The 11 Kinds of Insomnia

Paradoxical insomnia
Paradoxical insomnia is a complaint of severe insomnia. It occurs without objective evidence of any sleep disturbance. Daytime effects vary in severity, but they tend to be far less severe than one would expect given the expressed sleep complaints.

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. This awareness suggests a state of hyperarousal. A key feature is an overestimation of the time it takes them to fall asleep. They also underestimate their total sleep time.

Another feature is that the degree of sleep deprivation reported seems improbable. Their level of daytime functioning is likely to be only moderately impaired. Objective findings of fairly normal sleep duration and quality tend to result from an overnight sleep study. These findings are much different from their perception of poor quality sleep.

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

People with this sleep disorder worry too much about their insomnia and about being tired the next day. As a result they learn to become tense and anxious as bedtime approaches. They may have racing thoughts that all relate to insomnia and trying to fall asleep. As they worry about falling asleep, they become more and more tense, which makes it less likely that they will be able to fall asleep.

This tension and worrying about sleep increases through the night, setting up a cycle for ongoing insomnia. Even a simple bedtime routine may be a cue that causes tension to worsen. In fact, people with this insomnia may sleep better away from home. Focused and excessive worrying about sleep is the hallmark of this form of insomnia.