Skip to main content Accessibility help
×
Home
  • Print publication year: 2008
  • Online publication date: August 2009

6 - Insomnias

from SECTION 2 - SLEEP DISORDERS

Summary

Insomnia is amongst the most frequent complaints seen in medical practice, due to its high prevalence rate as a chronic medical condition and its high incidence as an acute condition. This chapter provides an overview of the development of insomnia, information required to make a diagnosis of insomnia, the various recognized insomnia diagnoses, and the pharmacologic, cognitive, and behavioral treatments available. The most important component involved in the diagnosis of insomnia is a thorough and in-depth sleep history. Insomnia due to a mental disorder is the most common diagnosis among people presenting to a sleep center with a complaint of insomnia. Mood disorders such as depression, dysthymia, bipolar disorder, as well as anxiety disorders can be associated with a complaint of insomnia. Aside from progressive muscle relaxation, data are lacking to demonstrate efficacy in insomnia treatment. The most intriguing treatment for insomnia is paradoxical intention.
FURTHER READING
American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual, 2nd edn (ICSD-2). Westchester, IL: American Academy of Sleep Medicine, 2005.
Beck, AT. Thinking and depression. I. Idiosyncratic content and cognitive distortions. Arch Gen Psychiatry 1963; 14:324–33.
Beck, AT. Cognitive therapy: a 30-year retrospective. Am Psychol 1991; 46:368–75.
Bootzin, RR. A stimulus control treatment for insomnia. Proc Am Psychol Assoc 1972: 395–6.
Bootzin RR, Epstein D, Wood JM. Stimulus control instructions. In: Hauri, PJ, ed. Case Studies in Insomnia. New York, NY: Plenum, 1991: 19–28.
Buysse, DJ, Reynolds, CF III, Kupfer, DJ, et al. Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial. Sleep 1994; 17:630–7.
Chesson, AL Jr, Anderson, WM, Littner, M, et al. Practice parameters for the nonpharmacologic treatment of chronic insomnia: an American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 1999; 22:1128–33.
Costa e Silva, JA, Chase, M, Sartorius, N, Roth, T. Special report from a symposium held by the World Health Organization and the World Federation of Sleep Research Societies. An overview of insomnias and related disorders: recognition, epidemiology, and rational management. Sleep 1996; 19:412–16.
Dundar, Y, Dodd, S, Strobl, J, et al. Comparative efficacy of newer hypnotic drugs for the short-term management of insomnia: a systematic review and meta-analysis. Hum Psychopharmacol 2004; 19:305–22.
Fass, R, Quan, SF, O'Connor, GT, Ervin, A, Iber, C. Predictors of heartburn during sleep in a large prospective cohort study. Chest 2005; 127:1658–66.
Gjerstad, MD, Wentzel-Larsen, T, Aarsland, D, Larsen, JP. Insomnia in Parkinson's disease: frequency and progression over time. J Neurol Neurosurg Psychiatry 2007; 78:476–9.
Gooneratne, NS, Gehrman, PR, Nkwuo, JE, et al. Consequences of comorbid insomnia symptoms and sleep-related breathing disorder in elderly subjects. Arch Intern Med 2006; 166:1732–8.
Guilleminault, C, Eldridge, FL, Dement, WC. Insomnia with sleep apnea: a new syndrome. Science 1973; 181:856–8.
Hauri, P. Current Concepts: the Sleep Disorders. Kalamazoo, MI: Upjohn, 1977.
Irwin, MR, Cole, JC, Nicassio, PM. Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age. Health Psychol 2006; 25:3–14.
Johnson, MW, Suess, PE, Griffiths, RR. Ramelteon: a novel hypnotic lacking abuse liability and sedative adverse effects. Arch Gen Psychiatry 2006; 63:1149–57.
Klink, ME, Dodge, R, Quan, SF. The relation of sleep complaints to respiratory symptoms in a general population. Chest 1994; 105:151–4.
Kravitz, HM, Ganz, PA, Bromberger, J, et al. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause 2003; 10:19–28.
Krystal, AD, Walsh, JK, Laska, E, et al. Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia. Sleep 2003; 26:793–9.
Littner, M, Kushida, CA, Anderson, WM, et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: an update for 2002. Sleep 2003; 26:337–41.
Littner, M, Hirshkowitz, M, Kramer, M, et al. Practice parameters for using polysomnography to evaluate insomnia: an update. Sleep 2003; 26:754–60.
Means, MK, Edinger, JD, Glenn, DM, Fins, AI. Accuracy of sleep perceptions among insomnia sufferers and normal sleepers. Sleep Med 2003; 4:285–96.
Morgenthaler, T, Kramer, M, Alessi, C, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine report. Sleep 2006; 29:1415–19.
Morin, CM. Insomnia: Psychological Assessment and Management. New York, NY: Guilford Press, 1993.
Morin, CM, Stone, J, Trinkle, D, Mercer, J, Remsberg, S. Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychol Aging 1993; 8:463–7.
Morin, CM, Culbert, JP, Schwartz, SM. Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry 1994; 151:1172–80.
Morin, CM, Hauri, PJ, Espie, CA, et al. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 1999; 22:1134–56.
Morlock, RJ, Tan, M, Mitchell, DY. Patient characteristics and patterns of drug use for sleep complaints in the United States: analysis of National Ambulatory Medical Survey data, 1997–2002. Clin Ther 2006; 28:1044–53.
National Institutes of Health State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults, June 13–15, 2005. Sleep 2005; 28: 1049–57.
Perlis, ML, Giles, , Buysse, DJ, Tu, X, Kupfer, DJ. Self-reported sleep disturbance as a prodromal symptom in recurrent depression. J Affect Disord 1997; 42:209–12.
Richardson, GS, Malin, HV. Circadian rhythm sleep disorders: pathophysiology and treatment. J Clin Neurophysiol 1996; 13:17–31.
Roehrs, T, Vogel, G, Roth, T. Rebound insomnia: its determinants and significance. Am J Med 1990; 88:39S–42S.
Roehrs, T, Papineau, K, Rosenthal, L, Roth, T. Ethanol as a hypnotic in insomniacs: self administration and effects on sleep and mood. Neuropsychopharmacology 1999; 20:279–86.
Rybarczyk, B, Lopez, M, Benson, R, Alsten, C, Stepanski, E. Efficacy of two behavioral treatment programs for comorbid geriatric insomnia. Psychol Aging 2002; 17:288–98.
Sateia, MJ, Doghramji, K, Hauri, PJ, Morin, CM. Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 2000; 23:243–308.
Schweitzer PK. Drugs that disturb sleep and wakefulness. In: Kryger, MH, Roth, T, Dement, WC, eds. Principles and Practice of Sleep Medicine, 4th edn. Philadelphia, PA: Elsevier Saunders, 2005: 499–518.
Smith, MT, Perlis, ML, Park, A, et al. Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. Am J Psychiatry 2002; 159:5–11.
Spielman, AJ. Assessment of insomnia. Clin Psychol Rev 1986; 6:11–25.
Spielman, AJ, Saskin, P, Thorpy, MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep 1987; 10:45–56.
Stepanski, EJ, Wyatt, JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev 2003; 7:215–25.
Summers, MO, Crisostomo, MI, Stepanski, EJ. Recent developments in the classification, evaluation, and treatment of insomnia. Chest 2006; 130:276–86.
Sun, ER, Chen, CA, Ho, G, Earley, CJ, Allen, RP. Iron and the restless legs syndrome. Sleep 1998; 21:371–7.
Taylor, DJ, Mallory, LJ, Lichstein, KL, et al. Comorbidity of chronic insomnia with medical problems. Sleep 2007; 30:213–18.
Valipour, A, Lothaller, H, Rauscher, H, et al. Gender-related differences in symptoms of patients with suspected breathing disorders in sleep: a clinical population study using the sleep disorders questionnaire. Sleep 2007; 30:312–19.
Wyatt, JK. Delayed sleep phase syndrome: pathophysiology and treatment options. Sleep 2004; 27:1195–203.
Yesavage, JA, Friedman, L, Ancoli-Israel, S, et al. Development of diagnostic criteria for defining sleep disturbance in Alzheimer's disease. J Geriatr Psychiatry Neurol 2003; 16:131–9.