types of insomnia *Image courtesy google, https://www.hindustantimes.com

The most critical aspect in identifying the type of insomnia one may have, it is important to understand the sleeping pattern of the individual.

So…the questions you’ve got to ask yourself are…

Do I find it difficult to FALL ASLEEP?

This would mean that you have ‘Sleep-onset insomnia’

Do I find it difficult to STAY ASLEEP? Am I waking every hour for no reason known to me throughout the night?

This would mean that you have ‘sleep-maintaining insomnia’

Do I WAKE UP EARLY feeling sleep deprived?

This would mean that you have ‘early morning awakening’

There are numerous other classifications or types of insomnia that have been documented by the American Academy of Sleep Medicine (AASM).

3 MAIN TYPES OF INSOMNIA:

1. Acute Insomnia (< 1 Month)

If you experience difficulty in falling asleep or staying asleep despite having sufficient opportunity and suitable environmental circumstances for approximately 30 days you may be suffering from Acute Insomnia. Due to the fact that stress is usually the cause of acute insomnia, it is sometimes referred to as “stress-related insomnia.”

2. Chronic Insomnia (1 + Month)

When sleeping disturbances persist for more than a month, you may be experiencing a more severe kind of insomnia – Chronic Insomnia. Sometimes, people experience this type of insomnia for years or even majority of their life-span if they don’t seek proper treatment. Chronic insomnia can be caused by another medical condition such as a neurological disorder or mental illness.

3. Transient Insomnia (1 Week)

As the name suggests, this refers to a temporary sleeping problem. Transient insomnia is often untreated because it generally subsides within one week. The cause of transient insomnia may be related to environmental changes, jet lag, stress, or medical conditions.

Now, that we have a fair understanding about the three main types of insomnia, let us gauge more about the disorder by understanding the subtypes.

1. Adjustment insomnia:

Adjustment insomnia is another name for acute insomnia. As the name suggest, it is the form of insomnia develops if we are unable to ‘adjust’ to changes in our social life, environmental changes, or physical health.

It mainly refers to our reaction to an identifiable stressor. This type of insomnia doesn’t persist for longer than a month.

The most common stressors include career problems, financial hardships, health problems, family/relationship conflicts and dealing with the death of a friend or family member.

This form of insomnia can occur at any age but there is an increased prevalence in older adults and women are more susceptible to this form of disorder than men.

Adjustment insomnia tends to subside when the stressful event is resolved. However, if adjustment insomnia lasts longer than a few days, you should seek medical advice as extended periods of disrupted sleep can have negative consequences on your physical and mental health.

2. Behavioral insomnia of childhood

Behavioral insomnia of childhood is a type of insomnia which solely depends on the parenting pattern adopted by parents to put their kids to sleep.

Whether it is reading fairy-tales to their little ones or simply rocking them to sleep, or even singing lullabies to their kids in order to help them sleep, there are various parenting approaches couples implement right from the child’s infancy stage. After several years, parents may help their children become more independent by letting them sleep on their own.

The problem is that some kids become kind of dependent or addicted to that pattern for sleeping well. This is the case of behavioral insomnia

A child may strive to fall asleep because they are no longer getting the direct parental attention and/or comfort before bed. This may provoke a fear-response, resulting in an inability to fall asleep due to lack of perceived comfort or safety

Some kids may also wake up in the middle of the night and are not able to fall back asleep (maintenance-insomnia) because their parents aren’t around in their room. It is estimated that between 10% and 30% of children experience childhood insomnia.

3. Idiopathic insomnia

Idiopathic insomnia is a long-lasting or permanent sleep disorder that starts during infancy or childhood and continues into adulthood.

This insomnia cannot be explained by other causes. It is almost a mystery to the medical sector. It has no clear cause, as it is not the result of another sleep disorder, medical problem, psychological problem, stress, medication, or poor sleep hygiene.

It may result from an imbalance in your body, such as an overactive awakening system and/or an underactive sleep system, but the true cause of this disorder is still unclear.

Certain individuals with idiopathic insomnia may successfully manage or treat their insomnia for short durations, but complete remission is rare. In addition to early onset and no sustained remission, there are also no logical or justifiable factors that could be contributing to the insomnia.

4. Insomnia due to medical condition / mental disorder

Certain people suffer from an inability to sleep or stay asleep due to a diagnosable medical condition or mental disorder.

As far as insomnia due to medical condition is concerned, it is important to note that this specific type of insomnia is only diagnosed when it causes significant distress.

Usually the symptoms could be due to side effects of the medication given or maybe the medical disease itself causes severe pain and ache leading to lack of sleep. However, this sleep impairment is temporary.

It shall only be considered as a subtype of insomnia when the sleep disturbance becomes more ‘permanent’ and prevails despite the improvement in the medical condition.

Mental disorders may result in abnormal brain activity which directly causes insomnia. Many drugs used to treat mental disorders can also cause insomnia.

5. Non-organic vs organic insomnia (Unspecified)

Experts will give the classification of ‘Non-organic unspecified insomnia’ when physical causes and known substances have been ruled out as the causal factors of insomnia.

Here, the insomnia is most likely due to a deep-rooted psychological factor that is causing sleep-disruption.

The classification may also be used on a temporary basis while further evaluation and testing are completed. It is the name used when a person with insomnia does not meet the criteria for another type of insomnia.

On the contrary, the classification of ‘organic unspecified insomnia’ is given when it is believed that the insomnia is caused by an identifiable mental condition, medical or physical condition, or to substance exposure.

In this case, the doctor has good reason to think that there is likely something contributing to the person’s insomnia (e.g. a minor physical injury), but cannot pinpoint the specifics. However, the specific cause still remains unclear and further testing is required.

6. Paradoxical insomnia

As the name suggests, paradoxical insomnia is a type of insomnia that stems from an inaccurate recall of the amount of time that a person actually slept the previous night. ​

This term is typically used when someone has a complaint of having ‘severe insomnia’, but the degree of their reported sleep deprivation seems questionable. He or she may report little or no sleep at night, but it’s believed they are underestimating their total sleep time.

This isn’t considered to be done purposely, but there are no apparent signs of sleep impairment nor cognitive impairment following the purported “severe” insomnia.

Those with paradoxical insomnia are still considered to be facing problems in sleep, but it is much less of an objective problem than reported by individuals.

Batteries of sleep tests may reveal that a person is getting significantly more sleep than they were able to recall.

7. Psycho-physiological insomnia

​This type of insomnia classification is given when an individual cannot sleep because they are focused on not being able to sleep. As their worry over not being able to sleep grows, they become tenser and less likely to fall asleep easily.

Have you ever wondered what it feels like to be ruminating over and over again about the idea of not being able to fall asleep?

Well, that’s the life of a person suffering from Psycho-physiological insomnia.

Its like a non-stop and annoying song constantly playing in your head...

‘what if I’m not able to sleep’

‘what if I’m not able to sleep’

‘what if I’m not able to sleep’

This type of insomnia classification is given when an individual cannot sleep because they are constantly focused on not being able to sleep.

As their worry over not being able to sleep grows, they become tenser and less likely to fall asleep easily.

People suffering from psychophysiological insomnia tend to have high levels of arousal than the rest of the people.

Think of this as going to bed, but being anxiously obsessed on the fact that you might not get enough sleep. As a result of the over-activation and heightened arousal state of the sympathetic nervous system, you actually start worrying about whether lack of sleep will make you be rejected in an interview or fail an exam or perform poorly at work and thanks to this constant worry…you’re up for several more hours than essential. You’re unable to turn off the annoying mental chatter because you keep worrying about whether or not you are sleeping satisfactorily.

8. Sleep Hygiene insomnia

​As the name suggest, ‘sleep hygiene insomnia’ is a consequence of poor sleeping patterns and habits

Sometimes, people do not make an effort to sleep in a comfortable bed, block out bright light, and loud noise. These people have simply developed extremely poor sleep hygiene.

Sleep hygiene can also be connected to following a fixed schedule. Not being able to adhere to a disciplined sleeping schedule, constantly staying up, speaking over the phone, watching TV, Computer, or simply using your mobile phone excessively till late in the night can eventually lead to sleep-hygiene insomnia.

Basically, you can consider this type of insomnia as a condition that’s caused when someone either consciously or unknowingly engages in activities that compromise his/her sleep.

9. Substance induced insomnia

People using drugs, alcohol, caffeine, (or even supplements) sometimes suffer from sleep disturbances and experience and inability to fall asleep or stay asleep. These people are said to have ‘drug-induced insomnia’.​

The drugs a person is taking could be over-the-counter, pharmaceutical prescriptions, or illegal. Regardless of what drug one consumes for whatsoever reason, if it keeps him awake and impairs the ability to sleep, he is experiencing substance-induced insomnia.

When people frequently use stimulatory substances in the latter half of the day particularly in the night may experience insomnia. In most cases, the insomnia subsides as soon as the individual discontinues using the substance that is causing it.

As mentioned earlier in the section of causes of insomnia may also occur as a result of drug withdrawal.