What Flavour of Insomnia Do You Have? By Mrs Vera West

     The worst thing about insomnia is perhaps not merely not being able to get to sleep, or waking up and not being able to get back to sleep, but having to face going to work the next day. I have always been a good sleeper, but my late husband, who died of a heart attack, was the worst insomniac I had ever known. He only use to get to sleep a few hour before he had to get up and go to work, and this went on year after year, until he died, maybe because of the sleep problems. Anyway, there are apparently five types of insomnia:

“There's a new way of looking at insomnia. Rather than just considering sleep-related symptoms, a new study from the Netherlands branches out to look at personality traits and emotions, and finds there are five types of insomnia. The findings may pave the way for a better understanding of the causes of insomnia, as well as the development of more personalized treatments for the condition, the researchers said. The study, conducted by researchers at the Netherlands Institute for Neuroscience in Amsterdam, was published online Jan. 7 in the journal The Lancet Psychiatry. Insomnia affects an estimated 10 percent of the population. The main symptoms involve difficulty falling or staying asleep — for example, people with the condition may lie awake for long periods before being able to fall asleep, or they may wake up too early and not be able to fall back to sleep, according to the National Institutes of Health.

But despite having similar symptoms, people with insomnia can vary widely in their response to treatment. In addition, attempts to find "biomarkers" for the condition — like commonalities in people's brain scans — have proved futile, the researchers said. These inconsistencies suggest that there may be more than one type of insomnia. In an effort to find "subtypes" of insomnia, the researchers analyzed information from more than 4,000 people who filled out online surveys about their sleep habits and other traits as part of a project called the Netherlands Sleep Registry. Based on their survey responses, about 2,000 of these participants had insomnia. (These participants scored high on an insomnia-related survey, but did not have a confirmed diagnosis.) To identify subtypes, the researchers went beyond looking at sleep-related symptoms and considered other factors, including personality traits, mood, emotions and response to stressful life events. The study authors found that participants with insomnia tended to fit into one of five categories:

•    Type 1: People with type 1 insomnia tended to have high levels of distress (meaning high levels of negative emotions like anxiety and worry) and low levels of happiness.
•    Type 2: People with type 2 insomnia had moderate levels of distress, but their levels of happiness and experiences of pleasurable emotions tended to be relatively normal.
•    Type 3: People with type 3 insomnia also had moderate levels of distress, but had low levels of happiness and reduced experiences of pleasure.
•    Type 4: People with type 4 insomnia typically had low levels of distress, but they tended to experience long-lasting insomnia in response to a stressful life event.
•    Type 5: People with type 5 insomnia also had low levels of distress, and their sleep disorder wasn't affected by stressful life events.

These subtypes were consistent over time: When participants were surveyed again five years later, most of them maintained the same subtype. The researchers also found that people with different insomnia subtypes differed in terms of their response to treatment and their risk of depression. For example, people with subtypes 2 and 4 saw the most improvement in their sleep symptoms after taking a benzodiazepine (a type of tranquilizer), while people with type 3 did not see improvement from this type of drug. In addition, people with subtype 2 responded well to a type of talk therapy called cognitive behavioral therapy, while people with subtype 4 did not. People with subtype 1 had the greatest lifetime risk of depression. The findings suggest that certain insomnia treatments may work best for certain subtypes, and future research should examine this. In addition, identifying people with insomnia who are at greatest risk of depression may lead to ways to help prevent depression in this group, the researchers said.”

     The problem most people will face today, is that they are likely to fall into category 1, high levels of stress and low levels of happiness, which is going to make both drug treatment and cognitive behaviour therapy largely impotent to solve. I guess one will have to sleep when one is dead.



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Monday, 08 August 2022