Chronic Insomnia
Chronic insomnia is a medical and psychiatric condition characterized by difficulty falling or staying asleep, for more than 3 nights per week, lasting more than 3 months. The symptoms of chronic insomnia may lead to poor function at work, school, at home, and in other domains. Chronic insomnia may also be associated with various psychiatric conditions such as anxiety and depression.
Chronic Insomnia Q&A
What is chronic insomnia?
Chronic insomnia is a medical and psychiatric disorder characterized by difficulty falling or staying asleep, for more than 3 nights per week, lasting more than 3 months. The symptoms of chronic insomnia may lead to poor function at work, school, at home, and in other domains. Chronic insomnia may also be associated with mood symptoms and anxiety.
The symptoms of chronic insomnia can first appear during childhood and persist throughout your life or appear later in your adult years in response to life stressors or new medical conditions. Chronic insomnia is one of the most common symptoms of psychological distress and once treated, can lead to significant improvement in health problems and quality of life.
What symptoms occur due to chronic insomnia?
Sleep initiation symptoms:
Difficulty falling asleep even when sleepy
Taking more than 20-30 minutes to fall asleep
Anxiety and restlessness while laying in bed
Anxious rumination while waiting to fall asleep
Physical symptoms of anxiety - jitteriness, heart pounding, shakiness - while in bed
Psychological resistance to going to bed
Dreading bedtime
Sleep maintenance symptoms:
Frequent night-time awakenings
Inability to fall asleep after waking up in the middle of the night
Being awake for more than 20 min in the middle of the night
Looking at the alarm clock over and over again with mounting anxiety as morning approaches
Early morning awakening and inability to fall asleep even when tired/sleepy
Secondary symptoms:
Daytime fatigue
Waking up not feeling rested
Hard time paying attention and focusing throughout the day
Muscle aches and body pain in the morning
Lack of motivation during the day
Depressed mood
Difficulty regulating emotions
Anxiety
How is insomnia diagnosed and treated at Regeneration Psychiatry?
Evaluation and assessment
Detailed clinical interview regarding symptoms of insomnia
Assessment for other psychiatric conditions that could contribute to insomnia, such as depression, anxiety, or PTSD
Review of your medical history, including ruling out other medical conditions that could cause insomnia, such as hyperthyroidism or sleep apnea
Review of current medication regimen and ruling out pharmacologic causes of insomnia
Medications
Consultation regarding possible medication options and their benefits vs. side effect profiles
over-the-counter medications
non-controlled medications
controlled medications
supplements
Adjustment and optimization of medications
Follow up as needed
Treatment of other contributing psychiatric conditions
Non-pharmacologic treatment
Counseling regarding cognitive behavioral therapy for insomnia (CBT-I) concepts:
Review of sleep hygiene
Education regarding sleep restriction
Discussion of integrative/complementary treatments:
Meditation
Supplements and nutrition
Exercise
Optimization of circadian rhythm
Discussion of psychotherapy methods addressing insomnia and referral to therapists if needed
Collaboration with other medical providers