Inability to sleep long term and
there is a problem initiating sleep.
Primary insomnia- having sleep
problems that are not directly
associated with any other health
condition such as drug abuse
Secondary insomnia- having sleep problems
because of something else. There is a singe
underlying medical, psychiatric or environmental
cause. In such cases, insomnia is a symptom of
the main disorder. E.g. insomnia is a symptom
of hear disease Insomnia is typical of people
doing shift work- abnormal biological rhythms
cause sleepiness at inappropriate times. It may
also be the result of environmental factors, such
as too much caffeine or alcohol.
Monti 2004 argued that many cases of
insomnia could be treated by treating
underling causes, such as a medical
condition. This suggests that some forms of
insomnia are secondary- the result of other
illnesses- and are not an illness in themelves.
Evaluation point- Chronic insomnia is
highly complex and unlikely to be
explained by one single factor. The are
number of factors that may contribute to a
person's insomnia makes it very difficult to
conduct meaningful research because
research tends to fond only small effects.
This means that research is unlikely to
uncover clear solutions to the problem.
Primary V Secondary insomnia- it is important to distinguish
between primary and secondary insomnia because of the
implication for treatment. If insomnia is a symptom of another
disorder then it is important to treat the disorder rather than the
insomnia. However, It may not be that simple to work out the
causes of a persons insomnia-does depression cause insomnia
or does insomnia cause depression. There is a clear problem of
cause and effect here.
Savard et al 2003 found fewer immune cells in the
bodies of people with chronic insomnia compared
with good sleepers. This would make insomniacs
more vulnerable to physical illness. However, there
is a problem with cause and effect because it could
be that stress was the initial cause of insomnia and
stress does have a negative effect on the immune
system researched by Kiecolt-Glaser et al
Primary insomnia subtypes
1. Psychophysiological- anxiety-induced
insomnia. Intermittent periods of stress
resulting in poor sleep. There is a vicious
cycle of trying harder to sleep and becoming
tenser. Bedroom habits wich condition an
individual to response.
IDA- one of the causes of primary insomnia is
a persons belief that they are going to have
difficulty sleeping. This expectation becomes a
self-fulfilling prophecy because the person is
tense when trying to sleep. One method to treat
this is based on attribution theory. The
insomniac has learned that their sleeping
difficulty is due to insomnia. If they can be
convinced that the source of difficulty is due to
something else this will end their dysfunctional
attribution. Storm and Nesbitt gave insomniacs
a pill and told either the pill would stimulate
them or act as a sedative. Those who expected
arousal went to sleep faster because they
attributed their arousal to the pill and relaxed.
2. Idiopathic- occurs at an
early age, may be due to
abnormalities in brain
mechanism controlling
SWC. t is suggested that
there is a brain
abnormality that exists in
the sleep cycle, causing a
person to have high
arousal and inability to
sleep.
However, there is
difficultly in generalising
as there are so many
types of insomnia
attributable to so many
different cases that it is
nearly impossible to make
generalisations that
describe all cases of
insomnia.
Sleep-state misperception- many
people sleep adequately but do not feel
it. Some underestimate total seep and
overestimate the time it takes to fall
asleep. It could be suggested that these
discrepancies result from an unclear
perception of consciousness and
difficultly distinguishing sleep from
waking.
Research to support-
Dement- each morning he
completed questionnaires
estimating how long t took
to fall asleep, he reported
1-4 hours but never took
longer than 30 minutes.
There may be a familial link. Asked 256 primary insomniacs to complete a
questionnaire on family history. 72.7% had a family link supporting the fact
there may be a hederdiatory element. However, subjective self reports should
never be relied on such as questionnaires as there may be a element of bias,
answering in a way that they think the researcher wants. This therefore
results in a undermined validity.
Secondary insomnia causes
Hormonal changes- in
women menstruation.
There is a decrease in
melatonin production that
helps to control sleep.
This reduces as people
age, this supprts the fact
that as we get older we
sleep for less time.
Medical illnesses- may disrupt sleep and
cause insomnia, e.g. high blood
pressure. Katz studied insomniacs with
chronic medical conditions such as
diabetes, finding 50% of them suffered
from insomnia, 34% from a mild form and
16% severe. This supports that
secondary insomnia results from other
conditions and is separate from primary
insomnia.
Lifestyle factors-
stimulants like caffeine
trigger awakenings.
Nicotine- smokers take
longer to fall asleep. Shift
work- hard to maintain
sleep due to rotating shift
Research to support-McClenaghan found
that low blood glucose levels are a
common cause of maintenance insomnia,
where suffers have problems waking
throughout the night or waking up too
early, with stimulants like tea, coffee and
alcohol negatively affecting blood sugar
levels. Other foods such as bacon and
potatoes stimulate production of
adrenaline which can interfere with sleep.
Protein rich food assist in production of
serotonin and melatonin, which help
induce and maintain sleep, suggesting
there are good and bad foods related to
sleep patterns and that some peoples diet
may be a significant factor in their
insomnia.
IDA- research can be considered holisitic because it
considers many wide-ranging influences, psychological and
physiological such as hormonal fluctuations, personality
factors, maladaptive learning experiences and cognitive
functioning, this demonstrates the fact that the research can
not be considered narrow as all factors are incorporated.