Idiopathic insomnia: Symptoms and treatment

Doctors used to use the term “idiopathic insomnia” to describe difficulty sleeping that began in childhood for no identifiable reason. However, sleep specialists no longer consider it to be a medical condition.

Idiopathic insomnia previously appeared in the International Classification of Sleep Disorders (ICSD), a manual doctors use to diagnose sleep-related conditions. However, the authors removed it from the manual’s third edition (ICSD-III) due to concerns the diagnosis might not be valid. Sleep Disorder

Idiopathic insomnia: Symptoms and treatment

Today, doctors consider these symptoms part of chronic insomnia or insomnia disorder, which is persistent difficulty sleeping that lasts at least 3 months.

Keep reading to learn more about idiopathic insomnia, including its symptoms, causes, diagnosis, and treatment.

Idiopathic insomnia, or childhood-onset insomnia, was a sleep disorder diagnosis that appeared in previous editions of the ICSD. It involved long-term difficulty getting enough sleep, beginning in childhood.

Medical News Today reached out to Dr. Alex Dimitriu, who founded Menlo Park Psychiatry & Sleep Medicine and is board certified in psychiatry and sleep medicine, for his definition.

“Essentially, this is insomnia that is not due to any particular cause, such as anxiety, alcohol, caffeine, or jet lag,” explains Dr. Dimitriu. “It is also not associated with another sleep disorder and is not linked to a mental [health condition], substance use, or a general medical condition.”

“The sleep disturbance causes significant impairment in occupational, academic, social, behavioral, or other areas of functioning,” adds Dr. Dimitriu.

The ICSD-III simplifies several insomnia subtypes into three categories:

The symptoms of idiopathic insomnia are the same as those that fit the current definition of chronic insomnia disorder. These include:

For a person to qualify as having chronic insomnia, they must experience symptoms persistently for at least 3 nights per week for more than 3 months. There must also be no other explanation for the symptoms, such as:

Previously, doctors believed a person could not have idiopathic insomnia if a mental health condition, such as anxiety, was responsible for the symptoms. They referred to this as psychophysiological insomnia.

However, the newer definition of chronic insomnia does not have this stipulation. A person can still have chronic insomnia if the coexisting mental health condition does not adequately explain it.

Because there is no test for chronic or idiopathic insomnia, doctors make a diagnosis based on a person’s symptoms. They may also perform tests to rule out other explanations. For example, a sleep study could rule out narcolepsy or sleep apnea.

It can be difficult to distinguish between insomnia that is a symptom of a mental health condition and chronic insomnia. This may be especially true for children, who may have difficulty explaining their thoughts and feelings.

If conditions such as anxiety or depression could be a factor, a doctor may also refer the person to a mental health professional for an evaluation.

The term “idiopathic” means unknown. However, sleep experts are still debating whether people can really have insomnia with no cause.

Chronic insomnia has many potential causes, so it may be that in some cases, the factors are simply difficult to identify.

A few of the known causes of insomnia include:

Treatment for chronic insomnia may involve:

Cognitive behavioral therapy for insomnia (CBT-I) is a type of talk therapy experts have adapted for those with persistent sleep difficulties. “For insomnia, CBT consists of changing and challenging one’s beliefs about sleep and not getting enough of it,” said Dr. Dimitriu.

According to a 2019 review, CBT-I can have a similar impact to sleep medication, without causing side effects. In addition to addressing a person’s thoughts and feelings, CBT-I also looks at behaviors that may help with sleep, such as sleep hygiene and sleep consolidation.

Sleep hygiene involves making changes in a person’s daily routine that promote sleep. For example, they may limit the use of electronics at night and avoid using caffeine, alcohol, or nicotine.

“Keeping regular bed and wake times helps a lot, too, as sleep loves rhythm and regularity,” continues Dr. Dimitriu. “Patterns of oversleeping and under-sleeping can also be unhealthy. It is better to avoid oversleeping if possible because this can lead to insomnia the next night.”

Sleep consolidation refers to only using the bed for sleep, and getting up if sleep does not come. This aims to reduce the pressure a person may feel to fall asleep.

These approaches help relax the nervous system. They can be part of CBT-I, or a person can learn them on their own.

“For teenagers, learning to quiet the mind and even meditate for 10 minutes per day can be helpful in slowing the brain down for sleep,” elaborates Dr. Dimitriu, who reminds clients “to start slowing down and turning off screens at about 10 p.m., which helps foster the transition to sleep.”

Other relaxation and mindfulness practices include:

Doctors may consider prescribing a medication to help with sleep where other interventions have not worked.

Difficulty sleeping from childhood on may be due chronic insomnia or another type of sleep disorder. Potential explanations include:

People who are having persistent difficulty getting to sleep or staying asleep may wish to speak with a doctor or sleep specialist. There are several types of insomnia and many possible causes, which a doctor can help identify.

Living with insomnia can be challenging, physically and emotionally. People may find it helpful to join support groups or forums with people having the same experiences. These groups can offer practical tips for managing the condition and help people feel that they are not alone.

Idiopathic insomnia was a condition doctors used to diagnose in people who had insomnia from childhood for no clear reason. Today, it no longer appears in diagnostic manuals due to concerns over its validity.

Instead, people with these symptoms may receive a diagnosis of chronic insomnia. Treatment for chronic insomnia can vary depending on the cause, but may include CBT-I, sleep hygiene techniques, stress reduction, and medication if behavior changes do not help.

Last medically reviewed on February 20, 2023

People with insomnia may experience symptoms such as poor concentration and tiredness. Learn more about the disorder here.

Idiopathic insomnia: Symptoms and treatment

Delayed Sleep Phase It is rare for insomnia to be a mental illness. Instead, it is typically a symptom of another medical condition. Learn more here.