El insomnio es el segundo trastorno mental más común y, aunque es aún limitado el entendimiento de sus mecanismos neurobiológicos, se han producido avances en su compresión y tratamiento. En este artículo, se pretende sintetizar su definición, y los nuevos enfoques terapéuticos y de evaluación clínica, paraclínica y diagnóstico. Se analizará el insomnio en el contexto de un trastorno con un alto impacto negativo en la calidad de vida de quienes lo sufren y con costos importantes para los sistemas de salud y la productividad de los países.

Purpose: The severity of obstructive sleep apnoea (OSA) ranges from mild or moderate to severe sleep apnoea. However, there is no information available on the clinical characteristics associated with cases involving more than 100 events per hour. This is a preliminary report and our goal was to characterise the demographics and sleep characteristics of patients with Extreme OSA and compare with patients with sleep apnoea of lesser severity. We hypothesised that patients with Extreme OSA (AHI4100) is associated with an increased comorbidities and/or risk factors. Methods: We carried out a case-control study on male patients with OSA who were seen in a private hospital in Lima, Peru between 2006 and 2012. Cases were identified if their apnoea/ hypopnea index (AHI) was higher than 100 (Extreme OSA), and four controls were selected per case: two with 15–29 AHI and two with 30–50 AHI, mat...