A diagnosis of primary insomnia sounds like it would be the first and most prevalent type, but in fact primary insomnia is infrequently seen. When a person is diagnosed with primary insomnia it means that their sleep problems are not caused by or a symptom of another medical condition. Insomnia that is secondary to or symptomatic of another condition appears far more frequently, and is much easier to treat.
People who suffer from primary insomnia fall into one of two categories. The first, and most common is a result of conditioning. It is officially referred to as psychophysiological insomnia, though some sleep specialists refer to it as conditioned or learned insomnia. The first indication that a sleep professional gets that the patient they are interviewing may be suffering from this condition is when they describe themselves as being extremely anxious or experiencing great stress when thinking about or trying to get to sleep. One of the reasons that this is considered to be a conditioned response is that most patients find relief when they are outside of their normal sleep environment where there are so many things that remind them of previous nights’ struggles with getting to sleep.
When people spend an inordinate amount of time concentrating on how difficult it is for them to get to sleep, sleep becomes even more difficult to attain. One of the requirements of a diagnosis of this particular condition is an inability to sleep for at least twenty minutes combined with unusual measures of alertness when they should be asleep. At the same time they must also suffer from typical daytime symptoms of sleeplessness, including irritability and depression in order for a diagnosis of psychophysiological insomnia to be made.
The second category that falls under the broad and unusual heading of primary insomnia is idiopathic insomnia. This is also known as childhood-onset insomnia, and the fact that it starts very early in life is one of its most specific symptoms. It is extremely rare and thought to be caused by a problem deep inside the brain – furthering this assumption is the fact that the symptoms of the condition include neurological differences between those diagnosed and people who experience normal sleep.
The treatment of primary insomnia is particularly difficult, and not something that can be expected to happen in a short amount of time. While secondary insomnia is treated by addressing the underlying condition that created it as a symptom, primary insomnia is a long-term condition that is a condition unto itself, and the use of sleep medications is generally frowned upon because of fears of becoming reliant upon their use. Instead, physicians tend to work to introduce techniques that help insomniacs learn to overcome their anxiety, reduce distractions and cues that contribute to their alertness, and eliminate any chemicals or other stimulants that might interfere with their ability to fall asleep.