Insomnia A Clinician's Guide to Assessment and Treatment

TABLE OF CONTENTS: 1: The basics of sleep. Introduction. The nature and organization of sleep. Biopsychosocial determinants of sleep. Sleep needs. The consequences of sleep deprivation. 2: Clinical features of insomnia. Introduction. Clinical presentation. Definition. Concomitant laboratory findings and clinical features. Course and prognosis. Insomnia as a symptom or a syndrome. Does your patient suffer from insomnia? 3: Assessment and differential diagnosis of insomnia. Introduction. The assessment of insomnia. Differential diagnosis of insomnia. Clinical formulation of the sleep problem. 4: Sleep hygiene and relaxation therapy. Introduction. Rationale for sleep hygiene. Practical instructions for using sleep hygiene advice. Rationale for relaxation therapy. Practical instructions for using relaxation therapy. Implementation issues with relaxation therapy. Clinical vignette. 5: Sleep scheduling. Introduction. Rationale for sleep scheduling. Practical instructions for using sleep scheduling. Implementation issues. 6: Cognitive therapy. Introduction. The role of dysfunctional cognitions in insomnia. Rationale and objectives. Principles and practice of cognitive therapy. Practical recommendations for changing beliefs and attitudes about sleeplessness. Clinical vignettes. Treatment implementation issues. Supporting evidence. Other cognitive approaches. 7: Sleep medications. Introduction. Types of medications used for insomnia. Clinical benefits, risks, and limitations. Indications and contra-indications. Clinical guidelines on the appropriate use of sleep medication. Combining psychological and pharmacological approaches. Clinical guidelines for hypnotic discontinuation. Conclusions. 8: Clinical and treatment implementation issues. Introduction. Treatment implementation formats - individual, group, and brief consultations models. Treatment parameters - frequency, timing and duration of treatment. Strategies to promote compliance. Treatment of special populations. References.