title: [Pathophysiology of insomnia].
abstract: Insomniacs generally report not only sleep-related symptoms such as difficulty in initiating, maintaining, obtaining sufficient restorative sleep, but also experience various daytime impairment reflective of sleep deficits. Although pathophysiology of insomnia remains to be explored, physiological hyperarousal evidenced by cognitive, endocrine, and neurophysiologic variables has been revealed to be involved in onset and development of insomnia. Patients with insomnia also suffer from cognitive impairment. Characteristically, they report their sleep and psychoperformance to be worse than are objectively measured. This "perceived" deficit is exactly what aggravates the QOL of insomniac patients and let them fall in a vicious cycle. Insomnia is often induced by stress events, and is assumed to develop by 3Ps, predisposing, precipitating and perpetuating factors. Concept and diagnostic criterion of insomnia are still fluctuating. There is a need for clarification of pathophysiology of insomnia for development of efficient treatment skills and critical prevention of chronic insomnia.
authors.affiliation: Department of Psychophysiology, National Institute of Mental Health, NCNP.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mishima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Abe
mesh_terms: D006801:Humans; D007319:Sleep Initiation and Maintenance Disorders / Q000473:pathology* / Q000503:physiopathology*