Sleep may be interfered with by a variety of causes, some of which may be preventive, while others may awaken the individual. The disturbance is essentially a symptomatic manifestation, though often the most conspicuous one. It may be associated with organic disease or with functional disturbance of other origin. It may be due to the action of poisons, introduced from without or generated within the body. The etiologic factor is sometimes obscure. Among the more common causes are pain, disease of the cranium or its contents, respiratory and circulatory disturbances, febrile and toxic states, nutritive impairment and chemical influences in general. The sleeplessness of old age must be attributed to changes in the blood-vessels of the brain, and in the cerebrum itself.
A number of the less common causes of disturbed sleep were discussed recently by Oppenheim1, before the Berlin Society for Psychiatry and Nervous Diseases. The qualification, psychogenic
INSOMNIA. JAMA. 1900;XXXIV(1):47. doi:10.1001/jama.1900.02460010055006
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