Primary chronic insomnia refers to problems with sleeping which do not have a direct cause – such as health or physical. It can be simply be due to developing and getting used to bad sleeping habits. Secondary chronic insomnia is where sleeping problems have an underlined cause, such as medical, physical or environmental, e. g. depression or heart disease. It is typical to be experienced by people who have shift work, as their circadian rhythm is not used to a sleeping pattern therefore the individual may have difficulties falling asleep.
Older people also tend to experience insomnia due to discomfort when sleeping. They tend to spend less time in deep sleep (SWS) therefore can be woken up easily during sleep. Teenagers also suffer from secondary chronic insomnia due to experiencing phase delay, where they tend to go to sleep later. One explanation of insomnia is depression. DSM showed that insomnia is a symptom of depression. Research has showed that it is very important to diagnose if the individual is suffering from another condition, such as depression.
This is because in order to treat insomnia, the underlining cause should be treated first, as it is unhelpful to treat the symptom but not the cause. However, this is not as simple. Insomnia and depression correlate, therefore it is difficult to say if insomnia is caused by depression or if depression is caused by insomnia. Chronic primary insomnia is developed by short term insomnia. Short term insomnia tends to last less than 4 weeks, however, when the individual gets used to bad sleeping habits, their expectations of insomnia will move onto developing chronic primary insomnia.
Storms and Nisbett used this to develop a ‘reverse placebo effect’. They found that individuals suffering from insomnia went to bed earlier when they took the placebo pill, believing it is an arousal pill, than usual nights. They fit themselves in with the arousal pills rather than insomnia, relaxing and letting themselves fall asleep. This supports the argument that individuals expectations on bad sleep can lead to insomnia, and a further belief will lead to chronic primary insomnia. There are studies which link sleeping habits and exercise. Baron looked at women between the ages of 57-70, focusing on exercise and their sleep diaries.
Tracing monitor used to see how long to fall asleep when woke up. After 6 week exercise programme the women had better sleep habits, and showed more improvement in sleep (slept extra 46min). This shows that other factors such as physical exercise may have an impact on our sleep. Research suggests that there are also gender differences in insomnia. There are gender differences in the diagnosis in both primary and secondary insomnia, more women tend to suffer from insomnia than men. Morin et al. suggest that this may be due to a higher level of neuroticism and anxiety in women than men.