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Abstract: 

A psychiatrist who first steps into a correctional facility will undoubtedly be confronted, during his or her first hour of working with patients, by the complaint, “I have trouble sleeping.” Commonly, inmates are referred by the primary care team for assessment and treatment of insomnia. Sometimes, the complaint is put in the context of other psychiatric problems such as anxiety, claustrophobia, or nightmares; sometimes it is quantified in terms of failure to sleep for specified number of nights in a row. Almost always, the chief complaint of poor sleep presents the correctional psychiatrist with a dilemma.

Keywords: DSM-IV, sleep onset, duration, hyperarousal, nonrestorative, bipolar, anxiety, schizophrenia, Antihistamines

Affiliations:  1: University of Nevada School of Medicine.