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Medical Author:

Aparna Ranjan, MD

Coauthor:

Angela Gentili, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Sleeplessness without any medical, psychological, or environmental cause can be divided into the following three subgroups:

Psychophysiological insomnia

In a person with previously adequate sleep, sleeplessness begins because of a prolonged period of stress. Tension and anxiety resulting from the stress causes awakening. Thereafter, sleep in such persons becomes associated with frustration and arousal, resulting in poor sleep hygiene. In most people, as the initial stress decreases, normal sleep habits are gradually restored because the bad sleep habits are not reinforced. However, in some people, the bad habits are reinforced, the person "learns" to worry about his or her sleep, and sleeplessness continues for years after the stress has subsided. Therefore, it is also called learned insomnia or behavioral insomnia.

Idiopathic insomnia

Lifelong sleeplessness is attributed to an abnormality in the neurologic control of the sleep-wake cycle involving areas of the brain responsible for wakefulness and sleep. It may begin in childhood. Those affected may have a dysfunction in the sleep state that predisposes the person towards arousal.

Sleep state misperception

The person complains of insomnia without objective evidence or symptoms of any sleep disturbance.

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