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I would like to thank Friedman for his comments on our article. As he has pointed out, there are plausible neurobiologic explanations that could account for our observations. However, the presumption that an increased prevalence of insomnia in women is linked to differences in cerebral hemispheric concentrations of dopamine will require more evidence than is currently available. I agree that it is important to address complaints of insomnia in patients with cardiovascular and respiratory disorders, but it should be emphasized that in many cases the optimum treatment for the insomnia will include addressing the underlying cardiovascular and respiratory dysfunction.
Quan SF. Neurobiology of Insomnia and Respiratory Symptoms-Reply. Arch Intern Med. 1996;156(7):812. doi:10.1001/archinte.1996.00440070145020