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[Pathophysiological hypothesis and diagnosis of insomnia disorder]
Jean-Arthur Micoulaud-Franchi1, Julien Coelho1, Léa Boileau2
1Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France. CNRS UMR 6033 Sanpsy, CHU de Bordeaux, Bordeaux, France.
Abstract:
PATHOPHYSIOLOGICAL HYPOTHESES AND DIAGNOSIS OF INSOMNIA DISORDER. All pathophysiological models place hyperarousal as a central process in the mechanisms of insomnia. These models differ, however, in terms of the importance and role of the variables explaining this hyperarousal. Behavioral and cognitive models describe self-maintenance behaviors and dysfunctional thoughts, such as worries and concerns about sleep and the consequences of insomnia. Alterations in cognitive functions related to hyperarousal in perceptual and memory processes can explain these behaviors and thoughts. Neurobiological models show instability in the sleepwake balance, with orexin possibly involved, but this remains to be confirmed. The diagnosis of insomnia must consider the semiology related to the mechanisms of insomnia, as well as co-morbidities.
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