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What are the 3 types of insomnia called?



What is initial insomnia?

Struggling to get to sleep at the beginning of the night


What is middle insomnia?

Waking up in the night for periods of time


What is terminal insomnia?

Waking up too early.


What are the 2 categories of insomnia?



What is primary insomnia?

When there is no obvious cause of insomnia so it is an illness in it's own right. To be diagnosed you need;
to have had problems sleeping for over a month
to experience social/occupational impairment
it not be the result of any other sleep disorder


What is secondary insomnia?

Symptom of another disorder e.g. apnoea


Who is more likely to experience insomnia?

OWLS-night people as their body wishes to function more readily at night.
Older people sleep less and hence their bodies produce less melatonin and hence experience less deep sleep. But this could be due to physical problems e.g. arthritis.
Women are more likely to suffer because of hormonal changes, research has found that women in sleep clinics, 60% were there because of insomnia.


What are the 3 explanations for insomnia?



Predisposing explanation

We have a genetic predisposition for insomnia.
Idiopathic insomnia begins at a young age and is a result of the body's SWC. Brain mechanisms are at fault.


Predisposing-research supporting it's genetic

Researchers put insomniacs through a series of tests and found 73% had a family history of insomnia. The assumption is that it is genetic, however, it could simply be a learned response and hence to say it's purely genetics is reductionist. It is more feasible to assume its genetic and environmental.


Predisposing-what is the positive of this explanation?

It allows the disorder to be studied methodologically and therefore proposes a treatment accordingly.


Precipitating explanation

Stress is a factor in insomnia as it results in increased activity in the sympathetic branch of the ANS making us more alert.


Precipitating-is there a link between stress and insomnia?

In a study involving insomniacs and a control group, both completed a series of questionnaires assessing their daily stressors and their sleep levels. Insomniacs were expressing higher levels of anxiety even though they were experiencing the same daily stressors.


Precipitating-how has personality come into the explanation?

Insomniacs were more likely to internalise psychological disturbances.
People with neurotic personalities showed higher levels of sleep disturbance. HOWEVER, is insomnia a cause or effect of these personality's.
Studies have found that insomnia preceded mood disorder.


Precipitating-how do drugs play a part?

Drugs interfere with ultradian rhythms.
Caffeine and nicotine cause increased activity in the nervous system.


Perpetuating explanation

The insomnia results from a learned behavioural condition. A cycle of anxiety resulting in the inability to sleep that become self-reinforcing. Regular actions that pre-empt sleep become associated with an inability to sleep e.g. brushing teeth. This is classical conditioning and can be helped by breaking some of the habits e.g. sleeping elsewhere.


Perpetuating-perceived insomnia

Many 'insomniacs' underestimate the amount of sleep they get and are actually sleeping normally. Making self-report unreliable. Those who have taken part in studies have been asked to push a button responding to a low sounds, in the morning they complain of having no sleep when their EEG scans say otherwise.



Poor sleep hygiene e.g. naps are discouraged to help break the cycle of being unable to sleep at night.
Sleep restriction therapies state that habits can be 'unlearnt' e.g. reducing the amount of time spend in the bedroom.
If insomniacs can be convinced the source of their difficulty sleeping comes from factors other than insomnia, this will end their maladaptive thinking. In a study involving expectations, participants were told the pill would either act as a sedative or arouse them. Those told to expect arousal went to sleep faster because the arousal was connected to the pill, not the insomnia.