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Insomnia: 2019


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Table of Contents

ToC Preface Acknowledgments Dedication 1 Description 1.1 Definition Terminology 1.2 Terminology Definition 1.2.1 Classification of Insomnia 1.3 Epidemiology 1.3.1 Prevalence 1.3.2 Economic Impact of Insomnia 1.4 Course and Prognosis 1.5 Differential Diagnosis of Insomnia From Other Sleep Disorders 1.6 Comorbidities 1.6.1 Sleep Disorders Comorbidities 1.6.2 Medical Comorbidities 1.6.3 Psychiatric Comorbidities 1.7 Diagnostic Procedures 2 Theories and Models of Insomnia 2.1 Fundamentals of Sleep-Wake Regulation 2.1.1 Homeostatic Process 2.1.2 Circadian Process 2.1.3 Interaction of Homeostatic and Circadian Processes 2.2 Behavioral Model of Insomnia 2.3 Cognitive Models of Insomnia 2.4 Physiological Hyperarousal Models 2.5 A Neurocognitive Model 2.6. Neurobiological Models 2.7 An Integrative Framework 3 Diagnosis, Assessment, and Treatment Indications 3.1 Diagnosis of Insomnia 3.2 Primary Tools in the Assessment of Insomnia 3.2.1 Clinical Interview 3.2.2 Sleep Diaries 3.2.3 Insomnia Severity Index 3.2.4 Instruments to Screen for Common Comorbid Psychiatric Conditions 3.2.5 Instruments to Assess Sleep-Related Cognitions 3.3 Other Methods of Assessing Sleep: Polysomnography and Actigraphy 4 Treatment of Insomnia 4.1 Methods of Treatment 4.1.1 Sleep Psychoeducation 4.1.2 Behavioral Strategies 4.1.3 Cognitive Strategies 4.1.4 Cognitive Behavioral Therapy for Insomnia 4.1.5 Cognitive Therapy for Insomnia 4.1.6 Mindfulness-Based Interventions in the Treatment of Insomnia 4.2 Mechanisms of Action 4.2.1 Understanding Sleep Physiology 4.2.2 Correcting Maladaptive Behaviors 4.2.3 Extinguishing Conditioned Arousal 4.2.4 Targeting Maladaptive Cognitions 4.3 Efficacy of CBT-I 4.4 Variations and Combinations of Methods 4.4.1 Self-Help Therapy 4.4.2 Group CBT-I 4.4.3 Stepped-Care Approach 4.4.4 CBT-I Combined With Sleeping Pills 4.4.5 CBT-I in Patients With Comorbid Medical or Psychiatric Disorders 4.5 Problems in Carrying Out CBT-I 4.6 Conclusion 5 Case Vignette 6 Further Reading 7 References 8 Appendix: Tools and Resources

About the Author

William K. Wohlgemuth, PhD, graduated from the University of Miami with a degree in Clinical Health Psychology. Following his internship, he completed postdoctoral training at Duke University Medical Center in the behavioral sleep medicine clinic. During that time, he was involved with several clinical trials investigating the efficacy of CBT-I. Since 2005, Dr. Wohlgemuth has been the director of the behavioral sleep medicine clinic at the Bruce W. Carter VA Medical Center in Miami. He is actively involved in training psychology practicum students and interns. Dr. Wohlgemuth is certified in behavioral sleep medicine by the American Academy of Sleep Medicine. Ana Imia Fins, PhD, received her doctorate in Clinical Health Psychology from the University of Miami. She completed predoctoral and postdoctoral training in behavioral sleep medicine at the Durham, NC Veterans Af fairs Medical Center and at the Duke University Sleep Disorders Center. Currently, she is professor at the College of Psychology at Nova Southeastern University, where she also codirects an insomnia clinic. For over 18 years she has been training students in the application of CBT-I and other behavioral sleep medicine intervention strategies.


This book provides an excellent concise introduction to insomnia and its treatment with cognitive behavioral therapy. A great addition to any therapist's bookshelf!, Philip Gehrman, PhD, CBSM, Associate Professor, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

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