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Insomnia Disorder—Pathophysiology 

Insomnia Disorder—Pathophysiology
Insomnia Disorder—Pathophysiology

Fee Benz

, Elisabeth Hertenstein

, Anna Johann

, and Dieter Riemann

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date: 31 July 2021

Insomnia disorder is defined as persistent difficulty with initiating or maintaining sleep, or early morning awakening accompanied by daytime impairment. Although insomnia disorder is a highly prevalent disorder and a major public health burden, the pathophysiology of the disorder is still not fully understood. Neurobiological as well as psychological models have been suggested highlighting genetic, behavioral, cognitive, emotional, and neurobiological factors. While psychological perspectives emphasize the role of dysfunctional sleep-related cognitions and a selective attention toward sleep-related stimuli, neurobiological perspectives particularly look at physiological alterations such as brain circuits that may be involved in the pathophysiology of insomnia. Relevant models explaining how insomnia develops and how it becomes chronic are described, and the evidence is summarized. Thus, this chapter provides an overview of important etiological models and further approaches dealing with the pathophysiology of insomnia disorder.

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