In presenting a case of extreme hyposomnia, psychosomatic insomnia is elaborated as a special type of primary insomnia. The case study of a 60 years old man is based on psychiatric examinations, an intersive one-week observation including polygraphic sleep recordings, and on reviewing medical data over a period of 35 years. In this case, the insomnia developed during a life situation with social stress and continued over 30 years with a gradual sleep reduction to 2-4 hours. Our sleep recordings confirmed a total sleep time of nearly 3 hours, a marked rhythmicity of sleep and day-time activities, fragmentation of sleep, and psychogenic extrasystoles, all symptoms having been reported by the subject previously. Autonomic functions indicated a good efficiency of NREM sleep, whereas a first night effect with subsequent adaptation revealed a good regulatory function of the sleep-waking-system. In addition to a detailed documentation of this extraordinary case, an interpretation is undertaken in order to explain, how the insomnia developed and continued. Psychodynamic aspects show a set of characteristics which are most typical for psychosomatic syndroms. The authors expect, that the knowledge about psychosomatic insomnia will be helpful in diagnosis and treatment of severe insomnias.

Adaptation, Physiological↗

PubMed1977

[Sleeping disorders and headaches in problem patients (author's transl)].

Explore the source record for details and available documents.

Headache↗

PubMed1976

[Education in psychiatry].

In order to give young doctors a specialist training in psychiatry and psychotherapy and to have the necessary number of available posts, the concept of training presently practised should urgently be revided. To justify this demand, the author points to new developments within psychiatry itself as well as to external circumstances. He mentions firstly the extension of the knowledge itself, the pluralism in therapy, the growing specialization within the specialty, the diffusion of the roles as well as the identity crisis and secondly the disproportion to be expected between the number of young graduated doctors and the number of available posts. So that the readermay for his own opinion, the author refers to the relevant literature. The author's personal opinion and his proposals are discussed.

Education, Medical, Continuing↗