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July 01, 2022
Contrary to popular belief, not all people who suffer from insomnia have the same symptoms. As happens with the different classifications for sleep disorders, there are also different classifications and types of insomnia.
In the definition of the International Classification of Sleep Disorders, this characteristic is already evident. ‘(Insomnia is) a repeated difficulty of sleep onset, duration, consolidation or that occurs despite adequate opportunities and circumstances for sleep, resulting in some form of daytime difficulty’.
In other words, insomnia can be related to the onset, number of hours, depth, quality, or a combination of two or more of these factors in a person’s sleep. Knowing which of them affects each person is essential to define the appropriate treatment for each case.
As with hypersomnias, types of insomnia can also be separated into two major groups: primary insomnia and secondary insomnia.
In other words, insomnia can be a symptom or a disease.
Primary insomnia is a problem in itself, existing ‘on its own’, and its occurrence does not depend on triggering situations to happen. Its cause or causes may have intrinsic or extrinsic factors involved, but they are not related to other disorders.
Secondary insomnia occurs due to a medical illness or disorder, sleep disturbance, or the use of legal or illegal substances. In summary, secondary insomnia actually has a detectable cause, and that cause is related to other factors, either natural or induced, in a person’s life.
In these cases, treatment should focus on both problems: the sleep difficulty and its origin. If it is the use of any medication, for example, talk to your doctor to discuss the possibility of changing the time you take it.
In the specialized literature, we can find different ways of classifying the types of insomnia. This is a way in which sleep researchers and scholars categorize and analyze different forms of the disorder.
The classification presented in this article is based on the one presented in the III Brazilian Consensus on Insomnia, 2013, a document prepared by ABS – Associação Brasileira do Sono, in collaboration with 29 of the country’s leading sleep specialists.
The first type of insomnia is called acute insomnia, whose main characteristic is its short occurrence term. It usually comes and goes in less than a month and has a well-marked trigger, such as the death of a loved one.
Acute insomnia can also be called ‘short-term insomnia’ and is more common in women than men.
As the name implies, this insomnia has the essential characteristic of being caused by or associated with a psychiatric disorder, what means that it is a symptom of this other disease.
Mood and anxiety disorders are most commonly associated with insomnia, but depression and attention deficit disorder can also trigger sleep problems.
This is the type of insomnia caused by and/or associated with a particular clinical condition.
Some of the diseases often related to insomnia are asthma, hyperthyroidism, heart failure and chronic pain syndromes (such as fibromyalgia), in addition to pregnancy and menopause.
Sleep hygiene is a set of techniques to apply in order to achieve a healthier sleep. Having inadequate habits that interfere with your bedtime can lead to a form of insomnia.
Among these habits are late consumption of caffeine and alcohol, excessive use of electronic equipment and very exhausting physical and intellectual routines at night.
This type of insomnia can appear both in people who take medication or consume sleep-depriving foods, and in those who remove substances that used to help them sleep from their routine.
For example, if a person who takes a muscle relaxant before going to bed suddenly withdraws from that medication, they may experience a kind of withdrawal that disrupts sleep.
To be considered psychophysiological, insomnia must be caused by the sum of a hyperalert state and another action that compromises sleep. It’s what many call ‘ruminating’ when you lie down.
In many cases, this compromising action can have a ‘snowball’ effect. The person goes to bed worried about the damage they will have the next day if they sleep poorly and, because of this anxiety, they effectively end up having a poor quality rest and ‘confirming’ the suspicion that they would have a bad day. It’s a vicious cycle.
The Insomnia Consensus says that ‘the essential feature of this condition is the complaint of insomnia without the presence of daytime impairment, or the impairment being disproportionate to the complaint.’
When a person with paradoxical insomnia undergoes a polysomnography, the result does not show compatibility ‘between the values of sleep onset latency and subjective total sleep time, and the objective values of these parameters.’
The key feature of idiopathic insomnia is not having a medical cause or condition as the trigger for sleep problems. That is, it is a primary chronic insomnia. Some theories support that this type of insomnia is the result of an underactive sleep system or an overactive awakening system, but its trigger cannot be exactly determined.
Naturally, this is an insomnia condition that occurs in children. More specifically, in children with a specific behavioral dysfunction, such as a lack of setting limits.
If a child never has a bedtime, it is normal for him or her to think that they do not need to sleep regularly.
Often, the effects of this type of insomnia have a series of daytime repercussions, including for their parents or guardians.
Remember: only a doctor can diagnose an insomnia disorder and determine which type of insomnia a person has. If you have noticed any changes in your sleep patterns or if you feel that your sleep lacks quality, seek for a health professional.
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