We all know that a good night’s sleep is important for good health. Insomnia, especially among the elderly, is among the most common complaints that doctors hear.

Individuals suffering from severe insomnia often have difficulty performing the tasks required for daily living. For elderly people, in particular, insomnia often causes complete disruption of their normal routine. Moreover, waking up feeling tired, needing to take naps throughout the day, and the inability to lead a “normal” life often lead to irritability, depression, and anxiety.

But what we may not realize is that there are a variety of ways in which sleep can be disordered.

Scientists at the Netherlands Institute for Neuroscience recently conducted a large-scale study on thousands of people in order to gain a greater understanding of insomnia. The results of their study were recently published in the journal Lancet Psychiatry.

The researchers concluded that insomnia is not a single condition. Some people have poor quality sleep, some have an insufficient amount of sleep, some find it difficult to fall asleep, and others find it difficult to stay asleep. Insomnia, they found, is composed of five subtypes, differing by personality traits, for example, depression, brain activity, and response to treatment.

Using data from approximately 4500 participants of the Netherlands Sleep Registry, the researchers identified the following five types of insomnia:

Type 1: People in this category are described as highly distressed, depressed or tense.

Type 2: People in this category are described as moderately distressed but reward sensitive, i.e., their ability to feel pleasure remains intact.

Type 3: People in this category are described as mildly distressed but reward insensitive.

Type 4: People in this category are described as slightly distressed, and have insomnia symptoms which vary widely according to their environment and the events in their life.

Type 5: People in this category are described as only slightly distressed, and have insomnia symptoms which do not vary widely with their environment or the events in their life.

After identifying these five independent categories, the researchers conducted a study with more than 250 new volunteers from the Netherlands Sleep Registry, and confirmed their initial categorization.

After five years, the researchers reevaluated volunteers from the original sample of participants and determined that most of them continued to suffer from insomnia, and more importantly, most of them were categorized as having the same type of insomnia as they had five years earlier. This result indicated that the new classification system had a high degree of stability.

Several important and measurable differences were discovered between individuals in the five distinct insomnia categories. One particularly important difference was that electroencephalograms showed distinct differences in the brain’s response to external stimuli. Research also revealed that individuals from the five different insomnia categories reacted differently both to medications and cognitive behavioral therapy. Indeed, the risk of developing depression was five times greater between the groups.

It is noteworthy that the researchers discovered that the symptoms of insomnia experienced by individuals in these five categories, for example difficulty falling asleep or difficulty staying asleep, did not vary.

However, by distinguishing the aspects of insomnia that varied according to personality factors, the concept of developing personalized and effective treatments has become more likely. Indeed, researchers are currently working on ways to prevent or treat depression in people with Type 1 insomnia. They hypothesize that treating individuals for the depression associated with Type 1 insomnia will help them overcome their insomnia.

Beacon of LIFE, in Oceanport, NJ, is a government-approved PACE program created to provide seniors, their family, caregivers and professional health care providers the flexibility to meet their health care needs while continuing to live in their community.

Beacon of LIFE maintains an interdisciplinary team of professionals who give each client the coordinated care they need. Our staff specialize in working with older people, and work with each client and their family to develop the most effective plan of care.

Our care and services allow people who would otherwise need to live in a nursing home to live where they want — in their own communities, in their own homes.

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