Three Classes of Insomniacs

by: Joseph Collins, MD

The causes of insomnia are countless, varying from an unkind word to a serious mental or bodily illness. It facilitates recognition of the causes of insomnia to classify the conditions to which it bears relationship. For instance, one class of patients have great difficulty is getting to sleep. If they are allowed to prolong their slumbers into miring, there are usually no ill consequences, but as duty compels them to rise at a stated time, many of them suffer from the effects of curtailed sleep and it is this class particularly in whom fear of not getting to sleep and distressing impotent efforts to secure sleep combine to exhaust the victims strength and energy. This variety of sleeplessness has a fairly uniform causation. It is dependent upon mental conditions, excitement, fear, dread, anxiety, overwork and use of intoxicants or stimulants, particularly tea. Not frequently such insomnia has its beginning in intentional and deliberate curtailment of sleep, in order to give more time to work.

It is commonest form of sleeplessness in those who carry their troubles and their labors to bed with them. It is the sleeplessness which afflicts the individual who has engaged in an argument or altercation where perhaps his vanity has been wounded or his feelings hurt. It is the form of insomnia experienced by the anxious mother, the possessor of a weak heart, or by the individual who has recently been listening to the plaudits attending his efforts.

Another class of insomniacs is made up of those who experience a profound drowsiness terminating, often against the patients will, in refreshing, slumber of variable duration which comes on early in the evening, followed either by repeated and apparently causeless awakenings, or by abrupt and complete awakenings, or by abrupt and compete awakening with mental alertness, but often with depression of spirits. Here again the ego which dominates the individual takes great delight in unwinding a scroll upon which is written in glittering letters a record of the infirmities of the spirit, or upon which is painted by the unforgotten brush of memory certain bitter or miserable incidents in the past, the contemplation of which revived the old emotions, awakens the old suffering and banished all possibility of sleep. Insomnia is this kind is most commonly associated with some variety of self-poisoning usually arising from indigestion and constipation and that is technically called ‘auto-intoxication.” Occurring in persons after middle life, it is not infrequently an expression of impaired elasticity of the blood vessels, the beginning of that disease whish is now having what might be called a conventional popularity, viz – arterio-sclerosis. This form of disturbed sleep is of course much more common in so- called nervous persons, especially in those how take alcoholic stimulants, than in phlegmatic individuals. Physicians have found out that the early manifestations of disorder of the circulation of the blood may be recognized more unmistakably by certain methods of instrumental examination than by any other means. They have learned also that this condition can be cured.

The third variety of sleeplessness, classifying sleeplessness now according to the time of its occurrence, is technically spoken of as dipsomania in contradistinction to insomnia. Here the adequate number of hours is apparently obtained by there is lacking that feeling of refreshment and invigoration which should come after normal sleep. The tired body and then exhausted mind craves sleep so keenly that at first it comes on very profoundly and then abruptly, the victim awakens to find his mind is carrying on its particular problems at exactly the same point, and in quite the same way, as before he went to sleep.

About the Author

Joseph Collins, MD