Chronic Insomnia: What Is It and Coping Strategies

Published: Dec 10, 2023
Updated: Sep 13, 2024
Chronic Insomnia: What Is It and Coping Strategies
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    10 min

    According to the American Academy of Sleep Medicine (AASM), about 10% of adults suffer from chronic insomnia. Chronic insomnia can be frustrating and debilitating, affecting your overall well-being.

    In this article, we’ll explore the causes and coping strategies for chronic insomnia, providing you with the knowledge and tools to reclaim a restful night’s sleep.

    Key Takeaways
    Chronic insomnia can be caused by underlying medical conditions, certain medications, and lifestyle patterns.
    Cognitive behavioral therapy (CBT) is an effective treatment option for chronic insomnia and is as effective, if not more effective, than sleep medications.
    Sleep deprivation from chronic insomnia can lead to increased risk of chronic conditions such as obesity, diabetes, and cardiovascular disease.
    Chronic insomnia frequently co-occurs with mental health disorders such as depression and anxiety.

    What Is Chronic Insomnia

    Before we go into what chronic insomnia means, we have to first define what insomnia is. Insomnia is defined as a sleep disorder in which you have trouble sleeping or staying asleep.

    Chronic insomnia happens when you are unable to sleep for 3 or more nights a week and lasts more than 3 months. It is unlike acute insomnia that only lasts from 1 night to a few weeks.

    Types of Chronic Insomnia

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

    Primary chronic insomnia is also known as idiopathic insomnia. There isn’t usually a specific cause for this.

    Seconary chronic insomnia is known as comorbid insomnia. It occurs more frequently than idiopathic insomnia and is usually a result of other underlying medical conditions.

    Common Causes of Chronic Insomnia

    white textile near white wall
common causes of chronic insomnia

    The common causes of chronic insomnia includes:

    • Chronic pain conditions (e.g. fibromyalgia, arthritis, etc.)
    • Psychological conditions (e.g. depression, anxiety, bipolar disorder, etc.)
    • Medications
    • Lifestyle patterns (e.g. jet lag, irregular sleep schedule, excessive caffeine intake, etc.)
    • Age
    • Stress and anxiety
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    Lifestyle Factors Contributing to Insomnia

    The causes of insomnia can vary, but certain lifestyle patterns can significantly impact your sleep quality. Here are some lifestyle factors that may contribute to insomnia:

    • Irregular sleep schedule: Inconsistent bedtimes and wake-up times can disrupt your body’s natural sleep-wake cycle, making it harder to fall asleep and stay asleep.
    • Poor sleep environment: Factors such as excessive noise, uncomfortable bedding, or a room that’s too hot or too cold can interfere with your ability to sleep well.
    • Unhealthy habits: Consuming caffeine or alcohol close to bedtime, eating heavy meals, and not engaging in regular exercise can all negatively affect your sleep.
    • High stress levels: Chronic stress can lead to racing thoughts and heightened arousal, making it difficult to relax and fall asleep.

    Addressing these lifestyle factors can help you sleep better and manage chronic insomnia disorder.

    Symptoms of Chronic Insomnia

    If you are experiencing chronic insomnia, you may notice several common symptoms. These symptoms can greatly impact your daily life and overall well-being. The table below outlines the most common symptoms associated with chronic insomnia:

    Symptoms of Chronic Insomnia

    These symptoms can vary in severity and frequency, but they are persistent and can last for months or even years. It is important to recognize these symptoms and seek appropriate help and support. Understanding the symptoms of chronic insomnia is the first step toward finding effective coping strategies and improving your quality of sleep.

    Diagnosis of Chronic Insomnia

    For you to properly determine if you are suffering from chronic insomnia, you would have to get a professional diagnosis. A doctor can diagnose you through a few ways which are:

    • Clinical Evaluation: This includes obtaining a detailed medical history of the patient including existing medical conditions, sleep history, physical and psychological examinations.
    • Sleep Diaries: Sleep diaries are used over a course of 2 to 4 weeks. It includes documenting the use of alcohol, caffeine consumption, bedtime activities and daytime napping.
    • Polysomnography (Sleep Studies): Preferred method in diagnosing sleep disorders. Used for sleep apnea, parasomnias and other sleep related disorders. This can only be done if there is an co-existing sleep disorder.
    • Actigraphy: This is done to monitor gross activities during the day and sleep. The sleep parameters assessed are total sleep duration, wakefulness after sleep, sleep latency and daytime naps.
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    Impact of Chronic Insomnia on Health

    The impact of insomnia on health ranges from physical health consequences to mental health conditions. In some cases, it can also affect your quality of life. Here are the health effects of chronic insomnia:

    • Increased risk of chronic conditions: Lack of sleep can contribute to the development of chronic conditions such as obesity, diabetes, and cardiovascular disease. This is because sleep deprivation affects hormone regulation and metabolism, leading to weight gain and an increased risk of developing these conditions.
    • Weakened immune system: Chronic insomnia can weaken the immune system, making individuals more susceptible to infections. Sleep is essential for immune function, and when it’s disrupted, the body’s ability to fight off infections is compromised.
    • Mental health disorders: Chronic insomnia has been linked to mental health disorders such as depression and anxiety. Lack of sleep can negatively affect mood and exacerbate symptoms of these disorders.
    • Impaired cognitive function: Sleep deprivation can impair cognitive function, affecting memory, concentration, and decision-making abilities. Chronic insomnia can make it difficult to focus, learn, and retain information.
    Can chronic insomnia be cured?
    Yes! The recommended treatment for chronic insomnia is cognitive-behavioural therapy. This involves working with a provider to change the thoughts and habits that feed the cycle of insomnia. The treatment has a high success rate, even among those who have suffered from insomnia for years.
    Dr. Julian Lim
    Lead Sleep Psychologist, Co-Founder of Somnus Sleep Wellness

    Effective Treatment Options

    One effective way to manage chronic insomnia is through a variety of treatment options. When it comes to treating insomnia, there are several approaches you can consider:

    Non-Medication Options

    • Cognitive Behavioral Therapy (CBT): This therapy focuses on changing beliefs and behaviors that interfere with sleep. It has been found to be as effective, if not more effective, than sleep medications.
    • Relaxation Techniques: Deep breathing exercises and progressive muscle relaxation can help promote better sleep.
    • Sleep Hygiene: Maintaining a consistent sleep schedule, creating a sleep-friendly environment, and avoiding stimulants like caffeine and nicotine close to bedtime are important for managing insomnia.

    Medication Options

    • Prescription Medications: In some cases, doctors may prescribe medications such as benzodiazepines and non-benzodiazepines to help manage insomnia. They are typically recommended as a short-term solution.
    • Over-the-counter Medications: Over-the-counter sleep aids like melatonin can also be used, but it’s important to use them as directed and be aware of potential side effects.

    Lifestyle Changes

    • Sleep Hygiene Practices: Practicing good sleep hygiene habits such as having a consistent bedtime and doing some relaxing activities such as meditation can help with restful sleep.
    • Regular Physical Activity: Incorporate regular physical activities into your lifestyle, try to exercise daily if you can.
    • Diet and Nutrition: Maintain a healthy diet by eating a good amount of protein and vegetables. Try to avoid eating large meals before bedtime. This will allow enough time for digestion.
    How to cope with long-term insomnia?
    If you’ve had trouble sleeping regularly for 3 months or more, don’t hesitate to seek help from a professional. There is no need to suffer in silence trying to cope with insomnia when safe and effective solutions are available.
    Dr. Julian Lim
    Lead Sleep Psychologist, Co-Founder of Somnus Sleep Wellness

    Conclusion

    In conclusion, chronic insomnia can have several negative health implications. In order for you to get the proper deep sleep you need, you should consider the treatments that are available. Whether it is making lifestyle changes or seeking professional help, you should not have to suffer from sleepless nights.

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    FAQ

    Symptoms of chronic insomnia may include trouble getting to sleep, trouble staying asleep, waking up too early, and experiencing fatigue or low energy during the day.

    Risk factors for chronic insomnia include high stress levels, certain medical conditions, erratic work schedules, and poor sleep habits.

    Chronic insomnia is diagnosed based on a thorough assessment of the individual's sleep patterns, medical history, and possibly through the use of sleep diaries and other diagnostic tests.

    Chronic insomnia can be caused by various factors such as stress, anxiety, depression, chronic pain, medications, and underlying health conditions.

    There are two primary types of insomnia: sleep onset insomnia, in which individuals have difficulty falling asleep, and sleep maintenance insomnia, characterized by difficulty staying asleep.

    Chronic insomnia can be treated through lifestyle changes, cognitive behavioral therapy, relaxation techniques, and in some cases, medications prescribed by a healthcare professional.

    Short-term insomnia lasts for a brief period due to specific stressors or life events, while chronic insomnia persists for an extended period, typically lasting for at least three months.

    Insomnia can affect individuals by causing daytime fatigue, impairing cognitive function, and increasing the risk of developing mental health issues such as anxiety and depression.
    About authors
    Dr. Cui is a board-certified internal medicine physician and applied psychologist with more than 30 years of experience in both fields especially in terms of the regulation and intervention of sleep disorders.
    Dr. Julian Lim is regarded internationally as an expert in mindfulness and sleep, with over 40 peer-reviewed publications and a position on the editorial board of the scientific journal Mindfulness. He is currently an Adjunct Professor at the Centre for Sleep and Cognition at the National University of Singapore.

    American Academy of Sleep Medicine (n.d.) Insomnia Factsheet [online]. https://aasm.org/resources/factsheets/insomnia.pdf

    Kaur H, Spurling BC, Bollu PC. Chronic Insomnia. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526136/

    Radhakrishnan, R. (2022) What Are the Five Types of Insomnia? [online]. https://www.medicinenet.com/what_are_the_five_types_of_insomnia/article.htm

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