Assessment and Management of Insomnia
- Carlos H. Schenck, MD;
- Mark W. Mahowald, MD;
- Robert L. Sack, MD
- 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).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- chronobiology disorders
- circadian rhythm disorders
- contempo updates: linking evidence and experience (torpy jm, ed)
- insomnia
- sleep initiation and maintenance disorders
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, low motivation, loss of productivity, irritability, interpersonal difficulties …
