5 types of insomnia A research group based in the Netherlands that rather than being one single condition, insomnia actually has 5 robust sub-types. The science behind this claim is relatively complex, the paper is 83 pages long, but the simple message is that while people with insomnia across the sub-types do not necessarily differ in their ability to fall asleep and stay asleep there are differences in their response to the various treatments used for poor sleep. In recent years Cognitive Behavioural Therapy for insomnia (CBT-I) has become the first line treatment for insomnia but this recent research has shown that while effective for some sub-types it is liable to be unsuccessful fir others. The research also shows that some people would benefit more from being treated with sleeping tablets than with CBT-I, against the prevailing negative view against sleeping tablets. Another finding is that different sub-types have markedly different prevalence’s for the development of depression. This research only came out on two weeks ago so of course it has had no time to percolate into clinical practice, but it is a ‘game-changer’ and may explain why some of you have had a less than successful treatment outcome. In my opinion the medical profession and therapists need to quickly learn from this study and stop treating everyone with insomnia as though the are suffering from the same problem and thus to treat them accordingly. Blanken, T.F., Benjamins, J.S., Borsboom, D., Vermunt, J.K., Paquola, C., Ramautar, J., Dekker, K., Stoffers, D., Wassing, R., Wei, Y. and Van Someren, E.J., 2019. Insomnia disorder subtypes derived from life history and traits of affect and personality. The Lancet Psychiatry, 6(2), pp.151-163. here