What is Chronic Insomnia and What Can I Do About It?
If you’ve ever spent the night tossing and turning or staring at the ceiling unable to fall asleep, you’re 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 we’ll 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 let’s explore what’s causing those sleepless nights.
What is Chronic Insomnia?
By definition, chronic is used to describe any illness that lasts for an extended period of time. Chronic insomnia is characterized by trouble falling or staying asleep for more than 3 nights a week for 3 months.
There are 2 common types of chronic insomnia: primary and secondary.
Primary insomnia is still a mystery for many researchers and scientists. Unlike secondary insomnia, primary insomnia isn’t caused by another medical condition or medication. Instead, it is a stand-alone condition with no known cause. Some studies show that this type of insomnia is caused by a change in levels of certain brain chemicals, but there’s no definitive evidence to support this.
Secondary insomnia is the most common and triggered by other medical conditions, medications, situations, or external forces. These factors can include but aren’t limited to, trauma, stress, health issues, lifestyle choices, or certain drugs and medications.
Causes of Chronic Insomnia
Let’s 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.
Because most forms of chronic insomnia are secondary (or caused by something else), 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 (asthma, sleep apnea, COPD)
- Acid reflux
- Congestive heart failure
- Chronic pain
- Anxiety or depression
- Alzheimer’s disease
- Parkinson’s disease
- Bipolar disorder
- Restless leg syndrome
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.
- Some cold and allergy medications
- Chemotherapy drugs
- Alcohol, nicotine, and illicit drugs
The last items on this list also fall under the category of lifestyle choices that may cause chronic insomnia. Smoking cigarettes, doing illegal drugs, or consuming too much alcohol are all unhealthy and potentially hazardous behaviors.
Speaking of lifestyle choices, here are a few things that can create long-term sleep disruptions.
- Poor sleeping environment
- Unhealthy sleep routine
- Daytime naps
- Jet lag or changing time zones frequently
- Lack of physical activity
- Shift work
- Poor diet or eating too close to bedtime
Your body has a natural sleep-wake cycle known as your circadian rhythm. When you work shift work, travel across time zones frequently, or nap during the day, your body and mind get “confused”. It interrupts your body’s natural reaction to start releasing melatonin as it prepares for sleep. For example, if you’re accustomed to going to sleep at 10:00 p.m. and waking at 6:00 a.m., altering this routine significantly or frequently makes it difficult for your body to prepare for sleep and may cause you to wake frequently throughout the night.
Eating too late in the evening also triggers your brain to start digesting food and to remain alert — the opposite of what you need to achieve a quality night’s sleep.
Lots of things change as you get older, including your sleep patterns and sleep health. Chronic insomnia is more common among people aged 60 and older. For many people, sleep becomes less restless as they get older. Small changes in your environment, including light and noise, can wake you more easily.
Certain health conditions like arthritis, depression, and joint pain can also develop into chronic insomnia. The frequent need to urinate, restless leg syndrome, and sleep apnea are all more common in aging adults and can all interfere with sleep patterns. An average of 9 in 10 adults over the age of 65 are currently taking prescription medication. The more medications you take, the more at risk you are of adverse side effects and the potential for chronic insomnia.
Women are at greater risk of developing long-term sleep interruptions due to constant fluctuations in hormone levels. Both menstrual cycles and menopause can cause a spike and dip in certain hormones that affect sleep.
During a woman’s menstrual cycle and during pregnancy, changes in estrogen and progesterone can interfere with sleep. Cramps can also add to your discomfort. Emotional changes and increased stress can also make it difficult to fall and stay asleep. Menopause is notorious for hot flashes, making it difficult to find a comfortable sleep position and temperature for sleep.
Signs and Symptoms of Chronic Insomnia
- Difficulty falling asleep
- Waking frequently during the night
- Waking up earlier than intended or getting tired earlier in the evening
- Daytime sleepiness
- Not feeling rested in the morning
- Irritability or mood swings
- Depression or anxiety
- Difficulty focusing, remembering things, or staying focused
- More frequent accidents or errors
- Worry or anxiety over not sleeping
While many of these symptoms are common with all forms of insomnia, they’re much more noticeable and persistent with a chronic condition.
Treatment of Chronic Insomnia
Treating chronic insomnia requires a comprehensive approach. In many cases, treating the underlying cause or condition will help ease symptoms. A mix of professional treatment and therapies, medication, and lifestyle changes can all help restore your sleep health.
Here are a few of the most common ways to treat chronic insomnia.
CBT-i (Cognitive Behavioral Therapy for Insomnia)
A popular treatment for countless mental and physical health conditions, CBT-i involves several different methods and approaches including stimulus control, relaxation exercises, and sleep restriction.
Stimulus control is a type of therapy designed to address and treat the alertness and arousal many insomnia sufferers experiences when trying to sleep. Approaches include associating your bedroom with sleep and sex only, resetting your circadian rhythm, and establishing a consistent sleep schedule. Some patients are encouraged to leave the bed if they don’t fall asleep after a certain period of time and to return only when they feel prepared for sleep. This helps your mind associate the bedroom with sleep instead of restlessness.
Sleep Restriction Therapy
This form of CBT isn’t nearly as harsh as it sounds. If frequent naps are getting in the way of a quality night’s sleep, restricting how often you rest during the day can help you feel more tired at night. Sleep restriction therapy also limits the amount of time you spend in your bed, working, reading, or performing tasks other than sleeping. The objective here is to deprive yourself of sleep long enough that you’re tired at bedtime, falling and staying asleep more easily.
Journaling, meditation, and mindfulness are all cognitive forms of CBT that help you connect more deeply with the thoughts and emotions that are keeping sleep at bay. Writing down your sleep concerns before going to bed or purging them from your mind can prevent you from trying to address them while also trying to fall asleep.
Meditation, mindfulness, and even yoga are also known as relaxation techniques designed to ease muscle tension and control both your breathing and heart rate, allowing you to relax and better prepare for sleep.
For some people, the only remedy for chronic insomnia involves medication. While there are plenty of medicines that can interfere with sleep, several can bring you both relief and the restful night’s sleep you’re after. These include both prescription and over-the-counter options.
Some of the most popular prescription medications include:
- Lunesta (eszopiclone)
- Ambien (zolpidem)
- Restoril (temazepam)
- Silenor (zaleplon)
- Belsomra (suvorexant)
Over-the-counter options include:
Be sure to check with your doctor if you’re currently taking other medications or have underlying health conditions. Some of the abovementioned sleep aids may negatively affect your current medications.
At-Home Remedies and Lifestyle Changes
In addition to therapy and medication, there are some easy and convenient at-home remedies for insomnia that you can try. Some sufferers prefer to try these lifestyle changes before seeking treatment. Either way, these minor adjustments can make a big difference in your sleep quality.
- Avoid eating large meals late in the evening
- Avoid caffeine late in the day (including coffee, tea, and sports or energy drinks)
- Incorporate physical activity into your daily routine
- Avoid using screens including tablets, cellphones, and television too close to bedtime
- Create a comfortable sleeping environment (comfortable mattress and pillows, the room at the right temperature, and dark)
- Set a sleep-wake schedule and stick to it
Any combination of these at-home remedies can help improve sleep. Unfortunately, many chronic insomnia sufferers are also dealing with other health conditions that make falling and staying asleep difficult, despite their best efforts.
There’s Hope for Those with Chronic Insomnia
Chronic insomnia can make you feel hopeless at times. The inability to fall and stay asleep leads to a long list of physical and mental side effects that plague you during your awake hours. Confusion, fatigue, the inability to focus, and mood swings are all common side effects of a restless night’s sleep.
What’s worse for those with chronic insomnia is that these side effects can be felt for weeks, months, or even a lifetime. The good news is, with a combination of therapies, medication, and lifestyle changes, you can finally achieve a quality night’s sleep that leaves you feeling energized, rejuvenated, and less stressed.
Somnus Therapy offers a combination of guided meditation, sleep sounds, stimulus control, and sleep restriction therapy to provide a comprehensive understanding of your condition and how to overcome it. With an at-home approach to treating chronic insomnia, you can progress through the program at your own pace and in a comfortable environment.
Say goodbye to countless restless nights and groggy mornings and start your journey toward better, faster, and longer sleep today!