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Onset and Maintenance insomnia

Posted by wolverine on June 02, 2009 at 07:09:55:

This post is about whether there is a fundamental difference between onset and maintenance insomnia. IE. Is your primary problem falling asleep? Or staying asleep?

I'm amazed how many medical professionals including sleep doctors never even asked me this question. Instead we are all lumped together as insomniacs and given the same treatment options. We share the same forum "insomnia" on this sleep board.

i think there may be a difference so fundamental it warrants separate classification/treatments/medication/forums.

I'm an onset insomniac, so I'll describe what I think are the symptoms of onset insomnia in a little more detail. Maybe a maintenance insomniac could do the same.

Onset insomnia
• Extreme difficulty falling asleep but good/normal sleep if you can get over the hump.
• Nights of 0 hours sleep or 8 hours sleep. Not much in between.
• Inability to sleep at all for several days at a time during acute phases.
• On bad nights more chance of some sleep on the back end of nights (morning) than the front end (bedtime).

What I'm wondering is whether other board members classify themselves as firmly onset or maintenance insomniacs, which tends to support the hypothesis that they are different conditions. Or whether most fall somewhere in between, which doesn't.

The use of drugs can complicate things. I developed maintenance insomnia in addition to my onset insomnia after 6 months of using Z-Drugs. This was caused, I think, by their short half-life. As soon as I quit Z-Drugs my maintenance issues went away and I reverted to being a plain old boring onset insomniac.

So what kind of animal are you?

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