An American Academy of Sleep Medicine Review
Published 1 January 2000
Michael J. Sateia, Karl Doghramji, Peter Hauri, Charles M. Morin
Citations362
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TL;DR
Insomnia is a condition which affects millions of individuals, giving rise to emotional distress, daytime fatigue, and loss of productivity, despite its prevalence, it has received scant clinical attention.
Abstract
Summary: Insomnia is a condition which affects millions of individuals, giving rise to emotional distress, daytime fatigue, and loss of productivity. Despite its prevalence, it has received scant clinical attention. An adequate evaluation of persistent insomnia requires detailed historical information as well as medical, psychological and psychiatric assessment. Use of a classification system for sleep disorders and familiarity with major diagnostic groups will facilitate the clinician's evaluation and treatment. Thorough assessment also requires attention to the unique aspects of presentation and specific set of etiologies which are associated with particular age groups.
Keywords
PsychologyMedicineNeuroscience
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314 Citations1993V. Hoffstein, J. P. Szalai
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300 Citations1998Coralyn W. Whitney, Paul Enright +4 more
Daytime sleepiness is common in the elderly, probably due to nocturnal disturbances such as frequent awakenings and snoring, but anatomic abnormalities such as evidence of previous strokes and brain atrophy were not associated with daytime sleepiness in these non-institutionalized elderly persons.
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294 Citations1987Rita Snyder‐Halpern, Joyce A. Verran
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In conclusion, weight lifting exercise was effective in improving subjective sleep quality, depression, strength, and quality of life without significantly changing habitual activity.
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271 Citations1987Þórarinn Gíslason, Magnus Almqvist
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SLEEPPractice Parameters for the Nonpharmacologic Treatment of Chronic Insomnia
262 Citations1999Andrew L. Chesson, William M. Anderson +6 more
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255 Citations1985I. Pilowsky, I. Crettenden +1 more
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American Journal of PsychiatryDelayed sleep phase syndrome: a review of its clinical aspects
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247 Citations1994Heikki Summala, Timo Mikkola
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246 Citations1982John A. Fleetham, Peter West +4 more
The 95% confidence bands for arterial O2 saturation (SaO2) in the various sleep stages suggest that it is not hypoxemia per se, but an associated phenomenon such as hypercapnia that causes the arousals.
SLEEPPrevalence and Treatment of Insomnia in the Community: Results from the Upper Bavarian Field Study
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235 Citations1976Anthony Kales
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231 Citations1998Stefania Maggi, Jean Langlois +5 more
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210 Citations1992Perry M. Nicassio, Kenneth A. Wallston
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209 Citations1982Laverne C. Johnson, DORIS A. CHERNIK
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209 Citations1992Patricia Lacks, Charles M. Morin
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207 Citations1986Patricia Lacks, Monique Rotert
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206 Citations1988Gabrielle A. Carlson, Javad H. Kashani
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189 Citations1989Thomas A. Mellman
Sleep electroencephalograms were studied in patients with panic disorder, six of whom experienced panic from sleep, and seven controls, and there was also an association of increased REM latency with nights of sleep panic.
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187 Citations1998Keith G. Wilson, Shannon T Watson +1 more
SLEEPAre Periodic Leg Movements Associated With Clinical Sleep Disturbance?
186 Citations1996Wallace B. Mendelson
In this clinical population of patients with periodic leg movement disorder, there was no significant association between the PLM arousal index and the subjective complaint of disturbed sleep, an objective measure of daytime sleepiness or a sense of awakening refreshed in the morning.
American Journal of PsychiatrySleep disturbance and its relationship to psychiatric morbidity after Hurricane Andrew
186 Citations1995Thomas A. Mellman, D. David +3 more
Results of sleep laboratory evaluations suggested brief shifts toward higher arousal levels during sleep for PTSD subjects and a relationship of REM phasic activity and symptom severity.
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185 Citations1996Christer Hublin, Jaakko Kaprio +3 more
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The overall increase in whole body oxygen use was less than that seen in psychophysiological insomniacs but was consistent with the view that Sleep State Misperception insomnia may be a mild version or a precursor to Psychophysiological insomnia.
Journal of the American Geriatrics SocietyNapping and 24‐Hour Sleep/Wake Patterns in Healthy Elderly and Young Adults
181 Citations1992Daniel J. Buysse, Kaitlin E. Browman +4 more
To examine differences between healthy elderly and young adults in daytime napping, nocturnal sleep, and 24‐hour sleep/wake patterns, a second objective was to determine whether elderly subjects with more and less frequent naps differed in their clinical features or no Nocturnal sleep.
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181 Citations1982Robert Freedman, Howard L. Sattler
A group of insomniacs whose only sleep-stage abnormality was prolonged sleep latency was identified and had significantly higher levels of physiological activity than did normal sleepers before sleep onset, and no group differences in presleep cognitive activity were found.
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180 Citations1991David J. Greenblatt, Jerold S. Harmatz +1 more
The weight of evidence indicates that old age is associated with impaired clearance of the benzodiazepines which are biotransformed by microsomal oxidation, which may lead to altered pharmacokinetics of sedative-anxiolytic drugs, causing higher plasma concentrations after single or multiple doses.
SLEEPPersistent Psychophysiologic (Learned) Insomnia
179 Citations1986Peter Hauri, Joan M. Fisher
PPI patients and Ns revealed less psychopathology than DD patients on almost all psychological scales, and PPIs typically had difficulties initiating and maintaining sleep, as did the DDs, but showed normal sleep staging.
GutSleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis.
176 Citations1991N Freidin, Michael J. Fisher +5 more
It is concluded that the awake state is crucial for the occurrence of nocturnal reflux episodes in normal subjects as well as in patients with reflux oesophagitis and that the difference between the frequency of gastro-oesophageal reflux between normal subjects and patients cannot be explained by different sleep patterns.
The British Journal of PsychiatryFrequency of Symptoms in Melancholia (Depressive Illness)
170 Citations1989Matthew Hamilton
The results show that the symptoms of depressive patients differ from those found in the classic descriptions, with a high frequency for anxiety, both psychic and somatic.
Psychosomatic MedicineBiopsychobehavioral Correlates of Insomnia. II. Pattern Specificity and Consistency with the Minnesota Multiphasic Personality Inventory
169 Citations1983Anthony Kales, Alex B. Caldwell +3 more
The results of this study confirm the original hypothesis that the handling of stresses and conflicts through an internalization of emotions leads to physiologic activation and is a major factor underlying the development and maintenance of chronic insomnia.
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167 Citations1991A. Dryman, William W. Eaton
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American Journal of PsychiatryMelatonin for the Treatment of Sleep Disturbances in Major Depressive Disorder
167 Citations1998Ornah T. Dolberg, Schmuel Hirschmann +1 more
Slow-release melatonin was effective in improving the sleep of patients with major depressive disorder and had no effect on the rate of improvement in symptoms ofmajor depressive disorder.
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165 Citations1994Mary E. Klink, Russell Dodge +1 more
Overall, there are significant relationships between rates of respiratory symptoms and sleep complaints and it is found that obesity, respiratory symptoms, gender, and age were the only variables related to the risk of insomnia or daytime sleepiness.
Journal of the American Geriatrics SocietySundown Syndrome in Institutionalized Elderly
165 Citations1987Lois K. Evans
No clear pattern of behaviors evolved but sundowners were found to increase restless and verbal behavior as evening approached, and were more likely to be demented, with greater mental impairment and organic involvement than nonsundowners.
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165 Citations1984Wallace B. Mendelson, Debra Garnett +2 more
Ten insomniacs and matched control subjects, in whom major physiologic disorders such as sleep apnea and nocturnal myoclonus were ruled out, underwent studies of sleep, temperature, motor activity, cognitive performance, and perception of depth of sleep.
Journal of the American Geriatrics SocietyPrevalence and Persistence of Sleep Complaints in a Rural Older Community Sample: The MoVIES Project
163 Citations1996Mary Ganguli, Charles F. Reynolds +1 more
To determine the prevalence and 2‐year persistence of subjective sleep complaints in a rural older population, a large sample of older people in rural areas is studied.
Journal of Psychiatric ResearchSubjective sleep quality and suicidality in patients with major depression
162 Citations1997Mehmet Yücel Ağargün, Hayrettin Kara +1 more
It is found that suicidal depressive patients had significantly higher scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and PSQI global scores than nonsuicidal patients.
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