Chronic Insomnia

Chronic insomnia is neither a disease nor an illness; instead, a symptom of a deeper underlying physical or mental disorder.

Causes of chronic insomnia

  • Medications:

    Among the many medications that can cause insomnia are antidepressants (fluoxetine, bupropion), theophylline, lamotrigine, felbamate, beta-blockers, and beta-agonists.

  • Drug or alcohol overuse:

    An estimated 10 -15% of chronic insomnia cases result from substance abuse, especially alcohol, cocaine, drugs and sedatives. Overuse of these things results in fragmented sleep. It also increases the risk for other sleep disorders, including sleep apnea and restless legs. Alcoholics often suffer insomnia during withdrawal and, in some cases, for several years during recovery.

  • Psychiatric disorders such as depression, anxiety
  • Medical Problem like allergies, arthritis, cancer, fibromyalgia, heart disease, gastroesophageal reflux disease (GERD), hypertension, asthma, emphysema, rheumatologic conditions, Alzheimer’s disease, Parkinson’s disease, hyperthyroidism, and attention deficit hyperactivity disorder can cause chronic insomnia.
  • Sleep-disorders and breathing problems
  • Circadian rhythm disorder
  • Abnormal levels of certain brain chemicals have been observed in some people with chronic insomnia.
  • Low levels of melatonin, the hormone secreted by the pineal gland, have sometimes been observed in chronic insomnia.
  • Chronic insomnia occurs in people who have persistently high levels of stress hormones and a shift in the levels of certain immune factors.
  • Long-term use of many psychotropic or sedative-hypnotic drugs can cause adverse reactions and may actually impair sleep.

Risks involved with chronic insomnia

  • People with chronic insomnia have a higher risk of automobile accidents.
  • It can develop dependence on alcohol or other drugs.
  • It can develop mood disorders like depression.
  • It impairs quality life.
  • It can impair memory and judgment.
  • It can create difficulty to learn new things or perform daily tasks.
  • It reduces the ability of the immune system to prevent illness.

Treatment for chronic insomnia

Treatment of chronic insomnia begins with the attempts to identify and treating the underlying medical or psychological cause.

It’s very important a physician must carefully evaluate a patient’s complaint of chronic insomnia before starting any treatment. A doctor should learn all possible causes, which could include medical conditions, physical conditions, and emotional conditions. Here are some treatment techniques that are used to treat chronic insomnia.

  • Drug therapy is beneficial for short-term improvement, possibly using sleeping pills, sedatives, tranquilizers, and anti-anxiety drugs. But the long-term use of drug therapy is controversial.
  • In many cases antidepressants are used. But all antidepressants have potentially significant adverse effects, raising concerns about the risk-benefit ratio.
  • Behavioral intervention provides more sustained effects in treating chronic insomnia. Behavioral techniques are used to improve sleep, such as relaxation therapy, sleep restriction therapy, reconditioning, and using bright light.
  • Evidences support the efficacy of cognitive-behavioral therapy and benzodiazepine receptor agonists in the treatment of this disorder, at least in the short term.
  • A variety of pharmacological approaches show promise for managing chronic insomnia symptoms.
  • Epidemiological surveys have shown that the most common treatments used by people with chronic insomnia are over-the-counter (OTC) antihistamines, alcohol, and prescription medications.
  • Herbal treatment
  • Both Prescription Medications and Nonprescription Medications are used to treat chronic insomnia. But there is no systematic evidence for efficacy and there are significant concerns about risks of these medications.
  • Other Treatments: There are a number of alternative treatments including Tai chi, yoga, meditations, acupuncture, and light therapy, that may be useful in the treatment of insomnia.

Once the underlying problem behind chronic insomnia is identified and worked through, a successful treatment plan can be implemented.