Insomnia

Section I. Fundamentals of Insomnia. Introduction. History. Definitions. Significance. Epidemiology. Consequences. Subjective and objective daytime consequences. Socio-economic impact. Insomnia as a risk factor in disease. Models. Psychological - cognitive/ behavioral models. Biological models. Sleep EEG in insomnia. Neuro-endocrine/immune /autonomic /metabolic function. Brain imaging. II. Clinical Assessment of Insomnia. Sleep history. Evaluation instruments and methodology. Classification and diagnosis overview. Primary insomnias. Secondary insomnias. Insomnia in psychiatric disorders. Insomnia in chronic pain. Insomnia in medical and neurological disorders. Insomnia in circadian rhythm disorders. Shift work / jet lag / DSP/ASP/Free-running - blindness. Insomnia in other sleep disorders. Movement disorders. Breathing disorders. Substance-induced insomnia. Insomnia In the elderly. Childhood insomnia. III. Treatment of Insomnia. Overview of treatment considerations. Psychological and behavioral therapies. Preface. Role of healthy sleep practices. Scheduling / role of exercise / caffeine/ alcohol. Specific behavioral treatment modalities. Stimulus control. Sleep restriction. Cognitive therapy. Short-term and group treatment approaches. Multimodal CBT. Specific populations. Secondary insomnia. Elderly. Pharmacological treatment. Pharmacology of the GABAA complex. BzRAs in the management of insomnia. Indications/efficacy and outcome. Safety / adverse effects / tolerance / withdrawal and rebound. Sedating antidepressants, neuroleptics, and other prescription medications. Melatonin in sleep-wake regulation. Melatonin as a hypnotic agent. Development of melatonin receptor agonists. Other pharmacotherapies. Over-the-counter products. Nutritional supplements /herbals. Emerging pharmacotherapies. Clinical trials in insomnia. Practice Models. Treatment setting / staffing. Managing comorbid populations. Combining and sequencing treatment modal