Insomnia is a broad term, casually used to describe the inability either to fall asleep or to remain asleep during the course of the night. Insomniacs usually do not feel rested the next morning and may experience excessive drowsiness, irritability, and poor cognitive function during the day. Fifty-eight percent of U.S. adults report bouts of insomnia recurring at least a few times each week, with shift workers experiencing insomnia more frequently than regular day workers do (66% compared to 55%). Sleep researchers classify insomnia in terms of the time of night that it effects: sleep-onset insomnia, sleep-maintenance insomnia, and early-morning-awakening insomnia.
Most researchers also characterize insomnia based on frequency. Transient insomnia lasts one or several nights and is usually triggered by stress, excitement, and traveling across time zones (jet lag). Intermittent insomnia occurs sporadically over a long course of time; it, too, is generally set off by stress. Chronic insomnia occurs on most nights and lasts a month or more, and may arise from various medical conditions, including depression, arthritis, asthma, heart disease, hyperthyroidism, kidney disease, and Parkinson’s disease. Postmenopausal women and older people tend to suffer from some type of insomnia.
Conventional treatment for transient and intermittent insomnia is usually with over-the-counter sleeping pills, or benzodiazepine prescription sedatives. Chronic insomnia rarely responds positively to sleeping pills.
• Sleep-Onset Insomnia—People suffering from sleep-onset insomnia take 30 or more minutes to fall asleep, after which they enjoy a relatively normal night of sleep. Of the adults who complain of having insomnia, 22% resort experiencing this type. People suffering from sleep-onset insomnia often exacerbate their situation by focusing on the fact that they are not sleeping; this is called psychophysiological insomnia. In this case, a person’s normal pre-sleep rituals, behavior, or sleeping environment trigger insomnia. The more the sleeper worries about falling asleep, the worse the insomnia becomes.
• Sleep-Maintenance Insomnia—This type of insomnia is characterized by waking up one or more times during the course of the night. It takes more than 30 minutes to fall back asleep after each awakening. This is the most common type of insomnia, accounting for 34% of insomnia cases.
• Early-Morning-Awakening Insomnia—If you awaken before dawn and can’t get back to sleep, you have early-morning-awakening insomnia. Twenty-two percent of insomniacs reportedly suffer from this type.
