Insomnia can be defined as repeated difficulty with sleep initiation, maintenance, or quality that occurs despite having adequate time and opportunity for sleep. Despite the blanket term of ‘insomnia’ most people use to refer to chronic sleep deprivation or the inability to either fall asleep or stay asleep, not all cases of insomnia are identical. Not only are there different types of insomnia, but insomnia can affect people in different ways. Understanding and distinguishing between the various forms of insomnia and its unique effect on individuals, is useful for both health professionals and the person suffering from insomnia.
Different types of Insomnia
There are three main types of insomnia:
- Acute Insomnia
- Transient Insomnia
- Chronic Insomnia
While there are several factors that have an impact on the development of insomnia, each type of insomnia can be categorized according to the following criteria:
- How long it lasts
- How it affects your sleep
- The underlying cause of the insomnia
1. Acute Insomnia
Acute insomnia, also referred to as short-term insomnia or adjustment insomnia, is the most common type of insomnia. It is described as a brief episode of difficulty sleeping. This type of insomnia can last anywhere from a few days to a couple of weeks. In more severe cases, acute insomnia can last up to one or two months, but never exceeding three months.
Acute or short-term insomnia mainly occurs due to acute situational stress or as a result of a stressful life event. Some examples include the death/loss of a loved one, starting a new job, a disconcerting medical diagnosis, a pandemic, urgent work deadlines, exams, a major job or relationship change.
Acute insomnia typically resolves when the stressor is no longer present. The associated symptoms begin to fade as the individual adapts to the stressor and puts successful coping mechanisms in place to deal with the stressful incident/event that gave rise to their sleeping problems (AKA acute insomnia) in the first place. However, short-term insomnia can be both relentless and persistent, and if it is not dealt with effectively and efficiently it can develop into chronic insomnia.
Acute insomnia can affect both adults and children of all ages. It is more common in women than in men, and it can arise during pregnancy as well as menopause.
Along with stress, acute insomnia can be caused by:
- Sleeping in an unfamiliar bed or unknown surroundings such as a hotel or a new home.
- Environmental factors that disrupt your sleep, such as light or noise.
- Certain medications can significantly disrupt your sleeping patterns and ability to fall or stay asleep.
- Physical discomfort, such as pain or being unable to assume a comfortable position.
- Certain illnesses have the potential to contribute towards developing acute insomnia.
- Jet lag.
2. Transient Insomnia
Transient insomnia is a type of insomnia that does not last very long. Transient insomnia typically lasts for less than one week, and, in many cases, only lasts for a few days. Transient insomnia or temporary insomnia can often times involve a single episode of poor-quality or unrefreshing sleep or recurring episodes of insomnia separated by periods of normal sleep.
One of the great things about transient insomnia is that it does not recur. If it does recur, the insomnia is considered intermittent. However, if the insomnia continues, affecting your ability to either fall asleep or stay asleep most nights, and continues to persist for a month or more, it is considered chronic insomnia.
Transient insomnia (provided that it does not progress) typically does not require any treatment. This type of insomnia is most often caused by some kind of interruption or change in your sleep schedule or environment, stress, depression, jet lag, or an outside stressor.
3. Chronic Insomnia
Chronic insomnia is a long-term pattern of having difficulty sleeping. Insomnia is considered chronic if you have trouble falling asleep or staying asleep at least three nights per week for three months or longer, and, in many cases, even exceeding 6 months. Most individuals who suffer from/experience chronic insomnia have a long history of difficulty sleeping. Depending on the individual and their circumstances, the sleep deprivation and inability to get the sleep they need may be persistent or go away and recur with months-long episodes at a time.
Depending on the underlying cause, patient history, and a myriad of other factors, chronic insomnia can either be primary or secondary. Primary chronic insomnia, also called idiopathic insomnia, does not have any obvious cause or underlying medical condition or co-existing disease that is responsible for triggering the insomnia. Much like acute insomnia, primary chronic insomnia can be linked to various potential causes. Some of these causes include stressful situations, severe stress-inducing experiences, irregular sleep schedules, poor sleep hygiene, persistent nightmares, the death/loss of a loved one, any major job or relationship changes, extreme life-altering events, to mention a few.
Secondary chronic insomnia, also called comorbid insomnia, is a more common form of chronic insomnia. Comorbid insomnia is when chronic insomnia exists in conjunction with another medical or psychiatric condition. Comorbid insomnia does not have to be caused by or change with the co-existing disorder and/or medical or psychiatric condition. While secondary chronic insomnia or comorbid insomnia may not be caused by the co-existing condition or disorder, it can in many cases make the medical or psychiatric condition worse and hinder its treatment. For example, if an individual suffers from both depression and insomnia, they may not respond as well to the depression treatment as a depressed individual without insomnia would.
Common causes of secondary chronic insomnia include:
- Mental health conditions: This includes mental health conditions such as depression, anxiety, and attention deficit hyperactivity disorder (ADHD).
- Chronic medical conditions: Conditions such diabetes, Parkinson’s disease, hyperthyroidism, and obstructive and central sleep apnea.
- Various medications: Chemotherapy drugs, antidepressants, and beta blockers.
- Caffeine and other stimulants: Alcohol, nicotine, and other drugs can trigger secondary chronic insomnia.
- Lifestyle factors: Frequent travel and jet lag, rotating shift work, and frequent napping.
Other Ways of Describing Insomnia
While insomnia is primarily classified as either short-term, transient, or chronic, there are several other terms that can be used to describe insomnia:
- Sleep-onset insomnia
- Sleep maintenance insomnia
- Mixed insomnia
- Early morning awakening insomnia