Chronic insomnia treatment is a greater challenge even for developed nations. By all means, this sleep disorder demands multi-prong strategy and consistent efforts. Surprisingly, the prevalence of insomnia is growing. It is prevalent in around 10 to 15% of general population. Old age, female gender are more susceptible to this silent sleep disorder. Additionally, modern lifestyle is more conducive to the average growth of prevalence.
Chronic Insomnia Definition and overview
In general, insomnia is a condition where a person lacks required amount of sleep. Either he or she fails to initiate the sleep or could not hold necessary amount of sleep. The sleeplessness or lack of enough sleep has various physiological and pathological dimensions. Keeping this in mind, there are a number of ways to classify insomnia sleep disorder.
Types of Insomnia based on the reason
- Primary Insomnia
- Secondary Insomnia
Insomnia may emerge as a primary condition or it may occur due to another health condition. Due to this insomnia can be primary insomnia or secondary insomnia. The health disorders like depression, pain disorders like arthritis can cause secondary insomnia. Similarly, disorders like restless leg syndrome, heart failure or hyperthyroidism can cause insomnia.
Types of Insomnia based on the duration
How long insomnia stays and continues would also help in classifying this disorder.
- Acute Insomnia
- Intermittent Insomnia
- Chronic Insomnia
A person may suffer from occasional sleeplessness during the course of time. However, acute or short-term insomnia usually remains for a couple of weeks. Sometimes insomnia comes and goes. This type of sleeplessness termed as intermittent insomnia. If the episode of sleeplessness extends beyond 3 weeks then it is termed as chronic insomnia.
Types of insomnia based on the time of occurrence
Insomnia can be also classified based on the time of occurrence of sleeplessness.
- Initial Insomnia: The patient troubles falling asleep.
- Middle Insomnia: The patient troubles remaining asleep for the required duration.
- Terminal Insomnia: The patient wakes up too early.
Sometimes a patient may suffer from more than one type. Generally anxiety, racing thoughts or pains are the main causes of initial insomnia. Middle insomnia, often observed in elderly patients. It is generally associated with painful disorders, breathing problems.
In case of terminal insomnia, the patient is unable to retain required amount of sleep. It is prevalent in adult or elderly patients. Anxiety or nervousness are the main reasons for causing terminal insomnia.
Chronic Insomnia Definition:
The cases where insomnia or the episode of sleeplessness stretches beyond 3 or more weeks and impacts sleep quality is called as chronic insomnia. The differentiation between intermittent or chronic insomnia often difficult in the initial stage. Generally, intermittent insomnia has a tendency to become chronic insomnia.
The widely accepted definition of chronic insomnia is “inadequate quantity or quality of sleep characterized by a subjective report of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment and has persisted for at least one month”.
The daytime consequences of sleeplessness are not attributable to environmental circumstances or inadequate opportunity to sleep.
As a matter of fact, most of the cases appear before clinic when they reach the chronic stage. Lack of awareness and ignorance towards personal sleep hygiene are the topmost reasons for delayed identification of chronic insomnia.
High-Risk Factors for chronic insomnia
There is a greater likelihood of short-term or transient insomnia turning chronic. Below is the list of few high-risk factors responsible for causing long-term sleeplessness.
- Older age
- Female gender
- Presence of one or more psychological disorders
- Presence of chronic painful disorders
- Working in shifts
- Physical or mental stress
- Long-term use of certain medications like Phenytoin
- Alcohol, smoking, drug abuse etc.
People over 60 years old would likely to suffer from chronic insomnia compared to the younger group. There are 3 conditions because of which older ones are more susceptible to chronic insomnia. First, aging process itself impact the sleep cycle. Second, the prevalence of painful disorders like arthritis is more in old population. And, the third one obviously the medication which is regularly consumed for mitigating various health disorders. The chronic insomnia treatment guideline considers all such factors while deciding the treatment plan.