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. 2007 Jun;2(2):279-291.
doi: 10.1016/j.jsmc.2007.04.002.

CHRONIC INSOMNIA AND STRESS SYSTEM

Maria Basta  1 , George P Chrousos, Antonio Vela-Bueno, Alexandros N Vgontzas
Affiliations

CHRONIC INSOMNIA AND STRESS SYSTEM

Maria Basta et al. Sleep Med Clin. 2007 Jun.

Abstract

SynopsisIn insomnia, which is a very common sleep disorder, objective sleep measures, EEG activity, physiologic findings, HPA axis activity and inflammation markers suggest that it is not a state of sleep loss, but a disorder of hyperarousal present both during the night and the daytime. Several psychological and physiological factors contribute to the onset and perpetuation of insomnia, such as anxious-ruminative personality traits, stressful events, age-related sleep homeostasis weakening mechanisms, menopause and biologic - genetic diathesis of CNS hyperarousal. The therapeutic approach in insomnia should be multidimensional reducing the overall emotional and physiologic hyperarousal and its underlying factors present throughout the 24-h sleep/wake period.

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Figures

Figure 1
Figure 1
Internalization Hypothesis
Figure 2
Figure 2
Correlation between wake time after sleep onset with 24-hr urinary NE, DHPG, and DOPAC
Figure 3
Figure 3
24-hr plasma ACTH (top) and cortisol (bottom) concentrations in insomniacs (■) and controls (○). The thick black line on the abscissa indicates the sleep recording period. Error bar indicates SE. *P<0.01
Figure 4
Figure 4
24-hr circadian secretory pattern of cortisol in insomniacs with low TST (□) and high TST(●).The thick black line on the abscissa indicates the sleep recording period. Error bar indicates SE. *P<0.05
Figure 5
Figure 5
24-hr circadian secretory pattern of IL-6 (left) and TNFa (right) in insomniacs (□) and controls (●). The thick black line on the abscissa indicates the sleep recording period. Error bar indicates SE. *P<0.05
Figure 6
Figure 6
Comparisons of changes in wakefulness and SWS from baseline (nights 2 and 3) to the night of CRH administration (night 4) between young (□) and middle-aged (■) healthy men after adjusting for baseline value. Values represent the least square mean ± SE. *, P<0.05
Figure 7
Figure 7
Heuristic Model of Psychologic and Physiologic Factors associated with Insomnia
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