Insomnia Is a Prevalent Complaint Both in the General Population and in Clinical Practice. It May Present as the Primary Complaint

INSOMNIA IS A PREVALENT COMPLAINT BOTH IN THE GENERAL POPULATION AND IN CLINICAL PRACTICE. IT MAY PRESENT AS THE PRIMARY COMPLAINT or in association with another physical or mental-health problem. Prevalence estimates indicate that about one third of the adult population reports insomnia symptoms, 9%-12% experience additional daytime consequences, and approximately 6% meet formal criteria for an insomnia diagnosis.1 Insomnia is more common among women, middle-aged and older adults, shift workers, and patients with medical or psychiatric disorders. Persistent insomnia can produce an important burden for the individual and for society, as evidenced by reduced quality of life, impaired daytime functioning and increased absenteeism at work, and higher health-care costs. Persistent insomnia is also associated with increased risks of depression and chronic use of hypnotics.2-5 The diagnosis of insomnia is based on a subjective complaint of difficulties falling or staying asleep, or nonrestorative sleep, that is associated with marked distress or significant daytime impairments.6,7 Several indicators are useful to quantify the severity and clinical significance of insomnia. These markers may include the intensity (e.g., time to fall asleep, duration of awakenings, total sleep time), frequency, and duration of sleep difficulties. In the case of duration, a distinction is made between adjustment insomnia, a condition lasting a few days or weeks and often associated with stressful life events or changes in schedules and environment, and persistent insomnia, a condition lasting more than 1 Psychological And Behavioral Treatment Of Insomnia:Update Of The Recent Evidence (1998-2004)