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Insomnia is not just a disorder, says new study



Researchers have reached five different types of insomnia – types that can help physicians adapt specific treatments in the future, make them more effective and better tailored to each person with sleep problems.

Unlike what you might expect, these groups are not actually based on your typical sleep symptoms, such as. Problems waking up or having trouble sleeping.

Instead, these new types are associated with other factors – stress, emotion, personality traits, mood and past life events.

Applying Labels Type 1 to Type 5 showed researchers how different people with insomnia had different cognitive properties, including levels of anxiety and emotional sensitivity. The study also showed that participants were likely to remain in the same type over time.

"While we have always considered insomnia to be a disorder, it actually represents five different ailments," says one of the researchers, Tessa Blanken from the Netherlands Institute for Neuroscience. "Underlying brain mechanisms can be very different."

"For comparison: progress in our understanding of dementia was propelled when we realized that there are different kinds, such as Alzheimer's, vascular and frontal-temporal dementia."

Data were collected from about 2,224 individuals who showed self-reported symptoms of insomnia. They were asked to complete questionnaires on personality traits that we already know are linked to the structure and function of the brain and compared to a control group.

Type 1

people scored a lot on distressing features such as neurotics and felt low, while those in type 2 and type 3 groups both scored lower for emergencies – although type 2 respondents were generally more positive and content than Type 3 and Type 5 individuals reported lower levels of distress, but Type 4 people tended to experience prolonged insomnia following stressed life events, while this was not noticeable in Type 5 people.

In follow-up studies five years later, the study participants were usually still in the same type of group – an average 87 percent probability.

Knowing some of the traits behind a person's insomnia could help doctors get treatment that gets better results, researchers say – Type 2 and type 4 people had the best possible improvement after taking benzodiazepine.

People in Type 2 seizure also responded well to cognitive behavioral therapy, while people of type 4 did not.

According to the team behind the work, people across all the different types had the same kind of insomnia symptoms and it is here that previous attempts to divide insomnia into different categories may have fallen. Look at the bigger picture could be a better way to split people up.

There are some limitations to talking about: First, these people who reported insomnia were rather than people diagnosed with insomnia. Secondly, participation was voluntary so that it cannot represent the population as a whole (just those who are happy to complete health surveys).

Nevertheless, it is interesting to see how sleeplessness products can be improved in the future. Previous work has looked at some of the genetic risk factors for insomnia, another way to explore more personalized treatments.

About one in ten people are believed to suffer from chronic insomnia, and it is known to significantly increase the risk of depression and other mental illnesses as well. Any help we can get to fight it will be welcome.

"Insomnia subtyping paves the way for studies aimed at preventing depression, resolving inconsistencies and reducing heterogeneity in insomnia and revealing various causes and developing better tailored personal treatment for insomnia problems," the researchers conclude.

The research has been published in The Lancet Psychiatry .


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