Early morning awakening is a feature of

Early morning awakening is seen in depression. It is a type of insomnia patients with depression have altered dexamethasone suppression test that is no suppression of steroid in blood after administration of dexamethasone usually the steroid is produced in normal individuals at 6 Am whereas the steroids in increased amount always keeps the brain active , ruminations and decreased sleep. Different patterns of insomnia include a) difficulty falling asleep versus b) middle or terminal insomnia (early morning awakening) Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no.351