Insomnia is a significant health care problem. It can create daytime fatigue, impaired social or occupational functioning, and reduced quality of life. Patients with insomnia are less productive workers, more prone to motor vehicle and workplace accidents, and utilize the general medical health care system to a greater degree than patients with normal sleep habits (Simon and VonKorff, 1997).
The elderly and patients with underlying psychiatric dis-orders are particularly prone to sleep difficulties. Schizophrenia, anxiety disorders and mood disorders frequently cause signifi-cant insomnia. Treatment of the underlying psychiatric illness often improves sleep. Sometimes, however, the medications used to treat the psychiatric illness may create insomnia as well. For example, selective serotonin reuptake inhibitors (SSRI) (particu-larly during the early weeks of treatment) may cause insomnia, even when they effectively treat an underlying depression.