ABSTRACT

Corresponding author: Malcolm Lader, E-mail: malcolm.lader@kcl.ac.uk

ABSTRACT

Sleep disturbances, in particular insomnia, are common in anxiety disorders. Consequently, complaints such as insomnia or nightmares have been incorporated in some definitions of anxiety disorder, such as generalized anxiety disorder and posttraumatic stress disorder. In this chapter, the various anxiety disorders are defined and described according to widely-used schemata. The include Generalized Anxiety Disorder, Panic Disorder, Post-traumatic Stress Disorder, ,Panic Disorder, and Social Anxiety Disorder. The epidemiology, treatment and sleep aspects are discussed. The physiology of Anxiety Disorders and the relationship to arousal, stress, and sleep-wake regulation are outlined.. Polysomnographic studies document limited alteration of sleep in anxiety disorders. There is some indication for alteration in sleep maintenance in generalized anxiety disorder and for both sleep initiation and maintenance in panic disorder; no clear

picture emerges for obsessive-compulsive disorder or posttraumatic stress disorder

12.1 INTRODUCTION

Anxiety disorders are the most frequent type of psychiatric disorder with a lifetime prevalence of 29% in the general population (Kessler et al., 2005). Anxious individuals have substantial disability and functional impairment (Roy-Byrne et al., 1999). Several studies have examined anxiety symptoms in people with sleep problems. In a parallel fashion, others have evaluated sleep problems in anxious individuals. Thus, among people complaining of sleep problems, 35-50% is comorbidly anxious. One study reported a 17 fold overrepresentation of clinically significant anxiety among those with sleep difficulties (Taylor et al., 2005).