Insomnia Linked to Hyperarousal, Not Sleep Loss

Chronic insomnia may be more a problem of hyperarousal than of sleep loss, new research indicates. Consequently, scientists are considering treating it with antidepressants rather than hypnotics.

A study in the Journal of Clinical Endocrinology & Metabolism found that two hormones associated with increased arousal in animals, cortisol and adrenocorticotropic hormone, are elevated in insomniacs, reports an article by Victoria Stagg Elliott in AMNews.

That finding, the article quotes researchers as saying, is important because of the link between increased levels of those hormones and conditions such as hypertension, depression and obesity.

Experts, the article continues, laud the study for shedding light on a condition that's often treated with a patchwork of behavior modification and hypnotics -- until something works. Now, it says, antidepressants have been effective for some patients - even though there's little evidence of their efficacy.

That's party because, the article notes, sleeplessness may be caused by sleep apnea, restless leg syndrome, depression or an anxiety disorder. That, it says, could be the reason antidepressants sometimes work.

The study was small, the article goes on, involving just 11 insomniacs and 13 healthy control subjects. It is also not clear whether the hormonal elevations detected were the cause of the insomnia or the result, it notes.

But, researchers notes in the AMNews article, their work could be especially beneficial if permits more accurate diagnosis of the disorder by leading to a blood test for it. Alexandros N. Vgontzas, M.D., lead author of the study and a professor in the Department of Psychiatry at the Pennsylvania State University Medical School, Hershey, is quoted in the article as pointing out that "objective measures of sleep can be useful to predict severity and, therefore, the urgency for treatment.

Now, the only way to diagnose insomnia is the patient complaint, which is subjective. If our data are replicated in other studies, a physician may have an objective measure."