Severe Insomnia is not a true medical diagnosis. It is a condition with symptoms that vary from person to person.
Why? Because each individual who describes their own insomnia as “severe” is using their own subjective experiences, background and thoughts to create that definition. One person’s severe insomnia might be another’s “slighty worse than normal” insomnia. It is a general term with variable interpretations.
I’ll give you my definition of severe insomnia as…
- Insomnia that has lasted more than a month.
- Involves at least three or more completely sleepless nights per week.
- When sleep does come, it is restless and doesn’t last long.
- Daytime functioning is definitely impaired.
- There is little sign of improvement using sleep hygiene methods.
- Medications help very little or the dosage must be increased often to still be effective.
- There is no known physical or mental cause of the sleeplessness (in other words, it is primary).
Have I ever personally had severe insomnia? Not by my own definition.
I have had what I call serious chronic insomnia, and I’ve had severe secondary insomnia (insomnia caused by a direct factor) but no, I haven’t had severe insomnia. Why? Because I have always been able to respond to medication, and I have always been able to link my insomnia to a cause — either physical (such as a drug side effect) or mental (such as sleep anxiety or other anxiety disorders).
If I changed my definition of severe insomnia by deleting the last two symptoms in my list (medications not helping and no known physical or mental cause), then I can say that yes, I have suffered from it.
What is Your Definition?
If you believe you are suffering from severe insomnia, how do you define it?
Do you define it, as most people do, simply by how few hours of sleep you get per night? Or do you add the other items as I have done?
Why do I have such a strict and limited diagnosis of severe insomnia?
Because I personally don’t like to use words like “severe” without having a really good reason. It’s a harsh word, and one that can add anxiety to a condition – insomnia – that already may have an anxious component to it.
I believe that both mind and body have great healing potential, and I just don’t like to put strong diagnoses on conditions that in most cases can be completely healed once you find the right approach.
So if you still think you have severe insomnia, write a list as I did above, of all your symptoms. Make sure you ask yourself these questions:
- When did my insomnia begin?
- How long has it lasted so far?
- How many hours of sleep have I gotten every night since it started? (NOTE: if you don’t know the answer to this one, you need to start your sleep diary ASAP – tonight – so you can have concrete evidence of what type of insomnia you have.)
- What is the quality of my sleep when it does come? Is it light and restless, or deep and solid?
- How has my insomnia responded to any changes I’ve already made in my sleep schedule, pre-sleep routine, diet and exercise routines? (NOTE: if you have not tried any of the changes I recommend in the Self-Help Tutorial, go there now to begin – then keep your sleep diary faithfully to see what the results are.)
- What medications have I tried, if any, to get some sleep, and have they helped on those particular times? (NOTE: if you haven’t tried any, that’s fine, you don’t have to – this isn’t a plug for drugs, it is simply a question to help you evaluate the severity of your insomnia.)
OK, here’s the last question that is, in my opinion, the most important.
What is going on in my life right now that could be causing my insomnia?
Make a list of every change, good or bad, that could be triggering your insomnia. Then divide them into
- Physical changes (menopause, chronic illness, pain, allergies, restless leg syndrome, overweight, etc.)
- Mental changes (new job, lost job, new school, graduation, new partner, breakup of relationship, other relationships, personal loss, any other life turning point, big or small)
- Environmental changes (new home, remodeling, air quality problems, noise problems, lighting problems, etc.)
- Behavioral changes (new diet, new exercise program, stopping exercise, changes in caffeine/ alcohol/ food consumption/ different sleep schedule, different job hours,
new baby, new pets, etc.)
If you cannot find one single thing that has changed in your life, you can then consider subconscious mental causes and unknown physical causes. Let’s try them both.
- Subconscious causes – these are things going on in your subconscious mind that you simply don’t know about. Either a life change is affecting you more than you think or no life changes (too much of the same) are affecting you in ways you don’t know or understand. Emotional stress and disruption do not need a direct, known trigger – sometimes, in fact, certain emotions pop up when things are quiet and stable, with no distractions to keep you busy.
- Unknown physical causes – these are physiological causes that you haven’t yet become aware of. These could include thyroid conditions, diabetic conditions, hormonal imbalances, sleep apnea… and many other things. This is why a complete physical exam is a good first step in any medical treatment of insomnia, especially if you haven’t had one for a while.
If all possible causes comes up negative, even after serious reflection… yet your sleeplessness nights persist… you could then say you have severe insomnia.