Insomnia is, quite simply, a condition in which we don’t get enough sleep. Sometimes it is a matter of not being able to fall asleep. Sometimes it is a matter of awakening too soon, after too little sleep. And other times it is a matter of the sleep that we are actually getting being less than what we need, or what we feel we need.
Insomnia that is caused by a known stimulus, such as a medication that we are taking, is easily cured – simply discontinuing the medication will generally resolve the insomnia. But insomnia that sets us to tossing and turning comes in three different forms, and it is helpful in understanding the condition to recognize the three types.
One thing that is helpful to understand in examining the different types of insomnia is that our ability – or inability – to sleep is largely controlled by a specific area of our brain that is located at the very top of our spinal cords, in our midbrain. Scientists have determined that this area of the brain is what is responsible both for our wakefulness, or alertness, and our ability to sleep. If the wake/sleep center is stimulated then we are alert, and if stimulation is removed then we are able to sleep. When the two areas are working properly and cooperatively, we are able to sleep and wake up normally and get the rest that we need. When we receive inappropriate stimulus it throws off the collaboration between the two, and that is when insomnia can occur.
Normal insomnia is the inability to sleep, or to stay asleep, as a result of something that is exciting or stimulating our brains. Perhaps you have a big event planned that you have been working on for months, or you are nervous about a test whose results will play a large part in determining your future. Just as children are unable to fall asleep because of their excitement at seeing Santa Claus or a person who is afraid of public speaking is unable to sleep the night before he has to make an important presentation to the management committee of his company, normal insomnia is expected, and may even aid us in nervous moments. One night of lost sleep can sometimes give us a bit of an adrenaline boost or nervous energy when we need it the most. In any case, when people complain of lost sleep due to nerves or excitement, it is rarely something to be concerned about or that will require any kind of treatment.
Abnormal insomnia is another form of sleeplessness that is to be expected under very specific circumstances, though not as pleasant as the type that comes when anticipating an exciting event. Abnormal insomnia occurs when the body is thrown into a state of shock as a result of a traumatic event, such as the sudden death of a loved one or similar catastrophe. If insomnia is seen as an imbalance of the wakefulness/sleep caused by being over-stimulated in anticipation of an event, abnormal insomnia reflects the enervation that happens to the entire body when our entire world is shaken. In times of extreme grief, people often turn to sleeping pills as a way to shut down their brain because the emotional stimulation is so overwhelming that it short-circuits their entire system. This type of insomnia, though similar to normal insomnia, is an expected physical reaction to an unexpected life event.
Finally, there is the insomnia that arrives without either excitement or grief. Chronic insomnia seems to appear from out of nowhere and leaves people who were previously sleeping normally suddenly unable to sleep, unable to remain asleep, or awakening after too little sleep. Chronic insomnia leaves its victims staring at clocks or at the ceiling, minds racing and frustrated at the strange combination of exhaustion and stimulation that they are experiencing. By the time morning comes the exhaustion that the insomniac spent all night wishing for has arrived, but the duties of the day call and they have no option but to muddle through.
Chronic insomniacs’ most frequently occurring problem is difficulty falling asleep. For most people, sleep comes after fifteen or twenty minutes after they make the decision that it’s time to close their eyes and go to sleep. Some people are lucky enough to fall asleep within minutes! But for those who have insomnia, the minutes drag on into hours because their brain’s sleep center is producing or attending to too much activity.
Those who can’t stay asleep have a different bedtime experience. They go to bed and fall asleep normally, then find themselves awake in the middle of the night and unable to go back to sleep. The experience of waking in the middle of the night isn’t unusual in and of itself. A normal sleep cycle involves a light awakening several times in the course of the evening. But for most of us, this awakening is so light that we often aren’t aware of it at all; we quickly return to deeper stages of sleep and wake up in the morning well rested. For those who can’t stay asleep, at least one of these awakenings results in a heightened state of alertness from which they can’t immediately return to sleep. The result is interrupted sleep and an unrefreshed feeling the next morning.
Finally, there is a variation on the inability to stay asleep – waking up too early. In this case, people who find themselves awake in the middle of the night are never able to fall back to sleep and lie awake the rest of the night, wishing that sleep would come. Having only gotten about half of the sleep that they needed leaves them feeling groggy and half-awake all day, unable to function normally and in a state very similar to sleep deprivation.
Understanding the different types of chronic insomnia and being able to identify which kind of insomnia you have can be very helpful in coming up with an effective treatment.