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Idiopathic Insomnia

  • Garrick Applebee
Chapter
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Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Idiopathic insomnia (Childhood-onset insomnia) is defined as the lifelong inability to get adequate amounts of sleep. It is presumably due to dysfunction in the sleep–wake centers in the brain. Idiopathic insomnia patients are thought to have hyperactivity in the wake center or hypoactivity in the sleep center. These patients have sleep disturbances such as inability to fall asleep, frequent awakenings, and early morning wakefulness since early childhood. Psychologically, most patients with idiopathic insomnia are remarkably healthy, given their chronic lack of sleep. Management strategies are rather disappointing in their effectiveness, but include behavioral techniques to prevent the worsening of the insomnia and medications.

Keywords

Idiopathic insomnia Sleep–wake center Childhood onset Benzodiazepines Zolpidem Melatonin Tricyclic antidepressants 

References

  1. 1.
    A.A.S.M. (2006) The international classification of sleep disorders: diagnostic and coding manual, 2nd ed. American Academy of Sleep Medicine, Westchester, ILGoogle Scholar
  2. 2.
    A.P.A. (1994) Diagnostic and statistical manual of mental disorders, 4th ed. American Psychiatric Association, Washington, DCGoogle Scholar
  3. 3.
    Reynolds CF 3rd, Kupfer DJ, Buysse DJ, Coble PA, Yeager A (1991) Subtyping DSM-III-R primary insomnia: a literature review by the DSM-IV Work Group on Sleep Disorders. Am J Psychiatry 148(4):432–438CrossRefPubMedGoogle Scholar
  4. 4.
    Association of Sleep Disorders Centers (1979) Diagnostic classification of sleep and arousal disorders, 1st ed. Sleep 2:1–137Google Scholar
  5. 5.
    Hauri P, Olmstead E (1980) Childhood-onset insomnia. Sleep 3(1):59–65PubMedGoogle Scholar
  6. 6.
    Hauri PJ (1983) A cluster analysis of insomnia. Sleep 6(4):326–338PubMedGoogle Scholar
  7. 7.
    Hauri P (2000) Primary insomnia. In: Kryger MD, Roth T, Dement WC (eds) Principles and practice of sleep medicine, 3rd edn. W.B. Saunders, Philadelphia, pp 633–639Google Scholar
  8. 8.
    Buysse DJ, Reynolds CF 3rd, Kupfer DJ et al (1994) Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV Field Trial. Sleep 17(7):630–637PubMedGoogle Scholar
  9. 9.
    Sano H, Itoh H (1998) Idiopathic insomnia. Nippon Rinsho 56(2):361–364PubMedGoogle Scholar
  10. 10.
    Bonnet MH, Arand DL (1995) 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep 18(7):581–588PubMedGoogle Scholar
  11. 11.
    Hauri PJ (1998) Insomnia. Clin Chest Med 19(1):157–168CrossRefPubMedGoogle Scholar
  12. 12.
    John J, Kumar VM, Gopinath G (1998) Recovery of sleep after fetal preoptic transplantation in medial preoptic area-lesioned rat. Sleep 21(6):601–606PubMedGoogle Scholar
  13. 13.
    Hauri P (1999) Idiopathic insomnia. In: Gilman S, Goldstein G, Waxman S (eds) MedLink neurology. Arbor, San DiegoGoogle Scholar
  14. 14.
    Regestein QR, Dambrosia J, Halleft M, Murawski B, Paine M (1993) Daytime alertness in patients with primary insomnia. Am J Psychiatry 150(10):1529–1534CrossRefPubMedGoogle Scholar
  15. 15.
    Perlis ML, Smith MT, Pigeon WR (2005) Etiology and pathophysiology of insomnia. In: Kryger MD, Roth T, Dement WC (eds) Principles and practice of sleep medicine, 4th edn. Elsevier Saunders, Philadelphia, pp 714–725CrossRefGoogle Scholar
  16. 16.
    Philip P, Guilleminault C (1996) Adult psychophysiologic insomnia and positive history of childhood insomnia. Sleep 19(3 Suppl):16–22Google Scholar
  17. 17.
    Archbold KH, Pituch KJ, Panahi P, Chervin RD (2002) Symptoms of sleep disturbances among children at two general pediatric clinics. J Pediatr 140(1):97–102CrossRefPubMedGoogle Scholar
  18. 18.
    Ferber R (1990) Childhood insomnia. In: Thorpy M (ed) Handbook of sleep disorders. Marcel Dekker, New York, pp 435–55Google Scholar
  19. 19.
    Mahowald MW (1996) Diagnostic testing. Sleep disorders. Neurol Clin 14(1):183–200CrossRefPubMedGoogle Scholar
  20. 20.
    Chang PP, Ford DE, Mead LA, Cooper-Patrick L, Klag MJ (1997) Insomnia in young men and subsequent depression. The Johns Hopkins Precursors Study. Am J Epidemiol 146(2):105–114CrossRefPubMedGoogle Scholar
  21. 21.
    Schenck CH, Mahowald MW (1996) Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med 100(3):333–337CrossRefPubMedGoogle Scholar
  22. 22.
    Salzman C (1998) Addiction to benzodiazepines. Psychiatr Q 69(4):251–261CrossRefPubMedGoogle Scholar
  23. 23.
    Darcourt G, Pringuey D, Sallière D, Lavoisy J (1999) The safety and tolerability of zolpidem – an update. J Psychopharmacol 13(1):81–93CrossRefPubMedGoogle Scholar
  24. 24.
    Regestein QR, Reich P (1983) Incapacitating childhood-onset insomnia. Compr Psychiatry 24(3):244–248CrossRefPubMedGoogle Scholar
  25. 25.
    Schenck CH, Mahowald MW (2001) Severe, childhood-onset, idiopathic, life-long insomnia responding selectively to opiate therapy: case report with 19 year follow-up. Sleep Med 2:531–536CrossRefPubMedGoogle Scholar
  26. 26.
    Smits MG, Nagtegaal EE, van der Heijden J, Coenen AM, Kerkhof GA (2001) Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial. J Child Neurol 16(2):86–92CrossRefPubMedGoogle Scholar
  27. 27.
    Van der Heijden K, Smits MG, van Someren EJ, Boudewijn Gunning W (2005) Prediction of melatonin efficacy by pretreatment dim light melatonin onset in children with idiopathic chronic sleep onset insomnia. J Sleep Res 14:187–194CrossRefPubMedGoogle Scholar
  28. 28.
    Attarian H (2002) Idiopathic insomnia. In: Gilman S, Goldstein G, Waxman S (eds) MedLink neurology. Arbor, San DiegoGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Garrick Applebee
    • 1
  1. 1.Departments of Neurology and Pediatrics, Vermont Regional Sleep CenterUniversity of Vermont College of MedicineBurlingtonUSA

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