neurologic disorders
Insomnia and Excessive Daytime Sleepiness (EDS)
Psychophysiologic insomnia
Insomnia, regardless of cause, may persist well beyond resolution of precipitating factors, usually because patients feel anticipatory anxiety about the prospect of another sleepless night followed by another day of fatigue. Typically, patients spend hours in bed focusing on and brooding about their sleeplessness, and they have greater difficulty falling asleep in their own bedroom than falling asleep away from home. Optimal treatment combines Cognitive-behavioral strategies Hypnotics Althoughcognitive-behavioral strategiesare more difficult to implement and take longer, effects last a long time after treatment is ended. These strategies include Sleep Hygiene (particularly restriction of time in bed) Education Relaxation training Stimulus control Cognitive therapy Hypnotics None 