7 Types of Insomnia: What You Should Know About Each One

You don't have to lie awake for hours past bedtime to have insomnia. Having trouble falling asleep, staying asleep, and even waking up too early are all signs of a sleep disorder.

To help you determine what type of insomnia you might have, here's what you should know about the seven classifications of insomnia.

General Insomnia

General insomnia is a classification of sleep disorders in which a person has trouble falling asleep, staying asleep, waking up too early, or combining any of those circumstances.

These disorders are either short-term or chronic and fall into primary and secondary categories. Primary insomnia exists independently of any other condition. Secondary, or comorbid, insomnia occurs alongside another condition. For example, anxiety may cause you to lose sleep. And insomnia can cause or worsen anxiety, so they are dually challenging.

About one-third of people in the United States deal with insomnia. It's also the most common sleep condition in the US.

Other factors contributing to insomnia are:

• Stress
• Losing a loved one
• Jet lag
• Shift work
• Poor sleeping environment (noise, light, temperature, poor sleeping surface)

There is a significant correlation between extensive angst and the development of insomnia.

Adjustment Insomnia

Adjustment insomnia disturbs your sleep and usually stems from a specific source of stress. It's a type of primary insomnia, also called acute insomnia. Adjustment insomnia is typically short-term, lasting up to a few weeks. This type of insomnia occurs in about 15% to 20% of people each year and is more common in older adults.

The sleep problem resolves itself when the source of stress is gone or when you've adapted to it. That stress does not have to come from a negative experience. Something positive, such as pregnancy or a new job, can make you too excited to sleep well.

That being said, adjustment insomnia can turn into chronic insomnia. If you lose sleep for over three months, you should talk to a sleep specialist.

Behavioral Insomnia of Childhood

As children grow, their sleep behavior changes drastically. Naps are discontinued, nocturnal sleep is extended, and the standard bedtime is pushed further back.

These changes are known as behavioral insomnia of childhood (BIC). They can cause sleep disruption in approximately 30% of children. There are three subtypes of this insomnia:

• Sleep onset association type: Difficulty falling asleep or returning to sleep after awakening without certain conditions or associations—like having a parent in the room or needing a favorite blanket to fall asleep.
• Limit-setting type: A child refuses to sleep and attempts to delay bedtime by asking for a drink or to go to the bathroom.
• Mixed type: Behaviors from the other subtypes are combined.

However, BIC is manageable with specified bedtimes and relaxing sleep routines.

Psychophysiological Insomnia

Psychophysiological insomnia is associated with excessive anxiety or worry focused explicitly on being unable to sleep. People with this type of insomnia may find sleeping somewhere other than their bed helpful.

Worrying about sleep makes the activity very difficult to achieve. People with this sleep disorder experience:

• Becoming tense and anxious as bedtime approaches
• Developing a negative association with rest

These experiences make psychophysiological insomnia tricky to navigate but can improve over time.

Treatment for psychophysiological insomnia may include a combination of sedative-hypnotic and sedating antidepressants, along with behavioral therapy. Cognitive behavioral therapy for insomnia (CBT-I) can be an effective treatment. 

Paradoxical Insomnia

Paradoxical insomnia, a type of primary insomnia, is a sleep disorder where people report severe insomnia yet don't have signs of sleep disturbance or difficulty functioning during the day.

People with the 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. 

That awareness suggests a state of hyperarousal. A key feature is overestimating the time it takes them to fall asleep.

Insomnia Due to a Medical Condition

This secondary insomnia is caused by a medical or neurological disorder, where insomnia is a symptom of the condition.

Medical conditions linked to insomnia may include:

• Chronic pain
• Cancer
• Gastrointestinal disorders
• Thyroid issues
• Parkinson's disease
• Alzheimer's disease

The course and severity of insomnia are directly linked to the medical condition. But insomnia is a particular focus of treatment if it is severe enough.

If you feel that insomnia might result from another health issue, you'll want to talk to a healthcare provider to determine if there's a connection.

Insomnia Due to a Drug or Substance

This type of secondary insomnia occurs when your sleep is disrupted after taking a substance, such as alcohol, caffeine, food, or medication.

With food and other substances, sleep problems occur because what you've consumed stays in your body for several hours—especially with high consumption.

Certain drugs used to treat conditions like high blood pressure, diabetes, and depression can lead to problems with sleepiness and insomnia.

It's important to note that insomnia can also occur when you stop taking or consuming the substance causing insomnia. Depending on the substance or medication and the severity of insomnia, it might be best to talk with a healthcare provider to determine the safest way to cut back or stop using the substance.

A Quick Review

There are several different types of insomnia with varying causes. Talk with a healthcare provider if, for several weeks, you've been having trouble sleeping or if the lack of sleep interferes with your daily activities and functioning. They can help figure out what might be causing insomnia and talk with you about possible treatment options. Getting enough sleep is important for both mental and physical health.