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Psychophysiologic insomnia can follow a few nights of sleeplessness due to an adjustment sleep disorder.
Concern regarding the prospect of facing yet another night of sleeplessness can result in an escalation of tension and anxiety with each successive night.
The insomniac begins to dread going to bed and often feels tension increasing as bedtime approaches.
He may become preoccupied with insomnia. Sufferers often spend hours in bed awake focused upon and brooding over their sleeplessness.
In severe cases, the focus of their thoughts, and even conversations with others, may begin to revolve around insomnia.
Curiously, sufferers often have little difficulty falling asleep during the course of the day when their minds are focused on other issues, such as during meetings.
They also may experience relief from their own bedrooms as they fall asleep easily when away from home, such as on v acation on in a hotel room. Psychophysiologic insomnia is often managed with a combination of behavioral measures and medications.
The most commonly utilized behavioral measures are relaxation training with EMG biofeedback training, psychotherapy (cognitive and insight-oriented), and stimulus control therapy (asking patients to use the bed only for sleep and to not stay in bed trying to sleep for more than ten minutes at a time, but to go into another room and to return to bed only after feeling sleepy).
Sleep hygiene measures should be closely adhered to during and after the termination of treatment, regardless of type.
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