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Carlos H. Schenck, MD; Mark W. Mahowald, MD; Robert L. Sack, MD

JAMA. 2003;289:2475-2479.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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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