Abstract

Insomnia is a heterogeneous disorder. A multidimensional, multimethod approach to its phenotyping is based on the degree of objective sleep duration, the relative role of behavioral and biological perpetuating factors, clinical features, natural course, and association with specific morbidity. Insomnia with objective short sleep duration (ISSD) phenotype is linked to physiologic hyperarousal, adverse cardiometabolic and brain health outcomes, and a persistent, unremitting course. Insomnia with normal sleep duration (INSD) phenotype is linked to sleep misperception, maladaptive beliefs, and coping, and shares with the ISSD phenotype the presence of cortical arousal and risk of adverse mental health outcomes. This phenotyping may help us improve insomnia's nosology, assessment, and treatment. However, the latter endeavor lacks evidence, particularly in terms of the need to modify or adapt CBT-I. We review the evidence on these insomnia phenotypes, their response to CBT-I and suggest potential modifications and adaptations. This chapter is not a clinical guideline ready to be delivered in routine clinical practice, rather it should foster future trials and implementations.

Original languageEnglish (US)
Title of host publicationAdapting Cognitive Behavioral Therapy for Insomnia
PublisherElsevier
Pages369-401
Number of pages33
ISBN (Electronic)9780128228722
ISBN (Print)9780128228739
DOIs
StatePublished - Jan 1 2022

All Science Journal Classification (ASJC) codes

  • General Psychology

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