• Sleep Medicine and Psychophysiology
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• v.16 no.1
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• pp.5-9
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• 2009

Relatively little is known about the neurobiology of insomnia, despite its wide prevalence and broad medical impact. Although much is still to be learned about the pathophysiology of the disorder, identification, systematic assessment, and appropriate treatment are clearly beneficial to patients. Recent research, using quantitative EEG, polysomnography (PSG), multiple sleep latency test (MSLT) and neuroimaging techniques, suggests that some broad areas can be identified as possible pathophysiological models. Sleep-wake homeostat model hypothesizes a failure in homeostatic regulation of sleep, an attenuated increase in sleep drive with time awake, and/or defective sensing of sleep need. Circadian clock model hypothesizes a dysfunctional circadian clock, resulting in changes in the timing of sleep-wake propensity that are incompatible with normal sleep. Intrinsic sleep-wake state mechanism model suggests that abnormal function of insomnia comprises the systems responsible for expression of the sleep states themselves. Extrinsic over-ride mechanism (stress-response) model suggests that insomnia reflects the consequences of overactivity of one of the systems considered "extrinsic" to normal sleep-wake control. Many current therapies for insomnia are based on these physiological models. Several attempts have been made to create a physiological model that would explain this disorder and could be used as a foundation for treatment. However, it appeared that no model can fully explain and clarify all aspects of insomnia. Future research should be necessary to expand our knowledge on the biological dimensions of insomnia.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.156-163
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• 1997

Objectives : The authors investigated the practice of sleep hygiene and its effectiveness in general population who had experienced insomnia. If we find the items which be little practiced but especially effective, we would establish empirical an and theoretical basis to design the treatment program for insomnia, therefore apply it in clinical practice. Methods : The 226 subjects who had experienced insomnia, were at the age above 18 in Seoul, Korea. The questionnaire included the demographic data, the experience of insomnia, and the practices and effects of sleep hygiene instruction. The interview was administered face to face by the investigators. Results : The subjects reported that they practiced many of the sleep hygiene items related with arousal in sleep setting, and that those items were effective. The items such as 'get regular exercise each day(H)', 'take a hot bath(H)', 'concentrate on the pleasant feeling of relaxation(A)' were not usually practiced, but these items were reported very effective for sleep. Conclusion : The findings suggested that there were sleep hygiene items which should be educated and directed to practice actively in treatment program for insomniacs. Some items, which were especially reported low practice but highly effective, would be recommended to be studied about each therapeutic effectiveness in follow-up studies.