title: The difficult to treat insomniac patient.
abstract: When a complaint of significant insomnia does not respond to standard interventions, the clinician must reassess the diagnosis with particular emphasis on psychiatric or psychological factors. This article describes the management of patients with 'sleeping pill insomnia,' insomnia associated with affective illness, sleep state misperception, 'sick role' behavior and treatment non-compliance.
authors.affiliation: Sleep Disorders Program, University Hospital-UBC Site, Vancouver, Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Fleming
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D010349:Patient Compliance; D012803:Sick Role; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology* / Q000628:therapy*