Chronic Insomnia: What It Is, Types, and How It Differs from Temporary Insomnia

At night you lie with your eyes open and hear the clock ticking. During the day you feel exhausted and irritable. If this repeats month after month, it may be chronic insomnia — a sleep disorder that deserves attention, not reproaches about weak willpower.

What chronic insomnia is

Insomnia is a sleep disorder in which a person complains of difficulty falling asleep, frequent awakenings at night, or early awakening, and does not feel rested. For a diagnosis, the disturbances must occur at least three times a week for a month and cause noticeable distress or interfere with work and everyday activities. The absolute number of hours of sleep is not decisive: the norm varies greatly among different people. The benchmark is how you feel during the day. Adults on average need 7–9 hours of sleep, children — 9–13, toddlers — 12–17.

Transient and chronic insomnia: what the difference is

Short-term, or transient, insomnia is classified as an acute condition: it usually lasts days or weeks, often against a background of stress at work, family burdens, or a difficult event. Chronic insomnia lasts a month or longer; by some criteria — three months or more. Acute insomnia often resolves with changes in sleep habits, whereas chronic insomnia more often requires working through the causes together with a doctor.

Absolute and abnormal insomnia: what is meant

Such terms are not used in clinical descriptions. When assessing insomnia, the absolute duration of sleep is not decisive, and a reduction in sleep time is not considered a pathology if it does not cause impairments in daytime functioning — drowsiness, worsening attention and memory. It is more accurate to describe your condition with the words "I have trouble falling asleep," "I wake up at night," "I wake up too early" — this makes it easier for the doctor to understand the picture.

Types of insomnia and sleep disorders

Insomnia is divided into acute and chronic, as well as primary and secondary. Secondary insomnia is a symptom or side effect of another condition: an illness, medications, other sleep disorders, caffeine, tobacco, or alcohol. Primary insomnia is not associated with another disease; its cause is not fully understood, although prolonged stress, emotional upheavals, flights, and shift work are cited as factors. Other sleep disorders include:

• restless legs syndrome;
• sleep apnea — pauses in breathing and snoring;
• narcolepsy — sudden falling asleep anywhere;
• sleepwalking and nightmares, especially in children.

Possible causes and consequences of chronic insomnia

Common causes include stress, anxiety or depression, noise, a room that is too hot or too cold, an uncomfortable bed, alcohol, caffeine, and nicotine. Insomnia can be caused by mental disorders, Alzheimer's and Parkinson's diseases, restless legs syndrome, hyperthyroidism, menopause, many medications, and chronic pain. Chronification is often promoted by anxious thoughts about whether one will manage to fall asleep and attempts to "catch up" on sleep during the day or with alcohol at night. The consequences are daytime drowsiness, loss of energy, irritability, anxiety, difficulties with concentration, attention, and memory, and the risk of falling asleep at the wheel.

When to see a doctor

You should see a doctor if changes in sleep habits have not helped, sleep problems have lasted for months, or they interfere with coping with everyday life. The doctor will ask about your health and sleep history, perform an examination to rule out other causes, and may suggest keeping a sleep diary or undergoing polysomnography. Sometimes cognitive behavioral therapy is offered; if there are signs of another sleep disorder, you are referred to a sleep laboratory.

Insomnia by itself is not a reason to call an ambulance. You should call 103 or 112 for life-threatening conditions — for example, signs of a stroke or heart attack.

This material is for reference and does not replace a doctor's consultation: if insomnia has persisted for months, talk to a specialist about it.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer