Insomnia is quite common. Chronic insomnia disorder occurs in about 10% of the population, but sporadic insomnia (acute) symptoms is much higher (30% to 35% of the population). In order to diagnose insomnia you need to have the cardinal features of this. Based on the international classification of sleep disorders, insomnia is diagnosed when:
A. A patient has either Difficulty initiating, maintaining sleep or waking up earlier than desired.
B. A patient has subsequent daytime problems, such as fatigue/malaise, attention, concentration, or memory impairment or impaired social, family, occupational, or academic performance.
C. The sleep disturbance and associated daytime symptoms occur at least three times per week.
D. The sleep disturbance and associated daytime symptoms have been present for at least three months
If you meet this points you may have insomnia. Chronic insomnia disorder comes in many sizes and shapes. Some people may only have sleep onset issues, others might have sleep maintenance problems. The time aspect of insomnia is kinda arbitrary. Most people say if sleep onset is greater than 20-30 minutes then this is considered a problem.
Most recent classification are leaning towards just characterizing insomnia as chronic vs acute. There are however pathological sub types that do provided an added individualization of insomnia. The sub types are:
This subset of insomnia tries to describe patient that have an elevated “arousal and learned sleep-preventing associations” that are that the crux of the insomnia. A common trait is that these patient cannot sleep at home but do very well when they are traveling. They tend to focus and worry to much about sleep which lead to increased difficulty sleeping.
The term idiopathic refers to any disease with unknown cause or apparently spontaneous in origin. People who have this type of insomnia tend to have longstanding sleep difficulties with onset during early age. It tends to be attributed to genetically determined or congenital aberrations in the sleep-inducing or arousal systems in the brain, or both.
Also called sleep state misperception, is the complaint of insomnia without physical evidence of this. Some people even have sleep studies that prove they slept all night however when confronted with this question the results. They usually say something along the lines of “i didn’t sleep a wink.” These people tend to underestimate the amount of sleep they actually are obtaining.
Inadequate sleep hygiene
Some people just have poor technique. They have daily living activities that not conducive to good-quality sleep. The usual suspects include daytime napping, variable sleep-wake schedule (social jet-lag), too much caffeine, tobacco, or alcohol. This subset also includes people who frequently read or watch TV/iPAD in bed.
Insomnia is hard to treat, no matter what insomnia you have. It is important to see your health professional and talk about sleep.