Psychophysiology

In the most classic form, the subject slept pretty well, sleeping peacefully for 3 or 4 hours then wakes up for no apparent reason. Then follows a period of insomnia or light sleep interspersed with arousals. Insomniacs have indeed sleep very variable and are mostly concerned about how to place the next night. Indeed, the insomniac is so worried about not being able to sleep he does not sleep because of this idea. Insomniacs can sleep when they want it (watching TV, for example), but once they take the decision to sleep, they do not.

The sleep of insomniacs is fragmented, it should follow, as in normal, excessive daytime sleepiness. In fact, these patients complain of fatigue, poor concentration, memory problems sometimes but rarely excessive daytime sleepiness. They have, at most, drowsiness somewhat larger than the good sleepers in the early afternoon. Some studies showed no difference between insomniacs and good sleepers matched for age and sex, with regard to daytime sleepiness (subjective or objective) or psychomotor tests (measures of attention, vigilance, learning from memory). Often, instead of being more sleepy than good sleepers, they are more vigilant. Their fatigue accumulated due to their poor sleep is compensated by a state of constant hyper-arousal, certainly contributing to chronic malaise, complained of the insomniac. The central activation is linked to excessive sleep unstable and lower quality. In the insomniac as when taking central stimulants (caffeine) in normal subjects, there was a decrease of approximately one third of the sleep latency and frequent awakenings, sleep in a relatively conserved organization. The hyper-arousal of insomniacs in the day, the brevity of their sleep the sleep of their similarity with that of a good sleeper who have drunk too much coffee, suggests that their disorder is more the result of pressure of excessive arousal that impaired mechanisms Hypnogen.

Severe insomnia is often difficult cases. Their persistent complaints, isolated from any pathological context, sometimes even without objective disorder sleep laboratory, poor response to hypnotics make difficult their treatment by the doctor. But above all we must remember that insomnia is often only the visible part of a sum of hidden problems. Any inappropriate intervention can lead to crystallization problems and sometimes the phenomena of decompensation, especially in the depressive mode. 47% of severe insomniacs cons only 11% of subjects free from sleep disorders have psychological distress (depression, anxiety) serious.