Insomnia Insomnia

Series Editor’s Introduction
The areas of sleep research as a scientific discipline and sleep medicine as a
medical specialty are relatively new but rapidly growing areas of interest. Early
investigations in sleep emphasized disorders of excessive daytime sleepiness. However,
among the sleep disorders, insomnia may be the most common and yet, at the
same time, the least well-managed sleep disorder. To many patients and physicians,
insomnia is presumed to be the result of underlying anxiety, recognized or
unrecognized. Perhaps for this reason, large numbers of affected individuals do not
seek medical attention but self-treat with alcohol or relatively ineffective over-thecounter
medications.
As stated in the Clinical Handbook of Insomnia, contrary to popular belief, psychological
factors are not the most common causes of insomnia and, very appropriately,
clues to possible physiologic causes of insomnia are given important
attention. On the other hand, the authors in this volume emphasize that untreated
insomnia may be an important risk factor for secondary psychiatric morbidity. Surprisingly,
it is currently unclear whether insomnia should be considered a disorder
of sleep or a disorder of arousal. Insomnia is a symptom, not a disease, but apparently
can occur as a primary or secondary disorder. Clinical Handbook of Insomnia
carefully defines insomnia, emphasizes the broad scope of the problem worldwide,
discusses its differential diagnosis, differentiates the primary and secondary
insomnias, and reports critically on the available modes of behavioral and pharmacologic
treatment.
This collection within a single volume of very practical information concerning
a common, but often neglected, disorder will be a useful addition to the armamentarium
of the generalist or specialist who wishes to deal with insomnia in an intelligent
and responsible manner.
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Daniel Tarsy, MD
Movement Disorders Center,
Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA