Insomnia

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  • Insomnia
    • Primary
      • Increase in physiological measures over 24hrs
        • Body temp
        • HR
        • Metabolic rate
      • Hyper arousal
        • Less sleepy altogether
      • Not caused by meds/illness
    • Nofzinger
      • Put brain into hyper arousal
        • Smaller decrease in activity
          • Thalamus
          • Brain stem
          • Prefrontal coretx
        • Increase in brain activity
      • PET scans
    • Winkleman
      • Persistant insomnia = reduced GABA
        • Brain can't "quiet down"
    • Beaulieu - Bonneau
      • 34.9% of insomniacs had 1st relative with it.
        • Nature vs nurture
      • Mothers-daughters-fathers-sons
    • Watson
      • 1042 MZ = 0.47
      • 828 DZ = 0.15
    • Secondary
      • Caused by meds/illness
        • Symptom
      • Katz
        • 3445 with hypertension,depression, diabetes, myocardial infraction or chf
          • 34% mild insomnia, 16% severe
    • Bardage & Isacson
      • 20% of hypertension drug users
        • Sleeping meds
          • Dependancy
          • Rebound insomnia
            • Dependancy
            • Reductionist
            • Meds no longer effective - iatrogenic
    • Weiss
      • 72% of psych patients had sleep dist.
        • 18% control
      • Insomnia is symptom of depression
        • Share abnormalities in bio clocks
        • Neurochemical imbalance
        • Increased cortisol
        • Reduced seratonin

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