A comprehensive guide to Chronic Insomnia

A comprehensive guide to Chronic Insomnia

Chronic insomnia is a condition where you wake up tired every day, even after sleeping well at night. 

It is because you don't get enough sleep. If you have chronic insomnia, you might also experience other symptoms such as anxiety, depression, fatigue, irritability, and poor concentration.

Insomnia affects around 20% of adults worldwide. The condition has become a significant public health concern, especially in developed countries. In the UK alone, over 3 million people have chronic insomnia.

This article provides a detailed overview of chronic insomnia and its causes. It explains why you should seek medical attention if you suspect chronic insomnia. It also discusses the various treatments available for chronic insomnia. Finally, it lists the common side effects of these treatments.

Is Chronic Insomnia long term insomnia?

Chronic insomnia refers to an ongoing pattern of waking up feeling exhausted or not rested despite having slept soundly during the previous night.

There are two types of chronic insomnia: primary (also known as idiopathic) and secondary. 

Primary chronic insomnia occurs when there is no underlying cause for your sleeplessness. 

Secondary chronic insomnia happens when someone else's illness or medication is causing your sleeplessness. 

For example, if you're taking antidepressants, they could be responsible for your insomnia.

long term insomnia

What are the causes of Chronic Insomnia?

Several factors can cause chronic insomnia.

Sleep disorders (such as narcolepsy)

Sleep disorders are characterized by abnormal sleep-wake cycles. They can be caused by various factors, including genetic predisposition and environmental influences. 

The most common form of the disorder is idiopathic hypersomnia or excessive daytime sleepiness, affecting approximately 1 in 10,000 people. 

Other forms include periodic limb movement disorder, Kleine-Levin syndrome, and restless legs syndrome. 

Circadian rhythm disruption (e.g., jet lag)

Circadian Rhythm is associated with various health problems, including sleep disturbances and cardiovascular disease. 

The circadian system consists of an endogenous clock that generates rhythms in behaviour and physiology and synchronizes these rhythms to the solar day/night cycle. 

Circadian rhythm is disrupted when we travel across time zones or shift our clocks forward or backwards. These disruptions can lead to sleep disturbances.

Sleep deprivation due to shift work or extended working hours

It is a common problem in modern society.^ Sleep loss has been shown to have adverse effects on health, including increased risk of cardiovascular disease and diabetes.

Psychiatric conditions (e.g., anxiety disorder, depression)

Psychiatric conditions are common in children and adolescents. The prevalence of these disorders is higher among youth with a history of maltreatment. 

Anxiety disorders such as separation anxiety disorder, social phobia, and generalized anxiety disorder are more prevalent than depressive disorders. 

Depression and anxiety often coexist and share many symptoms, making them difficult to distinguish from one another.

Medical conditions (e.g. diabetes mellitus, heart disease, stroke)

Medical Conditions and lifestyle factors (e.g. obesity, smoking) also contribute to sleep disorders. 

People indulging in drinking alcohol excessively encounter the problems of sleep disruptions. Excessive drinking can lead to sleep apnea and other sleep disorders.

Environmental factors (e.g., noise pollution, air pollution, stress)

Ecological Factors are associated with the development of hypertension and cardiovascular diseases. 

An unpleasant sleeping environment attributes to sleep disorders. Hence, it is necessary to maintain sleep hygiene to escape any nuisance created by environmental factors. 

Risk Factors with Chronic Insomnia

The exact cause of chronic insomnia isn't always straightforward. However, some risk factors increase your likelihood of developing this condition. These include:

Age – Older individuals are more likely to develop chronic insomnia than younger ones.

Gender – Women tend to report more severe insomnia (acute insomnia) than men.

Sleep hygiene – Poor sleep hygiene refers to habits that negatively impact sleep quality. 

For example, staying awake late into the evening, drinking caffeine, smoking, overeating food before bedtime, exercising close to bedtime, watching TV before bed, etc.

Anxiety and depression – People suffering from anxiety or depression are more prone to experiencing chronic insomnia.

Shift work – Shift workers are more likely to experience chronic insomnia than those who do not work shifts.

Obesity – Being overweight increases your chances of having chronic insomnia.

Stress – Stressful situations can disrupt your circadian rhythms, leading to insomnia.

Medications – Certain medications can lead to insomnia. Examples include antidepressants, antihistamines, antipsychotics, beta-blockers, anticonvulsants, sedatives, hypnotics, opioids, benzodiazepines, and muscle relaxants.

Polypharmacy – Taking multiple medications can make it difficult to fall asleep.

Tobacco use – Smoking cigarettes reduces the amount of oxygen reaching your brain. It makes it harder to fall asleep.

Other lifestyle factors – Alcohol consumption, caffeine intake, lack of exercise, and insufficient sunlight exposure all contribute to the development of chronic insomnia.

Factors with Chronic Insomnia

What are the Symptoms of Chronic Insomnia?

If you have chronic insomnia, you may notice any combination of the following symptoms:

  • Unrefreshing sleep – You wake up feeling tired but unable to sleep.
  • Difficulty falling asleep – You find yourself lying down, trying to go to sleep, but failing.
  • Waking up early – You feel like you were sleeping when you woke up.
  • Waking up frequently during the night – You wake up repeatedly.
  • Morning headaches – You wake up with a headache.
  • Daytime fatigue – You feel exhausted even after getting adequate rest.
  • Irritability – Your mood is affected by your inability to sleep well.
  • Depression – Feeling sad, anxious, hopeless, or helpless is common with chronic insomnia people.
  • Mood swings – If you have difficulty sleeping, your mood will be affected. You may become irritable, angry, or depressed.
  • Poor concentration – It becomes hard for you to focus on the tasks.
  • Memory problems – Memory loss is also associated with chronic insomnia.
  • Impaired judgment – You may make poor decisions because you cannot think clearly.
  • Impaired decision making – You may make bad choices due to impaired judgement.
  • Decreased libido – Lack of sex drive is another symptom of chronic insomnia.
  • Weight gain – Weight gain is often seen in people who struggle to sleep.
  • Loss of appetite – Appetite loss is also a common side effect of insomnia.
  • Weight loss – A decrease in weight is also a sign of chronic insomnia.

Chronic Insomnia Treatment Options

There are several treatment options available for people who have chronic insomnia. 

These treatments vary depending on how long you've been struggling with this condition, what stage of the disease you're in, and whether you're experiencing one or more of the symptoms mentioned above.

Medication – Many people choose to take medication to treat their insomnia. However, there are some risks involved in using prescription drugs to treat insomnia. 

For example, if you're taking an antidepressant, you may experience withdrawal symptoms such as anxiety, depression, and agitation. 

Similarly, if you've taken an opioid painkiller, you may experience withdrawal effects, including nausea, vomiting, diarrhoea, and constipation. Therefore, it’s important to discuss these medications with your doctor before starting them.

Cognitive-behavioural therapy (CBT) – CBT can help improve your ability to fall asleep and stay asleep. 

This type of therapy focuses on improving your thoughts about sleep and learning new strategies that work for you. In addition, CBT helps you develop coping skills to not rely on unhealthy behaviours such as alcohol use, smoking, or excessive caffeine intake.

Sleep hygiene – Sleep hygiene refers to how you live your life to promote good quality sleep. Some examples include: limiting caffeine consumption, avoiding naps, keeping your bedroom cool, and having regular bedtimes.

Stress management – Stress management techniques can help reduce stress levels and increase your chances of falling asleep. One way to do this is through meditation. Another option is to exercise regularly.

Acupuncture – Acupuncture has been used for thousands of years to treat various conditions. 

The theory behind acupuncture is that specific points along the body correspond to different organs. When these points are stimulated, they create energy flow throughout the body. It allows the body to heal itself naturally.

Homoeopathy – Homeopathic remedies are natural substances that stimulate the body's healing process. They have no known side effects and are safe for children and pregnant women.

Hypnosis – Hypnosis uses suggestion, relaxation, and imagery to induce deep trance states. It’s most commonly used to relieve anxiety and stress.

Massage Therapy – Massage therapy involves manipulating the muscles and connective tissue around joints. It’s thought to be beneficial for relieving tension and muscle spasms.

Herbal Remedies – Herbs are plants that contain active ingredients called phytochemicals. Herbal supplements are made from herbs. People often choose herbal remedies because they’re believed to be safer than pharmaceutical alternatives.

Treatment Options

Cure for Chronic Insomnia

Correcting the problem may cure your insomnia (onset insomnia) if your chronic sleeplessness is due to an underlying medical issue, such as acid reflux or pain. 

Chronic health problems that cause sleeplessness can be managed with therapy adjustments to help you sleep better. If a drug you're taking is causing insomnia, talk to your doctor about changing the dose or stopping the medicine altogether.

In addition, you may want to consider trying these tips to get more restful sleep:

  • Avoid caffeinated beverages afternoon. Caffeine stimulates the nervous system and keeps you awake at night.
  • Avoid alcohol within two hours of going to bed. Alcohol causes drowsiness and disrupts sleep patterns.
  • Don't eat heavy meals close to bedtime. Overeating food makes it harder to digest, which leads to stomach discomfort and interrupted sleep.
  • Don't nap during the day. Napping reduces alertness and productivity.
  • Keep your room cool. A warm room encourages tossing and turning. Keep your room between 60-and 70 degrees Fahrenheit.
  • Use a humidifier. Humidifiers keep air moist, making breathing easier.
  • Use a fan. Fans circulate air throughout the house, helping to keep rooms cooler.
  • Keep your bedroom dark. Light suppresses melatonin production, which helps regulate sleep cycles. Make sure all lights in your home are off before bedtime.
  • Exercise regularly. Exercise increases blood circulation, which improves the oxygenation of brain cells. Exercise also releases endorphins, chemicals that make you feel good.

How to help yourself?

The best way to deal with chronic insomnia is to find out what's causing it. You might need to consult a physician or therapist to rule out any serious physical issues. Once you've identified the cause, you'll be able to take steps to correct it.

Home remedies for chronic insomnia

There are many home remedies for chronic insomnia. Here are some of the most effective ones:

  1. Chamomile tea

Chamomile has been shown to reduce symptoms of anxiety and depression. Drinking chamomile tea before bedtime can help promote sleep.

  1. Lavender essential oil

Lavender essential oil is one of the most popular natural oils for promoting sleep. Studies show that lavender oil may improve sleep quality by reducing stress levels and promoting relaxation.

  1. Peppermint oil

Peppermint oil contains menthol, which promotes sleep. Peppermint oil has been used to treat insomnia since ancient times.

  1. Valerian root

Valerian root is another herb that promotes sleep. It relaxes muscles and relieves tension.

  1. Lemon balm

Lemon balm is known for its calming effect on the central nervous system. It has been used for centuries to relieve anxiety and depression.

  1. Passionflower

Passionflower is often recommended to remedy insomnia (childhood insomnia) because it calms the mind and reduces stress.

  1. Rosemary

Rosemary is well known for its relaxing properties. It is believed to have sedative effects.

  1. Ylang-ylang

Ylang ylang is a fragrant oil that promotes calmness and serenity.


Chronic insomnia is a prevalent condition. Many people suffer from this problem at least once in their lifetime. 

Many factors contribute to chronic insomnia, including poor sleeping habits, mental health conditions, and medical issues. If you have chronic insomnia, try implementing these tips into your lifestyle to see if they work.

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