Doxepin
In 2016 the American College of Physicians advised that insomnia be treated first by treating comorbid conditions, then with cognitive behavioral therapy and behavioral changes, and then with drugs; doxepin was among those recommended for short-term help maintaining sleep, on the basis of weak evidence. The 2017 American Academy of Sleep Medicine recommendations focused on treatment with drugs were similar. A 2015 AHRQ review of treatments for insomnia had similar findings.
Psychological stress and sleep
Insomnia is a common condition affecting up to a fifth of the population in many countries across the world and is often complicated by a number of psychiatric conditions. Paradoxical insomnia is the phenomenon of a discrepancy between reported sleep duration and objective measurement of sleep. In some cases however the stress and anxiety produced by this perception does in fact result in an objective reduction in quality of sleep.