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Differential Diagnosis of Insomnia

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Clinical Handbook of Insomnia

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Insomnia is the inability to obtain sleep of sufficient length or quality to produce refreshment the following morning. It is not defined by total sleep time per 24 hours. For example, a person who needs only 4 hours of sleep does not have insomnia if he or she is refreshed in the morning after having 4 hours of sleep, whereas someone who needs 10 hours of sleep may have insomnia if he or she does not feel refreshed even after 8 hours of sleep (1). Contrary to popular belief, psychiatric or psychological factors are not the most common causes of insomnia (1). In fact, untreated insomnia, itself, is a risk factor for the subsequent development of clinical depression and psychiatric distress (2).

Not poppy, nor mandragora, Nor all the drowsy syrups of the world, Shall ever medicine thee to that sweet sleep Which thou owedst yesterday.

—William Shakespeare (1564–1616) “Othello. Act iii. Sc. 3”

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References

  1. Mahowald, M. W., Kader, G., and Schenck, C. H. (1997) Clinical categories of sleep disorders I. Continuum 3(4), 35–65.

    Google Scholar 

  2. Katz, D. A. and McHorney, C. A. (1998) Clinical correlates of insomnia in patients with chronic illness. Arch. Intern. Med. 158(10), 1099–1107.

    Article  PubMed  CAS  Google Scholar 

  3. Bastien, C. H. and Morin, C. M. (2000) Familial incidence of insomnia. J. Sleep Res. 9(1), 49–54.

    Article  PubMed  CAS  Google Scholar 

  4. Hauri, P. and Olmstead, E. (1980) Childhood-onset insomnia. Sleep 3(1), 59–65.

    PubMed  CAS  Google Scholar 

  5. Hauri, P. J. (1998) Insomnia. Clin. Chest Med. 19(1), 157–168.

    Article  PubMed  CAS  Google Scholar 

  6. Attarian, H. (2002) Idiopathic insomnia. In: MedLink Neurology ( Gilman, S., Goldstein, G. W., Waxman, S. G., eds.), Arbor Publishing, San Diego, CA, pp.

    Google Scholar 

  7. Bonnet, M. H. and Arand, D. L. (1997) Physiological activation in patients with Sleep State Misperception. Psychosom. Med. 59(5), 533–540.

    PubMed  CAS  Google Scholar 

  8. Reder, A. T., Mednick, A. S., Brown, P., et al. (1995) Clinical and genetic studies of fatal familial insomnia. Neurology 45(6), 1068–1075.

    Article  PubMed  CAS  Google Scholar 

  9. Montagna, P. (1999) [Fatal familial insomnia: clinical, laboratory and pathological features]. Rev. Neurol. 29(11), 1006–1009.

    PubMed  CAS  Google Scholar 

  10. Bara-Jimenez, W., Aksu, M., Graham, B., Sato, S., and Hallett, M. (2000) Periodic limb movements in sleep: state-dependent excitability of the spinal flexor reflex. Neurology 54(8), 1609–1616.

    Article  PubMed  CAS  Google Scholar 

  11. Ohayon, M. M. and Roth, T. (2002) Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J. Psychosom. Res. 53(1), 547–554.

    Article  PubMed  Google Scholar 

  12. Allen, R. P. and Earley, C. J. (2001) Restless legs syndrome: a review of clinical and pathophysiologic features. J. Clin. Neurophysiol. 18(2), 128–147.

    Article  PubMed  CAS  Google Scholar 

  13. Sanz-Fuentenebro, F. J., Huidobro, A., and Tejadas-Rivas, A. (1996) Restless legs syndrome and paroxetine. Acta Psychiatr. Scand. 94(6), 482–484.

    Article  PubMed  CAS  Google Scholar 

  14. Glasauer, F. E. (2001) Restless Legs Syndrome. Spinal Cord 39(3), 125–133.

    Article  PubMed  CAS  Google Scholar 

  15. Lee, K. A., Zaffke, M. E. and Baratte-Beebe, K. (2001) Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J. Womens Health Gend. Based Med. 10(4), 335–341.

    Article  PubMed  CAS  Google Scholar 

  16. Silber, M. H. (1997) Restless legs syndrome. Mayo Clin. Proc. 72(3), 261–264.

    Article  PubMed  CAS  Google Scholar 

  17. Lichstein, K. L., Riedel, B.W., Lester, K. W., and Aguillard, R. N. (1999) Occult sleep apnea in a recruited sample of older adults with insomnia. J. Consult Clin. Psychol. 67(3), 405–410.

    Article  PubMed  CAS  Google Scholar 

  18. Vgontzas, A. N., Kales, A., Bixler, E. O., Manfredi, R. L., and Vela-Bueno, A. (1995) Usefulness of polysomnographic studies in the differential diagnosis of insomnia. Int. J. Neurosci. 82(1–2), 47–60.

    Article  PubMed  CAS  Google Scholar 

  19. Zisapel, N. (2001) Circadian rhythm sleep disorders: pathophysiology and potential approaches to management. CNS Drugs 15(4), 311–328.

    Article  PubMed  CAS  Google Scholar 

  20. Parkes, J. D., Chen, S. Y., Cleft, S. J., Dahletz, M. J., and Dunn, G. (1998) The clinical diagnosis of the narcoleptic syndrome. J. Sleep Res. 7(1), 41–52.

    Article  PubMed  CAS  Google Scholar 

  21. Overeem, S., Mignot, E., vanDijk, J. G., and Lammers, G. J. (2001) Narcolepsy: clinical features, new pathophysiologic insights, and future perspectives. J. Clin. Neurophysiol. 18(2), 78–105.

    Google Scholar 

  22. Boeve, B. F., Silber, M. H. and Ferman, T. J. (2002) Current management of sleep disturbances in dementia. Curr. Neurol. Neurosci. Rep. 2(2), 169–177.

    Article  PubMed  Google Scholar 

  23. Sutton, D. A., Moldofsky, H. and Badley, E. M. (200 1) Insomnia and health problems in Canadians. Sleep 24(6), 665–670.

    Google Scholar 

  24. Raiha, I., Impivaara, O., Seppala M., Knuts, L. R., and Sourander, L. (1993) Determinants of symptoms suggestive of gastroesophageal reflux disease in the elderly. Scand. J. Gastroenterol. 28(11), 1011–1014.

    Article  PubMed  CAS  Google Scholar 

  25. Dodge, R., Cline, M. G., and Quan, S. F. (1995) The natural history of insomnia and its relationship to respiratory symptoms. Arch. Intern. Med. 155(16), 1797–800.

    Article  PubMed  CAS  Google Scholar 

  26. Owens, J. F. and Matthews, K. A. (1998) Sleep disturbance in healthy middle-aged women. Maturitas 30(1), 41–50.

    Article  PubMed  CAS  Google Scholar 

  27. Polo-Kantola, P., Erkkola, R., Helenius, H., Irjala, K., and Polo, O. (1998) When does estrogen replacement therapy improve sleep quality? Am. J. Obstet. Gynecol. 178(5), 1002–1009.

    Article  PubMed  CAS  Google Scholar 

  28. ASDA. (1997) International classification of sleep disorders: diagnostic and coding manual. American Sleep Disorders Association, Rochester, MN.

    Google Scholar 

  29. APA. (1994) Diagnostic and statistical manual of mental disorders. 4th ed. American Psychiatric Association, Washington DC.

    Google Scholar 

  30. Zajecka, J., Amsterdam, J. D., Quitkin, F. M., et al. (1999) Changes in adverse events reported by patients during 6 months of fluoxetine therapy. J. Clin. Psychiatry 60(6), 389–394.

    Article  PubMed  CAS  Google Scholar 

  31. Leppik, I. E. (1995) Felbamate. Epilepsia 36(Suppl 2), S66–S72.

    Article  PubMed  CAS  Google Scholar 

  32. Sadler, M. (1999) Lamotrigine associated with insomnia. Epilepsia 40(3), 322–325.

    Article  PubMed  CAS  Google Scholar 

  33. Pappenheimer, J. R. (1984) Hypoxic insomnia: effects of carbon monoxide and acclimatization. J. Appl. Physiol. 57(6), 1696–1703.

    PubMed  CAS  Google Scholar 

  34. Rossini, S. R., Lefevre, B. H., and Medrado-Faria, M. A. (2000) Chronic insomnia in workers poisoned by inorganic mercury: psychological and adaptive aspects. Arq. Neuropsiquiatr. 58(1), 32–38.

    Article  PubMed  CAS  Google Scholar 

  35. Sateia, M. J., Doghramji, K., Hauri, P. J., Morin, C. M. (2000) Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 23(2), 243–308.

    PubMed  CAS  Google Scholar 

  36. Bonnet, M. H. and Arand, D. L. (2000) Activity, arousal, and the MSLT in patients with insomnia. Sleep 23(2), 205–212.

    PubMed  CAS  Google Scholar 

  37. Mahowald, M. W. (1996) Diagnostic testing. Sleep disorders. Neurol. Clin. 14(1), 183–200.

    Article  PubMed  CAS  Google Scholar 

  38. Sadeh, A., Lavie, P., Soher, A., Tiroash, E., and Epstein, R. (1991) Actigraphic home-monitoring sleep-disturbed and control infants and young children: a new method for pediatric assessment of sleep-wake patterns. Pediatrics 87(4), 494–499.

    PubMed  CAS  Google Scholar 

  39. Chesson, A. L., Jr., hartse, K., Anderson, W. M., et al. (1999) Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 22(7), 961–968.

    PubMed  Google Scholar 

  40. Sun, E. R., Chen, C. A., Ho, G., Eearley, C. J., and Allen, R. P. (1998) Iron and the restless legs syndrome. Sleep 21(4) 371–377.

    PubMed  CAS  Google Scholar 

  41. Attarian, H. (2001) Practical Approaches to Insomnia. Primary Care Reports 20(7), 171–178.

    Google Scholar 

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Authors
  1. Hrayr P. Attarian
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Editors and Affiliations

  1. Sleep Program in Neurology and Sleep Laboratory of the Clinical Neurophysiology Laboratories, University of Vermont College of Medicine, Burlington, VT, USA

    Hrayr P. Attarian MD

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© 2004 Springer Science+Business Media New York

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Attarian, H.P. (2004). Differential Diagnosis of Insomnia. In: Attarian, H.P. (eds) Clinical Handbook of Insomnia. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-662-1_4

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  • DOI: https://doi.org/10.1007/978-1-59259-662-1_4

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-465-4

  • Online ISBN: 978-1-59259-662-1

  • eBook Packages: Springer Book Archive

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