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

Insomnia can present itself in multiple ways.

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 kind you might have, here's what you should know about the eight 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. Still, insomnia can also cause anxiety, so they are dually problematic, per the Sleep Foundation.

About one-third of people in the United States deal with insomnia, according to the National Library of Medicine (NLM). It is also the most common sleep issue.

Other factors contributing to insomnia are divorce, separation, losing a loved one, and low socioeconomic status. 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, according to the American Academy of Sleep Medicine (AASM). Still, it can last up to three months.

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 seek 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 that insomnia, according to the American Thoracic Society:

  • Sleep onset association type: This concerns difficulty falling asleep or returning to sleep after awakening without certain conditions—like having a parent in the room or needing their favorite blanket to fall asleep.
  • Limit-setting type: This occurs when a child refuses to sleep and attempts to delay bedtime by asking for a drink or to go to the bathroom.
  • Mixed type: This happens when 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 not being able to sleep. Someone with that type of insomnia may find it more helpful to sleep somewhere other than their beds, per the Centers for Disease Control and Prevention (CDC).

With that type of insomnia, worrying about sleep makes the activity very difficult to achieve. People with the sleep disorder become tense and anxious as bedtime approaches and develop a negative association with rest, making psychophysiological insomnia tricky to navigate.

Cognitive behavioral therapy for insomnia (CBT-I) is the best way to treat psychophysiological insomnia, according to the authors of an article published in October 2017 in Scientific Reports.

Paradoxical Insomnia

Paradoxical insomnia, a type of primary insomnia, is a complaint of severe insomnia. It occurs without objective evidence of any sleep disturbance, per a study published in May 2021 in Frontiers in Psychiatry

Daytime effects vary in severity, but they tend to be far less severe than expected, given the expressed sleep complaints. 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 link to insomnia may include chronic pain, cancer, gastrointestinal disorders, thyroid issues, Parkinson's disease, and Alzheimer's disease, per the Office on Women's Health (OWH).

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 rule out that connection.

Insomnia Due to a Drug or Substance

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

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

Additionally, certain medications used to treat conditions like blood pressure, diabetes, or depression can lead to problems with both sleepiness and insomnia, per one study published in 2013 in Sleep Science.

It's also important to note that insomnia can also occur when you stop intaking whatever is causing insomnia. Depending on the substance or medication and the severity of insomnia, it would be best to consult a healthcare provider to determine the safest way to cut back or stop using the substance.

Unspecified Insomnia

Unspecified insomnia is when a cause has yet to be specifically proven, so further testing is required to discover the exact cause. "Unspecified" is used as a temporary classification while further evaluation and testing are completed. 

There are two subtypes of unspecified insomnia:

  • Unspecified insomnia considered nonorganic: This suggests that known substances and other physical causes of insomnia have been ruled out. This means that the cause of insomnia is most likely due to an underlying mental health disorder, psychological factor, or disruptive sleep behaviors that is yet to be determined.
  • Unspecified insomnia considered organic: This is caused by a medical disorder, physical condition, or substance exposure, but the specific cause remains unclear.

Summary

Overall, you must get the sleep you need to remain as healthy as possible. See your healthcare provider for possible treatment options if you have sleep issues.

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