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What Is Chronic Insomnia

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How Does Chronic Insomnia Affect Sufferers

Acute vs. Chronic Insomnia | Insomnia

Disrupted sleep can have severe effects on your health and well-being because, as Dr. Thornber says, lack of rest “puts the body under pressure.”

Chronic insomnia in particular can disrupt many different areas of your life including, “your sex drive, your memory, and your judgment.” As well as that, “being low on energy can lead to feelings of anxiety, depression, or irritation.”

What Is Chronic Insomnia

Insomnia is a sleep disorder characterized by difficulty falling asleep or remaining asleep. According to the World Health Organization, insomnia can be recurrent or episodic and is defined as difficulty falling asleep or trouble staying asleep.

If you have insomnia, you may not feel rested or refreshed when you wake up. This is because of poor quality sleep caused by insomnia. Daytime fatigue is also another sign of insomnia in which impairment is seen in social, occupational, and other important areas of functioning.

Chronic insomnia is the long-term recurrence of sleep difficulty. Continue reading to learn more about the causes and symptoms of chronic insomnia, as well as potential treatments.

Causes Of Chronic Insomnia

Lets take a closer look at some common causes of chronic insomnia including the above-mentioned factors and more.


With over 77% of people experiencing stress that affects their physical health and another 73% reporting a negative impact on their mental health, stress is one of the main causes of chronic insomnia.

Ongoing stress over everything from work and finances to your health or relationships can keep your mind alert and active at night. This makes it difficult to fall and stay asleep. In addition to everyday stress, traumatic events or major life changes can also cause chronic insomnia. These include a death, divorce, career change, or move.

Medical Conditions

Because most forms of chronic insomnia are secondary , medical and health issues are often the culprit.

Here are some of the most common health conditions that may also accompany chronic insomnia.

  • Respiratory conditions
  • Diabetes
  • Restless leg syndrome
  • Menopause

These are just a few medical conditions that can make it difficult for you to fall and stay asleep. For many, these conditions cause ongoing medical issues, which lead to chronic insomnia.


In addition to dealing with health conditions that may cause chronic insomnia, the medications you take could also make it difficult to fall and stay asleep.

  • Antidepressants
  • Some cold and allergy medications
  • Chemotherapy drugs
  • Laxatives
  • Alcohol, nicotine, and illicit drugs
Lifestyle Choices

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Definition Of Chronic Insomnia

Although there are various definitions of chronic insomnia, the most widely accepted is the one that defines it to be a condition characterized by “inadequate quantity or quality of sleep characterized by a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment and has persisted for at least one month”. The causes of this are many, the most important of which are medications, drug or alcohol abuse, psychiatric disorders like depression or anxiety, medical disorders , poor sleep hygiene, and other disorders like sleep apnea, periodic limb movements, conditioned insomnia , restless legs syndrome, circadian rhythm disorder or advanced/delayed sleep-phase syndrome. Neurological causes such as fibromyalgia and Morvan’s syndrome, medical causes such as gastroesophageal reflux disease, and in children, sleep-onset association disorder and limit-setting sleep disorder also need to be identified and addressed since these can commonly present as chronic insomnia.

Types Of Chronic Insomnia

Major signs, symptoms and causes of insomnia and the ...

There are two main types of chronic insomnia: primary and secondary.

Primary insomnia isnt due to other medical conditions or medications and is poorly understood by scientists. Specialized MRI scans are being used to study this condition. Primary insomnia may be related to changes in levels of certain brain chemicals, but research is ongoing.

Secondary insomnia is caused by other conditions or situations. This means that its a symptom that goes along with some medical issues, such as emotional stress, trauma, and ongoing health problems certain lifestyle patterns or taking certain drugs and medications.

Chronic insomnia can cause symptoms at night as well as during the day and can interfere with your ability to go on with your daily tasks.

Symptoms may include:

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What Are The Causes Of Insomnia During Pregnancy

Multiple factors can cause insomnia during pregnancy:

  • Discomfort: Increased weight and changed body composition can affect positioning and comfort in bed.
  • Disrupted Breathing: Growth of the uterus places pressure on the lungs, creating potential for breathing problems during sleep. Hormonal changes can increase snoring and the risk of central sleep apnea, which involves brief lapses in breath.
  • Reflux: Slower digestion can prompt disruptive gastroesophageal reflux in the evening.
  • Nocturia: Greater urinary frequency can create the need to get out of bed to go to the bathroom.
  • Restless Leg Syndrome: The exact cause is unknown, but pregnant women have a greater risk of RLS even if they have never had symptoms before becoming pregnant.

Studies have found that more than half of pregnant women report sleeping problems consistent with insomnia. In the first trimester, pregnant women frequently sleep more total hours, but the quality of their sleep decreases. After the first trimester, total sleep time decreases, with the most significant sleeping problems occurring during the third trimester.

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The Challenge Of Using Herbal Remedies For Treatment Of Insomnia Is That There Is No Consistent Protocol Or Safety And Efficacy Profile When It Comes To The Products

Her doctor suggested that she begin with lifestyle strategies that include avoiding looking at electronic devices for several hours before sleep, avoiding caffeine after noon, and adopting a more consistent exercise schedule. After a month, she did not experience improvement of her symptoms and asked to try prescription medication. Her doctor gave her a prescription for temazepam. After 1 month, she was pleased with the results, but she was concerned about the potential for addiction, so she asked if she could switch to melatonin. Her doctor gave her a schedule to taper the prescription and wanted to reevaluate the situation before starting the patient on another medication. After she discontinued the medication, the patient felt she was still getting better quality sleep and felt less tired during the day. The decision was made to hold off on any new medications as long as her symptoms were not troublesome.

Take home points

Patients who have primary insomnia might be concerned about medical causes of insomnia. Often, ruling out underlying causes can be a great relief for patients.

Herbal treatments and alternative therapies may be beneficial in the management of primary insomnia, but doses and adverse effects are not well established.

Treatment of chronic insomnia can be more effective when the patient is given several treatment options and has a voice in the plan.


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What Is The Best Medication For Chronic Insomnia

If CBT-I and sleep hygiene techniques do not help treat your insomnia, you may need medications to help you sleep. Many prescription medications are available to treat insomnia. These medications require a virtual visit with your PlushCare provider and together, you can determine the best treatment plan.

Prescription medications used to treat insomnia include:

  • Benzodiazepines
  • Melatonin receptor agonists
  • Orexin receptor antagonists

Benzodiazepines are habit-forming and should only be taken for a few weeks. Some other prescription medications are used off-label to treat insomnia such as antidepressants, antipsychotics, and anticonvulsants.

Surprising Causes Of Chronic Insomnia You May Not Know About

What Is Insomnia? | Insomnia

Everyone experiences some form of insomnia during their lifetime. Lifes ups and downs can play out when youre sleeping. However, chronic insomnia is defined as insomnia that occurs at least 3 times per week for at least 3 months. Long-term insomnia can significantly affect your physical and mental health, as well as your ability to do normal everyday tasks like going to work and caring for your family. Knowing what causes this debilitating sleep disorder can steer you toward getting help from a sleep specialist who treats chronic sleep disorders.

We understand how difficult it can be to live with chronic insomnia. Here are 6 surprising causes of chronic insomnia.

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When Does Acute Insomnia Become Chronic Insomnia

Most people will experience sleep disturbance or acute insomnia at some point in any given year. This often occurs around predictable times of stress or when sleep patterns are disrupted, such as with travel, busy periods at work, illness, or emotional upset. While people may be distressed about sleep loss during acute insomnia, once the trigger factors are removed, sleep usually returns to normal.

Insomnia becomes chronic when someone has difficulty either getting to sleep or staying asleep for at least three nights a week for at least three months and is distressed by their sleep symptoms.

What Are The Signs And Symptoms Of Chronic Insomnia

Symptoms of chronic insomnia. Chronic insomnia can cause symptoms at night as well as during the day and can interfere with your ability to go on with your daily tasks. Symptoms may include: trouble falling asleep. waking up throughout the night. trouble staying asleep or trouble returning to sleep.

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What Are Causes Of Insomnia In The Elderly

Insomnia occurs in 30-48% of older adults, who often have particular struggles with sleep maintenance.

As in people of a younger age, stress, physical ailments, mental health problems, and poor sleep habits can cause insomnia in the elderly. However, elderly people are often more sensitive to these causes because of higher levels of chronic health conditions, social isolation, and an increased use of multiple prescription drugs that may affect sleep.

Research indicates that people over age 60 have less sleep efficiency. They spend less time in deep sleep and REM sleep, which makes it easier for their sleep to be disturbed. A decrease in daylight exposure and reduced environmental cues for sleep and wakefulness can affect circadian rhythm, especially for elderly people in managed care settings.

What Is Chronic Insomnia And What Can I Do About It

Chronic Insomnia: Treatment, Causes, Symptoms, and More

If youve ever spent the night tossing and turning or staring at the ceiling unable to fall asleep, youre one of the millions of people that suffer from insomnia. Defined as trouble falling or staying asleep, or both, insomnia plagues nearly 70 million Americans at one time or another.

But not all forms of insomnia are treated equally. Acute, or transient insomnia, is a short-term condition characterized by a recent event or change in sleeping habits. Chronic insomnia, on the other hand, is a long-term condition that can negatively impact many other aspects of your life.

Here well take a closer look at exactly what chronic insomnia is, symptoms, side effects, causes, and even treatment options. So grab your pillow, get comfortable, and lets explore whats causing those sleepless nights.

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What Are The Consequences Of Chronic Insomnia

Insomnia symptoms have significant immediate and long-term consequences affecting both our days and nights. Insomnia is responsible for exhausting night and day symptoms such as fatigue, lower energy, lack of concentration, mood swings, increased risk of work and car accidents, as well as a long-term negative impact on health caused by sleep loss.

The cumulative long-term effects of sleep deprivation and insomnia have been associated with a wide range of deleterious long-term health consequences including an increased risk of hypertension, obesity, depression, etc.

Insomnia is also a societal issue. The economic burden of insomnia is very high worldwide. Insomnia is taken seriously more and more by insurance companies. Many industries and several countries are now addressing it as a public health matter. In Quebec alone, a study published in 2009 estimated the total annual cost of insomnia at $6.6 billion, mostly attributed to insomnia-related work absences and reduced productivity. Society pays too. The economic burden of not treating insomnia is thought to be higher than the cost associated with providing effective treatment such as CBTi.

The general public and healthcare providers alike need to learn more about sleep, including sleep disorders such as insomnia, to make life better for everyone.

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Combined Therapy For Insomnia

Hypnotic medications are efficacious as short-term treatment for insomnia, and more recent evidence suggests that benzodiazepine and BzRA hypnotics may maintain effectiveness over the longer term without significant complications. These facts, however, do not provide the clinician with a clear set of practice standards, particularly when it comes to sequencing or combination of therapies. The literature that has examined the issue of individual pharmacotherapy or cognitive behavioral treatment versus a combination of these approaches demonstrates that short-term pharmacological treatments alone are effective during the course of treatment for chronic insomnia but do not provide sustained improvement following discontinuation,, whereas cognitive behavioral treatments produce significant improvement of chronic insomnia in the short-term, and these improvements appear sustained at follow-up for up to two years. Studies of combined treatment show mixed and inconclusive results. Taken as a whole, these investigations do not demonstrate a clear advantage for combined treatment over cognitive behavioral treatment alone.,,

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What Are Its Most Common Causes

Plenty of factors can contribute to you developing chronic insomnia. According to Dr. Thornber, your sleep cycle can be disrupted by many things, from environmental factors like noise pollution, to physical and mental health reasons.

He explains that the sleep disorder can be caused by things such as “drug or alcohol abuse psychiatric disorders like depression or anxiety medical disorders, and poor sleep hygiene.” In addition to that, lifestyle choices can play a major role in the onset of chronic insomnia, Dr. Thornber says, “drinking too much alcohol and caffeine especially before bedtime can perpetuate chronic insomnia. Also, overuse of mobile and technical devices before bedtime can stimulate the brain and have an impact on sleep.”

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Overnight Treatment For Chronic Insomnia

What are the Different Types of Insomnia and Their Symptoms?

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Each night, as millions of Americans slumber peacefully, millions more cant fall asleep or stay asleep. For some, its just a now-and-then hitch. For others, insomnia is a chronic problem that affects mood, daytime alertness and performance, and emotional and physical health.

Chronic insomnia often starts out innocently enough. Stress or trouble at home or work interferes with sleep for a few nights. But then the habits that come along with not sleepinglooking at the clock, lying in bed wide awake, worrying about not getting to sleepcan stick. Soon just the sight of your bed or the tick of the clock toward 10:00 pm can trigger anxiety and render you wide awake.

Loosening the grip of chronic insomnia can take time and effort. Some of the sleepless turn to medications. One widely used behavioral approach, called stimulus control therapy, aims to break harmful sleep habits and thoughts over the course of several weeks. A new approach that uses a 25-hour program called intensive sleep retraining may be enough to break the cycle in a day.

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Can My Insomnia Be Cured

Absolutely. It may not be easy though, as curing insomnia often means improving your sleep hygiene and establishing habits that are more conducive to good sleep. And habits, especially routines you follow every day, can be tough to break.

But it is possible. And according to Aouad, each small step you take to establish better sleep is an important one.

I think people underestimate how much making small changes to their habits can be beneficial, Aouad says. Even though those habits can be hard to change, gradually changing them over time can really improve someones sleep.

Challenging The Worries And Thoughts That Fuel Insomnia

Its also helpful to challenge the negative attitudes about sleep and your insomnia problem that youve developed over time. The key is to recognize self-defeating thoughts and replace them with more realistic ones.

Challenging self-defeating thoughts that fuel insomnia
Self-defeating thought:Sleep-promoting comeback:
Unrealistic expectations: I should be able to sleep well every night like a normal person. I shouldnt have a problem!Lots of people struggle with sleep from time to time. I will be able to sleep with the right techniques.
Exaggeration: Its the same every single night, another night of sleepless misery.Not every night is the same. Some nights I do sleep better than others.
Catastrophizing: If I dont get some sleep, Ill tank my presentation and jeopardize my job.I can get through the presentation even if Im tired. I can still rest and relax tonight, even if I cant sleep.
Hopelessness: Im never going to be able to sleep well. Its out of my control.Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.
Fortune telling: Its going to take me at least an hour to get to sleep tonight. I just know it.I dont know what will happen tonight. Maybe Ill get to sleep quickly if I use the strategies Ive learned.

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Relieving Anxiety That Keeps You From Falling Or Staying Asleep

If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing elseespecially not frustration and anxiety.

Use the bedroom only for sleeping and sex. With many of us working from home now, it can be difficult to avoid, but if possible dont work, use your computer, or watch TV in your bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that its time to nod off when you get into bed.

Move bedroom clocks out of view. Anxiously watching the minutes tick by when you cant sleepknowing that youre going to be exhausted when the alarm goes offis a surefire recipe for insomnia. You can use an alarm, but make sure you cant see the time when youre in bed.

Get out of bed when you cant sleep. Dont try to force yourself to sleep. Tossing and turning only amps up your anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, meditating, or taking a bath. When youre sleepy, go back to bed.

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