Forms of insomnia
In everyday life, the most common cause of sleep disorders - adaptive insomnia - is a sleep disorder that occurs when acute stress, conflict, or environmental changes occur. As a result of these factors, the overall activity of the nervous system increases, making it difficult to enter into sleep at nightfall or nightly awakenings. With this form of sleep disorders, you can determine with great certainty the cause that caused it. The duration of the adaptive insomnia does not exceed 3 months.
If sleep disturbances persist for a longer period, they are joined by psychological disorders (most often, the formation of a "fear of sleep"). At the same time, the activation of the nervous system increases in the evening hours, when the patient tries to "force" himself to fall asleep more quickly, which leads to aggravation of sleep disturbances and worsening anxiety the next evening. This form of sleep disorders is called psychophysiological insomnia.
A special form of insomnia is pseudo-insomnia (formerly called a distorted perception of sleep, or sleep agnosia) in which the patient claims to be completely awake, but objective research confirms that he has enough sleep (6 hours or more). Pseudo-insomnia is caused by a disturbance in the perception of one's own sleep, associated primarily with the peculiarities of the sense of time at night (periods of wakefulness at night are well remembered, and sleep periods, on the contrary, are amnesed), and fixation on their own health problems associated with sleep disorders.
Insomnia can develop and against the background of inadequate sleep hygiene, that is, the characteristics of human life, which lead to increased activation of the nervous system (drinking coffee, smoking, physical and mental stress in the evening), or conditions that prevent the onset of sleep (stacking at different times of the day , the use of bright light in the bedroom, uncomfortable for the sleeping environment). Similar to this form of sleep disturbance, behavioral insomnia of childhood, caused by the formation in children of incorrect associations associated with sleep (for example, the need to fall asleep only with motion sickness), and when trying to eliminate or correct them, there is an active resistance of the child, leading to a reduction in sleep time.
Of the so-called secondary (associated with other diseases) sleep disorders, insomnia is most frequently observed in disorders of the psychic sphere (in the old way - in diseases of the neurotic circle). In 70% of patients with neuroses, there are disorders of initiation and maintenance of sleep. Often, sleep disturbance is the main symptom-forming factor, because of which, according to the patient, numerous vegetative complaints (headache, fatigue, visual impairment, etc.) develop and social activity is limited (for example, they think that they can not work , since they do not get enough sleep). Particularly great is the role in the development of insomnia anxiety and depression. Thus, with various depressive disorders, the frequency of disturbances in night sleep reaches 100% of cases. Polysomnographic correlates of depression are considered shortening of the latent period of FBS (<40 min - hard, <65 min - "democratic" criterion), decrease in the duration of δ-sleep in the first cycle of sleep, a-δ-sleep. Increased anxiety is most often manifested by presumptive disorders, and as the disease progresses - and intrasomnicheskimi and postsomnicheskim complaints. Polysomnographic manifestations with high anxiety are non-specific and are determined by prolonged sleep, an increase in surface stages, motor activity, waking time, a decrease in the duration of sleep, and deep stages of slow sleep.
Complaints on sleep disorders are also very common in patients with somatic diseases, such as hypertension, diabetes, etc.
A special form of insomnia are sleep disorders associated with a disorder of the biological rhythms of the body. At the same time, the "internal clock", giving a signal for the onset of sleep, provides preparation for the onset of sleep either too late (for example, at 3-4 hours of the night), or too early. Accordingly, at the same time, either falling asleep when a person tries unsuccessfully to fall asleep at a socially acceptable time, or a morning awakening that comes too early in the time of the day (but at the "right" time according to the internal clock) is violated accordingly. A common case of sleep disturbance due to a disorder of biological rhythms is the "reactive retardation syndrome" - insomnia, which develops with rapid movement through several time zones in one direction or another.
, , 
The course of insomnia
With the flow, acute (<3 weeks) and chronic (> 3 weeks) insomnia are isolated. Insomnia lasting less than 1 week is called transient. Chronization of insomnia is promoted by persistence of stress, depression, anxiety, hypochondriacal setting, alexithymia (difficulty of differentiation and description of one's own emotions and sensations), irrational use of hypnotic drugs.