The case histories and psychoanalytic therapy of two female patients, past fifty, served as a basis for the psychodynamic formulation of insomnia. In both the symptom occurred alone and late in life. Response to treatment was favorable.

Sleep disturbance results from failure of the integrating parts of the personality, particularly in the presence of unconscious death fantasies of long duration. But according to Rothenberg's observations, it is the overdetermination of an actual incident of death or imminence of death in the individual's reality history which produces the symptom of insomnia.