Skip to main content

Abstract

Insomnia complaints can be divided into two categories: (1) sleep-onset insomnia (difficulty in initiating sleep), and (2) sleep maintenance insomnia (difficulty in remaining asleep). The latter can be further divided into: (a) frequent and/or long-lasting awakenings during the night, and (b) early morning awakening with an inability to fall back to sleep (terminal insomnia). Insomniacs may present with only a single complaint or a combination of the above-mentioned categories. Because of the subjective nature of insomnia complaints, the actual degree of sleep onset or sleep maintenance disturbance varies greatly and is not necessarily correlated with the intensity of an insomniac’s dissatisfaction. For example, among three sleepers who average identical 40-minute sleep latencies, one may complain of severe insomnia, another may report mild insomnia, and the third person may be unconcerned about his or her sleep pattern. The frequency of insomnia also varies. Some insomniacs report difficulty sleeping nearly every night; others complain of less frequent sleep disturbance.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Aber, R., & Webb, W. B. (1986). Effects of a limited nap on night sleep in older subjects. Psychology and Aging, 1, 300–302.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

    Google Scholar 

  • American Sleep Disorders Association (1990). International classification of sleep disorders: Diagnostic and coding manual. Rochester, MN: Author.

    Google Scholar 

  • Bixler, E. O., Kales, A., Soldatos, C. R., Kales, J. D., & Healey, S. (1979). Prevalence of sleep disorders in the Los Angeles metropolitan area. American Journal of Psychiatry, 136, 1257–1262.

    PubMed  Google Scholar 

  • Bonnet, M. H., & Arand, D. L. (1992). Caffeine use as a model of acute and chronic insomnia. Sleep, 15, 526–536.

    PubMed  Google Scholar 

  • Buysse, D. J., & Reynolds, C. F. (1990). Insomnia. In M. J. Thorpy (Ed.), Handbook of sleep disorders (pp. 375–433). New York: Marcel Dekker.

    Google Scholar 

  • Carskadon, M. A., Dement, W. C., Mitler, M. M., Guilleminault, C., Zarcone, V. P., & Spiegel, R. (1976). Self-reports versus sleep laboratory findings in 122 drug-free subjects with complaints of chronic insomnia. American Journal of Psychiatry, 133, 1382–1388.

    PubMed  Google Scholar 

  • Edinger, J. D., Hoelscher, T. J., Webb, M. D., Marsh, G. R., Radtke, R. A., & Erwin, C. W. (1989). Polysomnographic assessment of DIMS: Empirical evaluation of its diagnostic value. Sleep, 12, 315–322.

    PubMed  Google Scholar 

  • Espie, C. A. (1991). The psychological treatment of insomnia. Chichester, United Kingdom: Wiley.

    Google Scholar 

  • Espie, C. A., Brooks, D. N., & Lindsay, W. R. (1989). An evaluation of tailored psychological treatment of insomnia. Journal of Behavior Therapy and Experimental Psychiatry, 20, 143–153.

    Article  PubMed  Google Scholar 

  • Espie, C. A., & Lindsay, W. R. (1985). Paradoxical intention in the treatment of chronic insomnia: Six case studies illustrating variability in therapeutic response. Behaviour Research and Therapy, 23, 703–709.

    Article  PubMed  Google Scholar 

  • Espie, C. A., Lindsay, W. R., Brooks, D. N., Hood, E. M., & Turvey, T. (1989). A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia. Behaviour Research and Therapy, 27, 79–88.

    Article  PubMed  Google Scholar 

  • Feinberg, I., March, J. D., Floyd, T. C., Jimison, R., Bossom-Demitrack, L, & Katz, P. H. (1985). Homeostatic changes during post-nap sleep maintain baseline levels of delta EEG. Electroencephalography and Clinical Neurophysiology, 61, 134–137.

    Article  PubMed  Google Scholar 

  • Ford, D. E., & Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders. Journal of the American Medical Association, 262, 1479–1484.

    Article  PubMed  Google Scholar 

  • Freedman, R., & Papsdorf, J. D. (1976). Biofeedback and progressive relaxation treatment of sleep-onset insomnia: A controlled all-night investigation. Biofeedback and Self-Regulation, 1, 253–271.

    Article  PubMed  Google Scholar 

  • Friedman, L., Bliwise, D. L., Yesavage, J. A., & Salom, S. R. (1991). A preliminary study comparing sleep restriction and relaxation treatments for insomnia in older adults. Journal of Gerontology, 46, 1–8.

    Article  Google Scholar 

  • Gillin, J. C., & Byerly, W. F. (1990). The diagnosis and management of insomnia. New England Journal of Medicine, 322, 239–248.

    Article  PubMed  Google Scholar 

  • Gross, R. T., & Borkovec, T. D. (1982). Effects of a cognitive intrusion manipulation on the sleep-onset latency of good sleepers. Behavior Therapy, 13, 112–116.

    Article  Google Scholar 

  • Hauri, P. J., & Wisbey, J. (1992). Wrist actigraphy in insomnia. Sleep, 15, 293–301.

    PubMed  Google Scholar 

  • Haynes, S. N., Adams, A., & Franzen, M. (1981). The effects of presleep stress on sleep-onset insomnia. Journal of Abnormal Psychology, 90, 601–606.

    Article  PubMed  Google Scholar 

  • Haynes, S. N., Fitzgerald, S. G., Shute, G. E., & Hall, M. (1985). The utility and validity of daytime naps in the assessment of sleep-onset insomnia. Journal of Behavioral Medicine, 8, 237–247.

    Article  PubMed  Google Scholar 

  • Hoddes, E., Dement, W. C., & Zarcone, V. (1972). The development and use of the Stanford Sleepiness Scale. Psychophysiology, 9, 150.

    Google Scholar 

  • Hoelscher, T. J., & Edinger, J. D. (1988). Treatment of sleep-maintenance insomnia in older adults: Sleep period reduction, sleep education, and modified stimulus control. Psychology and Aging, 3, 258–263.

    Article  PubMed  Google Scholar 

  • Hoelscher, T. J., Ware, J. C., & Bond, T. (1993, June). Initial validation of the Insomnia Impact Scale. Paper presented at the annual meeting of the Association of Professional Sleep Societies, Los Angeles.

    Google Scholar 

  • Kales, A., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (1983a). Early morning insomnia with rapidly eliminated benzodiazepines. Science, 220, 95–97.

    Article  PubMed  Google Scholar 

  • Kales, A., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (1983b). Rebound insomnia and rebound anxiety: A review. Pharmacology, 26, 121–137.

    Article  PubMed  Google Scholar 

  • Kay, D. C., & Samiuddin, Z. (1988). Sleep disorders associated with drug abuse and drugs of abuse. In R. L. Williams, I. Karacan, & C. A. Moore (Eds.), Sleep disorders: Diagnosis and treatment (pp. 315–371). New York: Wiley.

    Google Scholar 

  • Lacks, P., Bertelson, A. D., Gans, L, & Kunkel, J. (1983). The effectiveness of three behavioral treatments for different degrees of sleep onset insomnia. Behavior Therapy, 14, 593–605.

    Article  Google Scholar 

  • Lacks, P., & Morin, C. M. (1992). Recent advances in the assessment and treatment of insomnia. Journal of Consulting and Clinical Psychology, 60, 586–594.

    Article  PubMed  Google Scholar 

  • Lacks, P., & Rotert, M. (1986). Knowledge and practice of sleep hygiene techniques in insomniacs and good sleepers. Behaviour Research and Therapy, 24, 365–368.

    Article  PubMed  Google Scholar 

  • Ladouceur, R., & Gros-Louis, Y. (1986). Paradoxical intention vs. stimulus control in the treatment of severe insomnia. Journal of Behavior Therapy and Experimental Psychiatry, 17, 267–269.

    Article  PubMed  Google Scholar 

  • Levin, D., Bertelson, A. D., & Lacks, P. (1984). MMPI differences among mild and severe insomniacs and good sleepers. Journal of Personality Assessment, 48, 126–129.

    Article  PubMed  Google Scholar 

  • Iichstein, K. L. (1988a). Clinical relaxation strategies. New York: Wiley.

    Google Scholar 

  • Lichstein, K. L. (1988b). Sleep compression treatment of an insomnoid. Behavior Therapy, 19, 625–632.

    Article  Google Scholar 

  • Lichstein, K. L., & Fischer, S. M. (1985). Insomnia. In M. Hersen & A. S. Bellack (Eds.), Handbook of clinical behavior therapy with adults (pp. 319–352). New York: Plenum.

    Chapter  Google Scholar 

  • Lichstein, K. L., & Johnson, R. S. (1993). Relaxation for insomnia and hypnotic medication use in older women. Psychology and Aging, 8, 103–111.

    Article  PubMed  Google Scholar 

  • Lichstein, K. L., Nickel, R., Hoelscher, T. J., & Kelley, J. E. (1982). Clinical validation of a sleep assessment device. Behaviour Research and Therapy, 20, 292–297.

    Article  PubMed  Google Scholar 

  • Lichstein, K. L., & Rosenthal, T. L. (1980). Insomniacs’ perceptions of cognitive versus somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89, 105–107.

    Article  PubMed  Google Scholar 

  • Lick, J. R., & Heffler, D. (1977). Relaxation training and attention placebo in the treatment of severe insomnia. Journal of Consulting and Clinical Psychology, 45, 153–161.

    Article  PubMed  Google Scholar 

  • Marchini, E. J., Coates, T. J., Magistad, J. G., & Waldum, S. J. (1983). What do insomniacs do, think, and feel during the day? A preliminary study. Sleep, 6, 147–155.

    PubMed  Google Scholar 

  • Marlatt, G. A., & George, W. H. (1990). Relapse prevention and the maintenance of optimal health. In S. Shumaker, E. B. Schron, & J. Ockene (Eds.), The handbook of health behavior change (pp. 44–63). New York: Springer.

    Google Scholar 

  • Mellinger, G. D., Balter, M. B., & Uhlenhuth, E. H. (1985). Insomnia and its treatment. Archives of General Psychiatry, 42, 225–232.

    Article  PubMed  Google Scholar 

  • Mendelson, W. B., Garnett, D., Gillin, J. C., & Weingartner, H. (1984). The experience of insomnia and daytime and nighttime functioning. Psychiatry Research, 12, 235–250.

    Article  PubMed  Google Scholar 

  • Morin, C. M., & Azrin, N. H. (1987). Stimulus control and imagery training in treating sleep-maintenance insomnia. Journal of Consulting and Clinical Psychology, 55, 260–262.

    Article  PubMed  Google Scholar 

  • Morin, C. M., & Azrin, N. H. (1988). Behavioral and cognitive treatments of geriatric insomnia. Journal of Consulting and Clinical Psychology, 56, 748–753.

    Article  PubMed  Google Scholar 

  • Nicassio, P. M., Boylan, M. B., & McCabe, T. G. (1982). Progressive relaxation, EMG biofeedback and biofeedback placebo in the treatment of sleep-onset insomnia. British Journal of Medical Psychology, 55, 159–166.

    Article  PubMed  Google Scholar 

  • Puder, R., Lacks, P., Bertelson, A. D., & Storandt, M. (1983). Short-term stimulus control treatment of insomnia in older adults. Behavior Therapy, 14, 424–429.

    Article  Google Scholar 

  • Reynolds, C. F., Taska, L. S., Sewitch, D. E., Restifo, K., Coble, P. A., & Kupfer, D. J. (1984). Persistent psychophysiologic insomnia: Preliminary research diagnostic criteria and EEG sleep data. American Journal of Psychiatry, 141, 804–805.

    PubMed  Google Scholar 

  • Roth, T., Roehrs, T., & Zorick, F. (1988). Pharmacological treatment of sleep disorders. In R. L. Williams, I. Karacan, & C. A. Moore (Eds.), Sleep disorders: Diagnosis and treatment (pp. 373–395). New York: Wiley.

    Google Scholar 

  • Sanavio, E. (1988). Pre-sleep cognitive intrusions and treatment of onset-insomnia. Behaviour Research and Therapy, 26, 451–459.

    Article  PubMed  Google Scholar 

  • Schoicket, S. L., Bertelson, A. D., & Lacks, P. (1988). Is sleep hygiene a sufficient treatment for sleep-maintenance insomnia? Behavior Therapy, 19, 183–190.

    Article  Google Scholar 

  • Seidel, W. F., Ball, S., Cohen, S., Patterson, N., Yost, D., & Dement, W. C. (1984). Daytime alertness in relation to mood, performance, and nocturnal sleep in chronic insomniacs and noncomplaining sleepers. Sleep, 7, 230–238.

    PubMed  Google Scholar 

  • Soldatos, C. R., Kales, J. D., Scharf, M. B., Bixler, E. O., & Kales, A. (1980). Cigarette smoking associated with sleep difficulty. Science, 207, 551–553.

    Article  PubMed  Google Scholar 

  • Spielman, A. J., Saskin, P., & Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed. Sleep, 10, 45–56.

    PubMed  Google Scholar 

  • Torsvall, L. (1981). Sleep after exercise: A literature review. Journal of Sports Medicine and Physical Fitness, 21, 218–225.

    PubMed  Google Scholar 

  • Turner, R. M., & Ascher, L. M. (1979). Controlled comparison of progressive relaxation, stimulus control and paradoxical intention therapies for insomnia. Journal of Consulting and Clinical Psychology, 47, 500–508.

    Article  PubMed  Google Scholar 

  • Woolfolk, R. L., & McNulty, T. F. (1983). Relaxation treatment for insomnia: A component analysis. Journal of Consulting and Clinical Psychology, 51, 495–503.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer Science+Business Media New York

About this chapter

Cite this chapter

Riedel, B.W., Lichstein, K.L. (1994). Insomnia. In: Hersen, M., Ammerman, R.T. (eds) Handbook of Prescriptive Treatments for Adults. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1456-9_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-1456-9_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-1458-3

  • Online ISBN: 978-1-4899-1456-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics