What is insomnia, really?
“I can’t sleep.”
“I don’t sleep.”
“I’m tired but wide awake.”
“I’m up for hours.”
Sound like you or someone you know?
There are common experiences in those with insomnia - a term thrown around a lot. But what is insomnia, really?
I tell patients about “little i” insomnia and “big I” insomnia.
“Little i” insomnia is what we all experience from time to time – you’re sick with the cold or flu, before a flight the next morning, after a big fight or letdown, or before giving a big presentation at work. As long as these are infrequent or not terribly disruptive, “little i” insomnia is part of living.
“Big I” insomnia is the bigger problem – more commonly known as Insomnia Disorder.
Insomnia Disorder is a sleep disorder. It’s characterized by dissatisfaction with your sleep quality or quantity due to:
difficulty falling asleep,
staying asleep,
early morning awakenings, and/or
non-restful sleep.
These sleep issues are not infrequent – they occur at least 3 nights per week (or maybe nightly) for at least 3 months – in other words, it’s more than a bad week. These sleep issues occur despite adequate opportunity – meaning that it may not be insomnia if you are intentionally limiting your sleep by pulling long hours or interrupted by work or family members.
That’s the clinical explanation that focuses on sleep patterns. What makes insomnia a disorder, however, is one key factor.
These sleep disturbances cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Insomnia has to have a negative impact on your life for it to be a disorder.
If you are a retiree who doesn’t mind that it takes them a while to fall asleep at night and doesn’t mind taking an afternoon nap to offset the lack of sleep at night – without any of it interfering with doctors appointments, visiting grandkids, or living their overall best retired lives – can we really call that a disorder? I would have to think twice before throwing out that label.
But if the way you sleep causes you to struggle to stay awake at your desk job, or you have to cancel plans often because you haven’t been sleeping well, or even the idea of (not) sleeping tonight is a major stressor hanging over you, then that sounds like your sleep patterns are problematic. That’s when you want to seek professional help to address “Big I” insomnia.
