zurück zum Zitat Raoof AM, Asaad YA, Al-Hadithi TS (2014) Distribution of Chronotypes among a sample of iraqi Kurdish medical students. Sultan Qaboos Univ Med J 14:e356–e360PubMedCentralPubMed Raoof AM, Asaad YA, Al-Hadithi TS (2014) Distribution of Chronotypes among a sample of iraqi Kurdish medical students. Sultan Qaboos Univ Med J 14:e356–e360PubMedCentralPubMed
40.
Zurück zum Zitat Van Reen E, Sharkey KM, Roane BM et al (2013) Sex of college students moderates associations among bedtime, time in bed, and circadian phase angle. J Biol Rhythms 28:425–431PubMedCentralCrossRefPubMed Van Reen E, Sharkey KM, Roane BM et al (2013) Sex of college students moderates associations among bedtime, time in bed, and circadian phase angle. J Biol Rhythms 28:425–431PubMedCentralCrossRefPubMed
41.
Zurück zum Zitat Rodrigues RND, Viegas CAA, Abreu E, Silva AAA, Tavares P (2002) Daytime sleepiness and academic performance in medical students. Arq Neuropsiquiatr 60:6–11CrossRefPubMed Rodrigues RND, Viegas CAA, Abreu E, Silva AAA, Tavares P (2002) Daytime sleepiness and academic performance in medical students. Arq Neuropsiquiatr 60:6–11CrossRefPubMed
42.
Zurück zum Zitat Short MA, Gradisar M, Lack LC et al (2013) Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy. Nat Sci Sleep 5:23–26PubMedCentralCrossRefPubMed Short MA, Gradisar M, Lack LC et al (2013) Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy. Nat Sci Sleep 5:23–26PubMedCentralCrossRefPubMed
43.
Zurück zum Zitat Siebern AT, Manber R (2011) New developments in cognitive behavioral therapy as the first-line treatment of insomnia. Psychol Res Behav Manag 4:21–28PubMedCentralCrossRefPubMed Siebern AT, Manber R (2011) New developments in cognitive behavioral therapy as the first-line treatment of insomnia. Psychol Res Behav Manag 4:21–28PubMedCentralCrossRefPubMed
44.
Zurück zum Zitat Sivertsen B, Skogen JC, Jakobsen R, Hysing M (2015) Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years. Drug Alcohol Depend 149:180–186CrossRefPubMed Sivertsen B, Skogen JC, Jakobsen R, Hysing M (2015) Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years. Drug Alcohol Depend 149:180–186CrossRefPubMed
45.
Zurück zum Zitat Veldi M, Aluoja A, Vasar V (2005) Sleep quality and more common sleep-related problems in medical students. Sleep Med 6:269–275CrossRefPubMed Veldi M, Aluoja A, Vasar V (2005) Sleep quality and more common sleep-related problems in medical students. Sleep Med 6:269–275CrossRefPubMed
46.
Zurück zum Zitat Wolfson AR, Carskadon MA, Acebo C et al (2003) Evidence for the validity of a sleep habits survey for adolescents. Sleep 26:213–216PubMed Wolfson AR, Carskadon MA, Acebo C et al (2003) Evidence for the validity of a sleep habits survey for adolescents. Sleep 26:213–216PubMed
47.
Zurück zum Zitat Yang C-M, Chou CP-W, Hsiao F-C (2011) The association of dysfunctional beliefs about sleep with vulnerability to stress-related sleep disturbance in young adults. Behav Sleep Med 9:86–91CrossRefPubMed Yang C-M, Chou CP-W, Hsiao F-C (2011) The association of dysfunctional beliefs about sleep with vulnerability to stress-related sleep disturbance in young adults. Behav Sleep Med 9:86–91CrossRefPubMed
48.
Zurück zum Zitat Yogesh S, Abha S (2014) Priyanka S Mobile usage and sleep patterns among medical students. Indian J Physiol Pharmacol 58:100–103 Yogesh S, Abha S (2014) Priyanka S Mobile usage and sleep patterns among medical students. Indian J Physiol Pharmacol 58:100–103
49.
Zurück zum Zitat Zailinawati AH, Teng CL, Chung YC et al (2009) Daytime sleepiness and sleep quality among Malaysian medical students. Med J Malaysia 64:108–110PubMed Zailinawati AH, Teng CL, Chung YC et al (2009) Daytime sleepiness and sleep quality among Malaysian medical students. Med J Malaysia 64:108–110PubMed
Metadaten
Titel
Sleep pattern and insomnia among medical students
Effect of gender and dysfunctional beliefs and attitudes about sleep
verfasst von
MD, PhD, IBSM K. Joshi
D. Mishra
H. Dubey
R. Gupta
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Somnologie / Ausgabe 3/2015
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI
https://doi.org/10.1007/s11818-015-0012-x

Weitere Artikel der Ausgabe 3/2015

Somnologie 3/2015 Zur Ausgabe

Schwerpunkt

Somnonetz

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Restriktion auf vier Wochen Therapie bei Schlaflosigkeit ist absurd!“

06.05.2024 Insomnie Nachrichten

Chronische Insomnie als eigenständiges Krankheitsbild ernst nehmen und adäquat nach dem aktuellen Forschungsstand behandeln: Das forderte der Schlafmediziner Dr. Dieter Kunz von der Berliner Charité beim Praxis Update.

Stuhltransfusion könnte Fortschreiten von Parkinson-Symptomen bremsen

03.05.2024 Parkinson-Krankheit Nachrichten

Kann eine frühzeitige Stuhltransplantation das Fortschreiten von Parkinson-Symptomen verlangsamen? Die Ergebnisse einer randomisierten Phase-2-Studie scheinen dafür zu sprechen.

Frühe Tranexamsäure-Therapie nützt wenig bei Hirnblutungen

02.05.2024 Hirnblutung Nachrichten

Erhalten Personen mit einer spontanen Hirnblutung innerhalb von zwei Stunden nach Symptombeginn eine Tranexamsäure-Therapie, kann dies weder die Hämatomexpansion eindämmen noch die Mortalität senken.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders scheint das auf weibliche Kranke zuzutreffen, wie eine Studie zeigt.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.