In layman’s terms, it’s a hell beast that doesn’t let your body rest.
It’s an ineffable static that you wish you could physically beat down with a sledgehammer. Insomnia goes against your will. You can absolutely want to sleep, but it is like a broken ‘off’ switch for your mind.
Scientifically though, insomnia is a sleep disorder where you can’t fall asleep (sleep-onset insomnia), can’t stay asleep (sleep maintenance insomnia), or you wake up too early (also sleep maintenance insomnia)1. It is not feeling rested or refreshed the next day.
Additional signs include having difficulty concentrating, being irritable, and changes in appetite. There can also be physical sensations such as tingling and numbness.
The Five Types of Insomnia
Transient insomnia occurs when we lose sleep over short term events. Some examples are excitement for an upcoming trip, jet lag, sleeping in a new space (like a hotel)3, too much caffeine, and stress for an interview or test the following day. This is common and happens to almost everyone at some point in their life. Sleep returns when the temporary ‘excitement’ is gone2.
Acute insomnia is also common. It happens when your sleep is disturbed for at least 3 nights in one week and lasts up to three months4. Your sleeping habits return to normal once the temporary stress or change is resolved.
It usually occurs with more ongoing issues like tension at work and fighting with your significant other. However, it can even happen with neutral or positive events that you’d need some time to adjust.
Rest assured that losing sleep is a normal function if you got married, started a new job, or moved to a new city.
Chronic insomnia is described as having 3 or more nights of disturbed sleep per week for a period of six weeks or more5. This is when it starts taking on a life of its own, rather than just being a byproduct of temporary stress. It usually evolves from acute insomnia, particularly when a significant life change or stressor causes you to not sleep. Then sleep itself becomes the stressor.
Because the chronic version lasts for 6 weeks or more (sometimes literally decades), it affects you more deeply. Brain fog, a spotty memory, hard to control emotions are common side effects. Long term sleep loss can also affect areas of your life like romantic relationships, friendships, work, school, connecting with family, and your physical/mental/emotional health.
People with paradoxical insomnia have no signs of sleep deprivation6, however, they have the mental distress associated with insomnia. They dramatically underestimate the sleep they get and overestimate how long they are awake. So essentially, someone with paradoxical insomnia does sleep. But as with other types, there is an excessive worry around sleep. The treatment for this type is the same as other forms. So if this is you, this course should benefit you as well.
I wanted to touch on fatal familial insomnia because you may have come across it when trying to learn about your sleep troubles. I want to reassure you that it is exceptionally rare, and your chances of having it are literally 0.00000003%.
It stems from a specific variant in the PRNP gene that ultimately results in death within 6-36 months of diagnosis7. So far, only 70 families worldwide have been identified as having the gene8 though the exact number of cases is unknown.
Fatal familial insomnia is – well – fatal, the previously discussed forms (transient, acute, chronic, and paradoxical) are NOT fatal and can be cured through treatment.
Primary vs. Secondary
Primary (or idiopathic) insomnia is long term sleep disruption with no apparent cause. It is theorised that it’s due to an overactive wake system or under active sleep system9. Sometimes called “childhood onset insomnia”, the following list can ruled out as a cause for sleep disturbances:
- Lifestyle factors
- A medical condition
- Life change or significant stressor
- A mood disorder (e.g., anxiety, depression)
Primary insomnia is rare, and is likely genetic.
Conversely, secondary insomnia is caused by one of the points above.
What Insomnia is NOT
Anyone who chooses to stay awake is not suffering from insomnia. If you choose to stay awake because you’re binge watching Netflix, you are not an insomniac.
If you stay up all night studying for an exam but sleep fine the next night, you are not an insomniac.
When can’t sleep and choose to stay up, maybe you have insomnia. But you need to actually try then fail to sleep or stay asleep to be an insomniac. For now, you are someone who chooses to work late or screw around online til the wee hours.
In short, if you aren’t trying to sleep, that isn’t insomnia – that is you are making a CHOICE to not sleep. When you choose to try to sleep and still can’t, or you can’t stay asleep, then you likely have it.
Some Facts About Insomnia
⮞ Chronic insomnia is a remarkably common sleep problem for adults.
Over 50% of the people in a 2005 National Sleep Foundation poll reported having at least one symptom of insomnia.
Of those respondents, 33% said they experienced symptoms of insomnia every night or almost every night in that year. The main effects were not feeling rested the next day and waking up frequently.
Approximately 10 percent of people who reported trouble sleeping have symptoms of daytime functional impairment (like difficulty concentrating) associated with insomnia10.
⮞ Women experience it more than men.
Hormonal changes with menstrual cycles, pregnancy, and menopause11 are to blame.
⮞ Seniors also have more trouble sleeping due to changes in hormones which result in shorter slow wave (restorative sleep) sleep time11.
The change in hormones also causes an increase in lighter sleep, where we are more prone to waking up during the night.
⮞ Insomniacs are 10 times more likely to have depression than the rest of the population, and 17 times more likely to have anxiety12.
Insomniacs are also twice as likely to abuse alcohol than non-insomniacs13. It’s likely a maladaptive form of self-soothing for the turmoil sleep deprivation can cause.