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| The Basics of Sleep | |
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| Introduction | |
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| The Nature and Organization of Sleep | |
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| Biopsychosocial Determinants of Sleep | |
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| Circadian and Homeostatic Factors | |
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| Age and Maturation | |
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| Medical Conditions and Drugs | |
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| Psychosocial Factors | |
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| Lifestyle and Environmental Factors | |
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| Sleep Needs | |
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| The Functions of Sleep | |
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| Evaluating Individual Sleep Needs | |
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| The Consequences of Sleep Deprivation | |
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| Total Sleep Deprivation | |
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| Partial Sleep Deprivation | |
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| Insomnia, Sleep Loss, and Daytime Functioning | |
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| Impact of Insomnia on Psychological Well Being | |
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| Impact of Insomnia on Physical Health | |
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| Clinical Features of Insomnia | |
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| Introduction | |
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| Clinical Presentation | |
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| Definition | |
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| Concomitant Laboratory Findings and Clinical Features | |
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| Polysomnographic (PSG) Findings | |
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| Fatigue and Sleepiness | |
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| Psychological Profile | |
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| Neuropsychological Findings | |
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| Course and Prognosis | |
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| Insomnia as a Symptom or a Syndrome | |
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| Differential Diagnosis between Primary and Secondary Insomnia | |
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| Subtypes of Primary Insomnia | |
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| Does Your Patient Suffer from Insomnia? | |
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| Assessment and Differential Diagnosis of Insomnia | |
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| Introduction | |
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| The Assessment of Insomnia | |
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| The Sleep History | |
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| The Sleep Diary | |
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| Informant Report | |
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| Polysomnography | |
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| Actigraphy and Other Behavioral Devices | |
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| Daytime Sleepiness | |
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| Predisposing, Precipitating and Perpetuating Factors | |
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| Differential Diagnosis of Insomnia | |
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| Insomnia | |
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| Normal Aging | |
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| Sleep Related Breathing Disorder | |
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| Restless Legs Syndrome and Periodic Limb Movement Disorder | |
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| Circadian Disorders | |
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| Narcolepsy | |
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| Parasomnias | |
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| Sleep Problems Associated with Medical/Psychiatric Disorders | |
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| Extrinsic Sleep Disorders | |
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| Clinical Formulation of the Sleep Problem | |
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| Sleep Hygiene and Relaxation Therapy | |
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| Introduction | |
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| Rationale for Sleep Hygiene | |
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| Practical Instructions for Using Sleep Hygiene Advice | |
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| Caffeine | |
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| Nicotine | |
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| Alcohol | |
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| Diet | |
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| Exercise | |
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| Noise | |
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| Room Temperature | |
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| Body Temperature | |
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| Air Quality | |
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| Lighting | |
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| Mattress and Pillows | |
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| Rationale for Relaxation Therapy | |
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| Practical Instructions for Using Relaxation Therapy | |
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| Bedtime Wind-Down | |
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| Relaxation Training | |
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| Implementation Issues | |
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| Clinical Vignette | |
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| Sleep Scheduling | |
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| Introduction | |
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| Rationale for Sleep Scheduling | |
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| Practical Instructions for Using Sleep Scheduling | |
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| Objectives | |
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| Restrict Your Time Spent in Bed | |
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| Establish Your Rising Time | |
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| Establish Your "Threshold Time" for Bed | |
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| Go to Bed Only When You Feel Sleepy | |
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| Follow a 7-Night-per-Week Schedule | |
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| Observe the 15-Minute Rule | |
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| Make Adjustments to Your New Schedule | |
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| Make the Connection between Bed and Sleep | |
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| Avoid Daytime Naps | |
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| Implementation Issues | |
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| Cognitive Therapy | |
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| Introduction | |
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| The Role of Dysfunctional Cognitions in Insomnia | |
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| Rationale and Objectives | |
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| Principles and Practice of Cognitive Therapy | |
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| Identifying Dysfunctional Sleep Cognitions | |
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| Challenging Dysfunctional Sleep Cognitions and Changing them with More Rational Substitutes | |
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| Practical Recommendations for Changing Beliefs and Attitudes About Sleeplessness | |
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| Keep Realistic Expectations | |
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| Revise Attributions about the Causes of Insomnia | |
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| Don't Blame Sleeplessness for All Daytime Impairments | |
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| Do not Catastrophise after a Poor Night's Sleep | |
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| Don't Place Too Much Emphasis on Sleep | |
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| Develop Some Tolerance to the Effects of Sleep Loss | |
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| Never Try to Sleep | |
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| Clinical Vignettes | |
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| Vignette 1 | |
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| Vignette 2 | |
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| Vignette 3 | |
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| Implementation Issues | |
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| Supporting Evidence | |
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| Other Cognitive Approaches | |
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| Paradoxical Intention | |
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| Cognitive Control | |
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| Thought-Blocking | |
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| Sleep Medications | |
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| Introduction | |
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| Types of Medications Used for Insomnia | |
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| Benzodiazepine-Receptor Agents | |
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| Antidepressants | |
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| Antihistamines | |
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| Herbal and Dietary Supplements | |
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| Clinical Benefits, Risks, and Limitations | |
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| Indications and Contra-Indications | |
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| Clinical Guidelines on the Appropriate Use of Sleep Medication | |
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| Combining Psychological and Pharmacological Approaches | |
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| Clinical Guidelines for Hypnotic Discontinuation | |
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| The Natural History of Hypnotic-Dependent Insomnia | |
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| A Step-by-Step Approach to Discontinue Hypnotics | |
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| Clinical and Practical Issues | |
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| Evidence for Efficacy of Hypnotic Discontinuation Programs | |
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| Conclusions | |
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| Clinical and Treatment Implementation Issues | |
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| Introduction | |
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| Treatment Implementation Formats: Individual, Group, and Brief Consultations Models | |
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| Treatment Parameters: Frequency, Timing, and Duration of Treatment | |
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| Strategies to Promote Compliance | |
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| Treatment of Special Populations | |
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| Appendixes | |
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| Outline Plan for a Sleep History Assessment Comprising Content Areas and Suggested Interview Questions | |
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| Sleep Diary | |
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| The Insomnia Severity Index | |
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| The Epworth Sleepiness Scale | |
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| The Pre-Sleep Arousal Scale | |
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| The Sleep Disturbance Questionnaire | |
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| Sleep Hygiene Practice Scale | |
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| Caffeine Knowledge Quiz | |
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| Transcript of a Relaxation Therapy Session (12-Minute Duration) | |
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| The Sleep Behavior Self-Rating Scale | |
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| Summary of the Sleep Scheduling Treatment Program | |
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| Calculating Current Sleep Requirement for Sleep Restriction | |
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| Self-Monitoring Form of Sleep-Related Thoughts | |
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| Dysfunctional Beliefs and Attitudes about Sleep Scale | |
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| Example of an Automatic Thought Record Used for Cognitive Therapy | |
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| The Glasgow Content of Thoughts Inventory | |
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| The Glasgow Sleep Effort Scale | |
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| A Medication Withdrawal Schedule Form | |
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| References | |
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| Index | |