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Among the commonest of all neurotic symptoms is insomnia. In fact it occurs so frequently that it is often regarded as a normal variation of habit rather than an evidence of disease. We can recognize at least two types of this disorder--an organic and a functional. The latter is the one to which I wish to direct your attention to-day. Its features are familiar to you all. There is difficulty in getting to sleep and when the patient does drift off, he is disturbed by troublous dreams and easily awakened by chance sounds. The only sound sleep is apt to occur when he ought to be leaving his bed. The other type is that of early waking, which is probably associated with vascular changes either anatomic or functional, inasmuch as it occurs predominantly with advancing age. Psychologically the two are distinguishable in the difference of attitude toward the trouble. The patient is obsessed with his symptoms if they are neurotic, while the organic cases are indifferent or make a virtue of their early rising. I do not claim that these are the only kinds of insomnia. There may be other varieties and, of course, sleeplessness is the natural result of many unpleasant thoughts and sensations. The abnormality I am discussing seems, on the surface, to be more or less primary. Whether the insomnia of anxiety states is ever occasioned by such factors as are to be discussed is a problem for the future. (PsycINFO Database Record (c) 2006 APA, all rights reserved)

The psychology and treatment of insomnia in fatigue and allied states.