INDEX. Group psychotherapy, described, 97 Group stimulus control, 29-47; see also Stimulus control (group setting)

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1 Index Abdominal breathing, 70; see also Breathing; Relaxation therapy Activation, sleep drive/responsivity, 6-9 Age level; see also Elderly circadian rhythms and, delayed sleep phase syndrome and, 194 pharmacotherapy and, 118, 120 vicious circle model and, 167 Alcohol delayed sleep phase syndrome and, 200, 201 pharmacotherapy and, 116 sleep hygiene rules and, 68 treatment selection strategy and, 140 Antidepressants; see also Depression; Pharmacology pharmacotherapy protocols and, sleep behavior management and, 181 Anxiety barriers to sleep and, 4 209, 2U insomnia and, 156 pharmacotherapy and, 119, 122-U3 predisposing factor, 11 psychotherapy (short-term), 103, 1U sleep restriction therapy. 61 treatment selection strategy and, 137, 138, 140, Arousal barriers to sleep and, 3 Arousal (cont.) functional chronic insomnia, 104, 106 psychotherapy (short-term), 112 stimulus control instructions and, 19 Associative control of sleep, 4-6 Asthma, 233 Autogenic training, 70; see also Relaxation therapy Bed cue, stimulus control instructions, 19 Bedtime regularization, sleep hygiene rules, Behavior therapy pharmacotherapy combined with, 117 stimulus control (group setting), stimulus control instructions and, 21 Benzodiazepine sedative-hypnotics, 115; see also Pharmacology; Pharmacotherapy Biofeedback, 70; see also Relaxation therapy Body temperature rhythms sleep hygiene rules, 68 wake-maintenance zone and, 9, 10 Breathing; see also Relaxation therapy abdominal breathing, 70 good night's sleep model, 142 Bright light therapy body temperature rhythms and, 10 delayed sleep phase syndrome and, 196, early morning awakening insomnia and, 207, , 214; see also Early morning awakening insomnia effectiveness discussed,

2 250 Caffeine phannacotherapy and, 116 psychotherapy and, 88 sleep hygiene rules and, 68 Chronic illness, ; see also Organic sleep pathology cardiogenic nocturnal dyspnea case study, hypnogenic dystonia case study, method of treatment, overview of, treatment application~ Chronic insomnia: see Functional chronic insomnia Chronicity, phannacotherapy, 119 Chronic obstructive pulmonary disease (COPD) sleep disturbance and, 224 treatment method and, 225 Chronic pain chronic illness and, treatment strategy and, Circadian rhythm bright light therapy and, delayed sleep phase syndrome, 194, good night's sleep model, 144 sleep hygiene rules, sleep-wake schedule disorders, 191 vicious circle model, 155 wake-maintenance zone and, 10 Classical conditioning, associative control of sleep, 4-6 Oock, sleep hygiene rules, 67 Oonazepam, organic sleep pathology, 123; see also Pharmacotherapy Coffee, sleep hygiene rules, 68; see also Caffeine Cognitive relaxation, sleep behavior management, Cognitive restructuring good night's sleep model, sleep behavior management and, 178 Cognitive therapy combined therapy, psychotherapy (short-term), 103 Combined therapies pharmacotherapy/behavior therapy, 117 INDEX Combined therapies (cont.) sleep hygiene/relaxation therapy/ cognitive strategies case history (successful), case history (unsuccessful), cognitive component, relaxation therapy component, sleep hygiene component, Compliance: see Patient compliance Conditioned insomnia, psychotherapy, 90 Conditioning, associative control of sleep, 4-6 Control needs, treatment selection strategy, 138, Coping, functional chronic insomnia, 104 Core temperature: see Body temperature rhythms Countertransference, psychotherapy, 95 Daily sleep log: see Sleep log Deep breathing exercises: see Breathing Delayed sleep phase syndrome, background of, case study (successful), case study (unsuccessful), method of treatment, overview of, 193 Depression barriers to sleep and, 3 delayed sleep phase syndrome, 193, 195, insomnia and, 30, 156 pharmacotherapy and, 115, predisposing factor, 11 psychotherapy and, 89 stimulus control instructions and, 23-24, 25 treatment selection strategy and, 138 Disease-related insomnia: see Chronic illness; Organic sleep pathology Dreaming, early morning insomnia, 209; see also Night terror Drug abuse, delayed sleep phase syndrome, 200, 201; see also Alcohol; Substance abuse Drug treatment: see Pharmacology Dysthymia sleep behavior management and, 181

3 INDEX Dysthymia (cont.) stimulus control instructions and, 25 Early morning insomnia, bright light and the sleep-wake cycle, case history in, differential diagnosis of, effectiveness discussed, overview of, symptoms of, 208 treatment summarized, Education (of patient) sleep behavior management, 175; see also Sleep behavior management treatment selection strategy, Ego-supportive psychotherapy, described, Elderly, ; see also Age level case example (successful), case example (unsuccessful), circadian rhythms and, method of treatment, overview of sleep in, sleep drive and, 8 sleep restriction therapy and, 51, 54 stimulus control (group setting), Electromyography, relaxation therapy, 71 Emotional arousal: see Arousal Exercise delayed sleep phase syndrome, 195-1% good night's sleep model, 142 sleep hygiene rules, Family counseling, described, 97 Family therapy, psychotherapy (shortterm), 103 Flurazepam, sleep behavior management, Forbidden zone: see Wake-maintenance zone Functional chronic insomnia; see also Insomnia pharmacotherapy and, 115, 116 psychotherapy (short-term), 104 Gestalt therapy, described, 95-% Good night's sleep model; see also 1leatment selection strategy attributes of, described, Group psychotherapy, described, 97 Group stimulus control, 29-47; see also Stimulus control (group setting) Hand temperature, relaxation therapy, 71 Hunger, sleep hygiene rules, 69 Hypnotics: see Pharmacology; Pharmacotherapy Iatrogenic insomnia, 223 Insomnia; see also Functional chronic insomnia; Sleep barriers to sleep and, 2-4 chronic illness and, ; see also Chronic illness elderly and, functional chronic insomnia, 104 overview of, 1-2 predisposing, precipitating, and perpetuating factors in, sources of, 30, 156 treatment revolution for, vii treatment variety for, viii Life-style treatment selection strategy and, 138 Light therapy: see Bright light therapy 251 Marriage counseling, described, 97 Meals, sleep hygiene rules, 69 Medical problems, treatment selection strategy, ; see also Organic sleep pathology Meditation relaxation therapy and, 70; see also Relaxation therapy sleep behavior management and, Napping, sleep hygiene rules, 69 Neurosis, functional chronic insomnia, 104 Nicotine sleep hygiene rules, 68 treatment selection strategy, 140 Night terror 209 vicious circle model and, 164 Nonrestorative sleep syndrome, pharmacotherapy, 115 Older adults: see Elderly

4 252 Organic sleep pathology, 30; see also Chronic illness assessment and, 31 chronic illness and, 228 pharmacotherapy protocols for, U2-U3 psychotherapy and, 89 psychotherapy (short-term) and, 105 sleep restriction therapy contraindicated, treatment selection strategy and, 137 Outcomes chronic illness and, combined therapy (sleep hygiene/ relaxation therapy/cognitive strategies), delayed sleep phase syndrome, U-218 elderly and, pharmacotherapy, U4-126 psychotherapy, 94, 100 psychotherapy (short-term), sleep restriction therapy, stimulus control (group setting), treatment selection strategy, vicious circle model, Pain chronic illness and, treatment strategy and, Patient compliance, sleep restriction therapy, 52, 53 Pharmacology, associative control of sleep and, 5-6 chronic illness and, , , early morning insomnia, 2U sleep behavior management and, 181, sleep drive and, 8 sleep hygiene rules and, stimulus control (group setting), 44 treatment selection strategy, 137, 140 withdrawal of hypnotics, stimulus control instructions, 20-21, 24 Pharmacotherapy, 115-U9 behavior treatment combined with, 117 case histories in, contraindications for, 127 delayed sleep phase syndrome, 1%, 200 discontinuation of medication, U6-127 INDEX Pharmacotherapy (cont.) indications for, medication choice, dosages, UO duration of effect, metabolism type, 120 onset of effect, 119-UO method of treatment, antidepressant use, 123-U4 general rules, 120-U2 protocol examples for specific diagnoses, U2-123 overview of, 115 side effects, U7 sleep behavior management and, 178 vicious circle model, Polysomnography delayed sleep phase syndrome, 197, 198, , organic sleep pathology and, 31 pharmacotherapy and, 116 psychotherapy (short-term) and, 105 Problem diary, good night's sleep model, 143 Progressive muscle relaxation; see also Relaxation therapy Psychoanalysis, described, Psychoanalytic psychotherapy, described, 93 Psychopathology barriers to sleep, 3-4 delayed sleep phase syndrome, elderly, 239 Gestalt therapy, % insomnia, 30 psychotherapy, 90, psychotherapy (short-term), 105, 1U stimulus control instructions, treatment selection strategy, 137 Psychotherapy (general), 85-86, case history, classical psychoanalysis, differential diagnosis, ego-supportive psychotherapy, Gestalt therapy, 95-% group psychotherapy, 97 indications for, 90

5 INDEX Psychotherapy (general) (cont.) marriage and family counseling, 97 outcomes, 94 overview of, psychoanalytic psychotherapy, 93 referral considerations, sleep behavior management, 182 time-limited, dynamic psychotherapy, 94-95; see also Psychotherapy (shortterm) vicious circle model, 159, 160, Psychotherapy (short-term), case example (successful), case example (unsuccessful), discussion of, functional chronic insomnia and, method of, overview of, Rapid-eye-movement (REM) sleep, psychotherapy, 89 Relaxation therapy combined therapy, good night's sleep model, 142 sleep behavior management and, vicious circle model, 160, 171 Resistance, psychoanalysis, 92 Responsivity, activation/sleep drive, 6-9 Restless legs syndrome: see Organic sleep pathology Ritual, good night's sleep model, Schizophrenia, insomnia, 30 Secondary gains, treatment selection strategy, 138 Self-reports; see also Daily sleep log delayed sleep phase syndrome, pharmacotherapy and, 119 sleep behavior management, 177 treatment selection strategy and, Short-term insomnia, pharmacotherapy protocols for, 122 Short-term psychotherapy: see Psychotherapy (short-term) Sleep associative control of, 4-6 barriers to, Sleep (cant.) perception of, timing of, 9-10 Sleep apnea, Sleep behavior management, case study (successful), case study (unsuccessful), implementation of, overview of, 175 patient selection and management in, 176 treatment scheme, Sleep deprivation therapy: see Sleep restriction therapy Sleep diary: see Sleep log Sleep disturbance threshold, 7-9 Sleep drive, activation/responsivity, 6-9 Sleep history questionnaire, 30 Sleep hygiene combined therapy, sleep behavior management and, Sleep hygiene rules listing of, stimulus control (group setting), 34, 35 Sleep log cognitive strategies and, 71 delayed sleep phase syndrome, good night's sleep model, 143, 148 sample of, 72, 73 sleep behavior management, 177, 182 sleep restriction therapy and, 51 stimulus control (group setting), 31, 37 stimulus control instructions, 20 treatment selection strategy, 140 vicious circle model and, 168 Sleep restriction therapy, assessment in, case examples, early morning insomnia, 214 method of, outcomes, overview of, 49 psychotherapy (short-term), 103 sleep drive and, 6-7 treatment selection strategy, 140 Sleep-wake schedule disorders delayed sleep phase syndrome, ; see also Delayed sleep phase syndrome

6 254 Sleep-wake schedule disorders (cont.) ; see also Early morning awakening insomnia overview of, 191 Snacks, sleep hygiene rules, 69 Socioeconomic class, stimulus control (group setting), 44 Stimulants, sleep drive and, 8; see also Caffeine; Pharmacology Stimulus control (group setting), method of study, assessment, behavior therapy elements, older adults, overview of, predictors of outcomes, sleep maintenance clients, treatment sessions in, Stimulus control (individual), case history (successful), case history (unsuccessful), good night's sleep model, 141 intake method for study, listing of, overview of, psychotherapy (short-term), 103 Stress perpetuating factor, treatment selection strategy and, 136 vicious circle model, 160 Substance abuse delayed sleep phase syndrome, 200, 201 pharmacotherapy contraindication, 127 INDEX Thought stopping, good night's sleep model, 143 Time in bed, curtailment of, sleep hygiene rules, 66 Time-limited, dynamic psychotherapy, described, 94-95; see also Psychotherapy (short-term) Tobacco: see Nicotine 'Iiansference, 92-93, 95 'freatment selection strategy, assessment in, case study (successful), case study (unsuccessful), overview of, treatment program, education, good night's sleep model, learning factors, 140 mcyclic antidepressants, pharmacotherapy protocols, ; see also Depression; Pharmacology 'frying to sleep, sleep hygiene rules, 67 'fryptophan, sleep hygiene rules, 69 Vicious circle model, background of, case example (successful), case example (unsuccessful), discussed, method of treatment, overview of, Wake-maintenance zone, timing of sleep, 9-10

Insomnia. Learning Objectives. Disclosure 6/7/11. Research funding: NIH, Respironics, Embla Consulting: Elsevier

Insomnia. Learning Objectives. Disclosure 6/7/11. Research funding: NIH, Respironics, Embla Consulting: Elsevier Insomnia Teofilo Lee-Chiong MD Professor of Medicine National Jewish Health University of Colorado Denver School of Medicine Learning Objectives Learn about the causes of transient and chronic Learn how