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Primary Insomnia (cont.)

What are the signs and symptoms of primary insomnia?

Patient Comments

Psychophysiological insomnia symptoms:

  • Sleep disturbance varies from mild to severe.
  • Sleeplessness may manifest as difficulty falling asleep or as frequent awakenings in the night.
  • Persons with insomnia often find that they can sleep well anywhere else but in their own bedroom.
  • Persons with this type of insomnia tend to be more tense and dissatisfied compared to good sleepers. Emotionally, they are typically repressors (suppress their feelings), denying problems.

Idiopathic insomnia symptoms:

  • Insomnia is long-standing, typically beginning in early childhood.
  • Persons with idiopathic insomnia often complain of difficulties with attention or concentration or hyperactivity.
  • Emotionally, persons with childhood-onset insomnia are often repressors, denying and minimizing emotional problems.
  • Individuals often show atypical reactions, such as hypersensitivity or insensitivity, to medications.
  • Insomnia tends to persist over the entire life span and can be aggravated by stress or tension.

Sleep state misperception: Persons complain of insomnia subjectively, while sleep duration and quality are completely normal. They typically do not display daytime sleepiness or other signs of poor-quality sleep. These people may be described as having "sleep hypochondriasis." They may subsequently develop anxiety and depression.

What causes primary insomnia?

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.

Medically Reviewed by a Doctor on 8/26/2016
Medical Author:

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Patient Comments & Reviews

The eMedicineHealth doctors ask about Primary Insomnia:

Primary Insomnia - Exprience

Please share your experience with primary insomnia.

Primary Insomnia - Medications & Side Effects

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Primary Insomnia - Symptoms

What are the symptoms of your primary insomnia?

Primary Insomnia - Home Treatment

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Read What Your Physician is Reading on Medscape

Primary Insomnia »

Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause.

Read More on Medscape Reference »


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