It. should be stressed that anxiety in itself is present in many psychiatric disorders and that, therefore the assessment of anxiety as a single influence on sleep is quite difficult. Our current preclinical understanding of arousal responses to aversive stress and some confirmation that similar mechanisms may play a role in human stress, should open the way to the development of more specific therapeutic tools in sleep

medicine, particularly for anxiety-induced sleep alterations. Selected abbreviations and acronyms ACTH adrenocorticotropic hormone AN autonomic nervous (system) BZD benzodiazepine CNA central nucleus of the amygdala CRH corticotropin-releasing hormone GAD generalized anxiety disorder PA hypothalamic-pituitary Inhibitors,research,lifescience,medical -adrenal (axis) LC locus ceruleus NE norepinephrine NREM Inhibitors,research,lifescience,medical non-rapid eye movement OCD obsessive-compulsive disorder PTSD posttraumatic stress disorder PVN paraventricular nucleus REM rapid eye movement SSRI selective serotonin reuptake inhibitor

SWS slow-wave sleep TCA tricyclic antidepressant
Anxiety is a universal response to threatening or frightening situations. Those individuals who present with more pronounced or persistent symptomatology, or without any reasonable context, may in fact, meet, the diagnostic criteria for an anxiety disorder. Such disorders include generalized anxiety disorder (GAD) and panic disorder (PD), as well as obsessive compulsive Inhibitors,research,lifescience,medical disorder (OCD), social anxiety disorder, posttraumatic Inhibitors,research,lifescience,medical stress disorder, phobias, and a number of other diagnoses.1 Universal estimates of prevalence are difficult, to obtain, but, among US residents age 18 to 54, the National Institute of MK-0518 price Mental Health reports that 19 million Americans

(approximately 13%) have anxiety disorders.2 In the case of GAD, for which diagnostic criteria were first introduced in the Diagnostic and Statistical Manual, of Mental Disorders, Third Edition3 (DSM-III) and later also added to the International Classification of Mental and Behavioral Disorder4 (ICD10), there has been some question as to whether this is indeed a separate disorder or part of a Inhibitors,research,lifescience,medical continuum of another disorder, such as depression.5 Investiga-tions suggest that GAD is a distinct and common disorder,5,6 with lifetime prevalences reported up to 7%.7-11 PD and the other diagnoses appear less common.8 Some data indicate that anxiety disorders result in more occupational disability and cost, society MTMR9 more than affective disorders or schizophrenia, and yet are vastly undertreated.12 Estimates suggest that both psychiatrists and primary care physicians encounter GAD and other anxiety disorders frequently.13-15 Making an accurate diagnosis can be difficult – particularly in primary care settings – because of time constraints on patient contact and the fact that patients often present, with physical rather than psychological or emotional complaints.