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Ernest H. Friedman, MD
Cleveland, Ohio

Arch Intern Med. 1996;156(7):811-812.

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Dodge et al¹ report that in their study the prevalence of insomnia was higher in women than in men, more common among older subjects, and significantly related to cough, dyspnea, or wheeze. Sadness and thoughts about current problems were at least partially responsible for subjects' insomnia. Neurobiologic features are suggested by reports linking induction of breathing, mood, rumination, subclinical impairment of lung airways, and wakefulness to dopamine lateralized to the right hemisphere, in which the metabolic rate is higher in women.^2,3 This hypothesis is supported by diurnal variation of serotonergic-mediated inhibition of dopamine, optimal response organization at intermediate dopamine tone in a medial-frontal-striatal activation system,² and deactivation of the right hemisphere, a state marker of depression, promoting dominance of the left hemisphere, which is associated with cardiac arrhythmia, vasoconstriction,^4-6 and violence⁷ in disruptive nocturnal behavior.⁸ It is also supported by a report that anger . . . [Full Text PDF of this Article]

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