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In the early 1980s, as the sleep medicine movement was just gathering steam, there was perhaps no rallying cry as popular as “insomnia is a symptom, not a disorder.” Presumably, this position was taken in part for medico-political reasons, but also because it was genuinely believed that the polysomnographic study of sleep was destined to reveal all the underlying pathologies that give rise to the...
Patients with insomnia often have symptoms that include tension, anxiety, depression, fatigue, and irritability (1–4). Frequently, insomnia begins in conjunction with significant stress (5). As a result, many investigators hypothesized that insomnia is the result of internalization of emotions producing emotional arousal. More recently, it has been hypothesized that insomnia can develop entirely from...
Insomnia is the inability to obtain sleep of sufficient length or quality to produce refreshment the following morning. It is not defined by total sleep time per 24 hours. For example, a person who needs only 4 hours of sleep does not have insomnia if he or she is refreshed in the morning after having 4 hours of sleep, whereas someone who needs 10 hours of sleep may have insomnia if he or she does...
Insomnia affects youth from the cradle to college. Diagnosis and management of insomnia relies on an understanding of normal childhood sleep development. Using a developmental approach, this chapter describes insomnia in infants, toddlers, school-aged children, adolescents, and children with developmental disabilities. The treatment of insomnia in youth is driven by the diagnosis. Treatment, either...
The International Classification of Sleep Disorders defines psychophysiological insomnia as “a disorder of somatized tension and learned sleep-preventing associations that results in a complaint of insomnia and associated decreased functioning during wakefulness” (1). Psychophysiological insomnia is included under the category of primary insomnias in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders...
The International Classification of Sleep Disorders (ICSD) defines idiopathic insomnia, or childhood-onset, insomnia as a lifelong inability to get adequate amounts of sleep.
Sleep state misperception (SSM) is defined by the International Classification of Sleep Disorders (ICSD) as “a disorder in which a complaint of insomnia or excessive sleepiness occurs without objective evidence of sleep disturbance” (1). SSM is included under the category of primary insomnias in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (2). It is also referred...
The American Academy of Sleep Medicine (AASM; previously the American Sleep Disorders Association [ASDA]) classifies poor sleep hygiene-induced insomnia as one of the 13 extrinsic sleep disorders in the 1997 revised edition of the International Classification of Sleep Disorders (ICSD) (1). Inadequate sleep hygiene and extrinsic sleep disorders are those sleep disorders caused or maintained by forces...
Any systemic or neurological condition can cause sleep disruption. Diseases of the central nervous system (CNS) in particular may profoundly affect sleep initiation and maintenance by disrupting the structural and neurochemical substrates that regulate sleep. Medical conditions can lead to chronic insomnia in several ways. They may cause unpleasant stimuli, which in turn disrupt sleep continuity....
Management of insomnia without a basic understanding of the possible underlying psychiatric disorders might result in an inadequate, if not hazardous outcome. Insomnia is listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a symptom of several psychiatric disorders (see Table 1) (1).
Insomnia is defined in the International Classification of Sleep Disorders as “difficulty in initiating and/or maintaining sleep” (1). In primary insomnia, the term insomnia constitutes a diagnostic entity. In other disorders it is considered a symptom and not a primary diagnosis. Insomnia is frequently a component of the symptom complexes of other primary sleep disorders, and is listed among the...
This chapter provides an overview of how primary insomnia is assessed and treated using cognitive-behavioral therapy (CBT). Additionally, we provide some upfront information that reviews the CBTs regarding the etiology of chronic insomnia and some follow-up information of the efficacy of CBT for insomnia. The former is provided so that the reader may appreciate the principles on which CBT is founded...
Insomnia is the most common sleep-related complaint and the second most common overall complaint (after pain) reported in primary care settings. It affects 35% of the general population, according to the 1984 report of the National Institutes of Mental Health (1). Insomnia is not defined by total sleep time but by the inability to obtain sleep of sufficient length or quality to produce refreshment...
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