J Clin Endocrinol Metab 86(8):3787–3794īonnet MH, Arand DL (1995) 24-Hour metabolic rate in insomniacs and matched normal sleepers. Vgontzas AN, Bixler EO, Lin HM et al (2001) Chronic insomnia is associated with nyctohermeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. Haynes SN, Follingstad DR, McGowan WT (1974) Insomnia: sleep patterns and anxiety level. Morin CM, Stone J, Trinkle D, Mercer J, Remsberg S (1993) Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychiatr Clin North Am 10:541–553Įdinger JD, Sullivan RJ, Bastian LA, Hope TV, Young M, Shaw E et al (2000) Insomnia and the eye of the beholder: are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? J Consult Clin Psychol 68:586–593Įspie CA (1991) The psychological treatment of insomnia. Spielman AJ (1987) A behavioral perspective on insomnia treatment. Jefferson CD, Drake CL, Sofield HM et al (2005) Sleep hygiene practices in a population-based sample of insomniacs. Keywordsĭew MA, Reynolds CF, Monk TH et al (1994) Psychosocial correlates and sequelae of electroencephalographic sleep in healthy elders. This chapter will summarize the current understanding of the development of this disorder, and the clinical approaches that may be useful to resolve it. The essential feature of this form of insomnia is a pattern of sleep disturbance that evolves over time as a result of psychological distress that triggers unhelpful behaviors and physiological arousal. Patients with this form of chronic insomnia are often vexed by its seemingly unpredictable nature from night to night, but to be diagnosed symptoms must be present on three or more nights per week, for more than 1 month (DSM-IV) or 6 months (ICSD-2). Patients report reduced total sleep time, with increased sleep latency (greater than 30 min), or increased wakeafter sleep onset time, though these findings are not always corroborated on PSG studies. This sleep disorder is a final common pathway for many people who initially develop sleeplessness in the context of acute stressors (e.g., pain, job loss), but then acquire a form of “learned” sleeplessness as they become increasingly overconcerned about their unsatisfying sleep patterns. Of all the forms of chronic insomnia, perhaps the most insidious is Psychophysiologic insomnia, also called Primary Insomnia in the DSM-IV.
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