by Adele Gregory

Created on: March 18, 2009

In clinical terms, insomnia is often divided into two broad categories: sleeplessness which is main difficulty (primary insomnia) and insomnia that is a symptom of another condition such as respiratory problems, nightmares or depression. Insomnia is usually defined as wakefulness which last for more than half an hour, and where normal sleep patterns are disrupted for more than a month. People's own descriptions of their insomnia, on the other hand, tend to fall into three types: delayed onset, broken sleep and early waking.

Delayed onset or difficulty in getting to sleep is the type most familiar to us. It's the classic image of someone tossing and turning, mind buzzing and unable to switch off. It'll come as no surprise that stress, worry, erratic timetables, shift work and unhealthy habits are responsible for many difficulties people have in getting to sleep.

Most of the advice about tackling insomnia pertains to this form. It includes what's come to be called good "sleep hygiene" with tips such as cutting down on caffeine, making sure the bedroom is dark and quiet, and not eating too late in the evening. Warm baths, camomile tea, essential oils such as lavender, and relaxation techniques are also helpful for calming the mind down in readiness for sleep.

A broken sleep or fitful sleep is when someone has no problem dropping off but may wake for short intervals throughout the night. It can have either physical or psychological causes. Physically, It can stem from respiratory problems such as sleep apnoea, a brief cessation of breathing which also causes snoring. Uncomfortable conditions such as sudden changes in temperature or unsuitable bedding can disturb a restful sleep as can flushes and night sweats women sometimes experience during menopause. Sleep also gets lighter as we age.

Psychologically, someone may wake through the night because, subconsciously, they're staying vigilant. This is light, easily disrupted sleep will be familiar to new parents. It's a sort of sleeping with one eye or ear open. Life events such as caring for an ill relative, or in the aftermath of a crime or trauma can also turn on the nocturnal watchman. Occasionally, what appears to be broken sleep is actually a side-effect of more frightening sleep disorders like nightmares, panic attacks or night terrors and the a person wakes frequently as a kind of precautionary check. Because so many different factors can cause broken sleep, it's often useful to check for other issues first.

The third type is waking early, typically around 4:00am and being unable to return to sleep. This form of insomnia is associated with depression. Many suffers report an improvement in sleep when they begin anti-depressant medication. For some people, however, it's one of the later symptoms to subside.

One thing common to all forms of insomnia is that worrying about it will make it worse. Instead of trying to force yourself back to sleep, aim to simply relax. Allowing yourself to hover in the twilight zone between sleep and wakefulness, possibly with the help of a relaxation tape or gentle music, may not be as refreshing as a full night's sleep but it will still give your battery some recharging.

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