9
Insomnia
CONNSTANCE SHIVERS-SMITH
NOTE: This chapter corresponds to Chapter 12 in Fundamentals of Sleep Technology, 2nd edition.
Special Note: Publication of the revised version of the ICSD (American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014) occurred after the publication of the Fundamentals of Sleep Technology, second edition, and prior to the publication of this Workbook. Substantial changes in the diagnosis and conceptual framework for understanding insomnia were incorporated into ICSD-3. Insomnia diagnoses are now limited to chronic insomnia disorder, short-term insomnia disorder, and other insomnia disorder. The concept of comorbid disease was incorporated into the diagnostic criteria and essential features of insomnia. A discussion of the previous classification occurs in the section “Clinical and Pathophysiological Subtypes.” The reader is strongly encouraged to reference the ICSD-3 for up-to-date information regarding diagnosis of insomnia.
1. Insomnia subtypes include sleep-onset insomnia, sleep maintenance insomnia, and:
A. Fragmented sleep insomnia
B. Early morning awakening
C. Sleep attack insomnia
D. Dream enactment insomnia
2. Transient or short-term insomnia is expected to resolve:
A. With the administration of a suitable hypnotic
B. Within 1 year
C. After the first or second visit to the sleep specialist
D. When the stressor resolves or the patient adjusts
3. Patients with psychophysiologic insomnia tend to:
A. Have heightened arousal
B. Feel that they never sleep even when presented with objective evidence
C. Progress from short-term insomnia to total sleeplessness over weeks or months
D. Sleep normally when allowed to self-select bedtime and sleep until noon
4. During the interview, questions about bedtime and wake time allow the sleep specialist to evaluate the patient for the possibility of:
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