Fast Five Quiz: Insomnia Types and Causes

Stephen Soreff, MD


July 15, 2020

Paradoxical insomnia is also called "sleep state misperception." The essential feature is severe insomnia without supporting objective evidence, such as daytime sleepiness. Despite sleep study evidence indicating achievement of a normal amount of sleep, people with paradoxical insomnia persist in their belief and complaint that they do not get enough sleep.

The essential features of psychophysiologic insomnia include learned or behavioral insomnia and heightened arousal. The primary components are intermittent periods of stress that result in poor sleep and maladaptive behaviors. Patients with psychophysiologic insomnia (not paradoxical insomnia) often report "racing thoughts" and sensitivity to their environment. It is a transient condition that often occurs in relationship to an acute stress.

The essential feature of idiopathic insomnia is lifelong persistent sleeplessness that usually begins in infancy or childhood. Idiopathic insomnia can be aggravated by stress or tension. This sleeplessness is attributed to dysfunction of the neurologic control of the sleep-wake cycle. This control center involves many areas of the brain, including the reticular activating system, supra nuclei, raphe nuclei, and medial forebrain areas.

Learn more about types of insomnia.


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