title: [Psychosomatic insomnia].
abstract: In presenting a case of extreme hyposomnia, psychosomatic insomnia is elaborated as a special type of primary insomnia. The case study of a 60 years old man is based on psychiatric examinations, an intersive one-week observation including polygraphic sleep recordings, and on reviewing medical data over a period of 35 years. In this case, the insomnia developed during a life situation with social stress and continued over 30 years with a gradual sleep reduction to 2-4 hours. Our sleep recordings confirmed a total sleep time of nearly 3 hours, a marked rhythmicity of sleep and day-time activities, fragmentation of sleep, and psychogenic extrasystoles, all symptoms having been reported by the subject previously. Autonomic functions indicated a good efficiency of NREM sleep, whereas a first night effect with subsequent adaptation revealed a good regulatory function of the sleep-waking-system. In addition to a detailed documentation of this extraordinary case, an interpretation is undertaken in order to explain, how the insomnia developed and continued. Psychodynamic aspects show a set of characteristics which are most typical for psychosomatic syndroms. The authors expect, that the knowledge about psychosomatic insomnia will be helpful in diagnosis and treatment of severe insomnias.
mesh_terms: D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D002648:Child; D002940:Circadian Rhythm; D006801:Humans; D009790:Occupations; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology; D012895:Sleep, REM; D014851:Wakefulness
vernacular_title: Psychosomatische Insomnie