Primary Insomnia


Primary insomnia occurs in up to 10% of adults and up to 25% of elderly adults and appears slightly more common among women. The cause of primary insomnia can be different for each individual but often involves a preoccupation with the inability to sleep or excessive worry about sleep, which in turns causes the individual to not sleep. Many report that they sleep better away from home, suggesting that conditioning related to the bedroom has occurred, and resulting in bouts of sleep while watching TV, being a passenger in a car, or other area not associated with the bedroom.


The criteria for a diagnosis of primary insomnia include a difficulty falling asleep, remaining asleep, or receiving restorative sleep for a period no less than one month. This disturbance in sleep must cause significant distress or impairment in social, occupational, or other important functions and does not appear exclusively during the course of another mental or medical disorder or during the use of alcohol, medication, or other substances.


Treatment often involves relaxation and adhering to a predetermined sleep cycle. The individual sets a schedule of when he or she will sleep and does not allow sleep to occur at any other time. For instance, she may get into bed at 11pm each night and get out of bed at 6am every morning regardless of the amount of sleep that occurs. No sleeping would be allowed during the day and the individual would engage in exercise, healthy eating, and would then use relaxation techniques prior to the scheduled sleep time.


Prognosis is good as the body has a need for sleep and will often adjust to make up for the lack of sleep. When associated with stressors, sleep will often return to normal once the stressors is no longer a significant concern.