What are the Two Types of Insomnia?

Insomnia is not quite as straight forward as you might think. For one thing, there are two types of insomnia, and two modes of insomnia. The conclusion here is that, in layman terms, we might accept that there are four types of insomnia one might deal with.

The two types of insomnia are:

• Primary insomnia – insomnia as a direct result of something else
• Secondary insomnia – insomnia with no clear, underlying issue

The two modes of insomnia are:

• Acute insomnia – short term, a month or less
• Chronic insomnia – symptomatic, long term (at least three times per week for a month or more)

To summarize the four types of insomnia that can result from combinations of types and modes of insomnia, you get the following, with a sample quote that describes the combination:

• Secondary/acute insomnia – temporary insomnia in response to a temporary illness, stress, etc.
  • “Ever since my surgery two weeks ago I can’t get more than a couple hours of sleep per night”
• Primary/acute insomnia – temporary insomnia for no discernable reason
  • “I just can’t seem to sleep at all this month”
• Secondary/chronic insomnia – chronic insomnia in response to (usually) chronic life problem such as pain, long term illness, etc.
  • “Ever since my back injury last year I wake up constantly throughout the night in pain”
• Primary/chronic insomnia – chronic insomnia with no discernable cause
  • “I haven’t slept more than a few hours at a time all year and I don’t know why”

Causes of Short and Long-term Insomnia

Primary insomnia is insomnia with direct causes. Note that not all Acute, short-term insomnia is usually caused in response to temporary, external factors such as:

• Short term illness
• Jet lag
• Switching shifts at work
• Temporary regimens of medication
• Travel
• Significant stress (divorce, job loss, death of loved one, moving)

You get the idea. Generally, acute insomnia may clear up once the cause goes away.

Causes of chronic, long-term insomnia include things like:

• Age-related sleep changes
• Chronic stress
• Chronic anxiety
• Depression
• Chronic pain
• Circadian rhythm disorders
• Dependence on certain medications
• Habitual life style choices
• Chronic substance abuse
• Especially in Alaska, seasonal effects or transitions (light/dark extremes)

Risk Factors for Insomnia

There are countless risk factors for developing insomnia, both internal and external risk factors that range from natural changes to external, chronic environmental stresses.

As we age, our sleep cycles change. Namely, we tend to go to bed earlier, wake up earlier, and require naps during the day. People over the age of 60-65 are more likely to have insomnia and report trouble with sleep. This is likely due to natural biological changes, and also because as we age we are more likely to take certain medications that affect sleep.

Other biological factors for developing insomnia is sex. Insomnia is more common in women than men. Biological aspects of being female like pregnancy, premenstrual syndrome, and menopause can increase your risk for developing insomnia.

Many diseases can affect our ability to sleep, and make us at risk for developing insomnia:

• Diabetes
• Kidney disease
• Lung disease
• Arthritis
• Heart disease
• Heavy smoking
• Sleep apnea
• Restless leg syndrome (RLS)
• Addiction
• Parkinson’s disease
• Alzheimer’s disease
• Mental disease

Other medical reasons also cause. Certain medications cause insomnia (primary) as a side effect, and include:

• Diet pills
• Steroids
• High blood pressure medications
• Theophylline
• Phenytoin
• Levadopa
• Decongestants

Psychological factors are some of the most common root factors for developing primary insomnia, and include:

• Depression
• Anxiety
• Stress from marriage/job/health issues

Lastly, insomnia is also commonly caused by lifestyle choices that make sleep difficult, such as:

• Shift work
• Poor pre-sleep habits (screens, diet)
• Drinking before bed
• Drinking too much coffee
• Jet lag
• Poor sleep environment – noisy, bright, distractions, etc.
• Exercising close to bed time

Treatment for Acute and Chronic Insomnia

Insomnia should be treated differently depending on what type of insomnia you have. Acute insomnia will likely go away on its own – once the cause is removed you will likely be sleeping well again.

Chronic insomnia treatments may be a little less straightforward, and will likely require some intervention of some sort – usually behavioral therapy. This might include:

• Therapy
• Education on good sleep habits
• Lifestyle changes
• Ways to reduce severity of chronic causes (such as pain treatment)
• Avoiding screens before bedtime

It is not recommended to treat chronic insomnia with over the counter pills, such as melatonin, because they may have undesired side effects and lose their effectiveness over time.

Treating insomnia will likely require direct consultation with your doctor or a sleep specialist, and may require trial and error to narrow down possible causes and best treatment options.

If you live in Alaska and are worried that you are struggling with insomnia, please contact one of our sleep specialists - start by taking this free online sleep test.