title: The pathophysiology of insomnia:  from models to molecules (and back).
abstract: OBJECTIVE
  To provide an overview of foundational theories on the psychosocial and neurobiological mechanisms that underlie the pathophysiology of insomnia, a review of recent findings from across the spectrum of sleep sciences that are germane to conceptualizations of insomnia, and how such findings contribute to newer integrative models.
  
  
  RESULTS
  Recent findings come from a broad diversity of the sleep research spectrum including basic animal science, sleep neuroscience, especially sleep-wake regulation, psychoneuroimmunology, human genetics, epidemiology, psychology, and from the clinical research realm.
  
  
  CONCLUSIONS
  Our review focuses on the factors contributing to insomnia and to its maintenance over time as well as the theoretical models developed (and developing) to explain this pathophysiology. Early theoretical contributions have provided a backbone for insomnia research; the sleep sciences, in turn, have supported novel and increasingly complex theoretical models of insomnia. The overarching contention is that integrative models are needed that are fully comprehensive in scope.
authors.affiliation: Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York, USA. Wilfred_Pigeon@URMC.Rochester.edu
authors.forename: Wilfred R
authors.initials: WR
authors.lastname: Pigeon
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Cribbet
mesh_terms: D006801:Humans; D008954:Models, Biological; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*