Different Types of Insomnia

Transient insomnia 

A person may have problems sleeping for one week or less. Due to the brief disruption of sleep it’s one of the most recognizable types of insomnia. This disorder usually resolves itself – no treatment is necessary. Notable symptoms of transient insomnia include daytime sleepiness, difficulty to fall asleep, and waking up early in the morning. Some causes of it are:

• anxiety/stress
• jetlag
• side effects of medications
• short-term illness (cold, flu, allergies, etc.).

Acute insomnia 

This type of insomnia lasts longer than a week, but less than a month. Doctors will diagnose a patient with this type of insomnia if they experience three or more nights of sleep disruption each week. It’s often tied to:

• adjustment to a higher altitude
• illness/pain (after surgery pain included)
• new job or move
• stress/anxiety 
• pregnancy
• traveling.

Short-term insomnia 

A person may have symptoms for no more than three months (this condition occurs in about 20 percent of sufferers). There are several causes behind this type:

• birth of a baby
• death in the family
• divorce
• employment problems
• financial problems
• illness or other medical problem
• moving – new home or location.

Chronic insomnia (insomnia disorder)

This type of insomnia happens when a patient has been unable to sleep for a period lasting more than three months for three or more nights a week. The condition may result from acute insomnia or short-term anxiety, and become a lifelong issue. About 10 percent of American adults have this sleep disorder. The triggers of chronic insomnia include:

• conditioned negative response to the sleeping environment or the attempt to sleep
• medical problems, such as hyperarousal or head injuries. In hyperarousal the sympathetic nervous system is causing an extra release of cortisol (stress hormone).

There are many health problems associated with this type of insomnia – impairment of memory and cognitive functions, changes in mood, diminished alertness, increased risk of workplace injury, etc. A person who has chronic insomnia may also have problems maintaining relationships at work and home. The quality of life is reduced. 

Adjustment insomnia 

This type of insomnia is tied to a life event, but the underlying factors of the condition are lack of familiarity, anxiety, and stress. Many people describe adjustment insomnia as acute insomnia because they have similar causes. About 20 percent of people have adjustment insomnia every year. When the person learns how to address the positive or negative trigger, the problem usually resolves itself. What are some of the causes?

• death in the family
• divorce/marriage
• starting at a new school/job
• moving home/new location
• birth of a child or pet.

Comorbid insomnia 

This type of insomnia is the result of another disorder or illness such as bipolar disorder, anxiety, or depression. This sleep disorder can also be due to other medical problems that cause chronic pain – cancer, arthritis, gunshot wound injuries, migraines, shingles, autoimmune disorders, etc.  

Neurological disorders (for example dementia) can upset the circadian rhythm and central nervous system, leading to problems with sleep. Migraines are also culprits because of nausea and pain associated with them.

People who suffer from Tourette’s syndrome or some type of movement disorder may have tics while sleeping, which can lead to insomnia. 

Insomnia is often experienced at the end of life for a multitude of reasons:

• anxiety
• depression
• pain
• medications (steroids)
• noisy hospital environment.  

Cancer and end-stage renal disease may require treatments that can upset the ability to sleep. 

Conditioned insomnia (psychophysiological) insomnia

A conditioned response to going to bed is typically the reason behind this type of insomnia (also known as learned insomnia). Sufferers often experience a disturbing event that initiates sleeping problems, but once the trigger is eliminated, they still have insomnia.

Women are far more likely to suffer from this sleep disorder than men. Preparing for bedtime can also bring on conditioned insomnia due to anxiety or fear. Not getting enough sleep as well as fear of not being able to sleep may become habitual. Until the condition is diagnosed and treated it can continue for weeks, months, and years. 

According to the latest research conditioned insomnia may be tied to nervous system hyperarousal - exaggerated stress response prevalent even during sleep. This issue can lead to high blood pressure, worry, and an increase in emotional reactivity. Exaggerated stress response may be the cause of conditioned insomnia, not the result of it. And it’s a vicious cycle of bodily reactions that only worsen the problems. 

Behavioral insomnia of childhood (BIC)

This type starts when a child is not given a strict bedtime routine. Children of five years and younger often suffer from behavioral insomnia of childhood. 

As the result of not learning a regular sleep routine and habits children struggle with falling or staying asleep. Another potential trigger is the need to sleep with their parent. The symptoms of BIC may extend into adulthood and affect the sleeping habits for a lifetime.

The majority of children between the ages of 3 and 5 years need at least 12 hours of sleep with naps in between. Children who develop BIC don’t get near this amount of sleep and thus can suffer from other insomnia related problems such as hyperactivity, aggression, and daytime sleepiness.

Untreated BIC can also cause problems at school such as temper tantrums and poor grades. Erratic bedtimes may only exacerbate the problem because the circadian rhythm is out of sync. It’s thought that 25 percent of children have this sleep disorder in the first five years of their lives.

There are two kinds of BIC – sleep-onset association and limit-setting insomnia. 

Both kinds involve anxiety of falling asleep – similar to conditioned insomnia, but occurring in children. With limit-setting insomnia it’s often the child’s defiance to bedtime routine or specific bedtimes. They may try tactics such as crying, asking for food or water, or to use the bathroom to delay going to bed. 

Sleep-onset association is a sleep disorder that relates to a negative association with bedtime - watching TV or playing video games being stopped because the child must go to bed. 

A child who relies on a parent's singing, reading, or rocking may have a hard time "wanting" to go to sleep without these actions.

Sleep-onset disorder is often more than just an anxiety of going to bed or bedtime routine. It’s often linked to other behavioral problems such as ADHD. 

Idiopathic insomnia 

This type of insomnia is thought not to have an apparent underlying cause (such as psychological or medical condition), however some researches believe that it’s tied to hyperarousal of the body’s central nervous system. Hyperarousal may be the result of deregulated stress response causing the body to remain in a hypervigilant state. Continuous release of cortisol (the stress hormone) makes it harder for a person to fall asleep. 

A rise in body temperature, heart rate, and metabolic rate also contribute to the inability to sleep well.  

According to sleep studies all types of insomnia are found in people who have a hyperaroused central nervous system. The constant response to stress, even during sleep, could lead to insomnia once labeled as idiopathic. 

Paradoxical (pseudo-) insomnia

This type is tied to complaints of chronic or severe insomnia that isn’t accurately taking place. A person may exaggerate how long it takes them to go to sleep or how long they stay awake. People with the disorder may also underestimate how much they sleep.

Sleep studies on this disorder usually find normal sleep/wake patterns. Sleep efficiency and onset are healthy even when sufferers claim that they don’t get enough sleep or spend hours awake. They are really not as sleep deprived as they claim to be. 

The physical effects of paradoxical insomnia are not as serious as those of other types of insomnia, but there are psychological effects associated with it:

• frequent visits to the doctor
• repeated sleep testing 
• anxiety/stress.  

Sleep hygiene insomnia

This type occurs because a person does not have good sleep hygiene. Their bedroom may be too hot or cold, or their mattress may be uncomfortable. Any poor sleeping habits such as drinking alcohol or caffeine in the evening or using electronics just before bed can hinder a person from getting the sleep they need. 

This is one of the most common types of insomnia, and one of the most easily resolvable ones. 

Poor sleeping habits can lead to disruptions in the circadian rhythm and sleep hygiene insomnia. A new baby or pet, inconsistent bedtime, bright lights, or noise can also be culprits to this disorder.  

Sleep hygiene insomnia is highly noticeable in homes that have electronics in their bedrooms. After all, the blue light from phones and TVs can upset the circadian rhythm and hinder a person from getting a good night’s rest.