[Paleopsych] SW: NEJM: Abstract: On Chronic Insomnia

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Abstract: On Chronic Insomnia
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http://scienceweek.com/swbb/messages/bb208.htm
Abstract: On Chronic Insomnia - NEJM 09/29/05 11:30 AM
[Bibliography on chronic insomnia appended.]

    Insomnia is defined as difficulty with the initiation, maintenance,
    duration, or quality of sleep that results in the impairment of
    daytime functioning, despite adequate opportunity and circumstances
    for sleep. (Difficulty with sleep maintenance implies waking after
    sleep has been initiated but before a desired wake time.) Most
    research studies adopt an arbitrary definition of a delay of more than
    30 minutes in sleep onset or a sleep efficiency (the ratio of time
    asleep to time in bed) of less than 85 percent. However, in clinical
    practice, a patient's subjective judgment of sleep quality and
    quantity is a more important factor. Transient insomnia lasts less
    than one week, and short-term insomnia one to four weeks.
    Chronic insomnia -- insomnia lasting more than one month -- has a
    prevalence of 10 to 15 percent and occurs more frequently in women,
    older adults, and patients with chronic medical and psychiatric
    disorders. It may follow episodes of acute insomnia in patients who
    are predisposed to having the condition and may be perpetuated by
    behavioral and cognitive factors, such as worrying in bed and holding
    unreasonable expectations of sleep duration. Consequences include
    fatigue, mood disturbances, problems with interpersonal relationships,
    occupational difficulties, and a reduced quality of life.
    Full text: Michael H. Silber (New Engl. J. Med. 2005 353:803):

----------------

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http://scienceweek.com/swbb/messages/bb209.htm

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