You know how awful one night of bad sleep can make you feel. Now multiply that one bad night by weeks, even months, and it’s easy to understand why insomnia can take a tremendous mental and physical toll on people.
By definition, even having just a few restless night of sleep qualifies as a bout of insomnia. In and of itself, a night or two of bad sleep isn’t a critical problem. But one or two nights of bad sleep can easily turn into a chronic problem with sleep. And it’s the repetitive nights of continued sleep woes that exact the biggest drain on the body and brain. If you fall into any of those categories, you’re not alone.
Estimates suggest approximately 10 percent adults suffer from chronic insomnia and between 15 and 35 percent of adults suffer from some level of short-term insomnia lasting a few days or up to three months, according to the American Academy of Sleep Medicine.
Those numbers are problematic because sleep is one of the foundations of good health — and if you’re not getting the slumber you need, you could be putting your health in jeopardy.
“Epidemiological studies show that lack of sleep is associated with obesity, diabetes, and heart disease, even Alzheimer’s,” says Sara Nowakowski, PhD, a clinical psychologist and sleep researcher at the University of Texas Medical Branch in Galveston. Other consequences include increased risk of psychiatric disorders and motor vehicle accidents. When it comes to health, she adds: “Sleep is just as important as diet and other lifestyle behaviors.”
That’s why dealing with insomnia and getting the help you need is critical. So how do you know if you have it, and how do you treat it if you do have it? Read on to get answers to your most pressing questions.
What Is Insomnia: Defining Both Acute and Chronic Insomnia
Insomnia is the most common sleep disorder, but unlike other medical conditions, it has a relatively simple definition. “Insomnia means an inability to sleep,” says Gerard J. Meskill, MD, neurologist and sleep disorders specialist with Comprehensive Sleep Medicine Associates in Houston. Characteristics include not being able to fall asleep, not staying asleep throughout the night, and waking up too early in the morning.
More specifically, there are two types of insomnia: acute and chronic. Acute insomnia means you have trouble sleeping for only a short period of time, even if that means only for one night. “Virtually everybody gets acute insomnia every once in a while,” Dr. Meskill says. But this insomnia is so short lasting, according to a study in the journal Chest, that once the cause behind it disappears, you return to your normal sleep patterns. Still, acute insomnia can be a problem because if ignored and not addressed it can lead to longer-term chronic insomnia.
Chronic insomnia is more severe and involves difficulty sleeping three or more days per week over the course of three months. Individuals with chronic insomnia also report disruptions in their daytime functioning, including sleepiness, irritability, or anxiety, or difficulty paying attention, focusing on tasks, or remembering, Dr. Nowakowski says.
While acute insomnia can usually be solved without professional help, the same isn’t true for people with chronic insomnia. These individuals need to work with a trained professional, and the sooner they bring someone on board, the more quickly they can stop problems from becoming even more severe and thus taking longer to solve.
What Causes Insomnia? Stress, Other Medical Problems, and More
Insomnia doesn’t just have one cause — it can be caused by a number of factors.
These causes can include:
- Medical conditions, such as arthritis, asthma, chronic pain, sleep apnea, and neurological conditions (including Parkinson’s disease)
- Psychiatric conditions, such as depression, anxiety, schizophrenia, bipolar disorder, and ADHD (Note though that insomnia can raise the risk of anxiety and depression, too.)
- Dietary habits, such as consuming heavy meals too close to when you go to sleep, or consuming too much caffeine or alcohol
- Nicotine use
- Jet lag
- Unhealthy sleep habits, such as having an inconsistent or irregular sleep schedule
To better understand how insomnia develops and the specific causes in any one individuals, sleep experts often use what’s called the Spielman 3-P Model of Insomnia. It helps sleep medicine providers chart various factors that might trigger insomnia, and account for any possible contributing causes. Here’s what each P means, and how each can potentially contribute to insomnia:
- Predisposing Factors Any psychological or biological factors that would make you more prone to insomnia fall into this category. This could include anxiety, being a woman (because statistics show insomnia is more common in women than in men), hyperarousal (meaning that you’re at greater risk of anxiety or have a higher wake drive than normal), and family history. Type A, goal-driven personalities often fall into this category, Meskill says.
- Precipitating Factors Life events and medical, environmental, or psychological factors can often trigger acute insomnia. For instance, you might be dealing with stress at work, financial worries, bad news about something important in life, or travel. Pain, depression, illnesses, and medication may also play into this, and all of these factors can lead to chronic insomnia. Note though, that an ongoing medical issue, like chronic pain or untreated obstructive sleep apnea, can serve as both precipitating and perpetuating factors, Meskill says.
- Perpetuating Factors These are generally behaviors or beliefs people have adopted that either maintain their sleep difficulties or make them worse, all of which perpetuate chronic insomnia. This could include changes in daytime behaviors — many people take naps or try to sleep in later, which actually makes insomnia worse — or beliefs about sleep that give fuel to the insomnia flame, so to speak. For instance, people with insomnia often develop anxieties connected to the bed, fear about not sleeping, and even worries about how lack of sleep will affect their daytime routines. Medical issues, as Meskill mentioned above, can also fall into this category.
Though in some cases any one of these causes may be problematic enough to trigger insomnia, for most individuals who have trouble sleeping, a combination of factors from each of these categories contributes to insomnia.