It’s one in the morning according to the alarm on your bedside table. You turned off the television a while ago and the most absolute silence reigns around you. You’ve used all the tricks you know: from drinking a glass of hot milk to counting sheep or taking off your pajamas, but nothing works. You are unable to sleep, to immerse yourself in that deep and restful sleep that allows you to get up the next day with renewed strength. And, as the minutes pass and you can’t fall asleep, the more you wake up. You feel identified?
Between 10% and 15% of the population suffers from chronic insomnia in the world, the most frequent sleep disorder. Thus, in Spain more than 4 million adults suffer from it, according to data from the Spanish Neurology Society (SEN), a figure to which must be added those who have transitory insomnia, who represent between 25% and 35% of the adult population.
Insomnia, according to the SEN, affects our daily performance and also produces cognitive and memory deficits, as well as problems of anxiety and depression, diabetes, obesity and hypertension, among others.
One of the main difficulties with this infuriating disorder is that it remains an enigma: the discoveries that have been made so far regarding the underlying brain mechanisms have been inconsistent, so that the treatment that for some people is effective for others, on the contrary, it does not provide the slightest bit of relief.
Now, researchers from the Netherlands Institute of Neuroscience have revealed, in an article published in The Lancet Psychiatry, that there are five types of insomnia , a classification that can facilitate the identification of the causes that provoke it, as well as the development of personalized treatments – for example, in a specific case are sleeping pills better or is cognitive behavioral therapy preferable? – and the selection of patients at higher risk of suffering from depression to prevent it.
The five types of insomnia
Type 1 is characterized in that the person suffers from generalized distress, scores high on traits such as neuroticism, and is associated with the risk of depression ; types 2 and 3 feel less anxiety and are distinguished between them according to their ability to experience pleasure and to respond to the rewards linked to the possibility of sleeping better – higher in case 2 than in case 3 -; while types 4 and 5 experience an even milder degree of anguish associated with the disorder and differ between them according to whether their insomnia responds to the stressful events that happen to them in their day-to-day life and is punctual –the case of 5– or whether it is a long-term insomnia and is possibly linked to having suffered childhood trauma – type 4 -.
Dr. Tessa Blanken and her colleagues from the Netherlands Institute of Neuroscience reached these conclusions after collecting, between 2010 and the end of 2016, data from 4,322 volunteers who accessed the internet platform slaapregister.nl to fill out a questionnaire on personality traits. which are known to be rooted in the structure and function of the brain . Insomnia subtypes can be discovered by looking at trait profiles. 51% of the participants suffered from insomnia, and the remaining 49% served as a control group.
Blanken and his colleagues have revealed why it has been so difficult until now to find consistent brain mechanisms and treatments for this sleep-related problem. “While we have always considered insomnia to be a disorder, it actually represents five different disorders . And the underlying brain mechanisms can be very different. We could compare it to the progression we achieve in the case of dementia once we realized that there are different types, such as Alzheimer’s, vascular dementia and frontotemporal dementia ”, Blanken emphasizes.
