8 types of insomnia

There are few things worse than being unable to sleep night after night. Find out more about the different types of insomnia and their causes.

Insomnia is the inability to obtain an adequate amount or quality of sleep. The difficulty can be in falling asleep, remaining asleep, or both – leaving you unrested upon waking.

Insomnia can be caused by various conditions, diseases and circumstances, and can be divided into two main groups: 1) transient insomnia – a fairly common form of insomnia that usually lasts only a few days, and 2) chronic insomnia, which lasts longer than three weeks and increases your risk for injuries at home, at work or while driving due to decreased concentration. This type of insomnia can also lead to depression.

The eight different sub-categories of insomnia are classified by causes:

1. Insomnia due to a drug or substance is related to the use of any of the following substances (it can also occur when you stop using the substance):
• Alcohol
• A food item
• Medication
• Caffeine

2. Behavioural insomnia of childhood occurs when children don't have a specific bedtime. If children aren’t given consistent bedtimes, they may linger awake for hours at night and set a lasting behavioural pattern.

3. Adjustment insomnia is also called short-term insomnia or acute insomnia, and it usually stems from stress. The insomnia should end when the source of stress is gone or with adaptation to the stress. This stress isn’t always as a result of a negative experience – it can be something exciting or just a big change.

4. Insomnia due to a medical condition is a symptom of a mental health disorder. The course and severity of insomnia are directly linked to that of the mental health disorder. This kind of insomnia is considered a disorder only if it’s severe enough to require separate treatment.

5. Idiopathic insomnia is a lifelong sleep disorder that starts during infancy or childhood and continues into adulthood. This insomnia has no other explained causes and it’s not the result of any of the following:
• Other sleep disorders
• Medical problems
• Psychiatric disorders
• Stressful events
• Medication use
• Other behaviours

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

6. Insomnia organic, unspecified is caused by substance exposure, a medical disorder or a physical condition, but the specific cause remains unclear. Further testing is required and this name may be used on a temporary basis while further testing and evaluation are conducted.

7. Psychophysiological insomnia is associated with excessive worrying, specifically focused on not being able to sleep. The disorder may start suddenly following an event or develop slowly over many years.

People with this sleep disorder worry excessively about their insomnia and about being tired the next day, resulting in tension and anxiety as bedtime approaches. They may have racing thoughts about insomnia and trying to fall asleep, which makes falling asleep less likely.

8. Paradoxical insomnia is a complaint of severe insomnia. It occurs without objective evidence of any sleep disturbance. People with this disorder often report little or no sleep for one or more nights. They also describe having an intense awareness of the external environment or internal processes consistent with being awake, suggestive of a state of hyper-arousal.

A key feature is an overestimation of the time it takes them to fall asleep. They also underestimate their total sleep time.

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