Handbook of Insomnia
Insomnia is the difficulty initiating or maintaining sleep, including poor quality or quantity of sleep, often leading to impaired functioning and development of chronic sleep disturbances. Insomnia affects up to 50% of the general population globally, of
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Handbook of Insomnia
Handbook of Insomnia
Daniel J Taylor University of North Texas Philip Gehrman University of Pennsylvania Natalie D Dautovich University of Alabama Kenneth L Lichstein University of Alabama Christina S McCrae University of Florida
Published by Springer Healthcare Ltd, 236 Gray’s Inn Road, London, WC1X 8HB, UK. www.springerhealthcare.com © 2014 Springer Healthcare, a part of Springer Science+Business Media. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the copyright holder. British Library Cataloguing-in-Publication Data. A catalogue record for this book is available from the British Library. ISBN 978-1-907673-72-6 Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publisher nor the authors can be held responsible for errors or for any consequences arising from the use of the information contained herein. Any product mentioned in this publication should be used in accordance with the prescribing information prepared by the manufacturers. No claims or endorsements are made for any drug or compound at present under clinical investigation. Project editor: Katrina Dorn Designer: Roland Codd Printed in Great Britain by Latimer Trend
Contents Author biographies
1 Clinical features of insomnia
vii
1
Definition 1 Clinical presentation and symptoms of insomnia
2
Classification 3 Prognosis 7 References 7
2 Causes of insomnia
11
Age 11 Environmental factors
14
Physiology 15 Circadian rhythms
18
References 26
3 Patient assessment in insomnia Patient history
29 29
Scales and structured interviews
32
Differentiating between secondary contributors and comorbidities
34
References 35
4 Treating insomnia
37
Lifestyle adjustments
37
Behavioral therapy
38
Cognitive therapy
40
Pharmacotherapy 43 Emerging treatments
50
Treatment decisions
51
References 54
V
vi • co n te n ts
5 Managing insomnia in special populations
57
Treatment-resistant patients
57
Patients with depression
58
Patients with other psychotic disorders
58
Menopause
59
Other conditions
60
Chronic illness
63
References 64
Author biographies Natalie Dautovich, Ph.D, is an Assistant Professor of Clinical Geropsychology at the University of Alabama. She received her doctorate in Counseling Psychology from the University of Florida and completed a post-doctoral research fellowship at the University of South Florida. Within the area of geropsychology, Dr Dautovich’s research focuses on chronopsychology, the study of how our daily activity rhythms, routines, habits, and biological rhythms influence our mental and physical health. Specifically, she has published articles and presented at national conferences on the role of behavioral
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