Sleep Disorders-Types, Impact and Treatment of Insomnia

Feeling perpetually sleep-deprived? With this expert introduction to insomnia, find out what’s keeping you up at night and why.

By Debashruti Banerjee
29 Oct 2021

Nothing feels worse than feeling physically and mentally exhausted throughout the day and then hitting the sack—only to toss and turn until the alarm goes off. On an average, adults need 7 hours of sleep per night for healthy functioning. Consistent sleeplessness or insomnia is a sleep disorder that can result in lethargy, fatigue, memory dullness, depression and anxiety, reveals New Delhi-based pulmonologist and somnologist Dr. M. S. Kanwar of Indraprastha Apollo Hospitals. It can also affect your immunity and resistance. “Various studies worldwide have shown the prevalence of insomnia in 10%–30% of the population, some even as high as 50%–60%. It is common in older adults, females, and people with other medical conditions,” shows a 2016 study published in the Journal of Family Medicine and Primary Care. Dr. Kanwar believes that following a healthy lifestyle, receiving proper treatment and staying positive can show gradual but definitive progress.



Major types of insomnia

  • Short-term insomnia: Also known as acute insomnia, this type of insomnia can occur during or after a stressful life event. Symptoms can last for a few weeks.
  • Chronic insomnia: Persistent insomnia for three months or longer can be termed as chronic insomnia. According to Dr. Kanwar, long-term insomnia can lead to anxiety or depression and vice versa.
  • Secondary insomnia: This kind of insomnia occurs when the insomniac is struggling with other conditions, such as cardiovascular disease, gastroesophageal reflux disorder (GERD), asthma etc. This is why it is also known as comorbid insomnia.
  • Psychophysiological insomnia: A subtype of chronic insomnia, psychophysiological insomnia arises when the individual engages in a pathological cycle “in which the more the patient tries to sleep, the greater the anxiety and agitation, and the less the patient is able to initiate sleep,” says a 2013 paper published in the journal Encyclopaedia of Sleep.
  • Sleep onset insomnia: This refers to difficulty in falling asleep when the individual initially goes to bed.
  • Late-onset insomnia: Late or delayed onset insomnia refers to waking up way early and not being able to go back to sleep, according to Dr. Kanwar.
  • Sleep maintenance insomnia: This type of insomnia presents itself in the form of sleeplessness throughout the night. Individuals wake up intermittently and have a fragmented and disrupted sleep cycle.
  • Mixed insomnia: Often, insomnia is difficult to diagnose under a singular type of sleeplessness as sometimes symptoms of sleep onset, sleep maintenance and late-onset insomnias might overlap. This is when the broader term ‘mixed insomnia’ comes in.


General symptoms of insomnia
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders defines insomnia as a predominant dissatisfaction with the quality and quantity of sleep, having one or more of the following symptoms:

  • Difficulty in initiating sleep
  • Difficulty in maintaining sleep
  • Early awakening and inability to go back to sleep
  • Difficulties are present at least 3 nights per week or for more than 3 months
  • The insomnia cannot be adequately explained by substance abuse, another sleep disorder or coexisting conditions
  • Sleep disturbances cause stress and impairment in social, educational, occupational and other non-sleep areas of functioning



Ways to treat insomnia

  1. Have a sleep routine: “Maintain proper sleep hygiene—this includes not eating too late, keeping your room clean, dark and quiet,” recommends Dr. Kanwar. You can also try setting up a sleep schedule and avoiding caffeine, alcohol and nicotine before bed.
  2. Keep a sleep diary: A sleep diary is a detailed journal of your daily sleeping habits. This includes when you go to bed, how long you sleep, when you wake up, your mood, your environment and more. This activity can help you and your doctor get an idea about your sleeping patterns. Dr. Kanwar also asks his patients to keep a worry diary, which is used in treating anxiety (a common companion to insomnia).
  3. Try destressing: Any activities that calms you—be it a warm bath, a soothing playlist, a nice book—make it a part of your bedtime ritual. “Some of my patients even have a glass of hot milk,” reveals Dr. Kanwar.
  4. Do relaxation exercises: Fight stress by incorporating relaxation techniques into your daily exercise regimen. You can try yoga, meditation, breathing exercises to calm your nerves.
  5. Contact a sleep specialist: If none of the usual non-medicative methods work, make sure to contact a sleep specialist for psychological sessions. They can help you curate a treatment and therapy plan that is catered to your personal needs.


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