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Assessment and Management of Insomnia
Carlos H. Schenck, MD;
Mark W. Mahowald, MD;
Robert L. Sack, MD
JAMA. 2003;289:2475-2479.
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INTRODUCTION
Insomnia is a common treatable disorder of insufficient or poor-quality sleep, with adverse daytime consequences.1 Insomnia presents as trouble falling asleep (long-sleep latency), trouble staying asleep (excessive or prolonged awakenings), or feeling nonrestored from sleep. Insomnia can be a primary disorder emerging in childhood or later, a conditioned (psychophysiological) disorder, or comorbid with a psychiatric, medical, or other sleep disorder.1 Insomnia can be transient (related to stress, illness, travel) or chronic (occurring nightly for >6 months). Persistent untreated insomnia is a strong risk factor for major depression.2 Insomnia must be distinguished from sleep-state misperception and short sleep states without symptoms.1
More than 50 epidemiological studies have shown that one third of various general populations have insomnia symptoms and that 9% to 21% have insomnia with serious daytime consequences, such as bodily fatigue, diminished energy, difficulty concentrating, memory impairment, . . . [Full Text of this Article]
Assessment
Conditioned Insomnia
Insomnia Associated With Clinical Disorders
Caretaker Insomnia
Management Guidelines
Circadian Rhythm Sleep Disorders
Common Circadian Rhythm Sleep Disorders
Evaluation of Circadian Sleep Disorders
Treatment
Author Affiliations: Departments of Psychiatry (Dr Schenck) and Neurology (Dr Mahowald), Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis; and Department of Psychiatry, Oregon Health Sciences University, Portland (Dr Sack).
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ABSTRACT
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