Psychoneuroendokrinologie der Insomnie - Der Circulus vitiosus der psychophysiologischen Insomnie auf psychologischer, elektrophysiologischer und endokriner Ebene

Abstract

The concept of psychophysiological insomnia based on a vicious cycle of hyperarousal, insomnia and impaired daytime well-being. There is increasing evidence that the psychological hyperarousal and insomnia is caused by and perceived as chronic stress. Beside this psychological factor neuroendocrine dysfunctions are supposed to maintain insomnia. Impaired morning and daytime well-being, arousal-related sleep fragmentation, and an increased activation of the hypothalamic-pituitary-adrenal (HPA) axis are major psychoneuroendocrinological pathomechanisms in generating and maintaining insomnia. In contrast, the decreased nocturnal melatonin secretion reflects the chronification of insomniac disturbances and is a contributing factor in maintaining insomnia. These findings could be summarized in a psychoneuroendocrinological vicious cycle of insomnia, whose underlying neuroendocrinological dysfunctions might be true for all non-organic insomnia independent of their origin.