Last week was a whirlwind. I traveled to NYC for The Today Show, then to Las Vegas for the technology show CES, and finally LA for Face the Truth with Vivica Fox. I’m exhausted just writing this sentence. The upside is that I was able to catch up on my reading on the flights. I read a lot of interesting material including a recently published study which reinforces what I’ve been sharing with my patients and readers for years…which is that there are several types of insomnia, not just one
A group of Dutch researchers identified five different subtypes of insomnia in their recently published study online in Lancet Psychiatry (a very prestigious journal). This study is different than other published studies in medical literature because it goes beyond subtyping that is focused merely on the type of symptoms someone may experience.
These referenced symptoms may include:
- Difficulty falling asleep
- Difficulty staying asleep
- Awakening too early
The Dutch researchers approached insomnia in a completely different way. Instead of categorization based on symptoms, they based their categorization on different biological traits and a person’s life history. In scientific research, this is often referred to as a data-driven or bottom-up approach.
Doctoral candidate Tessa Blaken, at the Netherlands Institute for Neuroscience in Amsterdam, utilized the Netherlands Sleep Registry for her study. She looked at data on 4300 people, of which approximately 50% had a probable insomnia disorder (according to scores on the Insomnia Severity Index >10).
A statistical analysis of these 4300 people revealed five potential subtypes:
Sub-Type 1 (19%) references Highly Distressed Insomnia. People in this sub-type scored high on traits of distress, such as neuroticism, feeling tense, or feeling “down.”
Sub-Types 2 (31%) and 3 (15%) reference Moderately Distressed Insomnia. These groups of people had less distress in their lives, but were reward-sensitive (Type 2), or reward insensitive (Type 3). This means one group experiences pleasurable emotions tied with reward, while the other group experiences no pleasurable emotions derived from rewards.
Sub-Types 4 (20%) and 5 (15%) were also characterized with less distress than sub-type 1, but they were categorized differently than sub-types 2 and 3 because of the degree to which these groups experience insomnia in relation to stressful life events. People that fit into the sub-type 4 group are highly affected by stressful life events. People that fit into the sub- type 5 group are basically unaffected by events classified as stressful.
What does that mean for you?
It means there isn’t a one size fits all solution for insomnia. Insomnia takes multiple forms and what may trigger you or affect you may be different than someone else who suffers from a different sub-type of insomnia. You may need to experiment with various products or forms of remedies. Solutions may come as a therapy or in pill form, a tincture, beverage or spray. You may even need to try more than one to find what your individual body needs.
There appear to be at least three factors for you to consider:
- The level of distress or anxiety in your daily life. Is it high, medium, or Low?
- Do you get pleasure from rewards?
- Do life events affect your sleep?
What else can you do right now?
- Maintain a consistent wake up time to keep your circadian rhythm in sync. This will also help lower anxiety.
- Exercise regularly. This is a great way to reduce stress and help improve your sleep quality.
- Avoid caffeine. This is especially important if you’re an anxious person. Caffeine makes anxiety worse.
- Plan for potential “bad nights.” If you know you have a stressful event coming up, expect that your sleep will be impacted. Make sure you have a good sleep environment. You may even consider going to bed slightly later than normal. Sleep deprivation may help you fall and stay asleep.
- Consider taking magnesium in any form including magnesium oil. You can also get it from food (I like homemade Banana Tea) to help calm your nerves before bed. Read my post about magnesium to learn more about why this will benefit you.
If you struggle to sleep, see if you identify yourself in one of the five categories above. If you do, experiment with the strategies or remedies I mentioned earlier to help you fall asleep faster, stay asleep longer and sleep more soundly without waking too early.
Michael J. Breus, PhD
The Sleep Doctor™