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Four Different Types of Insomnia - Essay - Meaning
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Four Different Types of Insomnia – Essay

Insomnia Meaning:

Insomnia is a most common sleep order characterized by difficulty with sleep maintenance or early morning awakening despite attempts to be sleeping. It suggests inadequate sleep quality or quantity when one has an adequate opportunity to sleep. Approximately 30% of the general population was affected by insomnia at least occasionally. It is a severe or chronic problem for about 10% of the population across the world. insomnia has been viewed as a significant threat to physical and psychological well-being of an individual. Overall, insomnia operates as a significant socioeconomic burden both for individuals and for society. The experiences and consequences of insomnia vary from individual to individual

Types of Insomnia

The term insomnia has multiple meanings. A number of categorizations and definitions of insomnia have been   formulated over the years. Among the several methods that insomnia has been classified one of the more prominent distinctions has been based on the nature of the presenting sleep complaint or symptoms. This method examines the symptoms of the patient such as difficulty falling asleep, trouble maintaining sleep, or experiencing sleep as nonrestorative. The main drawback identified with classification by sleep complaint is that major sleep complaints may change over time, especially with age. A second method of distinguishing insomnia types is on the basis of duration of the complaint. insomnia has been divided into three broad temporal categories namely  acute or transient  insomnia, short-term insomnia and long-term insomnia. Acute or transient insomnia   can be defined as a reaction to an acute stressor. Short-term insomnia is usually associated with a situational stressor. The time course of this type of insomnia is relatively longer. Long-term insomnia is associated with certain medical cases or conditions such as primary insomnia or a psychiatric condition, drug or alcohol use, another medical condition or sleep disorder (prolonged time course). Insomnia is perceived either as a primary disorder or secondary to other conditions is another major way of classifying insomnia. This method distinguishes types of insomnia from a causal perspective.

Adjustment Insomnia

Adjustment insomnia is the most commonly experienced form of insomnia. It is defined as a transient or short-term insomnia related to an identifiable stressor.  Adjustment insomnia has several alternate names such as acute insomnia, transient insomnia, short-term insomnia, stress-related insomnia, transient psychophysiological insomnia and adjustment disorder. Generally adjustment insomnia occurs in older adults and women. According to the   Epidemiological evidence 15% to 20% of adults experience some kind of adjustment insomnia in a year.

Major  Symptoms and Signs

Hyperarousal plays a central role in the development of acute or adjustment insomnias. Traditionally, the hyperarousal linked with insomnia has been conceived as the result of a causal chain leading from emotional arousal to physiological activation. Insomnia cases caused by physiological activation alone also noted. Sleep disturbance or sleep disorder, the primary symptom of adjustment insomnia is often associated with waking psychological symptoms of arousal such as anxiety, worry, and ruminative thoughts. Anxiety-related physical symptoms such as muscletension, gastrointestinal upset, and headaches are also frequently present along with daytime symptoms of fatigue, impaired concentration, and irritability.

Key Risk Factors

Short duration is the main characteristic feature of Adjustment insomnia. It is also associated with the presence of a known precipitant, and the absence of a learned or association component. A unique feature of transient insomnia is that it occur in individuals who are commonly normal sleepers and whose sleep is expected to return to normal or stable state after resolving the precipitating conditions. Patients with a history of disturbed sleep at times of stress have a tendency to be predisposed to experience insomnia at future stressful times. The individual’s appraisal of stressors and the perceived lack of control over stressful events intensify the vulnerability to insomnia. Coping skills are found to play an important mediating role between stress and sleep

Psychophysiological Insomnia

Psychophysiological insomnia is a sleep disorder most frequently occurs in women. This condition is a very common type of insomnia affecting 1% to 2% of the general population and 12% to 15% of those who seek treatment. Psychophysiological insomnia is rare among children. Psychophysiological insomnia has several alternate names such as primary insomnia, learned insomnia, conditioned insomnia and chronic insomnia.

Major  Symptoms and Signs

Psychophysiological insomnia is characterized by physical and psychological arousal that intervenes with sleep. Hyperarousal or heightened arousal is the distinguishing feature of psychophysiological insomnia. Attention and anxiety about their ability or inability to sleep are central characteristics of patients affected by this disorder. Hyperarousal has been observed to be a 24-hour-a-day phenomenon in patients struggling with psychophysiological insomnia. They have been noticed to be more alert in the daytime than would be expected according to their sleep complaints, and they are more alert at night than asymptomatic control subjects.

Key Risk Factors

The onset or beginning stage of psychophysiological insomnia may be insidious or acute. Unresolved adjustment insomnia can lead to psychophysiological insomnia. In its insidious forms, adult patients had the history of symptoms in adolescence or young adulthood. Psychophysiological insomnia has an enduring tendency if it is not given a proper treatment. Time course or duration can be considered as a major distinction between adjustment and psychophysiological insomnia. Habitual light or episodic poor sleep causes the development of psychophysiological insomnia.  Anxiety, over concern about health and daytime functioning also

enhance  the risk of developing this disorder. Stressful situations such as life transitions or mood swings can serve as precipitants of psychophysiological insomnia. The appearance of a first episode or recurrence of major depression and the abuse of over-the-counter or prescription sleep-promoting medications are the potential complications of psychophysiological insomnia.

Paradoxical Insomnia

Paradoxical insomnia is a most common form of sleep disorder among young and middle aged adults. It usually starts in young adulthood or middle age. Overestimation of sleep latency or extreme underestimation of time spent asleep as compared with objective sleep recordings are the core characteristics of Paradoxical insomnia. This form of insomnia may be a transitional state of sleep disturbance between normal and objectively classifiable insomnia. Paradoxical insomnia is otherwise known as sleep state misperception, pseudo-insomnia, or sleep hypochondriasis.

Major  Symptoms and Signs

Paradoxical insomnia is a distinctive type of insomnia since it appears to be of relatively small prevalence. This sleep disorder is generally uncommon among children and adolescents. The prevalence of paradoxical insomnia is less than 5% among clinical populations. Subjective sleep complaints are not supported by objective findings in this form of insomnia.

Key Risk Factors

Depressive traits, neuroticism, and excessive central nervous system (CNS) activation during sleep are the main risk factors of paradoxical insomnia. The condition of this sleep disorder can continue for months or years without change in symptoms or presentation. Objective sleep may actually decline in time to meet criteria for other insomnia disorders in some patients. The persistence of paradoxical insomnia may enhance risk for depression, anxiety and substance abuse.

Idiopathic Insomnia

Idiopathic insomnia is a long-standing complaint of insomnia commence in infancy or childhood and persisting through adulthood. The prevalence of idiopathic insomnia is approximately 0.7% of adolescents and 1% of very young adults. The prevalence of this type of insomnia is less than 10% among sleep clinic patients.

Major  Symptoms and Signs

Lifelong difficulty with sleep is the typical feature of idiopathic insomnia. Sleep initiation, repeated awakenings, or short sleep duration are the major sleep difficulties associated with this form of insomnia. Idiopathic insomnia is usually first evident during early childhood. Insomnia is prolonged with few extended periods of remission. It is persistent throughout adulthood without the variability seen in other types of insomnia after insidious onset. The type of sleep difficulty may vary with time.

Key Risk Factors

Absence of specific precipitants of the condition is the notable feature of idiopathic insomnia. The presence of factors that typically precipitate insomnia such as psychosocial stressors or medical conditions can worsen baseline sleep associated with this condition. Idiopathic insomnia is associated with risk of major depression or substance abuse that may develop from patients’ attempts to improve their sleep problem. Some individuals with idiopathic insomnia with had attention deficit-hyperactivity disorder (ADHD) or a history of learning disabilities during childhood.


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