Sleep disruption vs. insomnia: what’s the difference?

There are different ways chronic insomnia is described and diagnosed. Clinically, it’s usually defined by persistent difficulty initiating or maintaining sleep despite adequate opportunity, together with dissatisfaction with sleep and associated daytime impairment.

I agree with that definition, but I don’t find it complete enough for understanding what we are dealing with and how we can address it. I think it’s helpful to expand on it and distinguish between different origins of sleep difficulties. What one person calls “insomnia” might be a completely different problem from what I’m talking about here.

Before I continue, I want to highlight that this article isn’t meant to diagnose anything; it simply expands on certain words that I use in my content. I think aligning the definitions in one place can help us better understand the teachings.

Definitions

Sleep is naturally variable and can be disrupted for many reasons: physical pain, hormonal changes, stress, medications, the environment we sleep in, parenting, jet lag, and so on. When the original source of sleep disruption gets resolved, or we adjust to the situation, sleep often improves on its own. While this may still fall under the clinical definition of insomnia, I prefer to call it sleep disruption.

But something different can happen when we start labeling the absence of sleep as a threat and become overly concerned and fixated on it. This can create a self-sustaining cycle, which is what I refer to as insomnia. The original source of sleep disruption might be long gone, but the worry, concern, fixation, and attempts to control sleep remain, leading to a persistent struggle with sleep.

So this is the distinction I make:

Sleep disruption is the absence or disturbance of sleep caused by an external or non-sleep-related factor.

Insomnia is the fear and struggle around sleep disruption developing into a self-sustaining cycle.

Importantly, two people could experience a similar amount of sleep disruption while having a very different relationship with it.

• A university student pulls an all-nighter to study or party. The next day he is likely to feel tired and sleepy, but he’s unlikely to experience emotional torment over the sleepless night.
• Another person spends the night scared of not sleeping and trying really hard to make sleep happen, but ends up awake all night. The next day he may feel just as tired and sleepy, but on top of that he feels dreadful and hopeless about what happened.

First helpful step

When a person starts struggling with sleep consistently, it’s also reasonable to investigate what might be disrupting their sleep first. A health check-up can be a helpful first step to look for physiological factors that might be addressed.

Oftentimes, a check-up doesn’t reveal an obvious physiological problem. That already narrows down our investigation and makes fear of not sleeping and the struggle around it a more plausible explanation – particularly when we can see signs of that struggle in the person’s thoughts and behaviours.

Can sleep disruption and insomnia overlap?

Absolutely, and it happens quite often.

• A mother of a newborn might wake up many times a night to feed her baby while also feeling intense pressure to sleep and struggles to sleep whenever the baby sleeps.
• A person living next to an airport might have their sleep repeatedly interrupted by noise while also living in fear of their sleep being disrupted.
• A man experiencing stress at work might have his sleep disrupted by that stress while also excessively worrying that a lack of sleep will make his work situation worse.

In each case, there may be a genuine source of sleep disruption and a secondary struggle developing around that disruption.

Can we overcome insomnia while facing sleep disruption?

We absolutely can! Life gives us plenty of reasons for our sleep to be disrupted. We can and should take reasonable steps to address the source when it clearly bothers us – in a measured and non-panicky way. But the fear of not sleeping isn’t necessarily resolved by trying to eliminate sleep disruption altogether.

My experience has shown me that it’s possible to break the vicious cycle of insomnia without eliminating sleep disruptions completely. Sleep disruptions may and will happen to all of us at different points in life. But living in fear of them isn’t necessary.

And that’s what we can address in insomnia recovery: accepting life in all its variety while learning to stop treating the absence of sleep as an immediate danger.