While many of us struggle with getting a good night’s sleep, not all of our struggles are the same. New research examined a range of reasons why people don’t sleep well and found that insomnia generally falls into one of five types. Which type you fit into, the study suggests, affects which solutions may help you break out of the sleep-loss pattern.
Insomnia is a disorder characterized by “chronic complaints of unsatisfactory sleep, despite having an adequate opportunity to sleep” according to the National Sleep Foundation. Insomnia complaints include “difficulty falling asleep, difficulty staying asleep, waking up too early, and/or having sleep that is not refreshing.”
The researchers analyzed survey responses from more than 4,000 people participating in the Netherlands Sleep Registry, a project that tracks information on the factors affecting sleep habits. Roughly half the participants in this group had insomnia, as indicated by their responses, although none had been formally diagnosed. When checked against several other factors—including personality traits, emotional dispositions, and mood characteristics—the results pointed to five categories of insomnia:
Type 1: People in this category tended to have high levels of negative emotions like anxiety, and low levels of pleasurable emotions and overall happiness.
Type 2: These participants had moderate levels of emotional distress, but their levels of pleasurable emotions and happiness were normal, on average.
Type 3: People in this group also had moderate levels of distress, but experienced lower-than-average levels of pleasure and happiness.
Type 4: These participants had low levels of distress, but tended to experience chronic insomnia in response to a stressful event.
Type 5: Finally, those in this group also had low levels of distress, and their variety of insomnia wasn’t typically affected by stressful events.
The researchers looked for correlations between the insomnia types and responses to treatment. They found that people in the Type 2 category respond well to talk therapy (including cognitive behavioral therapy (CBT)), but those in the Type 4 category don’t. Both Type 2 and Type 4 insomnia sufferers tend to experience improvements when prescribed medication, while those in the Type 3 category don’t respond well to sleep-inducing drugs.
The most concerning finding was that people in the Type 1 category are also at greatest risk for lifetime depression. Addressing the underlying emotional issues is crucial for improving their sleep.
In commentary accompanying the study, lead study author Tsuyoshi Kitajima (Department of Psychiatry, Fujita Health University School of Medicine) said that the way clinicians think of insomnia has recently experienced “revolutionary changes” largely based on “the recognition that insomnia and other psychiatric or somatic disorders have independent courses and bidirectional associations, each of which needs specific clinical attention and treatments.”
In other words, we can’t think of insomnia, which affects an estimated 10% of the population, as a singular problem. Instead it’s a multifaceted problem requiring multifaceted thinking to arrive at solutions that really work.
The researchers noted that all of the study participants volunteered (and were thus motivated to participate in a sleep study), a potential limitation when trying to extend the results to the broader population. Also, since all responses were gathered via surveys, the results relied on participants accurately representing their symptoms and related factors. Further clinical research will be needed to confirm the results and determine if there are other categories not yet identified.
The study was published in The Lancet Psychiatry.