Chronic Insomnia: Treatment, Causes, Symptoms, and More (2023)

Chronic insomnia lasts at least 3 months, with possible causes ranging from respiratory conditions to menopause to sleep habits. Therapy, medications, or lifestyle changes may help ease the symptoms.

Insomnia is a common sleep disorder in which you may have trouble falling asleep, staying asleep, or both. A third of Americans report that they don’t get the recommended amount of sleep every night, which is at least seven hours.

Periodically having trouble sleeping, also known as acute insomnia, is common. Acute insomnia lasts for a few days or weeks and often occurs during times of stress or life changes.

Have trouble getting to sleep or staying asleep more than three nights a week for three months or more is considered chronic insomnia. This is also known as chronic insomnia disorder.

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

Primary insomnia isn’t 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 it’s 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.

Symptoms of chronic insomnia

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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
  • waking up too early
  • daytime sleepiness or grogginess
  • not feeling rested after a night’s sleep
  • irritability
  • mood changes, such as feeling depressed
  • difficulty concentrating
  • problems with memory
  • increase in mistakes and accidents

There are many things that can cause chronic insomnia, but it’s often linked to an underlying medical condition. Certain medications and stimulants can cause chronic insomnia, along with lifestyle patterns.

Medical conditions

Chronic insomnia can be caused by a number of long-term medical conditions, including:

Medications and stimulants

For some people, certain medications and stimulants may cause chronic insomnia. These include:

  • alcohol
  • antidepressants
  • beta-blockers
  • caffeine
  • chemotherapy drugs
  • cold and allergy medications containing pseudoephedrine
  • diuretics
  • illicit drugs, such as cocaine and other stimulants
  • nicotine
  • stimulant laxatives

Lifestyle patterns

Certain lifestyle patterns may lead to chronic insomnia. These include:

  • rotating shift work
  • frequent travel across multiple time zones, leading to jet lag
  • physical inactivity
  • frequent daytime napping
  • lack of routine for waking and sleeping
  • poor sleeping environment

Treatment of chronic insomnia

(Video) New Help for Chronic Insomnia

A number of at-home and professional treatment options are available for chronic insomnia. Treatment will depend on the cause of your insomnia and may involve medication or therapy to address an underlying condition.

Along with treating any existing conditions, your doctor may recommend one or a combination of treatment options for chronic insomnia.

Cognitive behavioral therapy (CBT)

Research has shown CBT to be as effective, or more effective, than sleep medications in treating chronic insomnia. It involves educating you on sleep and better sleep habits, while teaching you to change the beliefs and behaviors that interfere with your ability to sleep.

Some of the strategies of CBT that are specifically focused on insomnia, known as CBT-I, include the following:

Cognitive techniques

Using journaling to write down worries or concerns before going to bed may help keep a person from actively attempting to work them out while also trying to sleep.

Stimulus control

This entails altering behaviors that condition your mind to fight sleep. Setting a sleep and wake time routine is part of this strategy.

Other examples are using your bed only for sleep and sex, and leaving your bedroom if you’re unable to fall asleep within a set number of minutes.

Sleep restriction

This therapy involves limiting the amount of time you spend in bed, including avoiding naps. The goal is to deprive you of enough sleep so that you’re tired at bedtime. Your time in bed is gradually increased as your sleep improves.

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Relaxation techniques

Breathing exercises, yoga, guided meditation, and other techniques are used to reduce muscle tension and control your breathing and heart rate so that you’re able to relax.

Paradoxical intention

This strategy involves focusing on staying awake in bed instead of expecting to fall asleep. It helps reduce worry and anxiety over being able to fall asleep. It’s most effective in treating learned insomnia.

Medications

There are a number of prescription medications and over-the-counter (OTC) sleep aids that may help you get to sleep or remain asleep.

While effective, doctors don’t typically recommend using sleeping pills long term because of the side effects, which can include daytime sleepiness, forgetfulness, sleepwalking, balance problems, and falling. Certain classes of sleeping pills are also habit-forming.

Some of the prescription medications that are approved for treating insomnia include:

  • zolpidem (Ambien)
  • eszopiclone (Lunesta)
  • zaleplon (Sonata)
  • doxepin (Silenor)
  • ramelteon (Rozerem)
  • suvorexant (Belsomra)
  • temazepam (Restoril)

OTC sleep aid options may include:

Always speak to your doctor before taking an OTC sleep aid, including natural remedies, such as melatonin and valerian root. Just like prescription drugs, OTC and natural sleep aids can cause unwanted side effects and interfere with other medications.

Cure for chronic insomnia

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If your chronic insomnia is caused by an underlying medical condition, such as acid reflux or pain, treating the condition may cure your insomnia.

Chronic health conditions that cause insomnia can be managed with changes in treatment, in turn managing or preventing insomnia. Talk to your doctor about changing medications or treatment plans if a drug you’re taking is causing insomnia.

There are several things that you can do at home to treat or prevent chronic insomnia. One important option for treatment is known as sleep hygiene. This calls for changes in patterns of behavior to help improve your ability to fall asleep and stay asleep.

Try the following tips:

Chronic insomnia can be effectively treated using a combination of behavioral therapies and by making a few lifestyle changes to help improve your sleep. If you’re having trouble sleeping and it’s interfering with your quality of life, talk to your doctor.

FAQs

What are the side effects of insomnia treatment? ›

Side effects of prescription sleeping pills
  • Dizziness or lightheadedness, which may lead to falls.
  • Headache.
  • Diarrhea or nausea.
  • Prolonged drowsiness, more so with drugs that help you stay asleep.
  • Severe allergic reaction.
  • Sleep-related behaviors, such as driving or eating when not fully awake.

What is the best treatment for chronic insomnia? ›

Cognitive behavioral therapy for insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. Typically, CBT-I is equally or more effective than sleep medications.

What is the safest thing to take for insomnia? ›

Melatonin: Melatonin is considered one of the safest over-the-counter sleep aids, with few side effects. A prescription drug called ramelteon is designed to mimic the effects of melatonin. Like melatonin, it is not considered habit-forming and it does not affect balance.

Is chronic insomnia a mental illness? ›

Insomnia is rarely an isolated medical or mental illness but rather a symptom of another illness to be investigated by a person and their medical doctors. In other people, insomnia can be a result of a person's lifestyle or work schedule.

Why is my insomnia getting worse? ›

In addition to anxiety over the stressors of life, there are several other reasons for insomnia. Some medical conditions such as chronic pain, hyperthyroidism, allergies or sinus issues, asthma, gastrointestinal problems such as reflux and neurological conditions such as Parkinson's disease can make it hard to sleep.

Can you fully recover from chronic insomnia? ›

Most people can recover from sleep deprivation with only a few — or even just one — nights where they get enough quality sleep. However, some people may need several nights of quality sleep to recover from long-term sleep deprivation.

Why won't my body let me fall asleep? ›

Anxiety, stress, and depression are some of the most common causes of chronic insomnia. Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. Other common emotional and psychological causes include anger, worry, grief, bipolar disorder, and trauma.

What deficiencies cause insomnia? ›

In particular, vitamins B6, B12, C, D, and E can improve or lower your sleep quality and duration. Vitamin C deficiency and both lack and an excess of vitamin B6 in the body might affect your sleep or cause insomnia.

What neurological problems cause insomnia? ›

Primary neurologic sleep disorders include: Central nervous system hypersomnia.
...
Common neurologic disorders that are accompanied by sleep problems and disorders include:
  • Alzheimer's disease and other dementias.
  • Epilepsy.
  • Neuromuscular disorders.
  • Parkinson's disease and movement disorders.
  • Stroke.

What is the new treatment for insomnia? ›

In January 2022, the FDA approved Quviviq (daridorexant) to treat insomnia in adults. This medication can be helpful both for falling and staying asleep. Studies suggest it's both safe and effective. Most people tolerated daridorexant well in studies.

What is the first line treatment for chronic insomnia? ›

Cognitive behavioral therapy for insomnia (CBT-I) is the preferred first-line treatment for chronic insomnia in adults and has been endorsed as first-line therapy by multiple societies and guideline panels [1-5]. Overall, the evidence base is stronger for CBT-I than for medications.

Which problems are the two most common side effects of drugs for insomnia? ›

Drowsiness can last into the day after you've taken them. Confusion and memory problems are also a known side effect. For older adults, this could result in falls, broken hips, and car accidents. Other symptoms of some over-the-counter sleep medications can be especially hard for older adults to handle.

What are the 2 problems given with sleeping pills? ›

They feel drowsy, have muddled thinking and experience dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, go to school and complete daily tasks. Over-the-counter and prescription sleeping pills (and supplements) can cause these side effects: Constipation or diarrhea.

What is the first drug of choice for insomnia? ›

Zolpidem (Ambien, Ambien CR, Edluar, Intermezzo, Zolpimist)

A sedative-hypnotic of the imidazopyridine class, zolpidem has a rapid onset and short duration of action. It is a good first choice for treatment of sleep-onset insomnia and produces no significant residual sedation in the morning.

What supplements increase deep sleep? ›

To improve deep sleep, you need to improve your overall restful sleep by following a healthy lifestyle and practicing good sleep hygiene habits. Certain ingredients and nutrients help support better sleep, including Melatonin, Typtophan, B Complex Vitamins, Omega-3, Vitamin D, and Magnesium.

How do I know if my insomnia is chronic? ›

Insomnia is considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer. Some people with chronic insomnia have a long history of difficulty sleeping.

Is insomnia considered a disability? ›

Insomnia is not classified as a disability because it's often a symptom of another condition. If your lack of restful sleep stems from illness, injury, or a mental health condition such as anxiety, depression, or chronic stress, you may qualify for disability benefits.

Is insomnia a brain disorder? ›

Insomnia is often considered a disorder of excessive activation of the arousal systems of the brain (ie, hyperarousal).

How do you break severe insomnia? ›

But here are a few tips to get better sleep without the use of sleep medication:
  1. Avoid electronics at night. And if possible, keep your phone or other devices out of the room you're sleeping in.
  2. Keep cool. ...
  3. Exercise. ...
  4. Get plenty of natural light during the day. ...
  5. Avoid caffeine, alcohol, and cigarettes. ...
  6. Use soothing sounds.
Mar 19, 2018

When does insomnia become serious? ›

If your insomnia is severe or chronic enough that it's affecting your quality of life, it's time to call a doctor. Your primary care provider may be able to treat your problem. However, a sleep-medicine specialist can likely dig deeper into the causes of your insomnia and offer more ways to resolve it.

Who suffers from insomnia the most? ›

Who gets insomnia? Anyone can get insomnia, but it affects more women than men. More than one in four women in the United States experience insomnia, compared with fewer than one in five men.

How long does it take for chronic insomnia to go away? ›

Chronic insomnia lasts at least 3 months, with possible causes ranging from respiratory conditions to menopause to sleep habits. Therapy, medications, or lifestyle changes may help ease the symptoms. Insomnia is a common sleep disorder in which you may have trouble falling asleep, staying asleep, or both.

Can your brain recover from insomnia? ›

Sleep deprivation significantly impairs a range of cognitive and brain function, particularly episodic memory and the underlying hippocampal function. However, it remains controversial whether one or two nights of recovery sleep following sleep deprivation fully restores brain and cognitive function.

Why won t my brain let me sleep? ›

It's all in your head: The brains of insomniacs are different than those of sound sleepers, says a new study from Johns Hopkins University. Researchers found insomniacs have brains with more plasticity, or a greater ability to react to change. Normally that's a good thing, says lead study author Rachel Salas, Ph.

How can I trick my brain into falling asleep? ›

Fall asleep faster with mental tricks that calm your racing mind
  1. Controlled deep breathing. ...
  2. Meditation. ...
  3. Visualization. ...
  4. Progressive muscle relaxation. ...
  5. Set up a 'worry time' before bed.
Mar 13, 2022

What hormone is responsible for insomnia? ›

Melatonin plays an important role in regulating human sleep.

What is the best vitamin for insomnia? ›

Supplementing vitamin B6 may improve sleep quality and duration. A 2019 study also found that taking a supplement of magnesium, melatonin, and vitamin B complex for 3 months improved sleep and helped treat insomnia.

What supplements should I take for insomnia? ›

If you need a little extra help to get a good night's sleep, consider trying the following 9 natural sleep-promoting supplements.
  • Melatonin. Melatonin is a hormone your body produces naturally that signals to your brain that it's time to sleep ( 9 ). ...
  • Valerian root. ...
  • Magnesium. ...
  • Lavender. ...
  • Passionflower. ...
  • Glycine.

What will a neurologist do for insomnia? ›

Neurological Treatment Can Help Sleeping Disorders

Instead of simply masking the problem, neurologists can treat the neurological condition responsible for causing the sleep disorder, which will likely improve your quality of sleep as well.

What area of the brain if damaged could cause insomnia? ›

Studying a group of 192 patients with focal brain lesions, we show a significant association between insomnia and left dorsomedial prefrontal damage.

Can a brain scan show insomnia? ›

MRI imaging can offer insights into insomnia brain connectivity abnormalities and how they correlate with cognitive impairments.

What is the new sleep medication for 2023? ›

The newest drugs for insomnia are classified as DORAs. Orexin-A and orexin-B are neuropeptides involved in, among other actions, arousal behavior and inducing wakefulness.

What is the gold standard for chronic insomnia treatment? ›

Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard treatment for chronic insomnia.

What is the gold standard treatment for insomnia? ›

Cognitive Behavioral Therapy: The Gold Standard Treatment for Insomnia.

What are the dangers of insomnia? ›

A lack of sleep can cause a bunch of health issues, such as higher blood sugar levels, liver problems, weight gain and severe depression. Chronic insomnia can increase the likelihood of some serious diseases and illnesses, including: Heart attack. Stroke.

How do you treat insomnia naturally? ›

Five tips for better sleep
  1. Drink up. No, not alcohol, which can interfere with sleep. ...
  2. Exercise . Physical activity can improve sleep, though researchers aren't completely sure why. ...
  3. Use melatonin supplements . ...
  4. Keep cool. ...
  5. Go dark.

Can you permanently cure insomnia? ›

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.

What is the most severe case of insomnia? ›

Called fatal familial insomnia, or FFI, it's an extremely rare genetic disease that causes progressively worsening sleeplessness. Difficulty sleeping soon turns into total insomnia, causing rapid physical and mental deterioration and, inevitably, death—within a year, usually sooner.

What insomnia does to your brain? ›

Lack of concentration is a major insomnia effect. An exhausted brain can't adequately focus on the important tasks and priorities at hand—especially not for extended periods of time. Critical thinking and problem-solving skills are also negatively impacted by prolonged sleep deprivation.

What is the drug of choice for insomnia? ›

The benzodiazepine medications approved for insomnia treatment in the United States are estazolam, flurazepam, quazepam, temazepam, and triazolam (table 6).

How do you break an insomnia cycle? ›

But here are a few tips to get better sleep without the use of sleep medication:
  1. Avoid electronics at night. And if possible, keep your phone or other devices out of the room you're sleeping in.
  2. Keep cool. ...
  3. Exercise. ...
  4. Get plenty of natural light during the day. ...
  5. Avoid caffeine, alcohol, and cigarettes. ...
  6. Use soothing sounds.
Mar 19, 2018

What is the strongest herb for sleep? ›

Results from multiple studies indicate that valerian — a tall, flowering grassland plant — may reduce the amount of time it takes to fall asleep and help you sleep better. Of the many valerian species, only the carefully processed roots of the Valeriana officinalis have been widely studied.

What can I take instead of melatonin? ›

Melatonin alternatives include magnesium, GABA, valerian root, and tart cherry. If you regularly struggle to fall or stay asleep, speak with your physician, who can determine if underlying issues are causing your sleep problems.
...
The Best Melatonin Alternatives
  • Magnesium. ...
  • GABA. ...
  • L-theanine. ...
  • Valerian root.
May 16, 2022

Is insomnia a mental disorder or not? ›

Insomnia is rarely an isolated medical or mental illness but rather a symptom of another illness to be investigated by a person and their medical doctors. In other people, insomnia can be a result of a person's lifestyle or work schedule.

How do you recover years of insomnia? ›

Eating a well balanced diet, getting regular exercise, staying mentally active, and keeping your blood pressure and cholesterol levels in check will improve sleep as well. You can also tackle any sleep problems by training your brain for better sleep.

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