Chronic Insomnia - Santos, A

5/7/2021 Chronic Insomnia: Treatment, Causes, Symptoms, and More
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What Is Chronic Insomnia and How Is It

Treated?
Medically reviewed by Judith Marcin, M.D. — Written by Adrienne Santos-
Longhurst — Updated on August 8, 2018
Primary vs. secondary Symptoms Causes Treatment Cure

Home remedies Outlook
Overview
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.
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https://www.healthline.com/health/chronic-insomnia 1/13
Types of chronic insomnia

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

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
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Causes of chronic insomnia

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:
respiratory conditions, including:

asthma
chronic obstructive pulmonary disease (COPD)
sleep apnea
congestive heart failure
diabetes
acid reflux
hyperthyroidism
fibromyalgia
pain
restless leg syndrome
menopause
urinary incontinence 
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stress, both physical and emotional
anxiety
depression
bipolar disorder
Alzheimer’s disease
Parkinson’s disease
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
A D V E Rfor
T I S Ewaking
MENT and sleeping 
poor sleeping environment
Treatment of 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 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
A D V E R T Ilimiting
SEMENT 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.
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) 
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OTC sleep aid options may include:
diphenhydramine (Benadryl)
doxylamine succinate (Unisom SleepTabs)

melatonin
valerian root
chamomile tea
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.
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Cure for chronic insomnia

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.
Home remedies for chronic insomnia

There are several things 
ADV E R T I S E M Ethat
NT 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:
Avoid caffeine, especially later in the day.
Avoid alcohol use and smoking cigarettes before bed.
Engage in regular physical activity.
Don’t take naps.
Don’t eat large meals in the evening.
Go to bed and get up at the same time every day, even on days off.
Avoid using computers, smartphones  , TV, or other technological

devices an hour before bedtime.
Keep your bedroom dark or use a sleep mask.
Keep your bedroom a comfortable temperature.
Make sure your sleep surface is comfortable.

ADVERTISEMENT
Outlook for chronic insomnia

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 
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with your quality of life, talk to your doctor.
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Can’t sleep? Try a natural solution

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Last medically reviewed on August 8, 2018
 10 sources
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5/7/2021 Chronic Insomnia: Treatment, Causes, Symptoms, and More

What Is Chronic Insomnia and How Is It

Primary vs. secondary Symptoms Causes Treatment Cure

Periodically having trouble sleeping, also known as acute insomnia, is

Types of chronic insomnia

Primary insomnia isn’t due to other medical conditions or medications and

Secondary insomnia is caused by other conditions or situations. This

Symptoms of chronic insomnia

Symptoms may include:

trouble falling asleep

waking up throughout the night

waking up too early

not feeling rested after a night’s sleep

problems with memory

Causes of chronic insomnia

Chronic insomnia can be caused by a number of long-term medical

respiratory conditions, including:

chronic obstructive pulmonary disease (COPD)

restless leg syndrome

stress, both physical and emotional

Medications and stimulants

cold and allergy medications containing pseudoephedrine

illicit drugs, such as cocaine and other stimulants

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

rotating shift work

frequent daytime napping

poor sleeping environment

Treatment of chronic insomnia

Cognitive behavioral therapy (CBT)

Research has shown CBT to be as effective, or more effective, than sleep

Some of the strategies of CBT that are specifically focused on insomnia,

Using journaling to write down worries or concerns before going to bed

that you’re tired at bedtime. Your time in bed is gradually increased as

Breathing exercises, yoga, guided meditation, and other techniques are

This strategy involves focusing on staying awake in bed instead of

There are a number of prescription medications and over-the-counter

While effective, doctors don’t typically recommend using sleeping pills

Some of the prescription medications that are approved for treating

OTC sleep aid options may include:

doxylamine succinate (Unisom SleepTabs)

Cure for chronic insomnia

Chronic health conditions that cause insomnia can be managed with

Home remedies for chronic insomnia

hygiene. This calls for changes in patterns of behavior to help improve

Try the following tips:

Avoid caffeine, especially later in the day.

Avoid alcohol use and smoking cigarettes before bed.

Engage in regular physical activity.

Don’t take naps.

Don’t eat large meals in the evening.

Avoid using computers, smartphones  , TV, or other technological

Keep your bedroom dark or use a sleep mask.

Keep your bedroom a comfortable temperature.

Make sure your sleep surface is comfortable.

Outlook for chronic insomnia

Can’t sleep? Try a natural solution

START FREE TRIAL

Last medically reviewed on August 8, 2018

READ THIS NEXT

What Is Cognitive Behavioral Therapy for

Everything You Need to Know About Insomnia

How Long Does It Typically Take to Fall

How Long Melatonin Remains in Your Body,