It is defined as difficulties in initiating and maintaining sleep, or early-morning awakening with inability to return to sleep. Insomnia is the most prevalent sleep disorder that affects 10% of adult population ( Morin & Benca, 2012 Ohayon & Reynolds, 2009). Therefore, sleep duration may change the patterns of stress systems ( Edwards, Evans, Hucklebridge, & Clow, 2001). In addition, brain centers that control sleep-wake cycle and stress-responsive biological systems are closely interrelated. Sleep disturbances change the autonomic activity and increase heart rate and blood pressure (Zhong et al., 2005). Previous studies have emphasized that the circadian mechanisms which control the sleep, also directly modulate ANS ( Leproult & Van Cauter, 2010). SCN as a circadian pacemaker is also responsible for modulation of sleep-wake cycle (Hastings, Reddy, & Maywood, 2003). Hypothalamus-Pituitary-Adrenal (HPA) and Autonomic Nervous System (ANS) are controlled by Suprachiasmatic Nucleus (SCN) of hypothalamus.
Biological rhythms that regulate two main stress systems, i.e. In particular, sleep duration and quality could alter biological systems responses to stress ( Meerlo, Sgoifo, & Suchecki, 2007). Poor sleep quality could also disrupt the endocrine system ( Ioja, Weir, & Rennert, 2012 Mullington, Simpson, Meier-Ewert, & Haack, 2010 Potter et al., 2016). These may be applied concurrently with somatic measurements in future studies to better understand this common psycho-physiologic condition.Sleep is an important body homeostatic behavior that plays a critical role in emotional and cognitive functions ( Koren et al., 2011). In particular, computerized tests of cognitive bias are seen as offering an objective means of appraising mental processes in insomnia. Drawing upon parallels in the literature on adult psychopathology, and upon recent clinical and experimental studies on insomnia, the evidence for this pathway is considered and a research agenda is outlined. Consequently, it is vulnerable, and may be inhibited, by focused attention and by direct attempts to control its expression. The argument is that sleep normalcy is a relatively automatic process. This paper proposes an explanatory model, that we call the attention-intention-effort pathway. What is less clear is exactly how PI develops and what are its crucial maintaining factors. It seems evident that behavioral and cognitive factors play a part. Moreover, a substantial outcome literature demonstrates that PI can be treated effectively using a range of psychological interventions. Its 'behavioral phenotype', comprising elements such as conditioned arousal, sleep-incompatible behavior and sleep preoccupation, has not changed markedly across several generations of diagnostic nosology. Psychophysiologic insomnia (PI) is the most common form of persistent primary insomnia.
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