INSOMNIA is a topic covered in the Harrison's Manual of Medicine.

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Harrison’s Manual of Medicine

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Insomnia is the complaint of poor sleep and usually presents as difficulty initiating or maintaining sleep. People with insomnia are dissatisfied with their sleep and feel it impairs their ability to function well. Affected individuals often experience fatigue, decreased mood, irritability, malaise, and cognitive impairment. Chronic insomnia, lasting >3 months, occurs in about 10% of adults. Acute or short-term insomnia affects over 30% of adults and is often precipitated by stressful life events. Most insomnia begins in adulthood, but many pts may be predisposed and report easily disturbed sleep predating the insomnia, suggesting that their sleep is lighter than usual.

All insomnias can be exacerbated and perpetuated by behaviors that are not conducive to initiating or maintaining sleep. Inadequate sleep hygiene is characterized by a behavior pattern prior to sleep, and/or a bedroom environment, that is not conducive to sleep. In preference to hypnotic medications, the pt should attempt to avoid stressful activities before bed, reserve the bedroom environment for sleeping, and maintain regular rising times.

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