Pathologies of awakenings: the clinical problem of insomnia considered from multiple theory levels

Abstract

Limit cycle-based mid-level theories that rationalize effective clinical treatments for chronic insomnia have empirical support from whole-organism studies of sleep physiology, but their relation to network-level and cellular neurobiologies remains obscure. The neurobiology of pharmacological treatments for insomnia has been increasingly understood, but has not been fully integrated with psychological theories or electroencephalographic descriptions of sleep. Better clinical diagnostic and treatment frameworks will require both greater conceptual clarity as to what an "awakening" is descriptively and detailed investigations to relate fundamental neuroscience to clinical technologies can be both accessible and diagnostically useful to clinicians.