I will review the changes that have occurred in the last 40 years in terms of the definition, etiology, nosology, diagnosis, cardiometabolic sequelae, and treatment of insomnia.
This objectives of this talk are to:
Review the changes in terms of the etiology and nosology of the disorder.
Present evidence supporting that insomnia is a disorder of 24-hour CNS hyperarousal, and not sleep loss.
Understand the usefulness of objective sleep measures in the diagnosis and prognosis of insomnia.
Become familiar with the evidence that insomnia with short sleep duration is the most severe phenotype of the disorder.
I was born and raised in Athens Greece where I studied medicine. After completing a three year program in psychiatry and neurology in 1985, I moved to Pennsylvania and I completed at Penn State University a four year residency in psychiatry and one year fellowship in sleep disorders medicine. In 1989 I became assistant professor of psychiatry and after 11 years I reached the rank of full professor and was awarded the Endowed Chair of Sleep Disorders Medicine. My research has focused primarily in understanding the pathophysiology and improving the diagnosis and treatment of the two most prevalent sleep disorders i.e. insomnia and sleep apnea. My basic tools are the science and methods of neuroendocrinology and neuroimmunology combined with findings from the adult and child Penn State large general population cohorts. Major conceptual contributions to the field is a) sleep apnea is a manifestation of the metabolic syndrome and b) insomnia is a disorder of hyperarousal and its phenotype associated with objective short sleep duration is the most severe form of the disorder. I have published 180 original papers in peer reviewed journals, numerous chapters in books, editor in one book and the citations of my work are more than 16,000 (google scholar). My research has been funded by NIH.