Types Of Insomnia: Causes And Treatments
We usually say that we suffer from insomnia when we are having trouble sleeping. But did you know that there are different types of insomnia? This is indeed so. There is not just one type, but several. And each of them requires different treatment. We will endeavor in this article to explain the different types of insomnia and the recommended treatment in each case. Let’s dig deeper.
Insomnia is one of the most common reasons for visiting primary health care. It is also one of the symptoms shared by virtually all psychological disorders.
Like other common problems in our society (such as anxiety or depression), many people use the term insomnia incorrectly. For example, having difficulty sleeping for a day or two is not insomnia. Being very stressed and not being able to sleep properly would not identify with this sleep disorder either. It would rather be, in the latter case, the fact of being subjected to a process of stress of which insomnia would be a symptom.
As we can see, there are some specifications that are essential to understand this problem, assess it and design the treatment. Let’s take a look at each of these aspects below.
What is insomnia?
Insomnia is formally referred to as primary insomnia, a sleep disorder in which the following characteristics appear:
- The person has persistent difficulty sleeping for at least four weeks.
- Difficulty may be experienced at the onset of sleep, during maintenance, finalization or due to the sensation of non-restful sleep (sleeping but not resting).
- There is no organic cause (traumatic brain injury, dementia, stroke) or medical / physiological cause that can explain insomnia (use of drugs, medication, disease causing insomnia).
- There is also no such thing as a psychological disorder such as anxiety or depression. In such cases we would be faced with a diagnosis of anxiety disorder or another disorder (with symptoms of insomnia related to another mental disorder according to DSM-5).
There are therefore three types of insomnia, depending on when the person is having difficulty sleeping:
- Conciliation or initiation insomnia
- Maintaining insomnia or fragmented sleep
- Late insomnia or early awakening
It is therefore necessary to meet the diagnostic criteria described above to be able to say that we are suffering from insomnia (strictly speaking). If we have another disorder or problem that causes insomnia, simply treating the sleep disorder will not end the problem. The main disorder will need to be diagnosed and treated in order to end the sleep problems. We will dive below into the three types of insomnia that exist.
Conciliation or initiation insomnia
It is the most common and known of the three types of insomnia. It is the inability to sleep when we go to bed. In other words, we have a problem getting to sleep. Reconciliation insomnia generally supports the maxim “we sleep as we live”. In other words, if we are spending the day stressed or worried, it is very difficult for the mind to disconnect and enter sleep mode.
In most cases, conciliating insomnia responds to a state of psychological discomfort, responsible for the difficulty in falling asleep. We may also have problems starting to sleep when there are changes in the usual schedule of our routine or in the hours of exposure to sunlight.
Treatment of conciliation or initiation insomnia
The recommended treatment for conciliating insomnia has several phases. What we call sleep hygiene is performed must first be performed. This approach is used because the person often acquires, with the development of insomnia, habits that are not healthy and which make their situation even worse. The first guidelines consist of developing correct habits and breaking the association: going to bed → not sleeping → anticipated anxiety about not sleeping.
If sleep hygiene guidelines are not enough, then different techniques or tasks are prescribed in order to break the association between bedtime and inability to sleep, as well as the discomfort that this generates. The psychologist designs a specific task for each case and each person. He also sets up a series of therapeutic goals that seek to generate changes in his daily life.
However, it is necessary to remember that all the therapeutic approaches that we have mentioned aim at conciliating insomnia as a primary disorder. In other words, these are treatments and approaches that are designed in the event that other types of insomnia or psychological disorders such as anxiety, depression, obsessive-compulsive disorder or mental disorder are excluded. bipolar.
In addition, medication may be necessary if the person cannot sleep despite the use of psychological techniques. The best options for conciliating insomnia are the non-bezodiazeine sleep inducers. These drugs work quickly and for a short time. They have no anxiolytic or residual effect the next day. For example, zolpidem, zaleplon or zopiclone.
Pharmacologic treatment for insomnia should always be prescribed and supervised by a physician. The latter decides which drug is most suitable and for how long it should be taken.
