Other Specified Insomnia Disorder

The symptoms of both forms of other specified insomnia disorder can closely resemble the symptoms of insomnia, with behavioral, psychological, physical, and cognitive impacts, such as difficulty in initiating or maintaining sleep, daytime tiredness, and loss of concentration. 

Behavioral symptoms

Potential behavioral symptoms of other specified insomnia disorder include the following: 

• Difficulty falling asleep (in children, this symptom can extend to difficulty falling asleep without a caregiver present)
• Waking up frequently throughout the night
• Having trouble falling back asleep after waking up in the middle of the night
• Waking up in the early morning (such as before 4 am for people on a nine-to-five work schedule) and being unable to fall back asleep if desired
• Napping throughout the day
• Erratic and inconsistent sleep schedules
• Spending significant amounts of time in bed
• Sleeping better when traveling or away from one’s bedroom
• Acting “wired,” despite subjective experience of exhaustion
• Negatively impacted interpersonal relationships and social life
• Reduced work productivity
• Increased risk of accidents

Psychological symptoms

Below are some of the psychological symptoms of other specified insomnia disorder: 

• Irritability
• Mood swings
• Sadness
• Thoughts of worthlessness or hopelessness 
• Anxiety
• Heightened reactivity to stressors

Physical symptoms

Insomnia disorders can cause physical symptoms, such as the following: 

• Fatigue
• Daytime sleepiness
• Tension headaches
• Muscle aches and pains
• Gastrointestinal disturbances

Cognitive symptoms

Cognitive symptoms of other specified insomnia disorder include the following: 

• Impairments in memory, attention, and concentration
• Difficulty completing daily or repetitive tasks
• A preoccupation with or excessive worry about sleep, to the point that thinking about sleep can keep one awake at night and become a cycle

There is no one definitive cause for other specified insomnia disorder that has been identified, like most sleep-wake disorders. However, various biological, psychological, and environmental influences may lead to the condition's onset. 

Environmental risk factors

Environmental risks for other specified insomnia disorder include the following: 

• Changes in sleep schedule or sleep environment, such as relocating, starting a new work schedule, or becoming a new parent
• A lack of a consistent bedtime routine in childhood
• Unhealthy sleep habits, such as using screens in bed
• Irregular sleep schedules
• Living in an area with higher altitude
• Excessive caffeine consumption 

Psychological risk factors

The psychological risks for the onset of an insomnia disorder, including one otherwise specified, include but are not limited to the following: 

• The presence of specific mental health conditions, such as bipolar disorder, depressive disorders including major depressive disorder, anxiety disorders, substance use disorders, post-traumatic stress disorder (PTSD),⁴ and schizophrenia⁵ 
• A predisposition toward worrying
• A tendency to internalize conflict and repress or suppress emotion

Biological risk factors

Some biological risk factors may exist for insomnia disorders, such as the following: 

• Being assigned female at birth (AFAB) 
• A history of “light” sleeping that is easily disturbed
• Experiencing recent childbirth
• Having parents or siblings with a history of insomnia
• Going through menopause
• The presence of certain medical conditions, such as diabetes, coronary heart disease, chronic obstructive pulmonary disease (COPD), arthritis, fibromyalgia, or chronic pain 
• Older age, which also increases the potential for developing other medical conditions

As the American Psychiatric Association explains, in some cases involving mental health and medical conditions, it is not clear whether symptoms of other specified insomnia disorder led to the mental health or medical conditions, or if the mental health and medical conditions led to symptoms of other specified insomnia disorder. In some cases, when an individual experiences insomnia that results from another medical condition, it may be referred to as secondary insomnia. 

The goal of treatment for other specified insomnia disorder, as with other sleep disorders, is often to achieve consistently restful sleep. Treatment may involve a combination of therapy and different sleep hygiene techniques, though medication can also be prescribed. 

Medication

There are various medications approved or indicated to treat symptoms of insomnia disorders. Some can have dangerous side effects, such as disorientation and risk of sleep activities such as sleepwalking or driving while asleep. Others can be habit-forming. Most are available only through a prescription from a licensed healthcare professional, and most are not intended to be taken long-term, but rather only for a few days or weeks as needed.

Medications for other specified insomnia disorder may include:

• Benzodiazepine receptor agonists (BZRAs): These medications are designed to address insomnia symptoms and include zaleplone, zolpidem, zopiclone, eszopiclone, and others. These pills may cause daytime grogginess and, for older adult patients, increase the risk of falls. They can also be habit-forming. These medications can cause life-threatening withdrawal symptoms if discontinued abruptly after long-term use. 
• Benzodiazepines: Benzodiazepines are a class of medications commonly prescribed to treat anxiety but also used for sleep. This category of medications includes diazepam, flunitrazepam, flurazepam, lormetazepam, nitrazepam, oxazepam, temazepam, triazolam, and others. They can be addictive and habit-forming and are typically prescribed to treat insomnia symptoms only in acute cases, such as while recovering from serious surgery. These medications can cause life-threatening withdrawal symptoms if discontinued abruptly after long-term use.
• Sedating antidepressant medications: Some antidepressants have demonstrated promise in addressing symptoms of other specified insomnia disorder. These medications include agomelatine, amitriptyline, doxepin, mianserin, mirtazapine, trazodone, trimipramine, and others. These medications also have serious side effects ranging from headaches and daytime sleepiness to priapism.
• Orexin receptor antagonists: Orexin receptor antagonists, such as suvorexant, inhibit the bodily processes that cause a person to wake up. These medications are less habit-forming than other forms of insomnia medication but may result in sleepwalking or participating in other activities while asleep.
• Over-the-counter sleep medication: Over-the-counter sleep medications are often antihistamines like diphenhydramine. They are generally not recommended by healthcare professionals to treat insomnia due to side effects and lack of effectiveness over other options.
• Melatonin receptor agonists: Medications like ramelteon act on the same receptors that melatonin does and is used to treat insomnia. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Self-care for other specified insomnia disorder

Self-care can be an essential component of treating other specified insomnia disorder or another sleep disorder, particularly self-care that focuses on practicing sleep hygiene. Sleep hygiene involves creating a regular bedtime routine that promotes restfulness and avoiding activities that interfere with sleep. Examples of healthy sleep hygiene practices include:

• Going to bed and waking up at around the same time every day, regardless of whether it’s a workday or a weekend
• Keeping the sleeping area dark, cool, and quiet
• Avoiding naps during the day
• Not using screens (cell phones, TVs, laptops, tablets) in the bedroom 
• Limiting how much liquid one consumes close to bedtime to prevent needing to get up and use the restroom
• Avoiding caffeine, alcohol, and nicotine before bed
• Exercising regularly and ensuring not to exercise vigorously too close to bedtime
• Not eating large meals late at night

Other specified insomnia disorder can lead to several complications in one’s daytime life. Exhaustion, fatigue, and sleepiness during the day may make the thought of an additional obligation, like attending a therapy appointment, seem overwhelming. In these instances, online therapy may be a beneficial option. With online therapy through a legitimate platform like BetterHelp, individuals can meet with a therapist from the comfort and convenience of their homes. 

Additional resources for finding support in addressing other specified insomnia disorder include the US Centers for Disease Control and Prevention (CDC), whose page on sleep and sleep disorders includes statistics on sleep disorders, information on research projects regarding sleep disorder treatments, and a compilation of patient support groups, including for specific disorders. The National Sleep Foundation (NSF), a non-profit organization dedicated to improving sleep health, provides education on sleep-related topics and advocates for funding to be allocated to sleep disorder research.

Research has consistently demonstrated a link between poor sleep quality and an increased likelihood of developing mental health disorders. Given the adolescent mental health crisis in the United States and the increased susceptibility of this population to symptoms of insomnia, it can be crucial to better understand how sleep disorders, including other specified insomnia disorder, can impact teenagers. 

A study found that several factors can lead to the development of insomnia symptoms in adolescents. These factors may include:

• Puberty and the associated hormonal and physical changes
• Worry and anxiety about school
• Increased stress levels, worsened emotional well-being, and heightened susceptibility to depression in teen girls, all of which occur at higher rates for this demographic than teenage boys
• Use of smartphones, laptops, and video game consoles in the bedroom or close to bedtime
• Increased levels of energy drink consumption among teens

Another recent research study examined the use of light therapy as a non-pharmacological alternative treatment for insomnia symptoms. Light therapy, or sitting in front of a device that emits high levels of light, like a lightbox, has been used to combat symptoms of seasonal affective disorder (SAD). Researchers wanted to know if the practice could also address sleep disorders, including other specified insomnia disorder. 

The study found that light therapy exposure in the morning after waking contributed to improved sleep efficiency and fewer wake-up periods during the following night. These results suggest that light therapy may reset the body’s circadian rhythms, also referred to as the “biological clock,” meaning it could be an effective treatment for sleep disorders like other specified insomnia disorder.

Below are several critical statistics on insomnia disorders as a whole: 

• 33% of adults experience insomnia symptoms at some point during their lives. 
• The age group most likely to experience “short sleep” (defined as sleep of seven hours or less) are adults aged 25 to 44 years old.
• In one representative sample, 45% of people with depressive disorders also experienced symptoms of insomnia.
• Between 70% and 80% of people with insomnia symptoms who go through a course of CBT-I treatment experience a reduction in symptom severity.

Insomnia Disorder