Types of Insomnia
Although there are several different degrees of insomnia, about three types of insomnia have been clearly identified: transient, acute, and chronic.
- Transient insomnia lasts from days to weeks. It can be caused by another disorder, by changes in the sleep environment, by the timing of sleep, or by stress. Its consequences - sleepiness and impaired psychomotor performance - are similar to those of sleep deprivation.[5] If this form of insomnia continues to occur from time to time, the insomnia is classified as intermittent.[citation needed]
- Acute insomnia is the inability to consistently sleep well for a period of between three weeks to six months.[6]
- Chronic insomnia lasts from months to years. It can be caused by another disorder, or it can be a primary disorder. Its effects can vary according to its causes. They might include sleepiness, muscular fatigue, and/or mental fatigue; but people with chronic insomnia often show increased alertness.[5]
Patterns of Insomnia
The pattern of insomnia often is related to the etiology.[1]
- Onset insomnia - difficulty falling asleep at the beginning of the night, often associated with anxiety disorders.
- Middle-of-the-Night Insomnia - Insomnia characterized by difficulty returning to sleep after awakening in the middle of the night or waking too early in the morning. Also referred to as nocturnal awakenings. Encompasses middle and terminal insomnia.
- Middle insomnia - waking during the middle of the night, difficulty maintaining sleep. Often associated with pain syndromes or medical illness.
- Terminal (or late) insomnia - early morning waking. Characteristic of Clinical depression.
Causes
Insomnia can be caused by:
- Psychoactive drugs or stimulants, including certain medications, herbs, caffeine, cocaine, ephedrine, amphetamines, methylphenidate,MDMA, methamphetamine and modafinil
- Hormone shifts such as those that precede menstruation and those during menopause
- Life problems like fear, stress, anxiety, emotional or mental tension, work problems, financial stress, unsatisfactory sex life
- Mental disorders such as clinical depression, schizophrenia, bipolar disorder, general anxiety disorder
- Disturbances of the circadian rhythm, such as shift work and jet lag, can cause an inability to sleep at some times of the day and excessive sleepiness at other times of the day. Jet lag is seen in people who travel through multiple time zones, as the time relative to the rising and setting of the sun no longer coincides with the body's internal concept of it. The insomnia experienced by shift workers is also a circadian rhythm sleep disorder.
- Certain neurological disorders, brain lesions, or a history of traumatic brain injury
- Medical conditions such as hyperthyroidism and Wilson's syndrome
- Abuse of over-the counter or prescription sleep aids can produce rebound insomnia
- Poor sleep hygiene
- Parasomnia, which includes a number of disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, andREM behavior disorder, in which a person moves his/her physical body in response to events within his/her dreams
- A rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called fatal familial insomnia
A common misperception is that the amount of sleep a person requires decreases as he or she ages. The ability to sleep for long periods, rather than the need for sleep, appears to be lost as people get older. Some elderly insomniacs toss and turn in bed and occasionally fall off the bed at night, diminishing the amount of sleep they receive.[7]
An overactive mind or physical pain may also be causes. Finding the underlying cause of insomnia is usually necessary to cure it. Insomnia can be common after the loss of a loved one, even years or decades after the death, if they have not gone through the grieving process. Overall, however, symptoms and the degree of severity affects different people differently, depending on their mental health, physical condition, and attitude or personality.
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