health topics

What Are the Three Types of Insomnia?

Insomnia is a sleep disorder that causes difficulty in falling asleep, staying asleep, or getting quality sleep. The three types of insomnia include transient insomnia (less than 1 week), acute insomnia (short term), and chronic insomnia (long term).
Insomnia is a common problem.

Insomnia is the most common type of sleep disorder, and it involves problems falling asleep or staying asleep, or getting quality sleep, despite having an adequate opportunity to do so.

There are three types of insomnia:

The duration of insomnia differentiates the three types of insomnia. The types of insomnia are described in greater detail in the table below.

Type Symptoms
Transient insomnia
  • Temporary: lasts for less than 1 week
  • Usually caused by recent stresses
Acute insomnia
  • Also called short-term insomnia or adjustment insomnia
  • Lasts less than 3 months
  • Is more common in women than men
  • Usually caused by a stressful life event, such as a death of a loved one, major job change, relationship problems, serious medical diagnosis, stopping a particular medication or marijuana, or a pandemic
  • Symptoms usually go away on their own over time as the stressful incident that caused the insomnia resolves.
  • If short-term insomnia doesn't go away, it can become chronic.
Chronic insomnia
  • Long-term problems sleeping
  • Characterized by trouble falling asleep or staying asleep at least three nights per week for 3 months or longer
  • May be due to stress, like short-term insomnia, but can also be due to irregular sleep schedules, poor sleep hygiene, persistent nightmares, mental health disorders, underlying physical or neurological problems, medications, a bed partner, and other sleep disorders
  • Also more common in women

What Are Symptoms of Insomnia?

Symptoms of all types of insomnia may include the following:

  • Difficulty falling asleep or staying asleep
  • Variable or disturbed sleep
  • Waking up too early
  • Daytime fatigue or sleepiness
  • Forgetfulness
  • Difficulty concentrating
  • Memory problems
  • Irritability
  • Anxiety
  • Depression
  • Decreased motivation or energy
  • Increased errors or accidents
  • Diminished performance at work or school
  • Headache
  • Persistent worry about sleep
  • Increased risk of anxiety and depression

What Causes Insomnia?

Insomnia may be caused by multiple factors. The main cause of insomnia is believed to be a state of mental and/or physical hyperarousal that interferes with falling asleep or staying asleep.

Causes of insomnia include the following:

  • Changes in sleeping environment
    • Light
    • Noise
    • Temperature
  • Stress
  • Illnesses, especially those that cause stress or breathing problems
  • Unhealthy lifestyle habits
    • Working late
    • Using electronic devices
    • Playing video games
    • Napping late in the afternoon
    • Sleeping in later to make up for lost sleep
    • Using the bed for activities besides sleep
    • Diet choices
      • Stimulants, such as caffeine
      • Alcohol
      • Consuming heavy meals
      • Eating spicy foods
  • Irregular sleep habits
  • Irregular sleep schedules that disrupt the circadian rhythm
    • Jet lag
    • Shift work
  • Pain
  • Surgery
  • Use of or withdrawal from some medications and illegal drugs
    • Blood pressure drugs such as beta blockers and clonidine
    • Anti-asthma medications
    • Antidepressants
    • Theophylline
    • Decongestants
    • Stimulants
    • Certain over-the-counter (OTC) and herbal remedies
  • Mental health problems
  • Neurological disorders
  • Other sleep disorders
  • Pregnancy
    • Nighttime urinary frequency
    • Discomfort
    • Disrupted breathing
    • Reflux
    • Restless leg syndrome
  • Genetics
  • Age: Teenagers and the elderly experience insomnia more frequently.
  • May not have a known cause

How Do Doctors Diagnose Insomnia?

Sleep disorders are diagnosed with a patient history and physical exam. Tests or procedures that may be used to diagnose sleep disorders or to rule out other underlying conditions include the following:

  • Daily sleep log
  • Sleep study (polysomnography)
  • Record of activity and movement with a monitor or motion detector, generally worn on the wrist throughout the day and night (actigraphy)
  • Home sleep apnea testing
  • Daytime multiple sleep latency testing (MSLT)
  • Studies for low blood oxygen (hypoxemia)
  • Home devices that monitor breathing, oxygen saturation, position, and heart rate
  • Melatonin sampling
  • Core body temperature measurements
  • Hormone tests
  • Electrocardiogram (ECG)
  • Computerized tomography (CT) scan
  • Pulmonary function tests
  • Magnetic resonance imaging (MRI) of the brain
  • Genetic testing (for example, for fatal familial insomnia, a very rare condition, but should be considered if first-degree relatives are affected)

What Is the Treatment for Insomnia?

Treatment for insomnia includes the following:

  • Cognitive behavioral therapy for insomnia (CBT-I)
  • Sleep education
  • Sleep restriction or sleep compression therapy
  • Stimulus control
  • Sleep hygiene education
  • Relaxation exercises
  • Sleep medications, both over-the-counter (OTC) and prescription
    • Sedative-hypnotics
      • Short- and intermediate-acting benzodiazepines (for example, triazolam, temazepam, estazolam)
      • Eszopiclone (Lunesta)
      • Zolpidem (Ambien)
      • Zaleplon (Sonata)
      • Ramelteon (Rozerem)
    • Sedating antidepressants
      • Amitriptyline (Elavil)
      • Nortriptyline (Pamelor)
      • Doxepin (Silenor)
      • Mirtazapine (Remeron)
      • Trazodone
  • Other measures:
    • Acupressure
    • Dietary modification
    • Exercise (done at least 6 hours before bedtime)
References
<https://www.uptodate.com/contents/insomnia-beyond-the-basics?search=insomnia&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3>.

<https://www.uptodate.com/contents/insomnia-treatments-beyond-the-basics?search=insomnia&topicRef=7717&source=see_link>.

<https://sleepeducation.org/essentials-in-sleep>.

<https://www.sleepfoundation.org/insomnia/what-causes-insomnia>.

<https://www.sleepfoundation.org/insomnia/types-of-insomnia>.

<https://emedicine.medscape.com/article/1187829-overview>.