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 Insomnia
is the most commonly reported sleep problem or symptom in industrialized
countries. It refers to the perception of getting poor quality
or insufficient sleep. Epidemiological studies show that
about one-third of the population report sleep problems. Between
10 and 15 percent of these people report moderate to severe insomnia
that is chronic or persistent (Roth
et al., 1999). Most people with insomnia do not seek medical
treatment for it directly, and its importance to health, diagnosis,
and treatment remains substantially under-recognized by clinicians.
Typical features of insomnia include:
- Difficulty falling
and/or remaining asleep for a desired period of time;
- Restless or troubled
sleep;
- Unrefreshing sleep;
- Waking up tired.
Insomnia and sleep
are dynamic, complex states of being which present special challenges
of measurement and interpretation. Sleeping patients cannot self-report
their condition in "real time" and, obviously, are not in the
normal waking conscious state. Sleep and wakefulness alternate
in a circadian rhythm, the precise mechanisms of which have still
not been fully explained (Horne,
2000). It is commonly believed that sleep serves both mental
and somatic restorative functions and is therefore an important
component of overall health. (Cai,
1991; Taylor
et al., 2000; Beersma,
1998; Rechtschaffen,
1998). Despite this importance, insomnia (and related fatigue)
has been neglected until relatively recently as a subject for
research. Much more investigation is warranted for creating explanatory
theories, understanding functional consequences, understanding
the relation of insomnia to various disease/health states, and
testing effective interventions.
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