Different Types of Insomnia
Many people around the world are affected by sleep disorders. While some are temporary and only affect a person in times of high stress or illness, there are other types of sleep disorders that are more permanent and have a profound impact on an individual's life. Insomnia is one such common sleep disorder. Insomnia makes it difficult for a person to fall asleep or stay asleep. It also leads to daytime sleepiness and you feel like you are never completely rested or refreshed, even when you wake up in the morning. There are many different types of insomnia and each type of the disorder is characterized by the time it lasts for, how it affects your sleep pattern, and what the underlying cause of the disorder is. Let us take a closer look at these different types of insomnia.
What is Insomnia?
Insomnia is a type of sleep disorder that makes it difficult for a person to fall asleep and stay asleep. Insomnia also leads to daytime sleepiness and you feel like you are never rested or refreshed, even when you wake up in the morning after sleeping. According to data from the Cleveland Clinic(1), nearly 50 percent of adults end up experiencing insomnia sometime or the other during their lifetime. Out of this, around one in every ten people have reported having chronic insomnia.
Insomnia can affect anybody at any time, but it is known to more commonly affect women and elderly adults. The condition can last for a couple of days, a few weeks, or even continue long term. Menopause, stress, and other medical and mental conditions are the most common known causes of insomnia.
Insomnia usually causes the following:
- You have difficulty in falling asleep
- You experience difficulty in staying asleep
- You end up waking up too early
Different Types of Insomnia
There are several different types of insomnia and each type of the disorder is characterized by how long the condition lasts, how it affects your sleep patterns, as well as the underlying medical cause behind insomnia. The different types of insomnia include:
Acute insomnia is short-term insomnia. It can last for a couple of days to a couple of weeks even and is the most common type of insomnia to affect adults. Acute insomnia is also known as adjustment insomnia since it usually strikes when a person experiences a stressful event in their lives, such as starting a new job or losing a loved one.
Apart from stress, there can be a wide range of physical to psychological to social to environmental causes of acute insomnia. Some of these other causes include:
- Jet lag
- Nocturia, a condition that causes nighttime urination
- Illness such as the common cold and cough or the flu
- Certain types of medications, especially ones that have stimulant properties
- Use of caffeine or nicotine, or experiencing withdrawal from alcohol
- Environmental factors such as noise or light, temperature, or any other conditions of the sleeping environment
- Physical discomfort such as being unable to get into a comfortable position to sleep, or experiencing pains somewhere in the body
- Sleeping in an unfamiliar bed or surroundings, for example in a new home or at a hotel
There are many common symptoms of acute insomnia, such as:
- Difficulty falling asleep
- Difficulty staying asleep
- Waking up early in the mornings
- Daytime sleepiness or fatigue
- Poor concentration or attention
- Mood changes including reduced motivation or energy and worrying
- Social or vocational dysfunction including an increase in errors or accidents
- Stomach symptoms
According to medical experts, acute insomnia should not last for more than three months. It is also usually easy to find an identifiable cause behind the condition.(2)
Chronic insomnia is a type of insomnia in which you experience trouble sleeping for at least three days in a week for a period of at least one month. Chronic insomnia can either be of primary or secondary type. Primary chronic insomnia is also known as idiopathic insomnia and does not have any obvious cause, neither is there any particular underlying medical condition.(3)
Secondary insomnia, also known as comorbid insomnia, is a more common type of chronic insomnia. This type of chronic insomnia usually occurs with another medical condition as well.
Some of the common causes of chronic insomnia are as follows:
- Chronic medical conditions such as Parkinson's disease, hyperthyroidism, diabetes, and central and obstructive sleep apnea.
- Mental health conditions like anxiety, depression, and attention deficit hyperactivity disorder (ADHD).
- Lifestyle factors such as jet lag, frequent traveling, napping in the day, rotating shift work.
- Stimulants such as caffeine, nicotine, alcohol, and other drugs.
- Certain medications such as antidepressants, chemotherapy drugs, and beta blockers.
When you have trouble initiating the process of sleep itself, this is known as onset insomnia. Onset insomnia can either be short term or it can be chronic insomnia. Any of the causes of chronic and acute insomnia make it difficult for a person to fall asleep. Usually, the most common causes are psychological or psychiatric issues, including stress, depression, or anxiety.
According to a study done by the Inje University College of Medicine in Busan, Korea in 2009(4), people who suffer from chronic onset insomnia generally have another sleep disorder as well, such as periodic limb movement disorder or restless leg syndrome.
In this type of insomnia, stimulants such as caffeine, nicotine, or alcohol, can also stop you from falling asleep.
Maintenance insomnia is also another type of sleep disorder that makes it difficult to stay asleep, difficult to wake up too early in the morning, and experiencing trouble getting back to sleep once awake. When you have maintenance insomnia, you are like to spend most of your time lying in bed worrying about not being able to go back to sleep and about not getting sufficient sleep. This will only interfere with your sleep further, giving rise to a vicious cycle.
Maintenance insomnia is usually caused by mental health conditions such as depression and anxiety. There are also some other medical conditions that can cause you to keep waking up in the middle of your sleep. These include:
- Sleep apnea
- Gastroesophageal reflux disease (GERD)
- Restless leg syndrome
- Asthma or other respiratory diseases
- Periodic limb movement disorder
Behavioral Insomnia of Childhood
According to research done by the Dalhousie University in Nova Scotia, Canada, nearly 25 percent of all children are affected by behavioral insomnia of childhood or BIC.(5) BIC can be segmented into three subtypes. These include:
BIC Limit Setting: BIC Limit Setting is a type of insomnia in which a child refuses to go to bed and they also make repeated attempts to delay going to bed. Examples of this behavior typically include asking for a drink, asking to go to the bathroom frequently, or asking a parent to read them another story.
BIC Sleep Onset: This type of insomnia results from the development of a negative association with sleep. This may include learning to go to sleep only by being nursed or by being rocked. It may also involve having a parent present at all times until the child goes to sleep or watching TV while falling asleep.
BIC Combined Type: This form of BIC combines both the other subtypes of the disorder. This happens when a child develops a negative association with sleep and therefore, resists all attempts to go to bed due to a lack of limit setting by a parent.
BIC can be resolved with a couple of behavioral changes, including creating a healthy sleeping routine or learning some relaxation techniques or self-soothing.
Are there any Risks or Side Effects of Insomnia?
There are certain risks and side effects associated with insomnia. These side effects and risks are known to affect you mentally as well as physically. Insomnia also affects your ability to function. Some of the risks and side effects of insomnia are as follows:
- Increased risk of accidents
- A decrease in performance at work or school
- Greater risk of depression
- Greater risk of other mental health disorders
- Higher risk of developing chronic medical conditions such as stroke, obesity, and heart disease
Treatment for Insomnia
There are different types of treatment for insomnia. The treatment varies according to the type of insomnia you have as well as the underlying cause. You can try to treat acute insomnia at home itself with the use of over-the-counter sleep aid or by lowering your stress levels. Learning how to manage your stress will go a long way in helping you combat your insomnia.
The treatment for chronic insomnia requires addressing the underlying condition, if any, that is causing your insomnia. Your doctor is likely to recommend cognitive behavioral therapy for insomnia (CBT-I), which has shown positive results and is known to be even more effective than medications.(6)
There are several different types of insomnia that can interfere with your ability to sleep in the night and function properly during the day. Acute insomnia is the most common type of insomnia that affects most adults and it is possible to treat the condition at home. If left untreated, chronic insomnia can greatly increase your risk of depression and other serious mental health conditions.
If you find yourself having trouble functioning properly during the day, you should definitely consider consulting your doctor. Also, take an appointment from your doctor if you find the symptoms of insomnia lasting for more than a few weeks. Your doctor will be able to help you determine the exact cause of your insomnia and also suggest the most effective treatment for your condition.
- Cleveland Clinic. (2019). Insomnia | Cleveland Clinic. [online] Available at: https://my.clevelandclinic.org/health/diseases/12119-insomnia [Accessed 15 May 2019].
- Ellis, J.G., Cushing, T. and Germain, A., 2015. Treating acute insomnia: a randomized controlled trial of a “single-shot” of cognitive behavioral therapy for insomnia. Sleep, 38(6), pp.971-978.
- Saddichha, S., 2010. Diagnosis and treatment of chronic insomnia. Annals of Indian Academy of Neurology, 13(2), p.94.
- Park, H.S., Joo, E.Y. and Hong, S.B., 2009. Sleep onset insomnia. Journal of Korean Sleep Research Society, 6(2), pp.74-85.
- Vriend, J. and Corkum, P., 2011. Clinical management of behavioral insomnia of childhood. Psychology research and behavior management, 4, p.69.
- Lie, J.D., Tu, K.N., Shen, D.D. and Wong, B.M., 2015. Pharmacological treatment of insomnia. Pharmacy and Therapeutics, 40(11), p.759.