Advertisement

Insomnia in Psychiatric Disorders

  • Samy S. Karaz
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Management of insomnia without a basic understanding of the possible underlying psychiatric disorders might result in an inadequate, if not hazardous outcome. Insomnia is listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a symptom of several psychiatric disorders.

Insomnia related to other DSM-IV mental disorders was found to be as high as 77%. In more than 50%S of the cases, the diagnosis was a depressive disorder. In general, 57% of individuals reporting insomnia have a psychiatric disorder or will develop one within a year. Anxiety seems to play a key role in the development of insomnia. Second to anxiety disorders, depression is strongly associated with the development of insomnia. Depression is considered as a possible precipitating mechanism but even more likely as a consequence of insomnia.

Keywords

Anxiety disorders Depressive disorder Insomnia Benzodiazepines SSRIs Prazosin PTSD 

References

  1. 1.
    Harvey AG (2001) Insomnia: symptom or diagnosis? Clin Psychol Rev 21(7):1037–1059CrossRefPubMedGoogle Scholar
  2. 2.
    Ohayon MM, Caulet M, Lemoine P (1998) Comorbidity of mental and insomnia disorders in the general population. Compr Psychiatry 39(4):185–197CrossRefPubMedGoogle Scholar
  3. 3.
    Bonnet MH, Arand DL (1999) Diagnosis and treatment of insomnia. Respir Care Clin North Am 5(3):333–348Google Scholar
  4. 4.
    Jansson M, Linton SJ (2006) The role of anxiety and depression in the development of insomnia: cross-sectional and prospective analyses. Psychol Health 21(3):383–397CrossRefGoogle Scholar
  5. 5.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  6. 6.
    American Sleep Disorders Association, Diagnostic Classification Steering Committee (1997) The international classification of sleep disorders, revised: Diagnostic and coding manual. American Sleep Disorders Association, Rochester, MNGoogle Scholar
  7. 7.
    Benca RM (2001) Consequences of insomnia and its therapies. J Clin Psychiatry 62(10):33–38PubMedGoogle Scholar
  8. 8.
    McCall WV (2001) A psychiatric perspective on insomnia. J Clin Psychiatry 62(10):27–32PubMedGoogle Scholar
  9. 9.
    Hales SC, Yudofsky RE, Talbott JA (eds) (1999) The American Psychiatric Press Textbook of Psychiatry, 3rd edn. American Psychiatric Press, Washington, DCGoogle Scholar
  10. 10.
    Naylan TC, Metzler TJ, Schoenfeld FB et al (2001) Fluvoxamine and sleep disturbances in posttraumatic stress disorders. J Traum Stress 14(3):461–467CrossRefGoogle Scholar
  11. 11.
    Sadock BJ, Sadock VA (eds) (1999) Kaplan and Sadock’s comprehensive textbook psychiatry, 7th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 1380–1384, pp 1490–1503Google Scholar
  12. 12.
    Simon GE, Heiligenstein JH, Grothaus L, Katon W, Revicki D (1998) Should anxiety and insomnia influence antidepressant selection: a randomized comparison fluoxetine of and imipramine. J Clin Psychiatry 59(2):49–55CrossRefPubMedGoogle Scholar
  13. 13.
    Kupfer DG (1999) Pathophysiology and management of insomnia during depression. Ann Clin Psychiatry 11(4):267–276CrossRefPubMedGoogle Scholar
  14. 14.
    Carney CE, Segal ZV, Edinger JD (2007) A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder. J Clin Psychiatry 68(2):254–260CrossRefPubMedGoogle Scholar
  15. 15.
    Krystal A, Fava M, Rubens R, Wessel T, Caron J, Wilson P, Roth T, McCall WV (2007) Evaluation of Eszopiclone discontinuation after cotherapy with Fluoxetine for insomnia with coexisting depression. J Clin Sleep Med 3(1):48–55PubMedGoogle Scholar
  16. 16.
    Bourdet C, Goldenberg F (1994) Insomnia and anxiety: sleep EEG changes. J Psychosom Res 38(Suppl 1):93–104CrossRefPubMedGoogle Scholar
  17. 17.
    Soldatos CR (1994) Insomnia in relation to depression and anxiety: epidemiologic considerations. J Psychosom Res 38(Suppl 1):3–8CrossRefPubMedGoogle Scholar
  18. 18.
    Mellman TA (2006) Sleep and anxiety disorders. Psychiatr Clin North Am 29:1047–1058CrossRefPubMedGoogle Scholar
  19. 19.
    Martinez-Gonzalez D, Obermeyer WH, Benca RM (2002) Comorbidity of insomnia with medical and psychiatric disorders. Prim Psychiatry 9(8):37–49Google Scholar
  20. 20.
    Kryger MH, Roth T, Dement WC (eds) (2000) Principles and practice of sleep medicine, 3rd edn. WB Saunders, Philadelphia, PA, pp 642, 1128, 1134–1135Google Scholar
  21. 21.
    Attarian HP (2000) Helping patients who say they cannot sleep. Postgrad Med 107(3):127–142CrossRefPubMedGoogle Scholar
  22. 22.
    Lepola U, Koponen H, Leinonen E (1994) Sleep in panic disorders. J Psychosom Res 38(1):105–111CrossRefPubMedGoogle Scholar
  23. 23.
    Warner MD, Dorn MR, Peabody CA (2001) Survey on the usefulness of Trazodone in patients with PTSD with insomnia or nightmares. Pharmacopsychiatry 34(4):128–131CrossRefPubMedGoogle Scholar
  24. 24.
    Dierks MR, Jordan JK, Sheehan AH (2007) Prazosin treatment of nightmares related to posttraumatic stress disorder. Ann Pharmacother 41(6):1013–1017CrossRefPubMedGoogle Scholar
  25. 25.
    Taylor FB, Martin P, Thompson C, Williams J, Mellman TA, Gross C, Peskind ER, Raskind MA (2008) Prazosin effects on objective sleep measures and clinical symptoms in civilian trauma posttraumatic stress disorder: a placebo-controlled study. Biol Psychiatry 63(6):629–632CrossRefPubMedGoogle Scholar
  26. 26.
    Raskind MA, Peskind ER, Hoff DJ, Hart KL, Holmes HA, Warren D, Shofer J, O’Connell J, Taylor F, Gross C, Rohde K, McFall ME (2007) A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder. Biol Psychiatry 61(8):928–934CrossRefPubMedGoogle Scholar
  27. 27.
    Krystal AD (2006) Sleep and psychiatric disorders: future directions. Psychiatr Clin North Am 29:1115–1130CrossRefPubMedGoogle Scholar
  28. 28.
    Krakow B, Johnston L, Melendrez D et al (2001) An open trial of evidence-based cognitive behavior therapy for nightmares and insomnia in crime victims with PTSD. Am J Psychiatry 158(12):2043–2047CrossRefPubMedGoogle Scholar
  29. 29.
    Brown RL, Brown RL, Saunders LA, Castelaz CA, Papasouliotis O (1997) Physicians decision to prescribe Benzodiazepines for nervousness and insomnia. J Gen Intern Med 12:44–52CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Chokroverty S (ed) (1999) Sleep disorders medicine, 2nd edn. Butterworth-Heinemann Medical, St Louis, pp 342–343Google Scholar
  31. 31.
    Barkoukis TJ, Avidan AY (2007) Review of sleep medicine, 2nd edn. Butterworth Heinemann Elsevier, Philadelphia, pp 169–184Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Samy S. Karaz
    • 1
  1. 1.University of North DakotaFargoUSA

Personalised recommendations