Insomnia has been defined as recurrent difficulties in initiation, duration and integrity of sleep despite adequate time and opportunity for sleep, resulting in impaired daytime functioning. Sometimes it can be one of the symptoms of a disease. Sometimes it can be seen as a disease on its own.

Insomnia has been defined as recurrent difficulties in initiation, duration and integrity of sleep despite adequate time and opportunity for sleep, resulting in impaired daytime functioning. Sometimes it can be one of the symptoms of a disease. Sometimes it can be seen as a disease on its own.

Common criteria for your insomnia are:

  1. You must have trouble starting or staying asleep, or waking up too early, or complaining of poor quality sleep that hasn’t been restful for a long time. In children, this may be difficulty sleeping and resistance to bedtime or inability to sleep independently, often reported by their caregivers.
  2. This difficulty sleeping occurs despite adequate opportunities or conditions for sleep.
  3. At least one of the following daytime complaints related to difficulty in sleeping at night must be reported by you or the patient.
  • fatigue or malaise
  • Difficulty with attention, concentration or memory
  • Impaired social or occupational functioning or poor school performance
  • Mood disorder or irritability
  • daytime sleepiness
  • Decreased motivation, energy, or initiative
  • Increased propensity to make mistakes or have accidents at work or while driving
  • Tension, headache, or gastrointestinal symptoms due to sleep deprivation
  • Worries and preoccupations about sleep

According to the International Classification of Sleep Disorders (ICSD-2), the types of insomnia are as follows:

  1. acute insomnia
  2. Psychophysiological Insomnia
  3. Paradoxical Insomnia
  4. Idiopathic Insomnia
  5. Insomnia Due to Psychiatric Disorders
  6. Inadequate Sleep Hygiene
  7. Childhood Behavioral Insomnia
  8. Drug or Substance Insomnia
  9. Medical Condition Related Insomnia
  10. Non-Drug or Substance Insomnia Not Specified (Non-Organic Insomnia)
  11. Physiological (Organic) Insomnia

What is acute insomnia?

Acute insomnia is a condition characterized by difficulty in initiating or maintaining sleep lasting less than three months, lasting for a few days or weeks. There is a specific reason for the patient’s insomnia. These patients report that they wake up earlier than desired. They show resistance not to go to bed when the appropriate time comes. They do not go to sleep without someone’s intervention.

Fatigue or weakness is common in patients with acute insomnia. There may be impaired attention or concentration or memory impairment. Social and familial activities of these patients may be impaired. Even in their professional or academic work, disruptions may occur. Mood disorder or irritability may also be seen in these patients. The patient is usually sleepy during the day. For this reason, behavioral problems may begin to appear. The patient may have a loss of motivation or a decrease in the desire to take responsibility. The patient may feel without energy. The patient is prone to error and expresses constant dissatisfaction with sleep.

The insomnia complaints of these patients cannot be explained simply as the lack of opportunity and environment to sleep. If these conditions are suitable, the patient will experience insomnia.

If the conditions that cause insomnia in these patients disappear or if the patient adapts to these conditions, the problem of insomnia disappears by itself.

What is psychophysiological insomnia?

Psychophysiological insomnia accounts for the majority of chronic insomnia. It is a state of insomnia that usually begins after a stress and can be exacerbated. It is generally short-lived. Due to this stress, the patient’s arousal has increased and there are thoughts that prevent sleep. It usually goes away on its own within a few days or weeks when the conditions causing the stress disappear, but it doesn’t last more than three months.

Intense concerns about insomnia in these patients may sometimes become more dominant than the stress factor that initiates insomnia, causing the patient’s complaints to increase. In this situation, which turns into a kind of vicious circle, the patient’s concerns increase gradually. Because of these features, this condition is also called learned insomnia, conditioned insomnia, primary insomnia. These patients are mostly anxious and nervous people.

How is psychophysiological insomnia diagnosed?

For a patient to be described as having psychophysiological insomnia, one of the following conditions must be present:

  • Insomnia must last at least 1 month.
  • Excessive focus or anxiety related to sleep
  • Difficulty falling asleep at the scheduled time or in bed; on the other hand, falling asleep during monotonous activities with no intention to sleep
  • Sleep better outside of home
  • Mental activity that affects falling asleep in bed
  • Increased somatic tension in bed that prevents falling asleep

What are chronic insomnia and its symptoms?

In order for your insomnia to be defined as a chronic insomnia, you must meet certain criteria. For example, you must be experiencing one or more of the following situations: difficulty in initiating or maintaining sleep, waking up earlier than you would like, resisting going to bed when necessary, and having trouble sleeping without the intervention of someone else.

If you have insomnia due to difficulty sleeping at night, you must have one or more of the following conditions:

  • Fatigue or weakness
  • Attention, concentration or memory impairment
  • Impairment in social, familial, occupational, or academic functioning
  • Mood disorder or irritability
  • Daytime sleepiness
  • Behavioral problems (Hyperactivity, impulsivity, aggression)
  • Decreased motivation, energy, or responsibility
  • Prone to mistakes and accidents
  • Dissatisfaction with sleep

The mere absence of insufficient opportunity or conditions for sleep as the cause of the above-mentioned conditions should not be sufficient for the diagnosis of insomnia. At the same time, your insomnia and its associated daytime symptoms must be experienced at least three times a week and must have been present for at least three months.

What is idiopathic insomnia?

Idiopathic insomnia usually begins in early childhood and is characterized by lifelong insomnia symptoms. There are no conditions that can cause insomnia. This type of insomnia is also resistant to treatment.

In order for the diagnosis of idiopathic insomnia to be made, the symptoms must be chronic, continue from childhood, have no specific cause, and be resistant to treatment.

In these patients, a history of alcohol or multiple drug use is more common. Like other insomnia conditions, temporary well-being is not observed, but patients say their complaints mimimiz.

This condition is not related to stress, but stress factors increase insomnia.