ABSTRACT
Longitudinal studies indicate a normal reduction in total nightly sleep time from birth until age 20, after which there is a plateau until age 35. Rules for improving the quality of sleep have evolved which can be quite useful to those with transient and milder forms of insomnia. Complaints about inadequate sleep are much more significant when the patient also complains of tiredness when awake. Caffeinated beverages and cigarette smoking may impair the initiation of sleep. Alcohol will interrupt sleep, inducing difficulty maintaining sleep. Sleep-related seizure disorders may prove quite difficult to identify but produce symptoms of nocturnal awakening, reducing sleep efficiency. Nonrestorative sleep suggests a difference in the distribution of sleep staging, implying an altered arousal threshold. Total sleep time appears to be within normal limits, but the patient complains of lack of satisfaction with his night’s sleep.
