Insomnia is a common sleep disorder in which you may have trouble falling asleep, staying asleep, or both. A third of Americans report that they don’t get the recommended amount of sleep every night, which is at least seven hours.

Periodically having trouble sleeping, also known as acute insomnia, is common. Acute insomnia lasts for a few days or weeks and often occurs during times of stress or life changes.

Have trouble getting to sleep or staying asleep more than three nights a week for three months or more is considered chronic insomnia. This is also known as chronic insomnia disorder.

There are two main types of chronic insomnia: primary and secondary.

Primary insomnia isn’t due to other medical conditions or medications and is poorly understood by scientists. Specialized MRI scans are being used to study this condition. Primary insomnia may be related to changes in levels of certain brain chemicals, but research is ongoing.

Secondary insomnia is caused by other conditions or situations. This means that it’s a symptom that goes along with some medical issues, such as emotional stress, trauma, and ongoing health problems; certain lifestyle patterns; or taking certain drugs and medications.

Chronic insomnia can cause symptoms at night as well as during the day and can interfere with your ability to go on with your daily tasks.

Symptoms may include:

  • trouble falling asleep
  • waking up throughout the night
  • trouble staying asleep or trouble returning to sleep
  • waking up too early
  • daytime sleepiness or grogginess
  • not feeling rested after a night’s sleep
  • irritability
  • mood changes, such as feeling depressed
  • difficulty concentrating
  • problems with memory
  • increase in mistakes and accidents

There are many things that can cause chronic insomnia, but it’s often linked to an underlying medical condition. Certain medications and stimulants can cause chronic insomnia, along with lifestyle patterns.

Medical conditions

Chronic insomnia can be caused by a number of long-term medical conditions, including:

Medications and stimulants

For some people, certain medications and stimulants may cause chronic insomnia. These include:

  • alcohol
  • antidepressants
  • beta-blockers
  • caffeine
  • chemotherapy drugs
  • cold and allergy medications containing pseudoephedrine
  • diuretics
  • illicit drugs, such as cocaine and other stimulants
  • nicotine
  • stimulant laxatives

Lifestyle patterns

Certain lifestyle patterns may lead to chronic insomnia. These include:

  • rotating shift work
  • frequent travel across multiple time zones, leading to jet lag
  • physical inactivity
  • frequent daytime napping
  • lack of routine for waking and sleeping
  • poor sleeping environment

A number of at-home and professional treatment options are available for chronic insomnia. Treatment will depend on the cause of your insomnia and may involve medication or therapy to address an underlying condition.

Along with treating any existing conditions, your doctor may recommend one or a combination of treatment options for chronic insomnia.

Cognitive behavioral therapy (CBT)

Research has shown CBT to be as effective, or more effective, than sleep medications in treating chronic insomnia. It involves educating you on sleep and better sleep habits, while teaching you to change the beliefs and behaviors that interfere with your ability to sleep.

Some of the strategies of CBT that are specifically focused on insomnia, known as CBT-I, include the following:

Cognitive techniques

Using journaling to write down worries or concerns before going to bed may help keep a person from actively attempting to work them out while also trying to sleep.

Stimulus control

This entails altering behaviors that condition your mind to fight sleep. Setting a sleep and wake time routine is part this strategy.

Other examples are using your bed only for sleep and sex, and leaving your bedroom if you’re unable to fall asleep within a set number of minutes.

Sleep restriction

This therapy involves limiting the amount of time you spend in bed, including avoiding naps. The goal is to deprive you of enough sleep so that you’re tired at bedtime. Your time in bed is gradually increased as your sleep improves.

Relaxation techniques

Breathing exercises, yoga, guided meditation, and other techniques are used to reduce muscle tension and control your breathing and heart rate so that you’re able to relax.

Paradoxical intention

This strategy involves focusing on staying awake in bed instead of expecting to fall asleep. It helps reduce worry and anxiety over being able to fall asleep. It’s most effective in treating learned insomnia.

Medications

There are a number of prescription medications and over-the-counter (OTC) sleep aids that may help you get to sleep or remain asleep.

While effective, doctors don’t typically recommend using sleeping pills long term because of the side effects, which can include daytime sleepiness, forgetfulness, sleepwalking, balance problems, and falling. Certain classes of sleeping pills are also habit-forming.

Some of the prescription medications that are approved for treating insomnia include:

  • zolpidem (Ambien)
  • eszopiclone (Lunesta)
  • zaleplon (Sonata)
  • doxepin (Silenor)
  • ramelteon (Rozerem)
  • suvorexant (Belsomra)
  • temazepam (Restoril)

OTC sleep aid options may include:

Always speak to your doctor before taking an OTC sleep aid, including natural remedies, such as melatonin and valerian root. Just like prescription drugs, OTC and natural sleep aids can cause unwanted side effects and interfere with other medications.

If your chronic insomnia is caused by an underlying medical condition, such as acid reflux or pain, treating the condition may cure your insomnia.

Chronic health conditions that cause insomnia can be managed with changes in treatment, in turn managing or preventing insomnia. Talk to your doctor about changing medications or treatment plans if a drug you’re taking is causing insomnia.

There are several things that you can do at home to treat or prevent chronic insomnia. One important option for treatment is known as sleep hygiene. This calls for changes in patterns of behavior to help improve your ability to fall asleep and stay asleep.

Try the following tips:

  • Avoid caffeine, especially later in the day.
  • Avoid alcohol use and smoking cigarettes before bed.
  • Engage in regular physical activity.
  • Don’t take naps.
  • Don’t eat large meals in the evening.
  • Go to bed and get up at the same time every day, even on days off.
  • Avoid using computers, smartphones, TV, or other technological devices an hour before bedtime.
  • Keep your bedroom dark or use a sleep mask.
  • Keep your bedroom a comfortable temperature.
  • Make sure your sleep surface is comfortable.

Chronic insomnia can be effectively treated using a combination of behavioral therapies and by making a few lifestyle changes to help improve your sleep. If you’re having trouble sleeping and it’s interfering with your quality of life, talk to your doctor.