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September 30, 1939

THE TREATMENT OF INSOMNIA: CLINICAL LECTURE AT ST. LOUIS SESSION

JAMA. 1939;113(14):1322-1326. doi:10.1001/jama.1939.72800390004013
Abstract

Insomnia is a chronic inability to sleep. To the clinical mind the term connotes a condition in which an alleged sleeplessness is the main or solitary symptom, in which there are few tangible physical causes and in which the pathologic basis, if any, is not readily detectable. A person who has genuine pain and whose physical derangements are such that sleep is obviously impossible is not ordinarily regarded as having insomnia.

What constitutes true insomnia is largely a matter of capricious opinion on the part of both patient and physician. It would be of considerable advantage to determine whether there is a definite optimum of human sleep, that is, a basic requirement comparable to basal metabolism, from which deviations could be measured. Adult normal sleep defies standardization, for even the most regular of sleep rhythms must be regarded as a complex process which can be influenced by both physical and

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