What is the Difference Between Primary and Secondary Insomnia

The key difference between primary and secondary insomnia is that primary insomnia does not occur due to an underlying issue such as health conditions, medication, pain, or substance abuse, while secondary insomnia directly occurs due to an underlying issue such as health conditions, medication, pain, or substance abuse.

Insomnia is a sleeping disorder that prevents people from getting enough sleep. The common symptoms of this condition include trouble falling asleep, trouble staying asleep throughout the night, and waking up abnormally early. Insomnia is mainly divided into two main types: primary and secondary insomnia.

CONTENTS

1. Overview and Key Difference
2. What is Primary Insomnia
3. What is Secondary Insomnia
4. Similarities – Primary and Secondary Insomnia
5. Primary vs Secondary Insomnia in Tabular Form
6. Summary – Primary vs Secondary Insomnia

What is Primary Insomnia?

Primary insomnia is a type of insomnia that is caused due to no discernable reason. Therefore, there is no direct underlying issue such as a health condition, medication, pain, or substance abuse. This type of insomnia is described as the decreased ability to fall asleep and/or stay asleep, with resulting daytime effects of sleep deprivation, such as fatigue, dozing off, and irritability. Primary insomnia is normally idiopathic, but it can be impacted slightly by mild stress. People who have a history of primary insomnia may also have a condition called sleep state misperception (SSM). In sleep state misperception, people feel that they are experiencing insomnia, although they are getting enough sleep and don’t experience daytime signs of sleep deprivation. The symptoms of primary insomnia include restlessness, feeling tired, falling asleep very easily during waking hours or daytime, trouble concentrating, moodiness, sadness, delayed sleep latency, sleep fragmentation, decreased efficiency of sleep, and reduced total sleep time in patients.

Primary insomnia can be diagnosed through medical history, physical examination, and sleep study. Furthermore, primary insomnia can be treated through non-pharmacological therapies like counselling, cognitive behavioural therapy, avoiding naps, consistent sleep schedule, managing caffeine and alcohol intake, avoiding stimulation before bedtime (bright light), and pharmacological medications such as antihistamines, benzodiazepines, and melatonin.

What is Secondary Insomnia?

Secondary insomnia is a type of insomnia that is associated with lifestyle habits and medical or psychiatric causes. It accounts for 70 to 90% of insomnia cases and is much more common than primary insomnia. The causes of this condition may include psychotic conditions like depression, mood disorders, anxiety, medical conditions like asthma, pulmonary disease, heart disease, back problems, headaches, Alzheimer’s disease, seizures, prescription medications, non-prescription drugs (over-the-counter), and substances of abuse. The symptoms of secondary insomnia may include high blood pressure, obesity, anxiety, depression, falls and fractures, frustration, memory problems, disorientation, hallucinations, strokes, crankiness, and slow reaction time in responding.

Moreover, secondary insomnia can be diagnosed through medical history, clinical evaluation, and polysomnographic (PSG) evaluation. Furthermore, secondary insomnia can be treated through pharmacological medications like low doses of hypnotics, particularly benzodiazepines, antidepressants, and pain relievers, and psychological methods such as cognitive behavioural therapy, relaxation, sleep restriction, and stimulus control.

What are the Similarities Between Primary and Secondary Insomnia?

• Primary and secondary insomnia are two types of insomnia.
• Both types of insomnia lead to sleep deprivation.
• They can be caused by stress.
• Both types of insomnia can be diagnosed through physical examination and sleep studies.
• They can be treated through pharmacological and non-pharmacological methods.

What is the Difference Between Primary and Secondary Insomnia?

The key difference between primary and secondary insomnia is that primary insomnia does not occur due to an underlying issue such as health conditions, medication, pain, or substance abuse, while secondary insomnia directly occurs due to an underlying issue such as health conditions, medication, pain, or substance abuse. Furthermore, primary insomnia accounts for 10 to 30 % of insomnia cases and is less common than secondary insomnia. On the other hand, secondary insomnia accounts for 70 to 90% of insomnia cases and is much more common than primary insomnia.

The below infographic presents the differences between primary and secondary insomnia in tabular form for side-by-side comparison.

Summary – Primary vs Secondary Insomnia

Insomnia leads to sleep deprivation. Primary and secondary insomnia are the two main types of insomnia. Primary insomnia is a type of insomnia that does not occur due to an underlying issue such as health conditions, medication, pain, or substance abuse, while secondary insomnia is a type of insomnia that occurs directly due to an underlying issue such as health conditions, medication, pain or substance abuse. So, this summarizes the difference between primary and secondary insomnia.

Reference:

1. Heidi Moawad, MD. “When Insomnia Doesn’t Have a Cause.” Verywell Health, Verywell Health, 25 Apr. 2022.
2. Pchelina, P. V., and M. G. Poluektov. “The Primary or Secondary Origin of Insomnias – Neuroscience and Behavioral Physiology.” SpringerLink, Springer International Publishing, 18 Mar. 2022.

Image Courtesy:

1. “Effects of sleep deprivation” By Häggström, Mikael (2014). “Medical gallery of Mikael Häggström 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. (CC0) via Commons Wikimedia