INSOMNIA, or the inability to sleep adequately. is a com mon enough symptom in modern life and varies greatly in degree. Our understanding of its underlying causes is often rendered the more difficult because of our lack of knowledge concerning the exact physiology of normal sleep.
Three varieties of insomnia may be roughly distinguished: the inability to fall asleep at the onset for a variable period: the frequent awakening with incapacity to resume _p for some time: the waking up at an unduly early hour with no n sleep. Every individual case must be _ . : - . ed care:....: on : _ : own merits, and the physician is taxed to the utmos: to combat the symptom on rational and not empirical lines. The responsible causes may have a bodily basis or must be sought in the mind. Among the former must be enumerated the evident factors of pain or discomfort from any cause: shortness of breath, cough. frequency of urination. itching. palpitation. Febrile condi tions. high blood-pressure and other circulatory disturbances. toxic states and organic disease of the brain are also liable to be responsible.
In many forms of mental derangement insomnia is a frequent. symptom and often heralds its inception_ This is specially so in anxiety conditions. where unpleasant dry .:::: e_xa„ - is _ the sleeplessness. and here the sufferer may ;o lose because of these experiences which he cannot control. In neuras thenia and many bv:: _ .:cal states is likely to be promi nent. In such psyc_hc,ses as manic-depressive insanity. dementia praecox. confusional insanity and general paresis. such a is generally part of the clinical picture..
The advent of insomnia should never be regarded ?i: ~.:}y but means should at once be taken to trace its root if poss: : The appropriate treatment ::. depend upon the phys:.::.. origin. Attacking the only is indiscriminate sedative drug :::- g mus : : _.: ed. the pc s : _ .
harm from the medical gerated. Good sleep thus broui: . ::bon:: cut short a men:.:.
illness. In mild cases simple measures <<.a:, Lo much while severe insomnia may be highly intractable. The use of suggestion or hypnosis is occasionally beneficial. (C. S. R..)